A BUDDHIST-INFORMED CONCEPTUAL FRAMEWORK FOR APPROACHING DIFFICULT EMOTIONS IN PSYCHOTHERAPY

Clients often enter psychotherapy with struggles and concerns related to their direct experience of emotion. Though most of the major psychotherapy theories in the West address the general issue of emotion, very few have developed a framework or theory for supporting clients in their direct encounters with difficult feeling states. Since Buddhism is highly experiential and Buddhist philosophy is mainly concerned with the issue of human suffering, its relevance to maneuvering difficult emotions in a clinical context is profound. While the use of Buddhist concepts and practices in mental health treatment in the West has proliferated in recent years, the clinical use of Buddhist material has often bypassed the larger philosophical framework of Buddhism. This secular, decontextualized use of Buddhist material has limited the potential value of Buddhist philosophy in mental health treatment. This dissertation offers a conceptual framework for approaching difficult emotions that is grounded in the wisdom of Buddhism. Zen Buddhism is especially relied upon in the development of the following themes: Sitting With, Middle Path, Healthy Interdependency, and Compassion. Further, clinical composite case vignettes are presented to demonstrate how the themes can be worked with in a therapeutic context

Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis to Inform Strategies for Mitigation

Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients\u27 experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation. Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework. Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean age was 46 years. Diagnoses ranged from ductal carcinoma in situ to metastatic breast cancer. Concordant with an established framework, we found that direct and indirect costs determined objective financial burden and subjective financial distress stemmed from psychosocial, behavioral, and material impact of diagnosis and treatment. We identified expectations as a novel theme affecting financial toxicity. We identified knowledge gaps in treatment expectations, provider conversations, identification of resources, and support-finding and offer strategies for mitigating financial toxicity on the basis of participant responses, such as leveraging support from decision aids and allied providers. This qualitative study confirms an existing framework for understanding financial toxicity and identifies treatment expectations as a novel theme affecting both objective financial burden and subjective financial distress. Four knowledge gaps are identified, and strategies for mitigating financial toxicity are offered. Mitigating patients\u27 financial toxicity is an important unmet need in optimizing cancer treatment

Characterisation of silicon strip detectors with a binary readout chip for X-ray imaging

In this paper we describe the development of a multichannel readout system for X-ray measurements using silicon strip detectors. The developed system is based on a binary readout architecture and optimised for detection of X-rays of energies in the range 6}30 keV. The critical component of the system is the 32-channel front-end chip, RX32N, which has been optimised for low noise performance, small channel to channel variation and high counting rate operation. The performance of the chip is demonstrated by measurements of complex X-ray spectra using silicon strip and pad detectors. The obtained results allow to use the system at room temperature with the detection threshold in the range from 500 to 10 000 electrons, which is enough in many crystallographic and medical imaging applications. ( 2000 Elsevier Scienc

SDWFS-MT-1: A Self-Obscured Luminous Supernova at z~0.2

We report the discovery of a six-month-long mid-infrared transient, SDWFS-MT-1 (aka SN 2007va), in the Spitzer Deep, Wide-Field Survey of the NOAO Deep Wide-Field Survey Bootes field. The transient, located in a z=0.19 low luminosity (M_[4.5]~-18.6 mag, L/L_MilkyWay~0.01) metal-poor (12+log(O/H)~7.8) irregular galaxy, peaked at a mid-infrared absolute magnitude of M_[4.5]~-24.2 in the 4.5 micron Spitzer/IRAC band and emitted a total energy of at least 10^51 ergs. The optical emission was likely fainter than the mid-infrared, although our constraints on the optical emission are poor because the transient peaked when the source was "behind" the Sun. The Spitzer data are consistent with emission by a modified black body with a temperature of ~1350 K. We rule out a number of scenarios for the origin of the transient such as a Galactic star, AGN activity, GRB, tidal disruption of a star by a black hole and gravitational lensing. The most plausible scenario is a supernova exploding inside a massive, optically thick circumstellar medium, composed of multiple shells of previously ejected material. If the proposed scenario is correct, then a significant fraction (~10%) of the most luminous supernova may be self-enshrouded by dust not only before but also after the supernova occurs. The spectral energy distribution of the progenitor of such a supernova would be a slightly cooler version of eta Carina, peaking at 20-30 microns.Comment: 26 pages, 5 figures, 1 table, accepted for publication in Ap