Prefrontal cortical and striatal activity to happy and fear faces in bipolar disorder is associated with comorbid substance abuse and eating disorder

Background: The spectrum approach was used to examine contributions of comorbid symptom dimensions of substance abuse and eating disorder to abnormal prefrontal-cortical and subcortical-striatal activity to happy and fear faces previously demonstrated in bipolar disorder (BD). Method: Fourteen remitted BD-type I and sixteen healthy individuals viewed neutral, mild and intense happy and fear faces in two event-related fMRI experiments. All individuals completed Substance-Use and Eating-Disorder Spectrum measures. Region-of-Interest analyses for bilateral prefrontal and subcortical-striatal regions were performed. Results: BD individuals scored significantly higher on these spectrum measures than healthy individuals (p < 0.05), and were distinguished by activity in prefrontal and subcortical-striatal regions. BD relative to healthy individuals showed reduced dorsal prefrontal-cortical activity to all faces. Only BD individuals showed greater subcortical-striatal activity to happy and neutral faces. In BD individuals, negative correlations were shown between substance use severity and right PFC activity to intense happy faces (p < 0.04), and between substance use severity and right caudate nucleus activity to neutral faces (p < 0.03). Positive correlations were shown between eating disorder and right ventral putamen activity to intense happy (p < 0.02) and neutral faces (p < 0.03). Exploratory analyses revealed few significant relationships between illness variables and medication upon neural activity in BD individuals. Limitations: Small sample size of predominantly medicated BD individuals. Conclusion: This study is the first to report relationships between comorbid symptom dimensions of substance abuse and eating disorder and prefrontal-cortical and subcortical-striatal activity to facial expressions in BD. Our findings suggest that these comorbid features may contribute to observed patterns of functional abnormalities in neural systems underlying mood regulation in BD.

Evaluation of the quality and promotion of open learning materials

In the UK, Open Learning has been used in industrial training for at least the last decade. Trainers and Open Learning practitioners have been concerned about the quality of the products and services being delivered. The argument put forward in this thesis is that there is ambiguity amongst industrialists over the meanings of `Open Learning' and `Quality in Open Learning'. For clarity, a new definition of Open Learning is proposed which challenges the traditional learner-centred approach favoured by educationalists. It introduces the concept that there are benefits afforded to the trainer/employer/teacher as well as to the learner. This enables a focussed view of what quality in Open Learning really means. Having discussed these issues, a new quantitative method of evaluating Open Learning is proposed. This is based upon an assessment of the degree of compliance with which products meet Parts 1 & 2 of the Open Learning Code of Practice. The vehicle for these research studies has been a commercial contract commissioned by the Training Agency for the Engineering Industry Training Board (EITB) to examine the quality of Open Learning products supplied to the engineering industry. A major part of this research has been the application of the evaluation technique to a range of 67 Open Learning products (in eight subject areas). The findings were that good quality products can be found right across the price range - so can average and poor quality ones. The study also shows quite convincingly that there are good quality products to be found at less than 50. Finally the majority (24 out of 34) of the good quality products were text based.

An evaluation of the effectiveness of intervention strategies for the promotion of health and safety performance in small firms

Recognition of the contribution of small firms to the UK economy has grown considerably since 1995 when this research first began. The poor record of small firms in managing health and safety effectively has caused concern, and efforts made to improve knowledge and awareness of the target group through various initiatives have had some success. This research thesis attempts to identify the range of intervention routes and methods available to reach the target group, and to consider ways of evaluating the outcome of such efforts. Various interventions were tested with small firms, including a Workshop; use of Questionnaires; short postal Reply Slip survey; leading to a closer evaluation of a specific industry- the Licensed Trade. Attitudes and beliefs of the sample were identified, and observations carried out to consider actions taken by workers and others in the workplace. These empirical research findings were used to develop the theme of Primary and Secondary interventions intended to change behaviours, and to confirm assumptions about what small firms currently do to manage health and safety risks. Guidance for small firms was developed as a Secondary intervention tool to support Primary interventions, such as inspection or insurance provision.