A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions.

This author manuscript is made available following 12 month embargo from the date of publication (March 8 2016) in accordance with publisher copyright policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s12529-016-9556-9.PURPOSE: A key issue regarding the provision of psychological therapy in a self-guided online format is low rates of adherence. The aim of this systematic review was to assess both quantitative and qualitative data on the predictors of adherence, as well as participant reported reasons for adhering or not adhering to online psychological interventions. METHODS: Database searches of PsycINFO, Medline, and CINAHL identified 1721 potentially relevant articles published between 1 January 2000 and 25 November 2015. A further 34 potentially relevant articles were retrieved from reference lists. Articles that reported predictors of, or reasons for, adherence to an online psychological intervention were included. RESULTS: A total of 36 studies met the inclusion criteria. Predictors assessed included demographic, psychological, characteristics of presenting problem, and intervention/computer-related predictors. Evidence suggested that female gender, higher treatment expectancy, sufficient time, and personalized intervention content each predicted higher adherence. Age, baseline symptom severity, and control group allocation had mixed findings. The majority of assessed variables however, did not predict adherence. CONCLUSIONS: Few clear predictors of adherence emerged overall, and most results were either mixed or too preliminary to draw conclusions. More research of predictors associated with adherence to online interventions is warranted

Regulation of chemokine expression in human airway smooth muscle cells

Asthma is an inflammatory disease of the airways characterised by airway remodelling and hyperresponsiveness. New treatments are needed for patients with severe asthma whose disease is not controlled with currently available therapies. Asthma pathophysiology is complex, however, accumulating evidence suggests multiple inflammatory pathways in asthma converge onto a relatively small number of downstream targets that may be of therapeutic interest. These include mitogen activated protein kinases (MAPKs), the pro-inflammatory transcription factors nuclear factor-kappaB (NF-kappaB) and activator protein-1 (AP-1) and transcriptional regulators such as histone acetyl transferases (HATs) and histone deacetylases (HDACs). Chemokines are molecules secreted at sties of inflammation, attracting inflammatory cells and perpetuating the inflammatory response. Here we studied the mechanisms by which the pro-inflammatory mediator endothelin-1 (ET-1) and the cytokine tumour necrosis factor-alpha (TNF-alpha) promoted expression by primary human airway smooth muscle cells (HASMC) of two important chemokines, monocyte chemotactic protein-1 (MCP-1) and eotaxin. Further, we studied the mechanisms by which existing asthma therapies (long acting beta agonists (LABA) and glucocorticoids) modulated TNF-alpha-stimulated eotaxin expression. Endothelin-1 stimulated MCP-1 release through a transcriptional mechanism involving NF-kappaB and AP-1; the upstream signalling pathway involved p38 and p44/p42 MAPKs. Previously, this lab showed that TNF-alpha-induced eotaxin release is also NF-kappaB-dependent, involving histone H4 acetylation at the eotaxin promoter. Here we found that TNF-alpha-induced eotaxin release does not involve histone H3 acetylation, and that TNF-alpha-dependent histone H4 acetylation does not occur through alterations in total histone activity or levels of the key HDACs -1 and -2. Similarly, modulation of TNF-alpha effects on eotaxin expression by glucocorticoids and LABA is independent of total HDAC activity and HDAC-1 and -2 levels. These studies support the body of evidence suggesting that multiple inflammatory pathways in asthma converge onto a small number of downstream targets, and are relevant to the understanding and treatment of asthma

A qualitative exploration of barriers and facilitatorsto adherence to an online self-help intervention for cancer-related distress

This author accepted manuscript is made available following 12 month embargo from date of publication (March 2017) in accordance with the publisher’s copyright policyObjective This study qualitatively explored barriers and facilitators of adherence to an online psychological intervention for cancer-related distress. Methods Semi-structured interviews were conducted with 13 adults with cancer, randomised to receive either a 6-week intervention (n = 8) or attention control (n = 5) as part of a larger RCT. Transcripts were coded for themes and subthemes, and recruitment ceased when saturation of themes occurred. Results Adherence overall was high: six participants completed all six modules, three completed five modules, two completed four modules, one completed one module, and one did not access the program. The total numbers of barriers (n = 19) and facilitators (n = 17) identified were equivalent and were categorised into five overarching themes: illness factors, psychological factors, personal factors, intervention factors and computer factors. However, the prevalence with which themes were discussed differed: illness factors (specifically cancer treatment side effects) were the main reported barrier to adherence; intervention factors (email reminders, program satisfaction, ease of use, program content) were the most common facilitators. Conclusion While some factors were cited as both facilitating and barring adherence, and therefore reflective of personal preferences and circumstances, a number of recommendations were derived regarding (i) the best timing for online interventions and (ii) the need for multi-platform programs

The Assessment of the Intrasubject Variability in Digoxin Absorption in Man from Two Oral Dosage Forms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97194/1/j.1552-4604.1981.tb01771.x.pd

Molecular Breeding of Transgenic Virus-Immune White Clover (\u3cem\u3eTrifolium Repens\u3c/em\u3e) Cultivars

White clover (T. repens L.) is a major component of improved pastures throughout the temperate world. It is, however, highly susceptible to virus infection. Alfalfa mosaic virus (AMV), clover yellow vein virus (CYVV) and white clover mosaic virus (WCMV) all contribute to a significant reduction in dry matter yield and persistence of white clover. Sources of natural resistance to AMV in white clover or sexually compatible species are not available. Pathogen-derived resistance strategies, such as the expression of viral coat protein in transgenic plants, thus provides opportunities for the development of virus immune transgenic white clover

Cradle to grave GHG emissions analysis of shale gas hydraulic fracking in Western Australia

Western Australia has globally significant onshore gas resources, with over 280 trillion cubic feet of economically recoverable gas located in five shale basins. The Western Australian Government and gas industry have promoted the development of these resources as a “clean energy source” that would “help to reduce global carbon emissions” and provide a “transition fuel” to a low carbon economy. This research examines those claims by reviewing existing literature and published data to estimate the life cycle greenhouse gas (GHG) pollution that would result from the development of Western Australia’s onshore gas basins using hydraulic fracking. Estimates of carbon pollution from each stage in gas development, processing, transport and end-use are considered in order to establish total life-cycle emissions in tonnes of carbon-dioxide equivalent (CO2e). The emissions estimates draw from published research on emissions from shale gas development in other jurisdictions as well as industry or government reported emissions from current technology for gas processing and end-use as applicable. The current policy and regulatory environment for carbon pollution and likely resulting GHG mitigation measures has also been considered, as well as the potential for the gas to displace or substitute for other energy sources. In areas where there is uncertainty, conservative emissions estimates have been used. Modelling of GHG emissions has been undertaken for two comparison resource development and utilisation scenarios; Australian domestic and 100% export i.e. no domestic use. Each scenario corresponds to a different proportionate allocation of emissions accounted for domestic emissions in Australia and emissions accounted for in other jurisdictions. Emissions estimates for the two scenarios are 245–502 MTCO2e/year respectively over a resource development timeframe of 20 years. This is roughly the same as Australia’s total GHG emissions in 2014 which were 525 MTCO2e/year. This research concludes that GHG emissions resulting from the development of Western Australia’s five onshore gas basins would be equivalent to all other Australian emissions sources combined at 2014 levels each year for 20 years which is the general lifetime of a well

Uptake and adherence to an online intervention for cancer-related distress: older age is not a barrier to adherence but may be a barrier to uptake

Purpose: While online interventions are increasingly explored as an alternative to therapist-based interventions for cancer-related distress, limitations to efficacy potentially include low uptake and adherence. Few predictors of uptake or adherence to online interventions have been consistently identified, particularly in individuals with cancer. This study examined rates and predictors of uptake and adherence to Finding My Way, a RCT of an online intervention versus an information-only online control for cancer-related distress. Methods: Participants were adults with cancer treated with curative intent. Adherence was assessed by login frequency, duration and activity level; analyses examined demographic, medical and psychological predictors of uptake and adherence. Results: The study enrolled 191 adults (aged 26–94 years) undergoing active treatment for cancer of any type. Uptake was highest for females and for individuals with ovarian (80%) and breast cancer (49.8%), and lowest for those with melanoma (26.5%). Adherence was predicted by older age and control-group allocation. Baseline distress levels did not predict adherence. High adherers to the full intervention had better emotion regulation and quality of life than low adherers. Conclusions: Uptake of online intervention varies according to age, gender and cancer type. While uptake was higher amongst younger individuals, once enrolled, older individuals were more likely to adhere to online interventions for cancer-related distressThis work was conducted as part of a larger clinical trial, supported by the National Health and Medical Research Council (grant number 1042942)