1,840 research outputs found

    Person-related and Treatment-related Barriers to Alcohol Treatment

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    Treatment underutilization by persons with alcohol use disorder is well-documented. This study examined barriers to treatment at the latter stages of the treatment-seeking process, which was conceptualized as recognizing the problem, deciding that change is necessary, deciding that professional help is required, and seeking care. All participants identified themselves as having a drinking problem that was severe enough to warrant treatment. Differences between those who had (Treatment Seekers) and those who had not (Comparison Controls) sought treatment were evaluated, including the experience of person-related (e.g., shame) and treatment-related (e.g., cost) barriers. Person-related barriers were more commonly endorsed by both groups than treatment-related barriers. Comparison Controls were more likely to endorse both types of barriers, especially the preference for handling the problem without treatment. Treatment-related barriers were less relevant than person-related barriers at the latter stage of help seeking. The significance of barriers endured after accounting for other differences, such as drinking-related negative consequences. Treatment implications are discussed

    The role of dopamine in the accumbens core in the expression of Pavlovian‐conditioned responses

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    The role of dopamine in reward is a topic of debate. For example, some have argued that phasic dopamine signaling provides a prediction‐error signal necessary for stimulus–reward learning, whereas others have hypothesized that dopamine is not necessary for learning per se , but for attributing incentive motivational value (‘incentive salience’) to reward cues. These psychological processes are difficult to tease apart, because they tend to change together. To disentangle them we took advantage of natural individual variation in the extent to which reward cues are attributed with incentive salience, and asked whether dopamine (specifically in the core of the nucleus accumbens) is necessary for the expression of two forms of Pavlovian‐conditioned approach behavior – one in which the cue acquires powerful motivational properties (sign‐tracking) and another closely related one in which it does not (goal‐tracking). After acquisition of these conditioned responses (CRs), intra‐accumbens injection of the dopamine receptor antagonist flupenthixol markedly impaired the expression of a sign‐tracking CR, but not a goal‐tracking CR. Furthermore, dopamine antagonism did not produce a gradual extinction‐like decline in behavior, but maximally impaired expression of a sign‐tracking CR on the very first trial, indicating the effect was not due to new learning (i.e. it occurred in the absence of new prediction‐error computations). The data support the view that dopamine in the accumbens core is not necessary for learning stimulus–reward associations, but for attributing incentive salience to reward cues, transforming predictive conditional stimuli into incentive stimuli with powerful motivational properties. Ongoing debate exists about dopamine’s exact role in reward‐related processes. We took advantage of natural individual variation in the degree to which reward cues are attributed with motivational value, and asked whether dopamine in the core of the nucleus accumbens is necessary for the performance of two forms of Pavlovian conditioned approach behavior ‐ one in which the cue acquires powerful motivational properties (sign‐tracking) and another related one in which it does not (goal‐tracking). We found that blocking dopamine transmission within the core impaired the expression of sign‐tracking responses, but not goal‐tracking responses.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93510/1/j.1460-9568.2012.08217.x.pd

    Web-Based Training for an Evidence-Supported Treatment: Training Completion and Knowledge Acquisition in a Global Sample of Learners

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    The purpose of this investigation is to describe the characteristics of professional and preprofessional learners who registered for and completed TF-CBTWeb, a modular, web-based training program designed to promote the dissemination of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and to demonstrate the feasibility of this method of dissemination. Between October 1, 2005, and October 1, 2012, a total of 123,848 learners registered for TF-CBTWeb, of whom 98,646 (79.7%) initiated the learning activities by beginning the first module pretest. Of those, 67,201 (68.1%) completed the full training. Registrants hailed from 130 countries worldwide, and they had varied educational backgrounds, professional identities (both professional and preprofessional), and a range of experience working with child trauma victims. Learners who were from the United States, students, those with master’s degrees, and those with fewer years of experience working with child trauma victims tended to have the highest course completion rates. Learners displayed significant increases in knowledge about each component of TF-CBT, based on module pretest and posttest scores. The advantages and limitations of this web-based training program evaluation are discussed, while important implications for the use of web-based trainings are reviewed

    The role of heterosocial perception in men's likelihood to sexually harass

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    Sexual harassment against women represents sexually aggressive and coercive behaviour that violates women’s dignity and creates an offensive environment, which threatens women’s well-being and ability to prosper in day to day life (Pina, Gannon & Saunders, 2009). Understanding the perceptual characteristics of men with inclinations to sexually harass, through how they perceive women is important in delineating the reasons why some men may engage in the sexual harassment of women. Heterosocial perception is a concept of how an individual perceives another person interacting with the opposite sex. It is typically measured using the Test of Reading Affective Cues (TRAC), a tool encompassing an array of video clips showing a woman interacting with a man, whereby the woman displays a range of affective cues. The perceiver is assessed on their perceptual accuracy when judging the affective cues. Perceptual accuracies of male rapists and male child molesters have been well researched (Lipton, McDonel & McFall, 1987; Stahl & Sacco, 1995), yet male sexual harassment as a singular category has been neglected. The current thesis explores the potential heterosocial perception characteristics of a distinct group of men who are relatively high in the likelihood to engage in sexual harassment of women from scores on Pryor’s (1987) Likelihood to Sexually Harass (LSH) scale focusing on their differences in performance on the TRAC in comparison to those men who are lower in the likelihood to engage in sexual harassment of women. Five empirical studies are reported in this thesis. Study 1 presents a modernized version of the TRAC and incorporates an analysis to develop it as a research tool, enabling judgements on five affective cues displayed by a woman; friendly, romantic, neutral, bored and rejecting. The tool provides this range of affective cues that were used in later studies to measure differences in heterosocial perception. Study 2 addressed theoretical explanations taken from previous perception research with sexually aggressive men (Malamuth & Brown, xiv 1994) to explain differences in heterosocial perception for men high in LSH. Explanations are given for potential biases evidenced by men high in LSH focusing on Error Management Theory (Haselton & Buss, 2000) arguing that an overperception bias will increase the frequency of falsely inferring a woman’s sexual intent towards sexual pursuit, but considerably reduce the costs of losing a sexual opportunity by falsely inferring that a woman lacked sexual intent. Altogether, study 2 provided support for the misidentification of negative affective cues (negativeness blindness), the overperception of negative affective cues and the romantic overperception bias of friendly affective cues in the perception of men high in LSH. Study 3 tested the established theoretical link that internal concepts of social power have within men who report sexual aggression and sexual coercion and the subsequent impact on perception. Unexpectedly, power did not exacerbate perceptual inaccuracy for negative affective cues and the romantic overperception bias of friendly affective cues. In study 4, objectification was assessed in its relationship to perception in high LSH men. Instrumental and both specific and general sexual objectification were significantly higher for men high in LSH. Specific sexual objectification was found to negatively mediate romantic categorizations of romantic affective cues, but general sexual objectification was found to positively mediate romantic categorizations of friendly affective cues for men high in LSH. Results also showed that men high in LSH showed poorest perceptual accuracy on bored and rejecting affective cues, and evidenced a greater romantic judgement of friendly affective cues overperception bias. In study 5, the impact of different mental states on perception was assessed, via the use of a cooling system to facilitate self-regulation. A cooling system is a psychological framework proposed for understanding self-control (Metcalfe & Mischel, 1999), and in this study it incorporated techniques of distraction, distancing and empathy enhancement. Results showed that the cooling system was not beneficial in making high LSH xv men’s perceptual judgements more accurate and in making their judgements accurate to the level of low and medium LSH men for negative affective cues. However, cooling did improve perceptual accuracy of friendly affective cues removing the overperception bias to romantic judgements in comparison to the neutral condition. The cooling system was not found to reduce instrumental and sexual objectification for high LSH men. There were differences found on empathy between men high and low and medium on LSH. Differences were found such that men high in LSH showed more state empathy, but less trait empathy than men low and medium in LSH

    Young adults' discursive constructions of chronic illness experience: accounts of Type 1 Diabetes and Inflammatory Bowel Disease (IBD)

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    This thesis investigates the experiences of young adults living with either Type 1 diabetes (T1DM) or Inflammatory Bowel Disease (IBD), two chronic conditions which are prevalent among this age-group. This is set against the long tradition of research into chronic illness experience; however, young adults are commonly underrepresented in this area, in spite of the contention that the new-found pressures and responsibilities associated with this life-stage may be especially difficult to manage alongside a chronic condition (Arber and Ginn, 1998). Semi-structured interviews were carried out with respondents aged 18-29 (n = 30). Transcribed interviews were subject to open-coding using qualitative software, which led to the systematic identification of predominant themes for analysis. Data was considered primarily as 'accounts' (Radley and Billig, 1996), with a focus on the moral-underpinnings of the respondents‟ talk. These accounts were examined from a rhetorical discourse analysis perspective (Arribas-Ayllon et al., 2011), which entailed micro-investigation of the discursive devices drawn upon by the respondents in representing their experiences as part of situated identity-performances (Riessman, 1990). Across the predominant themes identified (self, other and control), some similar trends were identified, but also considerable variation, most significantly across the two conditions. In relation to self, accounts of T1DM showed respondents constructing greater levels of agency regarding the integration or distancing of illness vis-à-vis selfhood, whereas in accounts of IBD 'loss of self' (Charmaz, 1983) was more prominent. In accounts of other-orientation, those with IBD more commonly constructed 'felt stigma' and 'enacted stigma' (Scambler and Hopkins, 1986) than T1DM-respondents, which had implications for reported disclosure practices vis-à-vis the two conditions. Within the theme of control, T1DM-respondents generally constructed greater condition control and lifestyle control than IBD-respondents. Variation was also observed in reported management-strategies, which reflected the respondents‟ differing conceptions of their 'healthy bodies' (Balfe, 2009) – those with T1DM focused on future health concerns, their 'longer-term' healthy body, whereas IBD-respondents' concerns centred primarily on more immediate health consequences, their 'short-term' healthy body. These differing conceptions of the 'healthy body' influenced how respondents accounted for their 'risky' social drinking practices, with IBD-respondents producing 'justifications', and those with T1DM primarily constructing 'excuses' (Scott and Lyman, 1968). In spite of this variation, a consistent thread running throughout the data was the constitution of the morally-driven self. A range of different moral figures were constructed by the respondents, allowing them to perform positive identities throughout. This eased the tension borne out of the conflict between the priorities, desires and demands of young adulthood and the complex considerations surrounding chronic illness

    Raman Quantum Memory with Built-In Suppression of Four-wave Mixing Noise

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    Quantum memories are essential for large-scale quantum information networks. Along with high efficiency, storage lifetime and optical bandwidth, it is critical that the memory add negligible noise to the recalled signal. A common source of noise in optical quantum memories is spontaneous four-wave mixing. We develop and implement a technically simple scheme to suppress this noise mechanism by means of quantum interference. Using this scheme with a Raman memory in warm atomic vapour we demonstrate over an order of magnitude improvement in noise performance. Furthermore we demonstrate a method to quantify the remaining noise contributions and present a route to enable further noise suppression. Our scheme opens the way to quantum demonstrations using a broadband memory, significantly advancing the search for scalable quantum photonic networks.Comment: 6 pages, 5 figures plus Supplementary Materia

    The Lived Experience of People with Lateral Elbow Tendinopathy – a Qualitative Study from the OPTimisE Pilot & Feasibility Trial.

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    Objectives: To explore the lived experience of people with lateral elbow tendinopathy (LET) and its impact on everyday life. Design: Qualitative semi-structured interviews, analysed using thematic analysis. Setting: Conducted as part of the mixed-methods OPTimisE pilot and feasibility randomised controlled trial of outpatient physiotherapy patients in the UK. Participants: 17 participants with LET, purposively sampled from the trial to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation. Results: Four themes were identified from the participants’ responses: (1) cause of onset—typically symptoms were attributed to: sudden changes in activity, repetitive work or compensating for other musculoskeletal conditions; (2) impact on everyday life—which included substantial impacts on quality-of-life, particularly due to pain disturbing sleep and difficulties performing daily tasks (related to work and hobbies) due to pain, although most reported being able to persevere with work; (3) self-help and understanding of the condition—with uncertainty about the appropriateness and potential harm of online advice and confusion from the diagnostic term ‘Tennis Elbow’ that non-sporting individuals struggled to relate to; (4) healthcare experiences—the treatments received were highly variable and often perceived as ineffectual. Conclusions: For the first time, the lived experience of people from a range of backgrounds suffering from LET has been explored. Findings suggest that people frequently related the cause to a specific activity. They reported substantial impacts on daily tasks, sleep, work and hobbies. People also reported hesitancy to trust online information without formal healthcare advice, were confused by the common label of ‘Tennis Elbow’, and perceived the wide array of healthcare treatment options they had received to offer false hope and be largely ineffective. This study provides stimulus for clinicians to consider the advice and treatment provided, and whether the messages conveyed reflect the favourable natural history of the condition. Trial registration number: ISRCTN6444458

    Exploring the feasibility and acceptance of an optimised physiotherapy approach for lateral elbow tendinopathy: a qualitative investigation within the OPTimisE trial

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    Objectives: To explore the acceptability of an optimised physiotherapy (OPTimisE) intervention for people with lateral elbow tendinopathy (LET) and feasibility of comparing it to usual care in a randomised controlled trial. Design: Semistructured interviews, analysed using thematic analysis and mapped onto the COM-B model of behaviour change. Setting: Conducted as part of the OPTimisE Pilot & Feasibility randomised controlled trial within physiotherapy departments in the United Kingdom National Health Service. Participants: 17 patients with LET (purposively sampled to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation) and all 8 physiotherapists involved as treating clinicians or site principal investigators. Results: Four themes were identified. First, participants reported the OPTimisE intervention as acceptable. Second, differences between the OPTimisE intervention and usual care were identified, including the use of an orthosis, holistic advice/education including modifiable risk factors, forearm stretches, general upper body strengthening and a more prescriptive exercise-dosing regimen. Third, participants provided feedback related to the trial resources, which were viewed positively, but identified language translation as a need. Fourth, feedback related to trial processes identified the need for changes to outcome collection and reduction of administrative burden. From the perspective of adopting the OPTimisE intervention, we found evidence that participants were able to change their behaviour. Considering the findings through the lens of the COM-B model, the intervention is likely to be deliverable in practice and the trial can be delivered at scale with some additional support for physiotherapists. Conclusions: Overall, the OPTimisE intervention was found to be different to usual care and acceptable to patients and physiotherapists. The study highlighted the need to refine trial processes and resources prior to a full-scale trial, to reduce administrative burden, increase support for physiotherapists, improve return rate of outcome questionnaires and provide language translation. Trial registration number: ISRCTN database 19 July 2021. https://www.isrctn.com/ISRCTN64444585