bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive Remediation for Psychological Disorders
Authors: Medalia Alice , Herlands Tiffany , Saperstein Alice , Revheim Nadine
Published: December 2017

Individuals with serious and persistent mental illnesses, including schizophrenia and affective disorders, often experience cognitive deficits that make it difficult to perform everyday tasks. For example, they may have difficulty with attention, memory, processing speed, and problem solving, and this may interfere with functioning at work, school, and in social situations. Cognitive remediation is an evidence-based behavioral treatment for people who are experiencing cognitive impairments that interfere with role functioning. This edition contains all the information needed to set up a cognitive remediation program so clients can strengthen the cognitive skills needed for everyday functioning. The program described is called Neuropsychological and Educational Approach to Remediation (NEAR), which is an evidence-based approach to cognitive remediation that uses carefully crafted instructional techniques that reflect an understanding of how people learn best. The goals of NEAR are to provide a positive learning experience, to promote independent learning, and to promote optimal cognitive functioning in daily life. This second edition of the popular 2009 therapist’s guide provides step-by-step instructions on how to implement NEAR techniques with patients to improve their cognitive functioning and quality of life. Guidelines are provided for setting up and running a successful cognitive remediation program. Therapists learn how to choose appropriate cognitive exercises, recruit and work with clients, perform intake interviews, and create treatment plans. This guide comes complete with all the tools necessary for facilitating treatment, including program evaluation forms and client handouts.
Treatment Principles
Authors: Medalia Alice , Herlands Tiffany , Saperstein Alice , Revheim Nadine
Published: December 2017

Chapter 2 provides the theoretical foundation and goals that inform the Neuropsychological Educational Approach to Remediation (NEAR). NEAR is a method of cognitive remediation that was developed for psychiatric patients. This group-based treatment provides highly individualized learning by allowing each person in the group to work at his own pace on tasks carefully chosen to be engaging and to address cognitive and learning needs. The NEAR program structure is described along with an explanation of the treatment principles and what the sessions look like. The evidence base for using NEAR is reviewed. Research indicates that participation in NEAR affects the client’s cognitive skills and psychosocial functioning.
Dealing with Difficult Clinical Situations
Authors: Medalia Alice , Herlands Tiffany , Saperstein Alice , Revheim Nadine
Published: December 2017

Clients sometimes present with behaviors that are counterproductive to learning or that interfere with the overall goal-oriented atmosphere in The Learning Center. Highly personalized, clinician administered CR programs like Neuropsychological Educational Approach to Remediation (NEAR) are designed to help clients who are not cognitively or emotionally ready to benefit from mainstream, non–therapeutic-based learning opportunities. Chapter 10 presents vignettes that highlight how to deal with some of the clinical issues that commonly arise in cognitive remediation programs.
Program Evaluation
Authors: Medalia Alice , Herlands Tiffany , Saperstein Alice , Revheim Nadine
Published: December 2017

Program evaluation provides a snapshot view of the activities of the cognitive remediation service. It serves the dual purpose of monitoring performance and making others aware of the program activities. Information about how the program is being used and program outcomes can be provided to supervisors and administrators to ensure appropriate allocation of resources and to identify areas of program strength and areas that may need improvement. Chapter 11 describes methods of assessment and explains how to use the data obtained to maximize the effectiveness of the services provided.
The Challenge of Entering Adulthood for Individuals with Autism Spectrum Disorder
Authors: Gelbar Nicholas W. , Volk Daniel T.
Published: December 2017

There is a tremendous amount of variation (heterogeneity) in terms of both symptom presentation and functional ability in individuals with autism spectrum disorder (ASD). The challenges faced by adolescents and emerging adults with ASD can be better understood by considering the unique sociocultural changes that most individuals experience within these stages. In general, adolescents and young adults with ASD have poor social relationship, employment, post–secondary, and independent living outcomes. Additional research efforts, particularly large-scale studies, are needed to better understand the experiences and outcomes of adolescents and young adults with ASD.
Executive Functions in Adolescents with Autism Spectrum Disorder
Authors: Dai Yael , Eigsti Inge-Marie
Published: December 2017

This chapter reviews strengths and weaknesses in executive function (EF) domains, including inhibition, working memory, flexibility, fluency, and planning, in adolescents (age 13–19) with autism spectrum disorder (ASD). Given the dramatic developmental changes in the brain regions that support EF during the period of adolescence, it is critical to evaluate which EF abilities show a distinct profile during this period. As this chapter will demonstrate, youth with ASD show deficits across all domains of EF, particularly in complex tasks that include arbitrary instructions. We describe the fundamental measures for assessing skills in each domain and discuss limitations and future directions for research, as well as clinical implications of these findings for working with youth with ASD.
Cognitive Behavioral Approaches for Treating Adolescents with Autism Spectrum Disorder
Authors: Conner Caitlin M. , DeVries Lindsey , Reaven Judy
Published: December 2017

Cognitive behavior therapies (CBT) are empirically supported interventions that have been used to successfully treat many forms of psychopathology among children, adolescents, and adults. Developed in the 1960s and 1970s, CBT is an evidence-based amalgamation of cognitive and behavioral therapy components that aim to address maladaptive thoughts, emotions, and behaviors to promote symptom reduction through a collaborative therapeutic relationship. CBT has also been adapted for individuals with Autism Spectrum Disorder (ASD); however, the primary focus of most treatment studies to date has focused on children with ASD and co-occurring anxiety. CBT programs for other psychiatric comorbid conditions in ASD are now emerging. Specific adaptations to traditional CBT, practical implications for clinicians, and suggestions for future directions for research will be highlighted.
Self-Determination and the Transition to Adulthood for Youth and Young Adults with an Autism Spectrum Disorder
Authors: Wehmeyer Michael L. , Shogren Karrie A.
Published: December 2017

More than two decades of research and evaluation have established promoting self-determination as an evidence-based practice leading to improved school and transition outcomes for youth and young adults with disabilities. This chapter examines self-determination as a critical component of successful transitions to adulthood for youth and young adults with autism spectrum disorder (ASD). In exploring these issues, the chapter addresses many topics, including the role of self-determination and student involvement in federal disability law and special education practices. It also discusses how self-determination is understood and conceptualized in psychology and special education and the research establishing the need for and efficacy of promoting self-determination as well as research documenting the impact of promoting self-determination on school and transition outcomes.
Employment Training for Young Adults with Autism Spectrum Disorder
Authors: Test David W. , Holzberg Debra G. , Clark Kelly , Terrell Misty , Rusher Dana E.
Published: December 2017

Despite legislation to improve post-school outcomes for young adults with autism spectrum disorder, they experience poorer employment outcomes than their peers without disabilities. Data indicate persons with ASD experience lower employment rates, earn less money, work fewer hours, are less engaged in their communities, and live independently less frequently than their peers without disabilities. Furthermore, the earnings of individuals with ASD lag behind earnings of their peers both with and without disabilities. In order to help improve employment outcomes for youth with ASD, this chapter describes the characteristics contributing to employment of individuals with ASD, the factors influencing employment of individuals with ASD, and the research related to evidence-based practices for young adults with ASD.
Young Women on the Autism Spectrum
Authors: Lai Meng-Chuan , Ameis Stephanie H. , Szatmari Peter
Published: December 2017

Females on the autism spectrum often face unique challenges in social-communication areas, sensory environments, mental health, physical health, gender-related issues and identity development. Autism tends to be less-recognized in females than in males. Anecdotal reports suggest that they may show more social interests and motivation, heightened emotion contagion or affective empathy, increased imagination, more friendships but with different quality, greater camouflaging of social difficulties, and different kinds of narrow interests. The diagnostic processes are independent of sex or gender, but they need to be optimized by taking into account influences from sex and gender (including gendered sociocultural contexts). Optimized support for young women on the autism spectrum is best based on the understanding of their characteristics, targeting resilience and person–environment fit, and taking into account the influences of gendered sociocultural contexts; this often involves not only skill-building and graded exposure for the individual, but more importantly, adjustments to the social and physical environments.
Adolescents and Young Adults with Psychosocial Difficulties
Authors: Ralph Alan
Published: December 2017

Significant numbers of teenagers globally are reported to have health and mental health problems. Parenting factors have been shown to be related to adolescent health and mental health problems as well as other social determinants. Teen Triple P is described as an example of an intervention developed as an upward extension of the Triple P—Positive Parenting Program for parents of children from 12 to 16 years of age. Challenges that need to be addressed to increase parental access to trained practitioners are discussed, including the tendency among workers in the adolescent mental health field to be oriented to working directly with the teenager and the identification and training of a workforce that has the capacity and opportunity to work with parents of teenagers.
Parenting Support in an Early Childhood Learning Context
Authors: Turner Karen M. T. , Dittman Cassandra K. , Rusby Julie C. , Lee Shawna
Published: December 2017

Early childhood education and child care settings have the potential to support parents and promote children’s cognitive, social, and emotional development, with likely long-term positive impacts well beyond school readiness. This chapter describes the development and pilot testing of a parallel program to Triple P, the Positive Early Childhood Education Program, a professional development and learning program designed for early childhood educators and carers. Key considerations in applying such programs in the early education setting are discussed, including awareness of local regulations, fit with early learning philosophies, and developing an environment that promotes partnerships between educators and parents. Parameters for professional development in the sector are also explored, such as online learning and opportunities for practice and coaching in the context of a busy early learning setting.
C Skill: Consider How I Feel
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 1 of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook (UP-C) introduces the “Emotions Detective” program, which is how the Unified Protocol for Children (UP-C) is presented in this child workbook. This treatment program teaches child clients about feelings and how to deal with some of the tough emotions that children sometimes need to handle. Chapter 1 looks at the three parts of an emotion and emotional behaviors.
E Skill: Experience My Emotions
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 11 of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook (UP-C) allows each child to complete several successful situational emotion exposures that reflect increasingly challenging items for the child. Initial situational emotion exposures in Session 11 allow the child to become accustomed to situational emotion exposures, as well as exposure planning and allow therapists to assess children’s responses to various emotion triggers. Sessions 12-14 provide extensive time to further challenge children and parents as they attempt increasingly difficult items.
Look at My Thoughts for Parents
Authors: Jill Ehrenreich-May , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 14 teaches parents how thinking flexibly can help children to reduce strong emotions. In this chapter, parents will focus on identifying and changing the inaccurate and unhelpful thinking patterns individuals typically exhibit when experiencing strong emotions. Parents learn about four thinking traps that get children with strong emotions stuck. Parents are taught about different types of reinforcement and punishment as well as how to identify the problems resulting from inconsistent discipline and praise. Lastly, parents are taught strategies for practicing more consistent discipline and praise in the household.
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents: Workbook (UP-A) provides evidence-based treatment strategies to assist adolescent clients to function better in their lives. This treatment is designed for adolescents who are experiencing feelings of sadness, anxiety, worry, anger, or other emotions that get in the way of their ability to enjoy their lives and feel successful. The workbook is written for adolescents and guides them through each week of the program with education, activities, and examples that will help them to understand the role that emotions play in their behaviors every day. Adolescents are taught helpful strategies for dealing with uncomfortable emotions and will receive support in making choices that will move them closer to their long-term goals. The evidence-based treatment skills presented in the accompanying Therapist Guide may be applied by the therapist to adolescents with a wide variety of emotional disorders. The UP-A takes a transdiagnostic approach to the treatment of the emotional disorders. Some of the disorders that may be targeted include anxiety disorders (e.g., generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, specific phobias, panic disorder, illness anxiety disorder, agoraphobia) and depressive disorders (e.g., persistent depressive disorder, major depressive disorder). This treatment is flexible enough for use with some trauma and stress-related disorders (including adjustment disorders), somatic symptom disorders, tic disorders, and obsessive-compulsive disorders. The transdiagnostic presentation of evidence-based intervention techniques within these treatments may be particularly useful for adolescents presenting with multiple emotional disorders or mixed/subclinical symptoms of several emotional disorders.
Awareness of Physical Sensations
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 4 focuses on the connection between body sensations and strong emotions. Many times the body provides clues that tell us when we experiencing those strong emotions. These sensations are part of the fight-or-flight response, and adolescent clients will learn how the body reacts to such feelings of threat or concerns about harm and what to do if they notice these things at times when they are not truly in danger. Clients learn to use body scanning to become more aware of their body clues. Clients practice experiencing body clues without doing something to make them go away.
Situational Emotion Exposures
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 7 begins by reviewing skills the client has learned so far in treatment, and then the client works with the therapist to identify which emotional behaviors to focus on next during situational emotion exposures. Clients are taught what to expect when they begin situational emotion exposures, and each client creates an Emotional Behavior Form for identifying situations that bring up strong emotions. With each in-session exposure and each home learning exposure, clients should be working on exposures that target distress related to behaviors from their Emotional Behavior Form. They will be exposing themselves to stronger and stronger emotions, without engaging in the emotional behaviors that give them trouble. Clients are taught that with practice, exposure will lead to habituation: uncomfortable emotions will gradually lessen and they will feel more confident in their ability to cope with situations that bring up strong emotions.
Core Module 4: Awareness of Physical Sensations
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Buzzella Brian A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 4 gives adolescent clients a greater awareness of the body’s reactions during intense and/or distressing emotion states. Principles of interoceptive or “sensational” exposure are introduced and practiced to build the adolescent’s ability to tolerate strong physical sensations. Taking this approach, which involves an acceptance-oriented stance toward uncomfortable physical sensations, is incompatible with taking actions to avoid or suppress these sensations prematurely. The interoceptive exposure techniques in this module were originally developed with panic disorder symptoms in mind. However, the body drawing and body scanning techniques, as well as interoceptive strategies, are presented in a manner broadly applicable to a range of concerns and are especially relevant for adolescents with poor distress tolerance or high reactivity to sensations in their bodies.
Introduction to the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C)
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Buzzella Brian A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 10 introduces the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). This is also called the “Emotion Detectives” program, which reflects the guiding treatment metaphor: teaching children to “solve the mystery of their emotions,” as detectives might. The UP-C is intended to reduce the intensity and frequency of symptoms common to youth with emotional disorders by using core evidence-based treatment strategies in a broad manner that applies to a wide range of aversive emotional experiences characteristic of youth emotional disorders (i.e., anxiety, depression, other internalizing disorders). Many anxiety, depression, adjustment, traumatic stress-related, or obsessive-compulsive or related disorders would be appropriate targets for this intervention. The UP-C is intended for children between the ages of 7 and 13, although children slightly above or below this age group may benefit from this format.
UP-C Session 3: Using Science Experiments to Change Our Emotions and Behavior
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Buzzella Brian A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 13 teaches children the skill of “acting opposite” to what their emotion may be telling them to do, and then applying this skill in a “science experiment” focused on sadness. Sadness is the primary focus of this session because children can often relate to the experience of feeling bored or sad at some point, and it is relatively easy for them to see how changing their behavior changes this emotion. This session also helps set the stage for situational emotion exposures. The parent session introduces the concept of using science experiments to see what happens when we take different “opposite” actions from those that have been maladaptive during emotional states. Parents learn how to support their children as they begin to engage in a series of opposite action science experiments for sadness and withdrawal.
UP-A Group and UP-C Individual Therapy Variations, Other Adaptations
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Buzzella Brian A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 23 highlights the flexibility and adaptability of this transdiagnostic, unified approach to treating emotional disorders in children and adolescents. These treatments target a common set of underlying features of emotional disorders (e.g., high levels of intense emotions, distress reactions to intense emotions, unhelpful behavioral choices when experiencing intense emotions). Thus, the skills detailed in these treatments are applicable to disorders or problem area sharing these core features. These include anxiety and depressive disorders and obsessive-compulsive (OC) spectrum disorders, tic disorders, stress-related disorders, somatic symptom disorders, and potentially even some eating disorders. This chapter reviews some of the most common modifications that may be needed for using the UP-C and UP-A under different conditions and with different types of symptom presentations.
On What Matters
Authors: Parfit Derek
Published: December 2017

This third volume of this series develops further previous treatment of reasons, normativity, the meaning of moral discourse, and the status of morality. It engages with critics, and shows the way to resolution of their differences. This volume is partly about what it is for things to matter, in the sense that we all have reasons to care about these things. Much of the book discusses three of the main kinds of meta-ethical theory: normative naturalism, quasi-realist expressivism, and non-metaphysical non-naturalism, which this book refers to as non-realist cognitivism. This third theory claims that, if we use the word ‘reality’ in an ontologically weighty sense, irreducibly normative truths have no mysterious or incredible ontological implications. If instead we use ‘reality’ in a wide sense, according to which all truths are truths about reality, this theory claims that some non-empirically discoverable truths — such as logical, mathematical, modal, and some normative truths — raise no difficult ontological questions. This book discusses these theories partly by commenting on the views of some of the contributors to Peter Singer's collection Does Anything Really Matter? Parfit on Objectivity.
Introduction
Authors: Portner Paul
Published: December 2017

This chapter develops a framework for trying to understand the nature of mood from the perspective of semantics and pragmatics. It introduces the concept of mood and its subtypes in an intuitive way, and gives a general definition which aims to capture what is essential to the way it figures in both descriptive and theoretical studies of language. It explains the relation between mood and the broader category of modality, and provides essential background on the theories of modality, speech acts, and discourse semantics which will be the frameworks for theories of mood discussed in later chapters.
Core mood, reality status, and evidentiality
Authors: Portner Paul
Published: December 2017

In the categories of mood it is usual to include two quite distinct subtypes: verbal mood and sentence mood. However, the results of the previous two chapters suggest that these subtypes may not be a separate as is usually assumed, and also point to the possibility that other linguistic phenomena may be understood as exemplifying mood as well. This chapter proposes a unification of verbal mood and sentence mood as a category of core mood, and then considers the relation of reality status (realis/irrealis marking) and evidentiality to core mood.
The Marine Chronometers at Greenwich
Authors: Betts Jonathan
Published: December 2017

The catalogue entries are the central core of this book and form the official published record of the collection of marine chronometers at Royal Museums Greenwich. Every entry includes highly detailed data on that instrument, including prose descriptions of the box, the dial, the main movement and the escapement, balance and jewelling. A commentary then interprets the descriptions if necessary, and a history section records all the known facts about the life of the instrument. A tabulated technical section completes the entry with extensive numerical and dimensional data on the movement. Preceding the first entry for an instrument by a given maker, is a biographical section material on that particular maker. All entries are illustrated with at least two photographs, some many more, and may include explanatory line drawings where there are details of particular interest.
Anglican Inter-Faith Relations from 1910 to the Twenty-First Century
Authors: Hedges Paul
Published: December 2017

This chapter explores the development of Anglican inter-faith relations since 1910 which has been shaped by a number of factors including: the ecumenical context, changing dynamics within the global Communion, globalization issues, and moves from mission to dialogue. The chapter begins with a historical overview and traces developments in key Anglican Communion texts and meetings, especially in recent times the Lambeth Conferences of 1988, 1998, and 2008. The ecumenical context which has shaped thought on inter-faith relations in this period is also given strong attention. The chapter concludes with two case studies. The first explores relations with Buddhism in the Sri Lankan context, while the second looks at relations with Islam focusing on the Middle East. While charting some general trends, it is noted that very different dynamics and varying standpoints exist in Anglican attitudes on inter-faith relations and have been part of the historical development throughout the period surveyed.
An Exilic Church
Authors: Zink Jesse A.
Published: December 2017

The Episcopal Church of South Sudan and Sudan (ECSSS) has been shaped by the experience of exile. A half-century of Anglican mission by the Church Missionary Society produced a Church that was of varied strength across the region. Two lengthy civil wars since Sudan’s independence displaced hundreds of thousands of southern Sudanese and led to Church growth, as refugees turned to Christianity in new ways. This was particularly true of the Dinka, southern Sudan’s largest ethnic group, who had long been uninterested in Christianity. In the midst of civil war in the 1980s and 1990s, Dinka showed new interest in Christianity and the Church exploded with growth. Church hierarchies have been tested by civil war, managing relations with rebel armies and governments, while also working for peace and reconciliation. The challenge for the ECSSS is to move from being a Church of the exiled to a Church of the returned.
Relations between the Churches of the Anglican Communion and the Churches of Eastern Christianity
Authors: Eaton Peter
Published: December 2017

In this chapter the author discusses the Anglican Communion and the Churches of the Christian East which have had a long and significant relationship both at an official level of international dialogue and at a more local level between clergy, laity, and congregations. This series of relationships has resulted in both practical assistance as well as deep theological and spiritual influence. The twentieth century saw a remarkable rapprochement between Anglicanism and Orthodoxy that left both communions changed, and this chapter outlines these general trends and focuses on two important episodes that show the depth that these relations attained. In spite of more recent developments and distance, the picture that emerges here supports the view that relations between Anglicanism and Byzantine and Oriental Orthodox communities have been formative for the respective traditions.
Anglican Schools in Muslim-Majority Societies, 1910–2010
Authors: Jones Richard J.
Published: December 2017

When the Christian movement inserts itself into a culture, indigenous institutions serving to inculcate values and to teach both a world-view and religious rites are necessarily affected. In societies where Islam was dominant or was reviving in the period 1910–2010, Christian schools had to win acceptance from local parents as well as from political authorities. Anglican missionaries in northern India; in greater Syria, Egypt, and Sudan; and in East and West Africa engaged their host societies at differing levels. Some proffered literacy in local languages, aiming to equip Bible readers and Church leaders. Others aimed to prepare elites to become social leaders using Western logic and techniques. Some Anglican schools retained their Christian ethos by confining their work to underserved populations, or by good service to elites; others were absorbed into state-run school systems.
Witness, Advocacy, and Union
Authors: Presler Titus
Published: December 2017

During the twentieth century indigenous leadership and mission initiative moved Anglicanism in South Asia from a British colonial identity to ecclesial autonomy and then to organic union with Protestant bodies in order to strengthen Christian proclamation and social advocacy amid the dominant Hindu, Muslim, and Buddhist populations of the subcontinent. This chapter addresses successively the early decades, mission in mass movements, local leadership and self-governance, and the distinctive drive towards church union that resulted in the Church of South India, the Church of North India, the Church of Pakistan, the Church of Bangladesh, and an unsuccessful union initiative for the Church of Ceylon. While new ecclesial identities now occupy centre stage, strong Anglican influences in the governance, liturgies, and public advocacy of the united Churches sustain their membership in the Anglican Communion and their place in the continuing global Anglican story.
Anglican Social Ministries in East Asia
Authors: Yieh John Y. H.
Published: December 2017

This chapter reviews exemplary social ministries of the Anglican churches in East Asia: China, Hong Kong, Japan, Korea, and Taiwan, in four periods of time divided by the First World War, the Second World War, and the economic boom of the 1980s. Early missionaries followed Jesus’ threefold pattern of mission to build churches, schools, and clinics, caring particularly for the poor. To release the suffering of the people caused by poverty, wars, injustice, and natural disasters, native leaders have developed proactive social services to address the new demands of life such as the ageing population, the threat posed by nuclear power, and the danger of environmental crises, which embody the Anglican five marks of mission. The theological rationale and social impact of these ministries are analysed.
Factors Influencing the Overall Satisfaction in Patients With Severe Brain Injury With Physiotherapy Services During Inpatient Rehabilitation
Authors: Leung Joan , Fereday Sarah , Sticpewich Bridget , Stroud Katarina
Published: December 2017

Objective:

To determine what influences the satisfaction of rehabilitation inpatients and their relatives with physiotherapy after severe traumatic brain injury.

Design:

A prospective purpose-designed survey of consecutive eligible patients discharged from a metropolitan brain injury unit.

Participants:

A total of 65 patients with severe traumatic brain injury and 32 relatives.

Results:

The vast majority of patients (99%) and relatives (97%) reported being “satisfied” or “highly satisfied” with the service. Patients' overall satisfaction was influenced by the extent of actual and perceived improvement, satisfaction with certain aspects of service delivery, and quality of interaction with physiotherapy staff. Satisfaction with the amount of therapy was the key determinant for patients' overall satisfaction, whereas relatives' overall satisfaction was influenced primarily by how well they felt they were listened to by physiotherapy staff.

Conclusion:

The high satisfaction of the patients and relatives suggests that our brain injury unit provides physiotherapy that meets their expectations. Promoting recovery, providing high-quality care, and ensuring good interaction are ways to maintain high satisfaction of patients and relatives with the service. In addition, staff may have to pay particular attention to patients' satisfaction with the amount of therapy and ensure that relatives' needs are listened to.
Shared Cared for Stable Glaucoma Patients: Economic Benefits and Patient-centered Outcomes of a Feasibility Trial
Authors: Goh David , de Korne Dirk F. , Ho Henrietta , Mathur Ranjana , Chakraborty Bibhas , Van Hai Nguyen , Wai Charity , Perera Shamira , Aung Tin , Wong Tien Y. , Lamoureux Ecosse L.
Published: December 2017

Purpose:

The purpose of this article is to assess the quality of care and economic benefits of a shared care model managing patients with stable glaucoma in a primary eye care (PEC) clinic compared with a tertiary specialist outpatient clinic (SOC) in Singapore.

Patients and Methods:

A randomized equivalence feasibility trial was preformed comparing the PEC with SOC models. Participants recruited from the SOC had no visual field progression or change in management for at least 3 years, were on a maximum of a single glaucoma medication, had no previous tube-shunt implant and were at least 3-year posttrabeculectomy surgery.

Primary outcomes were clinical assessment and management, economic benefits, and patient satisfaction. Differences were analyzed using equivalence testing and generalized odds ratios.

Results:

The trial included 233 patients, consisting of 42.1% glaucoma disc suspects (PEC: 47.4%; SOC: 36.8%), 27.5% primary angle closure suspects (PEC: 25.0%; SOC: 29.9%), 13.7% with ocular hypertension (PEC: 13.8%; SOC: 13.7%), 3.9% with primary angle closure glaucoma (PEC: 4.3%; SOC: 3.4%), and 3.0% with primary open angle glaucoma (PEC: 1.7%; SOC: 4.3%). Glaucoma clinical care for patients at PEC was as good as SOC [rate difference, 6.83%; 95% confidence interval (CI), 2.84-11.12) and management (rate difference, 7.69%; 95% CI, 3.21-12.17). In 23 cases (9.9%), 5.2% at PEC and 14.5% at SOC, there was disconcordance with the gold standard of senior consultant. Patient satisfaction at the PEC was equally high when compared with SOC (generalized odds ratio, 1.43; CI, 0.50-2.00). Direct costs per patient visit were 43% lower at PEC compared with SOC.

Conclusion:

Managing stable glaucoma patients at a primary care setting is a cost saving, safe, and effective shared care while enhancing professional collaboration between hospital and community settings.
A 20-Year Experience with 202 Segmental Mandibulectomy Defects: A Defect Classification System, Algorithm for Flap Selection, and Surgical Outcomes
Authors: Cordeiro Peter G. , Henderson Peter W. , Matros Evan
Published: December 2017

Background:

This study establishes a novel and broadly applicable defect classification system and flap selection algorithm for segmental mandibulectomy defects that emphasize the importance of the soft-tissue deficit, in addition to that of the bony defect.

Methods:

Between 1992 and 2011, 202 patients with mandibulectomy defects underwent immediate reconstruction performed by a single surgeon. Details of the bony and soft-tissue defects, recommendations for the most appropriate reconstruction for each clinical scenario, and surgical outcomes are presented.

Results:

A total of 211 flaps were performed in 202 patients. Forty-one (19 percent) were nonosseous only, and 170 (81 percent) were osseous-containing. The majority of osseous flaps were fibula osseous or osteocutaneous flaps (91 percent), and the majority of nonosseous flaps were vertical rectus abdominis myocutaneous flaps (68 percent). Flap selection was influenced by the number of soft-tissue zones resected; defects of one soft-tissue zone or less were predominantly reconstructed with an osseous flap, whereas defects that involved four or more zones underwent reconstruction with only a soft-tissue flap in 55 percent of cases.

Conclusions:

The algorithm for reconstruction of the mandibulectomy defect must include both nonosseous and osseous flaps based on defect size, location, and number of soft-tissue zones involved. As the extent of the soft-tissue defect increases, nonosseous flaps are preferred because of greater reliability of the skin island. The surgical outcomes associated with this algorithm are similar to or better than what is published in the literature. This series represents the largest reported single-surgeon experience with mandibulectomy defect reconstruction.
Fluorescent reporter lines for auxin and cytokinin signalling in barley (Hordeum vulgare)
Authors: Kirschner Gwendolyn K. , Stahl Yvonne , Imani Jafargholi , von Korff Schmising Maria , Simon Rüdiger
Published: December 2017

The phytohormones auxin and cytokinin influence the development and maintenance of plant stem cell niches. Although barley (Hordeum vulgare) is the fourth most abundant cereal crop plant, the knowledge about these important phytohormones in regard to the root and shoot stem cell niche in barley is still negligible. In this study, we analyse the influence of auxin and cytokinin on the barley root meristem and present reporter lines to describe the auxin and cytokinin signalling output. Application of high concentrations of auxin and cytokinin to barley seedlings had a negative influence on barley root and meristem growth. The expression of the cytokinin reporterTCSnrevealed that cytokinin signalling mostly takes place in the stele cells proximal to the QC and in the differentiated root cap cells, but can additionally be activated in the root stem cell niche by cytokinin application. Analysing signalling targets of auxin showed that a homologue of AtPLT1, HvPLT1, is expressed in a similar way as AtPLT1 inArabidopsis, in particular in the QC and the surrounding cells. Furthermore, a homologue of the auxin PIN transporters PIN1, HvPIN1, was expressed in the root and the shoot meristem and polarly localizes to the plasma membrane. Its expression is regulated by cytokinin and the intracellular localisation is affected by BFA. With this study, we provide a valuable tool set of fluorescent barley reporter lines for auxin and cytokinin.
Discovery and biosynthesis of the antibiotic bicyclomycin in distant bacterial classes
Authors: Vior Natalia M. , Lacret Rodney , Chandra Govind , Dorai-Raj Siobhán , Trick Martin , Truman Andrew W.
Published: December 2017

Bicyclomycin (BCM) is a clinically promising antibiotic that is biosynthesised byStreptomyces cinnamoneusDSM 41675. BCM is structurally characterized by a core cyclo(L-Ile-L-Leu) 2,5-diketopiperazine (DKP) that is extensively oxidized. Here, we identify the BCM biosynthetic gene cluster, which shows that the core of BCM is biosynthesised by a cyclodipeptide synthase and the oxidative modifications are introduced by five 2-oxoglutarate-dependent dioxygenases and one cytochrome P450 monooxygenase. The discovery of the gene cluster enabled the identification of BCM pathways encoded in the genomes of hundreds ofPseudomonas aeruginosaisolates distributed globally, and heterologous expression of the pathway fromP. aeruginosaSCV20265 demonstrated that the product is chemically identical to BCM produced byS. cinnamoneus. Overall, putative BCM gene clusters have been found in at least seven genera spanningActinobacteriaandProteobacteria(Alpha-, Beta-andGamma-). This represents a rare example of horizontal gene transfer of an intact biosynthetic gene cluster across such distantly related bacteria, and we show that these gene clusters are almost always associated with mobile genetic elements.

IMPORTANCE

Bicyclomycin is the only natural product antibiotic that selectively inhibits the transcription termination factor Rho. This mechanism of action, combined with its proven biological safety and its activity against clinically relevant Gram-negative bacterial pathogens, makes it a very promising antibiotic candidate. Here, we report the identification of the bicyclomycin biosynthetic gene cluster in the known producing organismStreptomyces cinnamoneus, which will enable the engineered production of new bicyclomycin derivatives. The identification of this gene cluster also led to the discovery of hundreds of bicyclomycin pathways encoded in highly diverse bacteria, including the opportunistic pathogenPseudomonas aeruginosa. This wide distribution of a complex biosynthetic pathway is very unusual, and provides an insight into how a pathway for an antibiotic can be transferred between diverse bacteria.
An interactive programming paradigm for realtime experimentation with remote living matter
Authors: Washington Peter , Samuel-Gama Karina G. , Goyal Shirish , Ramaswami Ashwin , Riedel-Kruse Ingmar H.
Published: December 2017

Recent advancements in life-science instrumentation and automation enable entirely new modes of human interaction with microbiological processes and corresponding applications for science and education through biology cloud labs. A critical barrier for remote life-science experimentation is the absence of suitable abstractions and interfaces for programming living matter. To this end we conceptualize a programming paradigm that provides stimulus control functions and sensor control functions for realtime manipulation of biological (physical) matter. Additionally, a simulation mode facilitates higher user throughput, program debugging, and biophysical modeling. To evaluate this paradigm, we implemented a JavaScript-based web toolkit, ‘Bioty’, that supports realtime interaction with swarms of phototactic Euglena cells hosted on a cloud lab. Studies with remote users demonstrate that individuals with little to no biology knowledge and intermediate programming knowledge were able to successfully create and use scientific applications and games. This work informs the design of programming environments for controlling living matter in general and lowers the access barriers to biology experimentation for professional and citizen scientists, learners, and the lay public.

Significance Statement

Biology cloud labs are an emerging approach to lower access barriers to life-science experimentation. However, suitable programming approaches and user interfaces are lacking, especially ones that enable the interaction with the living matter itself - not just the control of equipment. Here we present and implement a corresponding programming paradigm for realtime interactive applications with remotely housed biological systems, and which is accessible and useful for scientists, programmers and lay people alike. Our user studies show that scientists and non-scientists are able to rapidly develop a variety of applications, such as interactive biophysics experiments and games. This paradigm has the potential to make first-hand experiences with biology accessible to all of society and to accelerate the rate of scientific discovery.
Control of meiotic double-strand-break formation by ATM: local and global views
Authors: Lukaszewicz Agnieszka , Lange Julian , Keeney Scott , Jasin Maria
Published: December 2017

DNA double-strand breaks (DSBs) generated by the SPO11 protein initiate meiotic recombination, an essential process for successful chromosome segregation during gametogenesis. The activity of SPO11 is controlled by multiple factors and regulatory mechanisms, such that the number of DSBs is limited and DSBs form at distinct positions in the genome and at the right time. Loss of this control can affect genome integrity or cause meiotic arrest by mechanisms that are not fully understood. Here we focus on the DSB-responsive kinase ATM and its functions in regulating meiotic DSB numbers and distribution. We review the recently discovered roles of ATM in this context, discuss their evolutionary conservation, and examine future research perspectives.
Robust expression variability testing reveals heterogeneous T cell responses
Authors: Eling Nils , Richard Arianne C. , Richardson Sylvia , Marioni John C. , Vallejos Catalina A.
Published: December 2017

Cell-to-cell transcriptional variability in otherwise homogeneous cell populations plays a crucial role in tissue function and development. Single-cell RNA sequencing can characterise this variability in a transcriptome-wide manner. However, technical variation and the confounding between variability and mean expression estimates hinders meaningful comparison of expression variability between cell populations. To address this problem, we introduce a novel analysis approach that extends the BASiCS statistical framework to derive a residual measure of variability that is not confounded by mean expression. Moreover, we introduce a new and robust procedure for quantifying technical noise in experiments where technical spike-in molecules are not available. We illustrate how our method provides biological insight into the dynamics of cell-to-cell expression variability, highlighting a synchronisation of the translational machinery in immune cells upon activation. Additionally, our approach identifies new patterns of variability across CD4+ T cell differentiation.
A single-cell catalogue of regulatory states in the ageing Drosophila brain
Authors: Davie Kristofer , Janssens Jasper , Koldere Duygu , Pech Uli , Aibar Sara , De Waegeneer Maxime , Makhzami Samira , Christiaens Valerie , González-Blas Carmen Bravo , Hulselmans Gert , Spanier Katina I. , Moerman Thomas , Vanspauwen Bram , Lammertyn Jeroen , Thienpont Bernard , Liu Sha , Verstreken Patrik , Aerts Stein
Published: December 2017

The diversity of cell types and regulatory states in the brain, and how these change during ageing, remains largely unknown. Here, we present a single-cell transcriptome catalogue of the entire adult Drosophila melanogaster brain sampled across its lifespan. Both neurons and glia age through a process of “regulatory erosion”, characterized by a strong decline of RNA content, and accompanied by increasing transcriptional and chromatin noise. We identify more than 50 cell types by specific transcription factors and their downstream gene regulatory networks. In addition to neurotransmitter types and neuroblast lineages, we find a novel neuronal cell state driven by datilografo and prospero. This state relates to neuronal birth order, the metabolic profile, and the activity of a neuron. Our single-cell brain catalogue reveals extensive regulatory heterogeneity linked to ageing and brain function and will serve as a reference for future studies of genetic variation and disease mutations.