Reducing Eating Disorder Risk Factors: A Controlled Investigation of a Blended Task-Shifting/Train-the-Trainer Approach to Dissemination and Implementation

Recent advances in psychological intervention research have led to an increase in evidence-based interventions (EBIs), yet there remains a lag in dissemination and implementation of EBIs. Task-shifting and the train-the-trainer (TTT) model offer two potential strategies for enhancing reach of EBIs. The Body Project, an EBI found to prevent onset of eating disorders, served as the vehicle for this dissemination/implementation study. The primary aim of this study was to determine if training of peer-leaders for the Body Project could be task-shifted to undergraduate students using a hybrid task-shifting/TTT model. Our secondary aim was to determine if subgroups of participants evidenced different trajectories of change through 14-month follow-up. Regarding the first aim, we found almost no evidence to suggest that a presence of a doctoral-level trainer yielded superior participant outcomes compared to training by undergraduates alone. Regarding Aim 2, almost all classes for all variables evidenced improvement or a benign response. Additionally, for three key risk factors (thin-ideal internalization, body dissatisfaction, and ED symptoms) virtually all trajectories showed improvement. This study provides initial support for the use of a blended task-shifting/TTT approach to dissemination and implementation within prevention generally, and further support for broad dissemination of the Body Project specifically

Reducing Eating Disorder Risk Factors: A Controlled Investigation of a Blended Task-Shifting/Train-the-Trainer Approach to Dissemination and Implementation

Recent advances in psychological intervention research have led to an increase in evidence-based interventions (EBIs), yet there remains a lag in dissemination and implementation of EBIs. Task-shifting and the train-the-trainer (TTT) model offer two potential strategies for enhancing reach of EBIs. The Body Project, an EBI found to prevent onset of eating disorders, served as the vehicle for this dissemination/implementation study. The primary aim of this study was to determine if training of peer-leaders for the Body Project could be task-shifted to undergraduate students using a hybrid task-shifting/TTT model. Our secondary aim was to determine if subgroups of participants evidenced different trajectories of change through 14-month follow-up. Regarding the first aim, we found almost no evidence to suggest that a presence of a doctoral-level trainer yielded superior participant outcomes compared to training by undergraduates alone. Regarding Aim 2, almost all classes for all variables evidenced improvement or a benign response. Additionally, for three key risk factors (thin-ideal internalization, body dissatisfaction, and ED symptoms) virtually all trajectories showed improvement. This study provides initial support for the use of a blended task-shifting/TTT approach to dissemination and implementation within prevention generally, and further support for broad dissemination of the Body Project specifically

Representations of the Canonical group, (the semi-direct product of the Unitary and Weyl-Heisenberg groups), acting as a dynamical group on noncommuting extended phase space

The unitary irreducible representations of the covering group of the Poincare group P define the framework for much of particle physics on the physical Minkowski space P/L, where L is the Lorentz group. While extraordinarily successful, it does not provide a large enough group of symmetries to encompass observed particles with a SU(3) classification. Born proposed the reciprocity principle that states physics must be invariant under the reciprocity transform that is heuristically {t,e,q,p}->{t,e,p,-q} where {t,e,q,p} are the time, energy, position, and momentum degrees of freedom. This implies that there is reciprocally conjugate relativity principle such that the rates of change of momentum must be bounded by b, where b is a universal constant. The appropriate group of dynamical symmetries that embodies this is the Canonical group C(1,3) = U(1,3) *s H(1,3) and in this theory the non-commuting space Q= C(1,3)/ SU(1,3) is the physical quantum space endowed with a metric that is the second Casimir invariant of the Canonical group, T^2 + E^2 - Q^2/c^2-P^2/b^2 +(2h I/bc)(Y/bc -2) where {T,E,Q,P,I,Y} are the generators of the algebra of Os(1,3). The idea is to study the representations of the Canonical dynamical group using Mackey's theory to determine whether the representations can encompass the spectrum of particle states. The unitary irreducible representations of the Canonical group contain a direct product term that is a representation of U(1,3) that Kalman has studied as a dynamical group for hadrons. The U(1,3) representations contain discrete series that may be decomposed into infinite ladders where the rungs are representations of U(3) (finite dimensional) or C(2) (with degenerate U(1)* SU(2) finite dimensional representations) corresponding to the rest or null frames.Comment: 25 pages; V2.3, PDF (Mathematica 4.1 source removed due to technical problems); Submitted to J.Phys.

Coherent States of SU(l,1)SU(l,1) groups

This work can be considered as a continuation of our previous one (J.Phys., 26 (1993) 313), in which an explicit form of coherent states (CS) for all SU(N) groups was constructed by means of representations on polynomials. Here we extend that approach to any SU(l,1) group and construct explicitly corresponding CS. The CS are parametrized by dots of a coset space, which is, in that particular case, the open complex ball $CD^{l}$. This space together with the projective space $CP^{l}$, which parametrizes CS of the SU(l+1) group, exhausts all complex spaces of constant curvature. Thus, both sets of CS provide a possibility for an explicit analysis of the quantization problem on all the spaces of constant curvature.Comment: 22 pages, to be published in "Journal of Physics A

What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme

<b>Background</b> Preventive approaches to health are disproportionately accessed by the more affluent and recent health improvement policy advocates the use of targeted preventive primary care to reduce risk factors in poorer individuals and communities. Outreach has become part of the health service response. Outreach has a long history of engaging those who do not otherwise access services. It has, however, been described as eclectic in its purpose, clientele and mode of practice; its effectiveness is unproven. Using a primary prevention programme in the UK as a case, this paper addresses two research questions: what are the perceived problems of non-engagement that outreach aims to address; and, what specific mechanisms of outreach are hypothesised to tackle these.<p></p> <b>Methods</b> Drawing on a wider programme evaluation, the study undertook qualitative interviews with strategically selected health-care professionals. The analysis was thematically guided by the concept of 'candidacy' which theorises the dynamic process through which services and individuals negotiate appropriate service use.<p></p> <b>Results</b> The study identified seven types of engagement 'problem' and corresponding solutions. These 'problems' lie on a continuum of complexity in terms of the challenges they present to primary care. Reasons for non-engagement are congruent with the concept of 'candidacy' but point to ways in which it can be expanded.<p></p> <b>Conclusions</b> The paper draws conclusions about the role of outreach in contributing to the implementation of inequalities focused primary prevention and identifies further research needed in the theoretical development of both outreach as an approach and candidacy as a conceptual framework

Substance abusers' personality disorders and staff members' emotional reactions

<p>Abstract</p> <p>Background</p> <p>Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD) may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions.</p> <p>Methods</p> <p>Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations.</p> <p>Results</p> <p>Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions.</p> <p>Conclusion</p> <p>The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.</p