The relationship between working alliance with peer mentors and eating psychopathology in a digital 6-week guided self-help intervention for anorexia nervosa

Objective: The quality of working alliance (WA) is associated with treatment outcomes across several types of psychiatric disorders and psychological interventions. This study examined the role of WA with peer mentors (people with lived experience of illness) and student mentors (graduated psychology students) in a 6-week, digital, guided self-help (GSH) intervention for anorexia nervosa. Method: Ninety-nine patients rated weekly, for 6 weeks: (a) eating psychopathology using the short version of the Eating Disorder Examination Questionnaire (EDE-QS) and (b) WA with a student mentor (n = 14) or a peer mentor (n = 10). WA was assessed by asking patients the extent to which they felt comfortable working with their mentor and the extent to which they agreed with them on the goals for support. WA with mentors and the association with eating psychopathology change were measured on a session-by-session basis. The analysis involved a random intercepts cross-lagged panel model. Results: WA with peer mentors was slightly higher than WA with students (ES = 0.3). Peer mentors' WA in the previous session was significantly associated with eating psychopathology ratings in the next session. No significant relationship was found between the previous session's EDE-QS scores and peer mentor alliance in the following session. In the student mentor group, there were no session-by-session associations between WA and eating psychopathology. However, greater WA with the student mentor across sessions was associated with less eating psychopathology. Discussion: These findings suggest that clinical outcomes are in part associated with the characteristics of the mentor delivering guidance in an online GSH for eating disorders

The Feasibility of Using Guided Self-Help in Anorexia Nervosa: An Analysis of Drop-Out From the Study Protocol and Intervention Adherence

The implementation of online technologies to promote wellbeing is increasingly becoming a worldwide priority. This study includes secondary analyses of data and examined drop-out rates in an online guided self-help intervention for patients with anorexia nervosa. Specifically, rates of drop-out at end of treatment (i.e., 6 weeks assessment), as well as intervention adherence (minimum of four of six online guided sessions) and differences between completers and drop-outs were examined. Motivation to change and associated patient variables were assessed as predictors of drop-out using structural equation modeling. Ninety-nine patients were randomized to the intervention arm of the trial. Data were available for 82 individuals, 67 of whom completed the 6 weeks assessment and attended a minimum of four online sessions. No significant differences were found between completers and drop-outs at baseline. At the end of the first week of participation, drop-outs from the 6 weeks assessment or the intervention reported less satisfaction with their work with the mentor delivering online guidance. Greater confidence in own ability to change and higher controlled motivation (willingness to change due to pressure from others) predicted lower drop-out rates from the 6 weeks assessment. Stronger alliance with the therapist at the treatment center and lower psychological distress were associated with greater autonomous motivation (self-directed motivation) and importance and ability to change. Data demonstrate that a novel online guided self-help intervention for patients with anorexia nervosa is feasible. Early satisfaction with the program and external pressure to change have a protective role against drop-out rates. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02336841

Free-text keystroke dynamics authentication for Arabic language

This study introduces an approach for user authentication using free-text keystroke dynamics which incorporates text in Arabic language. The Arabic language has completely different characteristics to those of English. The approach followed in this study involves the use of the keyboard's key-layout. The method extracts timing features from specific key-pairs in the typed text. Decision trees were exploited to classify each of the users' data. In parallel for comparison, support vector machines were also used for classification in association with an ant colony optimisation feature selection technique. The results obtained from this study are encouraging as low false accept rates and false reject rates were achieved in the experimentation phase. This signifies that satisfactory overall system performance was achieved by using the typing attributes in the proposed approach, while typing Arabic text

CHANGING TRENDS IN MICROBIAL FLORA AND THEIR ANTIBIOTIC SENSITIVITY

Microbial resistance is a burning issue in the medical world from last few decades. Irrationale use of antibiotics in the treatment of infectious diseases has led to emergence of resistant strains of microorganisms; incapacitating the most potent weapon against infections. Thus, the present study was conducted to evaluate the trends in microbial flora and their antibiotic sensitivity. A retrospective study of five hundred twelve patients admitted in various hospitals attached to Dr. S. N Medical College, Jodhpur with various infections was conducted. The blood culture reports were screened to study microbial organisms and their antibiotic sensitivity pattern. The most common organisms isolated were staph aureus accounting for 29.5% of the isolates and followed by Klebsiella (13.87%), Enterococci (7.81%) and Citrobacter (7.42%). At the end of the study, it was observed that there were constant changes in the pattern of organisms and antibiotics in patients. Based on this study, it is suggested that before prescribing antibiotics, clinicians should be aware of recent trends of prevalent organisms and their sensitivity patterns. This would reduce emergence of resistant organisms and favour patient’s wellbeing

Orthorexic tendencies are linked with difficulties with emotion identification and regulation.

Background: Orthorexia nervosa (ON) is characterised by an unhealthy obsession with healthy eating and while it is not recognised as an eating disorder (or any disorder), current research is exploring similarities and differences with such disorders. The literature has shown that individuals with eating disorders have difficulties identifying and describing emotions (known as alexithymia) as well as regulating them. However no research to date has looked at whether people with orthorexic tendencies also suffer from difficulties with emotions. In this paper, we refer to people with orthorexic tendencies but do not assume that their healthy eating is at a pathological level needing clinical attention. Methods: The current study examined this by asking 196 healthy adults with an interest in healthy eating to complete four questionnaires to measure ON (ORTO-15 - reduced to ORTO-7CS), eating psychopathology (EAT-26), alexithymia (TAS-20) and emotion dysregulation (DERS-16). Results: We found that difficulties identifying and regulating emotions was associated with symptoms of ON, similar to what is found in other eating disorders. We suggest that ON behaviours may be used as a coping strategy in order to feel in control in these participants who have poor emotion regulation abilities. Conclusions: Our results show that individuals with ON tendencies may share similar difficulties with emotions compared to other eating disorders. While important, our results are limited by the way we measured ON behaviours and we recommend that further research replicate our findings once a better and more specific tool is developed and validated to screen for ON characteristics more accurately

Time-dependent 3D spectrum synthesis for type Ia supernovae

A Monte Carlo code (ARTIS) for modelling time-dependent three-dimensional spectral synthesis in chemically inhomogeneous models of Type Ia supernova ejecta is presented. Following the propagation of gamma-ray photons, emitted by the radioactive decay of the nucleosynthesis products, energy is deposited in the supernova ejecta and the radiative transfer problem is solved self-consistently, enforcing the constraint of energy conservation in the co-moving frame. Assuming a photoionisation dominated plasma, the equations of ionisation equilibrium are solved together with the thermal balance equation adopting an approximate treatment of excitation. Since we implement a fully general treatment of line formation, there are no free parameters to adjust. Thus a direct comparison between synthetic spectra and light curves, calculated from hydrodynamic explosion models, and observations is feasible. The code is applied to the well known W7 explosion model and the results tested against other studies. Finally the effect of asymmetric ejecta on broad band light curves and spectra is illustrated using an elliptical toy model.Comment: 20 pages, 13 figures. Accepted for publication by MNRA

Binary systems and their nuclear explosions

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