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MESSENGER’s exploration of Mercury has revealed a rich and dynamic geological history and provided constraints on the processes that control the planet’s internal evolution. That history includes resurfacing by impacts and volcanism prior to the end of the late heavy bombardment and a subsequent rapid waning of effusive volcanism. MESSENGER also revealed a global distribution of thrust faults that collectively accommodated a decrease in Mercury’s radius far greater than thought before the mission. Measurements of elemental abundances on Mercury’s surface indicate the planet is strongly chemically reduced, helping to characterize the composition and manner of crystallization of the metallic core. The discovery of a northward offset of the weak, axially aligned internal magnetic field, and of crustal magnetization in the planet’s ancient crust, places new limits on the history of the core dynamo and the entire interior. Models of Mercury’s thermochemical evolution subject to these observational constraints ...

Non-adherence to medication remains a major barrier to recovery from mental illnesses. Identification of those patients likely to experience adherence difficulties is best undertaken during inpatient treatment, prior to discharge into the community. More objective assessments of adherence behaviours might assist staff to more effectively target support to those patients most in need. This study investigated the interrater reliability of an inpatient behavioural observation scale of patient engagement with medication: the Observer Rating of Medication Taking (ORMT) scale. Eight mental health nurses working in a psychiatric hospital inpatient setting were trained in the use of the ORMT using video-based vignettes. Working in pairs, staff then independently rated adherence behaviours of 13 inpatients in a rehabilitation unit (total of 160 ratings) over a 1-week period. Concurrently, two expert raters also undertook independent ratings of patient medication-taking behaviour using the ORMT. Interrater reliability was assessed across both staff and expert raters. The results indicated that the ORMT has satisfactory interrater reliability, and can be appropriately used in an inpatient setting. The observational location of raters on the ward influenced the range of medication-taking behaviours observed, and thus the extent of concordance between raters. Further research to determine if the ORMT predicts adherence in the community is warranted.

Defining parenting, and good parenting in particular, is a complex task wrought with ambiguities. This creates problems in agreeing on a standard parenting capacity assessment, particularly in relation to strengths as opposed to weaknesses. To address this lack of consensus, the current study explored the convergence and divergence of different professional groups' opinions on good parenting. A mixed-methods design was employed, with semi-structured interviews and rating scales administered to 19 professionals with experience in parenting capacity assessments. Data were analyzed using a constructivist grounded theory. The findings suggest that, in general, professionals agree on main themes of good parenting, including (1) insight, (2) willingness and ability, (3) day-to-day versus complex/long-term needs, (4) child's needs before own, (5) fostering attachment, and (6) consistency versus flexibility. Within these six categories, individual differences emerged. Theoretical and practical implications are discussed. Keypoints Describes the importance of parenting capacity Assessments and the variances in practitioner approaches Adopts a strengths based approach as an adjunct to the traditional deficits based approach to Parenting capacity assessments Contextualises the key decision making issues affecting assessors and decision makers in the judicial system Provides a theoretical model on decision makers opinions regarding good parenting and outlines directions for the development of strengths based assessments as a contribution to child placement decisions

Background For many adults with an intellectual disability (ID), mealtimes carry significant health risks. While research and allied clinical guidance has focused mainly on dysphagia, adults with a range of physical and behavioural difficulties require mealtime support to ensure safety and adequate nutrition. The extent of need for and nature of such support within the wider ID population has yet to be reported. Methods In this study, we have estimated the prevalence of need for mealtime support among people with ID in the UK, using a population of 2230 adults known to specialist ID services (in Cambridgeshire, UK, total population 586 900). In a sample (n = 69, aged 19 to 79 years, with mild to profound ID), we characterised the support provided, using a structured proforma to consult support workers and carers providing mealtime support, and health and social care records. Results Mealtime support was found to be required by a significant minority of people with ID for complex and varied reasons. Prevalence of need for such support was estimated at 15% of adults known to specialist ID services or 56 per 100 000 total population. Within a sample, support required was found to vary widely in nature (from texture modification or environmental adaptation to enteral feeding) and in overall level (from minimal to full support, dependent on functional skills). Needs had increased over time in almost half (n = 34, 49.3%). Reasons for support included difficulties getting food into the body (n = 56, 82.2%), risky eating and drinking behaviours (n = 31, 44.9%) and slow eating or food refusal (n = 30, 43.5%). These proportions translate into crude estimates of the prevalence of these difficulties within the known ID population of 11.9%, 6.6% and 6.4% respectively. Within the sample of those requiring mealtime support, need for support was reported to be contributed to by the presence of additional disability or illness (e.g. visual impairment, poor dentition and dementia; n = 45, 65.2%) and by psychological or behavioural issues (e.g. challenging behaviour, emotional disturbance; n = 36, 52.2%). Conclusions These findings not only highlight the need for a multidisciplinary approach to mealtime interventions (paying particular attention to psychological and environmental as well as physical issues), but also signal the daily difficulties faced by carers and paid support workers providing such support and illustrate their potentially crucial role in managing the serious health risks associated with eating and drinking difficulties in this population.

The results of interventions to enhance patient adherence to medication have been inconsistent. This research investigated the utility of an enhanced adherence training programme to ascertain its effectiveness and the possible mechanisms of that effect. Forty-six clinicians were trained in 'medication alliance', and data were collected from 51 patients matched to the clinician. Data on clinician changes in skills, knowledge, and attitudes, in relation to enhancing patient adherence and patient changes in adherence, insight, and psychopathology were collected at baseline and at 6 and 12 months. The quality of the therapeutic relationship between the clinician and the patient was also assessed. The results indicated significant improvements in both clinician and patient measures, the majority of which were maintained over time. The quality of the therapeutic relationship was also enhanced. A hypothesized explanatory model accounting for the data was supported. It was concluded that clinician training to support improved patient adherence should include strategies that also enhance the therapeutic alliance.

Rationale, aims and objectives The Medication Alliance training programme has previously been shown to be effective in enhancing clinician knowledge, attitudes and skills in regard to non-adherent individuals in a community-based psychiatric setting. The current study attempts to replicate these findings in an inpatient setting and assess the feasibility of dissemination using a train-the-trainer model. Method One hundred and thirteen staff from four wards at an inpatient psychiatric facility attended Medication Alliance training workshops over 3 days. Two wards comprised an expert trained group (n = 67); and the remaining two wards made up a novice trained group (n = 46). The novice trained group attended training 6 months after the expert group, and were trained by selected trainees from the expert group. Participants completed a package of questionnaires both before and after their training to determine if Medication Alliance resulted in any changes in knowledge, attitudes and skills. Results Paired t-tests showed significant improvements across both groups for knowledge, attitudes and one skill domain following training in Medication Alliance. There were no differences at baseline between groups and analysis of post-test scores yielded no significant difference between the groups in terms of training effect for knowledge, attitudes or skills. Conclusions Medication Alliance can be successfully implemented in an inpatient setting, enhancing knowledge, attitudes and at least some skill domains of staff in dealing with non-adherent patients. The equivalence of results between the expert and novice trained training groups suggests that Medication Alliance may be more broadly disseminated using a cost-effective train-the-trainer model.

Objectives Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Methods Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Results Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. Conclusions This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training. © Blackwell Publishing Ltd 2009.

The capacity of 73 volunteer telephone counsellors to administer a brief and early intervention for secondary trauma was assessed. The counsellors participated in a 1-day training programme in the ‘Orienting Approach’ to Trauma Counselling (Phipps & Byrne, 2003). Volunteer counsellors showed significant improvements in both knowledge and skills from pre- to post-training. The potential benefits of this intervention to the community and professional health services are discussed. Copyright © 2006 John Wiley & Sons, Ltd.

Post-traumatic stress through indirect exposure to trauma can mimic the psychological experiences of direct victims. This is referred to as vicarious traumatization, an impairing condition that largely goes undetected in the general population. This study sought to describe this condition and predict those who may be at risk of developing this type of post-traumatic stress. One hundred and fifteen participants from south-east New South Wales (NSW) in Australia who had not experienced any direct exposure, loss or injury from the 2001–2002 NSW bushfires were interviewed using the Vicarious Traumatization Questionnaire, Impact of Events Scale and Coping Strategies Indicator. Results indicated that specific peri-event, post-event and pre-event characteristics were able to predict at least 75 per cent of those who experienced vicarious traumatization resulting from the 2001–2002 NSW bushfires. This study was able to identify and describe vicarious traumatization in a sample of the general population. The importance of these results and the issues for further research are discussed. Copyright © 2006 John Wiley & Sons, Ltd.

In previous studies, we found that Young's moduli of quenched isotactic polypropylene/high-density polyethylene (iPP/HDPE) exceeded the upper bound, calculated from the Voigt model, with the moduli of the quenched homopolymers as those of the two components. We suggested that this might be due to crystallization, as the components crystallized at higher temperatures in the blend than on their own. We repeated the same set of measurements, this time on iPP/HDPE blends that were cooled slowly. We also examined crystallization at various rates of cooling with differential scanning calorimetry. At slow cooling rates, the HDPE and iPP components in the blends crystallize at lower temperatures than in the pure homopolymers, suggesting that the presence of one component inhibits rather than promotes the crystallization of the other. Electron microscopy of slowly cooled blends revealed very different interfacial morphologies depending on whether the HDPE or the iPP crystallizes first. Young's moduli of most of the blends lie on the upper bound; however, some blends with co-continuous morphologies fall well below the lower bound. The mechanical properties are discussed in terms of the interfacial morphology, the crystallization behavior, and the large-scale phase separation.

Having to intervene in severe crises or bearing witness to human tragedy, can take its toll on the individual (Erickson, Vande Kemp, Gorsuch, Hoke & Foy, 2001; Lind, 2000; Lugris, 2000). These effects can include severe, debilitating anxiety that persists for months and sometimes even years following the event. Because these people are not directly involved in the event, their distress often goes undetected (Brady, Guy, Poelstra & Brokaw, 1999; Motta, Joseph, Rose, Suozzi & Leiderman, 1997). Support resources for people who are indirectly affected by a traumatic event are limited. To date, a history of previous trauma, previous psychological well-being, social support, age, gender, educational achievement, socio-economic status and styles of coping have been highlighted as mediating the effects of indirect exposure to a traumatic incident. Understanding this phenomenon and the mechanisms precipitating such distress is an important step in providing appropriate help for a large number of people indirectly affected by tragic events. Copyright © 2003 John Wiley & Sons, Ltd.

Recent literature in the area of trauma has highlighted the potential for interventions to exacerbate the trauma reaction. The general rule of ‘do no harm’ should apply not only to professionals but volunteers alike. This paper reviews the literature on brief interventions for people who have been exposed to trauma at varying levels. The parameters of a single session intervention and the skill of volunteers are considered in recommending a protocol for intervention. We propose an ‘orienting’ framework to intervention that emphasizes support, normalization and self-help strategies. Copyright © 2003 John Wiley & Sons, Ltd.

BACKGROUND : Routine HCV NAT of blood donors to detect persons in the preseroconversion phase of acute infection was introduced in Canada in October 1999. The source of virus exposure was investigated in the first, and to date only, blood donor found to be HCV NAT positive, anti-HCV negative in Canada. He was a regular donor with none of the commonly reported risk factors for HCV infection. STUDY DESIGN AND METHODS : Epidemiologic follow-up revealed that the blood donor had received antibiotics at an outpatient IV clinic 5 weeks before donation. IV solution bags and tubing for individual patients were stored in the clinic, and then the same equipment was used each time the patient returned for the next dose of antibiotics until it was replaced after every 72-hour period. Among eight other patients whose clinic visitation times overlapped was a man with chronic HCV infection. Genomic sequencing of HCV isolates from the blood donor, the patient with chronic hepatitis C, and local controls was carried out to study possible nosocomial infection. RESULTS : Genomic sequencing showed a high degree of relatedness in the hypervariable region of HCV isolates from the blood donor and putative source patient as compared with controls. Detailed molecular analysis of quasispecies of the HCV isolates further indicated that viruses from the two individuals were genetically very close to each other. CONCLUSION : The introduction of routine screening of blood donors by HCV NAT was directly responsible for the early detection and investigation of an unusual case of HCV infection involving a regular donor. Genomic sequencing studies provided firm evidence of patient-to-patient transmission of HCV in an IV clinic. The report clearly demonstrates the value of molecular fingerprinting in tracking nosocomial HCV infections.

The present paper reports the case history of a 50-year-old man born with Usher syndrome, who developed a psychotic illness later in life, to illustrate the specific diagnostic problems, and the value of direct observation and a detailed assessment of communication. The subject had had a significant hearing impairment since birth, problems with balance and developed retinitis pigmentosa, leaving him with progressively limited vision in adult life. A pattern of bizarre and aggressive behaviour, and a disintegration in his ability to communicate using signs developed over 3 months. An initial diagnosis of depression was made, but it later became clearer that the subject had developed a psychotic illness. This condition responded well to a combination of antidepressant and antipsychotic medication. The possible association between Usher syndrome and psychotic illness is also discussed.

A valine-overproducing mutant (MA7040, Streptomyces hygroscopicus) was found to produce 1.5 to 2.0 g/L of the immunoregulant, L-683,590, at the 0.6 m3 fermentation scale in a simple batch process using soybean oil and ammonium sulfate-based GYG5 medium. Levels of both lower (L-683,795) and higher (HH1 and HH2) undesirable homolog levels were controlled adequately. This batch process was utilized to produce broth economically at the 19 m3 fermentation scale. Material of acceptable purity was obtained without the multiple pure crystallizations previously required for an earlier culture, MA6678, requiring valine supplementation for impurity control. Investigations at the 0.6 m3 fermentation scale were conducted, varying agitation, pH, initial soybean oil/ammonium sulfate charges, and initial aeration rate to further improve growth and productivity. Mid-cycle ammonia levels and lipase activity appeared to have an important role. Using mid-cycle soybean oil additions, a titer of 2.3 g/L of L-683,590 was obtained, while titers reached 2.7 g/L using mid-cycle soybean oil and ammonium sulfate additions. Both higher and lower homolog levels remained acceptable during this fed-batch process. Optimal timing of mid-cycle oil and ammonium sulfate additions was considered a critical factor to further titer improvements. © 1998 John Wiley & Sons, Inc. Biotechnol Bioeng 60: 580–588, 1998.

A mutant strain of Streptomyces hygroscopicus was found to produce up to 9.0 units/L of an immunoregulant precursor, immunomycin, with up to 3.5% of a lower homolog impurity under either dual fed-batch or batch conditions. Glycerol and valine were key nutrients influencing productivity and impurity levels. Soybean oil was successfully substituted for glycerol as a carbon source to minimize shot additions to batch culture. The remainder of the production medium was composed largely of defined components with the exception of yeast extract. Valine limitation increased lower homolog formation while decreasing higher homolog formation; excess valine decreased lower homolog formation below 2–3% while increasing higher homolog formation. Higher homolog formation in the presence of valine seemed to be slower than lower homolog formation in the absence of valine. Valine was believed to be the major butyrate precursor; consequently its availability influenced the impurity profile. A preliminary cost analysis suggests that elimination of added valine from the cultivation and replacement of glycerol with soybean oil can result in a 6.6-fold reduction in media costs relative to the original fed-batch process. © 1998 John Wiley & Sons, Inc. Biotechnol Bioeng 59:595–604, 1998.

The use of gaseous fluorination as a pretreatment for wool has been assessed and compared with corona discharge. Mechanical and shrinkage properties have been examined both before and after the application of two commercial shrinkproofing polymers. Fluorination reduces fabric shrinkage during washing, and the subsequent application of low levels of Basolan MW imparts machine washability with no impairment of fabric handle.

The occurrence of a transient neurogenic stutter in a male anorexic patient is described. The stutter developed following a prolonged period of starvation, and during refeeding the patient recovered from the stuttering behavior. The patient was not receiving any drugs known to cause stuttering, and it is postulated that the stutter developed as a result of the gross impairment of brain function secondary to chronic starvation. A review of the literature has failed to reveal any information on anorexia nervosa as a cause of neurogenic (acquired) stuttering.

There are only limited published data on the glycemic index (GI) and insulin index of raisins. Further, the GI and insulin index of raisins have not been determined in endurance athletes or in persons with prediabetes. The objective of this study was to determine both the GI and the insulin index of raisins, and to evaluate if these indexes are similar when measured in different populations. The study groups consisted of 10 healthy sedentary subjects (S, 25.7±1.3 y, BMI=23.3±1.7 kg/m2), 11 endurance athletes (A, 23.1±1.0 y, BMI=24.1±0.3 kg/m2), and 10 prediabetic individuals (P, 50±2.6 y, BMI=32.6±1.9 kg/m2). Subjects consumed 50 g of available carbohydrates from raisins and from a glucose solution (reference food) on two separate occasions. Serum glucose and insulin concentrations were measured from capillary finger-stick blood samples at baseline and at 15, 30, 45, 60, 90, and 120 min (& 150 and 180 min for P) postprandially. The GI of raisins was low (GI≤55) in the S (49.4±7.4) and P (49.6±4.8) groups and was moderate (GI 55-69) in the A group (62.3±10.5), but there were no differences among the groups (P=0.437). The insulin index values of raisins were 47.3±9.4, 51.9±6.5, and 54.4±8.9 for the S, A, and P groups, respectively. On average, the A group secreted 2-2.5-fold less insulin per gram of carbohydrate compared with the S and P groups, respectively (P

Objective To assess the efficacy of cervical conization as primary management of cervical intraepithelial glandular neoplasia (CIGN). Design A multicentre prospective cohort study. Setting CRC Clinical Trials Unit, Birmingham. Subjects 84 women registered with the Unit between May 1986 and January 1989. After excluding 33 women, 51 who had been managed in accordance with the described protocol and had the presence of CIGN confirmed by central review of diagnostic histopathological material were included in the study. Intervention/Protocol Women with CIGN diagnosed on a cervical cone specimen were managed in accordance with a specific protocol: (a) women with negative cone margins were managed conservatively and followed up with regular cervical cytological and colposcopic examinations; (b) women with involved cone margins were managed by hysterectomy. Main outcome measures Presence or absence of CIGN at cone margins, results of cervical cytological examinations following conization, results of histopathological assessment of any surgical specimens taken after initial cone biopsy. Results Of the 51 women with confirmed CIGN, managed by conization, 14 (27%) were aged 30 or less and 15 (29%) were nulliparous. Thirty five women who had a cone biopsy showing margins free of CIGN have been managed by conization alone. After a median follow-up period of 12 months there is no apparent residual CIGN or invasive disease in this group. Thirteen women have had further surgical procedures (according to protocol) and two have had a hysterectomy for benign gynaecological disorders. Eight further procedures were carried out because the original cone biopsy had margins involved with CIGN, and only one of them was found to have residual CIGN. The other five procedures were carried out solely because of abnormal cytology, only one of them had a diagnosis of CIN 1. A total of 10 women had cytological abnormality following cone biopsy, one had CIGN, one had CIN 1 and a third had CIN 3. Conclusions Our preliminary data suggests that when a diagnosis of CIGN is made upon a cone biopsy, further surgery is unnecessary in those women in whom the margins of the cone specimen are free of disease. Cytological and colposcopic follow up, including cytological sampling of the endocervical canal, is recommended for these women.

Efficacite de cet analogue de la prostaglandine E1 utilise sous forme de pessaire vaginal, pour assouplir le col de l'uterus et provoquer l'accouchement chez 10 femmes dont le fœtus est mort lors du premier trimestre de gestation