The Effect of Negative External Cues on Self-Focus and Negative Recollections of an Interaction

Social anxiety is characterized by a fear of negative evaluation and avoidance of social situations. Clark and Wells (1995) suggest that socially anxious individuals tend to self-monitor, but Rapee and Heimberg (1997) posit that this may interact with another inclination to searchfor external threat cues, which could exacerbate social anxiety. In the current study, participants were randomly assigned to one of two conditions in a conversation task. Confederates gave critical and judgmental cues in the critical condition and neutral cues in the neutral condition Results show a trend toward significance for an interaction such that socially anxious participants in the critical condition engaged in self-focused attention m ore than the low social anxiety group, while social anxiety groups had similar levels of self-focused attention in the neutral condition. In the critical condition, socially anxious individuals reported significantly fewer positive thoughts about themselves than those in the low social anxiety group

Extending Training in Multicultural Competencies to Include Individuals Identifying as Lesbian, Gay, and Bisexual: Key Choice Points for Clinical Psychology Training Programs

Traditional models of multicultural training for professional psychology have focused primarily on racial and ethnic minorities and have not included competencies focused on individuals identifying as lesbian, gay, and bisexual (LGB), despite documented evidence of health disparities for sexual minorities. Ways to adapt models based on Sue’s (1992) 3 × 3 competencies (attitudes and beliefs, knowledge, and skills across the dimensions of awareness of one’s own cultural influences and biases, understanding the client perspective, and appropriate interventions for an individual client) for LGB health are described. This includes the addition of an action/advocacy dimension. Six key choice points for clinical psychology training programs adding LGB competency to a multicultural competency training component are outlined. Potential challenges and solutions for expanding multicultural training are discussed

Opportunities and Challenges in Developing a Cryptosporidium Controlled Human infection Model For Testing antiparasitic agents

Cryptosporidiosis is a leading cause of moderate-to-severe diarrhea in low- and middle-income countries, responsible for high mortality in children younger than two years of age, and it is also strongly associated with childhood malnutrition and growth stunting. There is no vaccine for cryptosporidiosis and existing therapeutic options are suboptimal to prevent morbidity and mortality in young children. Recently, novel therapeutic agents have been discovered through high-throughput phenotypic and target-based screening strategies, repurposing malaria hits, etc., and these agents have a promising preclinical in vitro and in vivo anti

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Extending Training in Multicultural Competencies to Include Individuals Identifying as Lesbian, Gay, and Bisexual: Key Choice Points for Clinical Psychology Training Programs

Traditional models of multicultural training for professional psychology have focused primarily on racial and ethnic minorities and have not included competencies focused on individuals identifying as lesbian, gay, and bisexual (LGB), despite documented evidence of health disparities for sexual minorities. Ways to adapt models based on Sue’s (1992) 3 × 3 competencies (attitudes and beliefs, knowledge, and skills across the dimensions of awareness of one’s own cultural influences and biases, understanding the client perspective, and appropriate interventions for an individual client) for LGB health are described. This includes the addition of an action/advocacy dimension. Six key choice points for clinical psychology training programs adding LGB competency to a multicultural competency training component are outlined. Potential challenges and solutions for expanding multicultural training are discussed

Rates and Processes of Active Folding Evidenced by Pleistocene Terraces at the Central Zagros Front (Iran)

http://www.springerlink.com/content/mr0420359248741x/The Zagros fold belt results from active collision of the Arabian plate with central Iran, and is characterized by the development of a spectacular >200 km-wide fold-train in its sedimentary cover. Although the architecture of this accretionary prism has been extensively studied because of its important implications for hydrocarbon exploration, aspects such as the kinematics of individual folds and the sequence of fold development remain to be investigated in detail. It is commonly believed that the ongoing deformation through the Zagros belt has led to the south-westward migration of the front of the fold belt. In the south-western Fars province (central Zagros), the most frontal structure is delineated by the Mand anticline, a well-exposed detachment fold on the shore of the Persian Gulf. This near-symmetrical anticline involves relatively competent Phanerozoic sedimentary rocks above a regional décollement in Hormuz salt. In order to document the geometry and kinematics of this fold, we have constructed several balanced cross-sections on the basis of a recently published section constrained by seismic data (Letouzey and Sherkati, 2004). Several solutions to the length versus area restoration problem common to detachment folds are then proposed: fault-related folding, detachment folding with internal deformation, and detachment folding accompanied by the flexure of the flanking synclines below the regional stratigraphic level. On the western limb of the anticline, fluvio-marine terraces, tilted by 1.7 to 4.5°, provide an additional constraint on fold kinematics and suggest that surface deformation is most compatible with a detachment fold, probably associated with synclinal flexure. Applying such a model, as well as new 14C ages for the marine terrace deposits, we calculate tilting rates of 0.04 to 0.05°/kyr, which would be produced by a Late Pleistocene shortening rate (perpendicular to the structure) of 3 to 4 mm/yr. Although this preliminary estimate suffers from relatively large uncertainties, mostly due to the absence of independent dating of the terraces and independent constraints on the folding model, we conclude that shortening across the Mand anticline could absorb 20 to 35% of the 8 mm/yr convergence across the entire Zagros. This result is consistent with a normal forward-propagating deformation sequence in a thin-skinned tectonic regime. It also implies that the sedimentary cover of the frontal Zagros is fully decoupled from the basement, most probably at the level of the Hormuz salt, in contrast to recent models that suggested active deformation of the sedimentary cover to be controlled by thrust faults in the basement