Evidence for feasibility of implementing online brief cognitive‐behavioral therapy for eating disorder pathology in the workplace

Objective: CBT-T is a brief (10-week) cognitive-behavioral therapy for non-underweight eating disorders. This report describes the findings from a single center, single group, feasibility trial of online CBT-T in the workplace as an alternative to health service settings. Method: This trial was approved by the Biomedical and Scientific Research Ethics committee, University of Warwick, UK (reference 125/20-21) and was registered with ISRCTN (reference number: ISRCTN45943700). Recruitment was based on self-reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who have not previously sought help and for those with sub-threshold eating disorder symptoms. Assessments took place at baseline, mid-treatment (week 4), post-treatment (week 10), and follow-up (1 and 3 months post-treatment). Participant experiences following treatment were assessed using quantitative and qualitative approaches. Results: For the primary outcomes, pre-determined benchmarks of high feasibility and acceptability were met, based on recruiting >40 participants (N = 47), low attrition (38%), and a high attendance rate (98%) over the course of the therapy. Participant experiences revealed low previous help-seeking for eating disorder concerns (21%). Qualitative findings indicated a wide range of positive impacts of the therapy and the workplace as the therapeutic setting. Analysis of secondary outcomes for participants with clinical and sub-threshold eating disorder symptoms showed strong effect sizes for eating pathology, anxiety and depression, and moderate effect sizes for work outcomes. Discussion: These pilot findings provide a strong rationale for a fully powered randomized controlled trial to determine the effectiveness of CBT-T in the workplace. Public Significance: This study demonstrates the feasibility of implementing an eating disorders intervention (online CBT-T) in the workplace as an alternative to traditional healthcare settings. Recruitment was based on self-reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who had not previously sought help. The data also provide insights into recruitment, acceptability, effectiveness, and future viability of CBT-T in the workplace

Model- and calibration-independent test of cosmic acceleration

We present a calibration-independent test of the accelerated expansion of the universe using supernova type Ia data. The test is also model-independent in the sense that no assumptions about the content of the universe or about the parameterization of the deceleration parameter are made and that it does not assume any dynamical equations of motion. Yet, the test assumes the universe and the distribution of supernovae to be statistically homogeneous and isotropic. A significant reduction of systematic effects, as compared to our previous, calibration-dependent test, is achieved. Accelerated expansion is detected at significant level (4.3 sigma in the 2007 Gold sample, 7.2 sigma in the 2008 Union sample) if the universe is spatially flat. This result depends, however, crucially on supernovae with a redshift smaller than 0.1, for which the assumption of statistical isotropy and homogeneity is less well established.Comment: 13 pages, 2 figures, major change

A feasibility study of the delivery of online brief cognitive-behavioral therapy (CBT-T) for eating disorder pathology in the workplace

Objective CBT-T is a brief (10 sessions) version of cognitive behavioral therapy for non-underweight eating disorders. This report describes the protocol for a single center, single group, feasibility trial of online CBT-T in the workplace as an alternative to the health-service setting. By offering mental health services for eating disorders in the workplace, greater accessibility and increased help-seeking behaviors could be achieved. Method Treatment will be delivered online over 10 weeks and offered to employees based on self-referral rather than meeting diagnostic criteria, making treatment available to employees with sub-threshold eating disorder symptoms. Results Assessments will be conducted at baseline, mid-treatment (week 4), posttreatment (week 10) and at follow-up (1 month and 3 months posttreatment). For the primary outcome, measures will include recruitment, attrition and attendance data using pre-set benchmarks to determine high, medium or low feasibility and acceptability. Qualitative participant experiences data will be analyzed using thematic analysis. Impact on work engagement and effect sizes will be determined from secondary outcome measures; the latter enabling sample size calculations for future study. Discussion These pilot data will provide insights to recruitment, acceptability, effectiveness and viability of a future fully powered clinical trial of online CBT-T in the workplace. Public Significance Statement This study will present feasibility data from an eating disorders intervention (online CBT-T) using the workplace as an alternative to the healthcare setting to recruit and treat workers. Recruitment will be based on self-reported eating and weight concerns rather than diagnosis potentially enabling treatment to employees who have not previously sought help. The data will also provide insights to recruitment, acceptability, effectiveness, and future viability of CBT-T in the workplace

Digital cognitive behavioural therapy intervention in the workplace:study protocol for a feasibility randomised waitlist-controlled trial to improve employee mental well-being, engagement and productivity

INTRODUCTION: One in six workers experience some form of mental health problems at work costing the UK economy an estimated £70 billion/year. Digital interventions provide low cost and easily scalable delivery methods to implement psychological interventions in the workplace. This trial tests the feasibility of implementing a self-guided 8-week digital cognitive behavioural therapy intervention for subthreshold to clinical depression and/or anxiety versus waitlist control (ie, life as usual) in the workplace. METHODS AND ANALYSIS: Feasibility of implementation will be tested using a mixed-methods evaluation of the two-arm randomised waitlist-control trial. Evaluation will include examination of organisational buy-in, and the engagement of employees through the trial indicated by the completion of outcome measures. In addition, we also explore how participants use the platform, the appropriateness of the analysis both with reference to the outcome measures and linear modelling. Finally, we examine the acceptability of the intervention based on participants experiences using qualitative interviews. Assessments take place at baseline (T0), at 8 weeks post-treatment (T1), at short-term follow-up 4 weeks post-treatment (T2) and long-term follow-ups (6 and 12 months after-end of treatment). We will recruit from 1 July 2021 to 31 December 2021 for employees and self-employed workers with depression and anxiety symptoms (subclinical and clinical levels) who are not seeking or engaged in treatment at the time of the trial. ETHICS AND DISSEMINATION: Full approval was given by the University of Warwick Biomedical and Research Ethics Committee (BSREC 45/20–21). The current protocol version is 2.8 (August 2021). Publication of results in peer-reviewed journals will inform the scientific, clinical and business communities. We will disseminate results through webinars, conferences, newsletter as well as a lay summary of results on the study website (mhpp.me). TRIAL REGISTRATION NUMBER: ISRCTN31161020

Model-Independent Reconstruction of the Expansion History of the Universe from Type Ia Supernovae

Based on the largest homogeneously reduced set of Type Ia supernova luminosity data currently available -- the Union2 sample -- we reconstruct the expansion history of the Universe in a model-independent approach. Our method tests the geometry of the Universe directly without reverting to any assumptions made on its energy content. This allows us to constrain Dark Energy models and non-standard cosmologies in a straightforward way. The applicability of the presented method is not restricted to testing cosmological models. It can be a valuable tool for pointing out systematic errors hidden in the supernova data and planning future Type Ia supernova cosmology campaigns.Comment: 10 pages, 8 figures, to be published in Montly Notices of the Royal Astronomical Societ

Educational and vocational goal disruption in adolescent and young adult cancer survivors

ObjectiveCancer in adolescents and young adults (AYAs) can interrupt important developmental milestones. Absence from school and time lost from work, together with the physical impacts of treatment on energy and cognition, can disrupt educational and vocational goals. The purpose of this paper is to report on AYA cancer survivors’ experiences of reintegration into school and/or work and to describe perceived changes in their educational and vocational goals.MethodsAdolescents and young adults recruited from 7 hospitals in Australia, aged 15 to 26 years and â ¤24 months posttreatment, were interviewed using the psychosocial adjustment to illness scale. Responses were analysed to determine the extent of, and explanations for, cancer’s effect on school/work.ResultsFortyâ two AYA cancer survivors (50% female) participated. Compared with their previous vocational functioning, 12 (28.6%) were scored as experiencing mild impairment, 14 (33.3%) moderate impairment, and 3 (7.1%) marked impairment. Adolescents and young adults described difficulties reintegrating to school/work as a result of cognitive impacts such as concentration problems and physical impacts of their treatment, including fatigue. Despite these reported difficulties, the majority indicated that their vocation goals were of equal or greater importance than before diagnosis (26/42; 62%), and most AYAs did not see their performance as compromised (23/42; 55%). Many survivors described a positive shift in life goals and priorities. The theme of goal conflict emerged where AYAs reported compromised abilities to achieve their goals.ConclusionsThe physical and cognitive impacts of treatment can make returning to school/work challenging for AYA cancer survivors. Adolescents and young adults experiencing difficulties may benefit from additional supports to facilitate meaningful engagement with their chosen educational/vocational goals.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142495/1/pon4525_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142495/2/pon4525.pd

Probing the Cosmic Distance Duality Relation with the Sunyaev-Zeldovich Effect, X-rays Observations and Supernovae Ia

The angular diameter distances toward galaxy clusters can be determined with measurements of the Sunyaev-Zel'dovich effect and X-ray surface brightness combined with the validity of the distance-duality relation, $D_L(z) (1 + z)^{2}/D_{A}(z) = 1$, where $D_L(z)$ and $D_A(z)$ are, respectively, the luminosity and angular diameter distances. This combination enables us to probe galaxy cluster physics or even to test the validity of the distance-duality relation itself. We explore these possibilities based on two different, but complementary approaches. Firstly, in order to constrain the possible galaxy cluster morphologies, the validity of the distance-duality relation (DD relation) is assumed in the $\Lambda$CDM framework (WMAP7). Secondly, by adopting a cosmological-model-independent test, we directly confront the angular diameters from galaxy clusters with two supernovae Ia (SNe Ia) subsamples (carefully chosen to coincide with the cluster positions). The influence of the different SNe Ia light-curve fitters in the previous analysis are also discussed. We assumed that $\eta$ is a function of the redshift parametrized by two different relations: $\eta(z) = 1 + \eta_{0}z$, and $\eta(z)=1 + \eta_{0}z/(1+z)$, where $\eta_0$ is a constant parameter quantifying the possible departure from the strict validity of the DD relation. The statistical analysis presented here provides new evidence that the true geometry of clusters is elliptical. We find that the two-light curve fitters (SALT2 and MLCS2K2) present a statistically significant conflict, and a joint analysis involving the different approaches suggests that clusters are endowed with an elliptical geometry as previously assumed.Comment: 33 pages, 15 figures, some typos corrected, accepted for publication in the Astronomy \& Astrophysic