Therapist-Guided Practical Skills in the Treatment of Complex Dissociation

The Contextual Trauma Therapy (CTT) model includes a collaborative relationship, client-guided conceptualization, and therapist-guided practical skills. This workshop will discuss the application of therapist-guided skills for complex dissociation: 1) promoting a safe and stabile therapeutic setting, 2) improving emotion regulation, distress tolerance, and experiential presence, 3) therapist modeling of skills in session, and 4) collaborating with clients to foster utilization of skills beyond sessions. Presenters will provide examples of applications of this CTT component, benefits when clients incorporate consistent practice of these skills, and challenges associated with encouraging clients to extend the use of these skills in their personal lives

Primary care patients in psychiatric clinical trials: a pilot study using videoconferencing

<p>Abstract</p> <p>Background</p> <p>While primary care physicians play a pivotal role in the treatment of depression, collaboration between primary care and psychiatry in clinical research has been limited. Primary care settings provide unique opportunities to improve the methodology of psychiatric clinical trials, by providing more generalizable and less treatment-resistant patients. We examined the feasibility of identifying, recruiting, screening and assessing primary care patients for psychiatric clinical trials using high-quality videoconferencing in a mock clinical trial.</p> <p>Methods</p> <p>1329 patients at two primary care clinics completed a self-report questionnaire. Those screening positive for major depression, panic, or generalized anxiety were given a diagnostic interview via videoconference. Those eligible were provided treatment as usual by their primary care physician, and had 6 weekly assessments by the off-site clinician via videoconferencing.</p> <p>Results</p> <p>45 patients were enrolled over 22 weeks, with 36 (80%) completing the six-week study with no more than two missed appointments. All diagnostic groups improved significantly; 94% reported they would participate again, 87% would recommend participation to others, 96% felt comfortable communicating via videoconference, and 94% were able to satisfactorily communicate their feelings via video.</p> <p>Conclusion</p> <p>Results showed that primary care patients will enroll, participate in and complete psychiatric research protocols using remote interviews conducted via videoconference.</p

The Conceptual and Methodological Mayhem of "Screen Time".

Debates concerning the impacts of screen time are widespread. Existing research presents mixed findings, and lacks longitudinal evidence for any causal or long-term effects. We present a critical account of the current shortcomings of the screen time literature. These include poor conceptualisation, the use of non-standardised measures that are predominantly self-report, and issues with measuring screen time over time and context. Based on these issues, we make a series of recommendations as a basis for furthering academic and public debate. These include drawing on a user-focused approach in order to seek the various affordances gained from "screen use". Within this, we can better understand the way in which these vary across time and context, and make distinction between objective measures of "screen time" compared to those more subjective experiences of uses or affordances, and the differential impacts these may bring

Evolution since z = 0.5 of the Morphology-Density relation for Clusters of Galaxies

Using traditional morphological classifications of galaxies in 10 intermediate-redshift (z~0.5) clusters observed with WFPC-2 on the Hubble Space Telescope, we derive relations between morphology and local galaxy density similar to that found by Dressler for low-redshift clusters. Taken collectively, the `morphology-density' relationship, M-D, for these more distant, presumably younger clusters is qualitatively similar to that found for the local sample, but a detailed comparison shows two substantial differences: (1) For the clusters in our sample, the M-D relation is strong in centrally concentrated ``regular'' clusters, those with a strong correlation of radius and surface density, but nearly absent for clusters that are less concentrated and irregular, in contrast to the situation for low redshift clusters where a strong relation has been found for both. (2) In every cluster the fraction of elliptical galaxies is as large or larger than in low-redshift clusters, but the S0 fraction is 2-3 times smaller, with a proportional increase of the spiral fraction. Straightforward, though probably not unique, interpretations of these observations are (1) morphological segregation proceeds hierarchically, affecting richer, denser groups of galaxies earlier, and (2) the formation of elliptical galaxies predates the formation of rich clusters, and occurs instead in the loose-group phase or even earlier, but S0's are generated in large numbers only after cluster virialization.Comment: 35 pages, 19 figures, uses psfig. Accepted for publication in Ap

The interplay between learner beliefs and foreign language anxiety: insights from the Turkish EFL context

Foreign language learning in classroom settings has long been found to be associated with anxiety (Horwitz, 1986). Though it is known that sources of foreign language anxiety are varied (Young, 1991), whether anxiety is related to learners’ inherent beliefs about language learning is understudied. To this end, the present study examines the possible relationship between learner beliefs and language anxiety in the under-researched Turkish EFL context. A population of university-level Turkish EFL learners (n=153) completed the Beliefs about Language Learning Inventory (BALLI) and the Foreign Language Classroom Anxiety scale (FLCAS). The underlying constructs in both instruments were explored using an Exploratory Factor Analysis (EFA). A series of Pearson Product-Moment Correlation Coefficient (PPMCC) tests were performed on the factor scores from both instruments. The findings revealed that fear of ambiguity was positively linked to classroom performance anxiety and negative feelings towards English. In addition, the more confident learners feel themselves using English, the more desire they seem to have to interact with native speakers. Overall, positive beliefs about language learning may be helpful in reducing anxiety and boosting confidence in language learning. These findings not only enhance our understanding of the complex psychology of language learning but also have important implications for instructed EFL/ESL settings

Physician decision making in selection of second-line treatments in immune thrombocytopenia in children.

Immune thrombocytopenia (ITP) is an acquired autoimmune bleeding disorder which presents with isolated thrombocytopenia and risk of hemorrhage. While most children with ITP promptly recover with or without drug therapy, ITP is persistent or chronic in others. When needed, how to select second-line therapies is not clear. ICON1, conducted within the Pediatric ITP Consortium of North America (ICON), is a prospective, observational, longitudinal cohort study of 120 children from 21 centers starting second-line treatments for ITP which examined treatment decisions. Treating physicians reported reasons for selecting therapies, ranking the top three. In a propensity weighted model, the most important factors were patient/parental preference (53%) and treatment-related factors: side effect profile (58%), long-term toxicity (54%), ease of administration (46%), possibility of remission (45%), and perceived efficacy (30%). Physician, health system, and clinical factors rarely influenced decision-making. Patient/parent preferences were selected as reasons more often in chronic ITP (85.7%) than in newly diagnosed (0%) or persistent ITP (14.3%, P = .003). Splenectomy and rituximab were chosen for the possibility of inducing long-term remission (P < .001). Oral agents, such as eltrombopag and immunosuppressants, were chosen for ease of administration and expected adherence (P < .001). Physicians chose rituximab in patients with lower expected adherence (P = .017). Treatment choice showed some physician and treatment center bias. This study illustrates the complexity and many factors involved in decision-making in selecting second-line ITP treatments, given the absence of comparative trials. It highlights shared decision-making and the need for well-conducted, comparative effectiveness studies to allow for informed discussion between patients and clinicians

ULTRAENDURANCE CYCLING IN A HOT ENVIRONMENT: THIRST, FLUID CONSUMPTION, AND WATER BALANCE

ABSTRACT Armstrong, LE, Johnson, EC, McKenzie, AL, Ellis, LA, and Williamson, KH. Ultraendurance cycling in a hot environment: thirst, fluid consumption, and water balance. J Strength Cond Res 29(4): 869-876, 2015-The purpose of this field investigation was to identify and clarify factors that may be used by strength and conditioning professionals to help athletes drink adequately but not excessively during endurance exercise. A universal method to accomplish this goal does not exist because the components of water balance (i.e., sweat rate, fluid consumed) are different for each athlete and endurance events differ greatly. Twenty-six male cyclists (mean 6 SD; age, 41 6 8 years; height, 177 6 7 cm; body mass, 81.85 6 8.95 kg) completed a summer 164-km road cycling event in 7.0 6 2.1 hours (range, 4.5-10.4 hours). Thirst ratings, fluid consumed, indices of hydration status, and body water balance (ingested fluid volume 2 [urine excreted + sweat loss]) were the primary outcome variables. Measurements were taken before the event, at designated aid stations on the course (52, 97, and 136 km), and at the finish line. Body water balance during exercise was not significantly correlated with exercise time on the course, height, body mass, or body mass index. Thirst ratings were not significantly correlated with any variable. We also observed a wide range of total sweat losses (4.9-12.7 L) and total fluid intakes (2.1-10.5 L) during this ultraendurance event. Therefore, we recommend that strength and conditioning professionals develop an individualized drinking plan for each athlete, by calculating sweat rate (milliliter per hour) on the basis of body mass change (in kilograms), during field simulations of competition

Environmental DNA metabarcoding for fish diversity assessment in a macrotidal estuary: A comparison with established fish survey methods

Fishes are a dominant component of the macrofauna in estuaries and are important for assessing the health of these threatened ecosystems. Several studies have applied environmental DNA (eDNA) metabarcoding to assess the biodiversity of fishes in estuaries. However, none have combined measurement of physicochemical variables with a spatially extensive sampling design across the full salinity gradient. This study aimed to compare spatial fish assemblage composition detected via eDNA metabarcoding of surface water samples with conventional fishing gear surveys in a macrotidal estuary (river Dee, North Wales, UK). In addition, eDNA assemblage composition across seasons was investigated. In autumn 2018, triplicate eDNA samples were taken at 13 stations in a spatially systematic design alongside seine, fyke and beam trawl sampling. In summer 2019, eDNA samples from eight of the 13 original stations were collected again in the upper and lower estuary. DNA was extracted from samples and subjected to metabarcoding analysis using an established assay targeting teleost fishes. The key findings were that in autumn, eDNA detected 17 of the 26 (71%) species caught by fishing gears, which included the most abundant species. Overall, eDNA detected a greater species richness, per 30 samples, than seine or fyke nets (but not beam trawling). Additionally, there was a clear correlation between salinity and assemblage composition, which was consistent across seasons. Overall, the study indicates that eDNA metabarcoding could enhance existing fish sampling methods, by generating a more comprehensive picture of estuarine fish biodiversity and providing additional information for ecological inference and management actions

A Network Integration Approach to Predict Conserved Regulators Related to Pathogenicity of Influenza and SARS-CoV Respiratory Viruses

Respiratory infections stemming from influenza viruses and the Severe Acute Respiratory Syndrome corona virus (SARS-CoV) represent a serious public health threat as emerging pandemics. Despite efforts to identify the critical interactions of these viruses with host machinery, the key regulatory events that lead to disease pathology remain poorly targeted with therapeutics. Here we implement an integrated network interrogation approach, in which proteome and transcriptome datasets from infection of both viruses in human lung epithelial cells are utilized to predict regulatory genes involved in the host response. We take advantage of a novel "crowd-based" approach to identify and combine ranking metrics that isolate genes/proteins likely related to the pathogenicity of SARS-CoV and influenza virus. Subsequently, a multivariate regression model is used to compare predicted lung epithelial regulatory influences with data derived from other respiratory virus infection models. We predicted a small set of regulatory factors with conserved behavior for consideration as important components of viral pathogenesis that might also serve as therapeutic targets for intervention. Our results demonstrate the utility of integrating diverse 'omic datasets to predict and prioritize regulatory features conserved across multiple pathogen infection models