Feasibility of a Peer Support Oriented Dialectical Behavior Therapy Skills Training Massive Open Online Course for Emotion Dysregulation

Public interest in mental health care modernization has steadily gained momentum since ratifying The United States Health Care Affordability Act (U.S. Office of the Legislative Counsel, 2010). Furthermore, with 1 in every 1000 people seeking online support for mental health issues (DeAndrea & Anthony, 2013), research concerning the development of virtual mental health applications is critical to ensure science guides their innovation. To this end, this study explores the feasibility of a mental health intervention that unites the experiential, recovery-oriented, and self-determined values of mental health peer support (Kaufman et al., 2014) with dialectical behavior therapy skills training (DBT-ST) (Linehan, 1993b) (Linehan, 2014a) (Linehan, 2014b) in a massive open online course (MOOC) format to create an adjunct, no-cost, DBT-ST resource for people with emotional difficulties. People stagnating on program waitlists, lacking access to comprehensive DBT, who want to brush up on prior DBT-ST, or who are simply curious and want to learn more about DBT-ST are most likely to benefit from this novel intervention. The pilot DBT-ST MOOC offers a robust user interface (see Appendix A for details), which increases flexibility in time and space and costs little to nothing compared to traditional brick and mortar learning environments (Hu, 2013). The DBT-ST program teaches all four skill sets prescribed in standard DBT: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills, respectively (see Figure 1) while presenting an introduction to the rapidly growing field of DBT-oriented Internet applications

The Impact of Type of High School Institution on University Retention of Undergraduate Students

The primary purpose of this study was to determine the impact of the type of high school completed and selected academic and demographic characteristics on university retention to degree completion at a research university – very high research (RU/VH) in the Southern Region of the United States. The dependent variable of this study was persistence to graduation within six years of first enrollment. The target population was defined as traditional-age undergraduate students enrolled in a research university – very high research (RU/VH) in the Southern Region of the United States. The accessible population was defined as traditional-age undergraduate students enrolled in one selected research university - very high research (RU/VH) in the Southern Region of the United States who began as first semester freshmen during the Fall semester 2014 (n = 5354). Of the 5354 students, who completed a high school program in 2014 and entered the study institution in the Fall 2014 entering class, 3168 completed a public high school program, 2157 completed a private high school program, and 29 completed a home school program. Students in each group were described on selected academic and demographic characteristics. Students in the three groups were found to be different on numerous characteristics. On most of the academic measures, public school graduates were different from private school graduates and home school graduates were not different from either of the other groups. On the personal demographic characteristics, especially race and gender, the home school graduates were very different from one or both of the other two groups. Additionally, a Multiple Discriminant analysis was utilized to identify a seven variable model explaining persistence to graduation. The findings indicated that first semester GPA and attempted hours were the best predictors of a student’s persistence to graduation. The researcher concluded that interventions designed to improve student retention should intentionally target first semester students. Consequently, the researcher recommends implementation of an early warning system designed to identify student issues prior to the semester midpoint and the initiation of intervention programs designed to address problems that are identified in this early warning system

‘You do act differently when you're in it’: lingerie and femininity

This paper examines British women’s accounts of buying and wearing lingerie taken from in-depth interviews exploring experiences of shopping in sex shops. Lingerie forms one part of a sexual consumer culture that is positioned within a neoliberal discourse of postfeminism. Women’s engagement with the representation of lingerie, the way they enact lingerie buying and wearing in their everyday lives and the ways they speak about these practices show complex and often incongruous strategies of accommodation and negotiation. Such strategies can make lingerie pleasurable and liveable whilst at the same time expressing forms of anxiety, ambivalence or laughter directed towards the performance of femininity and feminine sexuality required and represented by lingerie. I contend that it is precisely through this often contradictory engagement with lingerie that strategic counter discourses emerge, by which women can resist some of the respectable norms of female sexuality. Women position themselves in ambivalent ways in relation to the visual imperative of feminine sexuality represented by lingerie, particularly through an embodied discourse of comfort and discomfort, or through the playful and pleasurable performance of non-naturalised gender roles

Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes

Background Despite the number of medications for type 2 diabetes, many people with the condition do not achieve good glycaemic control. Some existing glucose-lowering agents have adverse effects such as weight gain or hypoglycaemia. Type 2 diabetes tends to be a progressive disease, and most patients require treatment with combinations of glucose-lowering agents. The sodium glucose co-transporter 2 (SGLT2) receptor inhibitors are a new class of glucose-lowering agents. Objective To assess the clinical effectiveness and safety of the SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. Data sources MEDLINE, Embase, Cochrane Library (all sections); Science Citation Index; trial registries; conference abstracts; drug regulatory authorities; bibliographies of retrieved papers. Inclusion criteria Randomised controlled trials of SGLT2 receptor inhibitors compared with placebo or active comparator in type 2 diabetes in dual or combination therapy. Methods Systematic review. Quality assessment used the Cochrane risk of bias score. Results Seven trials, published in full, assessed dapagliflozin and one assessed canagliflozin. Trial quality appeared good. Dapagliflozin 10 mg reduced HbA1c by −0.54% (weighted mean differences (WMD), 95% CI −0.67 to −0.40) compared to placebo, but there was no difference compared to glipizide. Canagliflozin reduced HbA1c slightly more than sitagliptin (up to −0.21% vs sitagliptin). Both dapagliflozin and canagliflozin led to weight loss (dapagliflozin WMD −1.81 kg (95% CI −2.04 to −1.57), canagliflozin up to −2.3 kg compared to placebo). Limitations Long-term trial extensions suggested that effects were maintained over time. Data on canagliflozin are currently available from only one paper. Costs of the drugs are not known so cost-effectiveness cannot be assessed. More data on safety are needed, with the Food and Drug Administration having concerns about breast and bladder cancers. Conclusions Dapagliflozin appears effective in reducing HbA1c and weight in type 2 diabetes, although more safety data are needed

General practice views of managing childhood obesity in primary care: a qualitative analysis:managing childhood obesity in primary care

Objective: To explore general practice staff views of managing childhood obesity in primary care. Design: A qualitative study to elicit the views of clinical and non-clinical general practice staff on managing childhood obesity. Setting: Interviews were conducted at 30 general practices across England. These practices were interviewed as part of the Quality and Outcomes Framework (QOF) Pilot Study. Participants: A total of 52 staff from 30 practices took part in a semi structured interview. Main outcome measures: Key themes were identified through thematic analysis of transcripts using an inductive approach. Results: Three themes were identified: lack of contact with well children, sensitivity of the issue, and the potential impact of general practice. Identifying overweight children was challenging because well children rarely attended the practice. Interviewees felt ill equipped to solve the issue because they lacked influence over the environmental, economic and lifestyle factors underpinning obesity. They described little evidence to support general 4 practice intervention and seemed unaware of other services. Raising the issue was described as sensitive. Conclusion: General practice staff were unconvinced they could have a significant role in managing childhood obesity on a large scale. Participants believed schools have more contact with children and should coordinate the identification and management of overweight children. Future policy could recommend a minor role for general practice involving opportunistically identifying overweight children and signposting to obesity services

Reflectance Transformation Imaging: Documenting Graffiti in the Maya Lowlands

In the late 19th century, explorers identified graffiti etched in stucco walls of residences, palaces, and temples in the Maya Lowlands. By the mid-20th century, scholars acknowledged that the ancient Maya produced these incised images. Today, archaeologists struggle with documenting these instances of graffiti with precision and accuracy, often relying solely on to-scale line drawings to best represent the graffitied image they see before them. These images can be complex, multilayered, and difficult to see so identifying the sequence of creation of the incisions can be challenging. Reflectance Transformation Imaging (RTI) is a method that uses a moving light source and photography in order to visualize, interact with, and analyze a three-dimensional object in a two-dimensional image. Performed on a series of 20 unique graffiti from the Maya archaeological site of Holtun, RTI showed promise as a viable technique for documenting and preserving graffiti as cultural heritage and for providing new information about an enigmatic aspect of Maya archaeology. Additionally, RTI is compared to other common methods used to document incised graffiti in the Maya lowland area including to-scale line drawing, tracing, photogrammetry, and scanning to show the new and unique information and data that can be gathered from this method. Finally, RTI is a low-cost, low-maintenance alternative data-gathering method for highly remote archaeological projects where other technology is difficult to obtain and use in the field setting

Understanding grip shifts:how form factors impact hand movements on mobile phones

In this paper we present an investigation into how hand usage is affected by different mobile phone form factors. Our initial (qualitative) study explored how users interact with various mobile phone types (touchscreen, physical keyboard and stylus). The analysis of the videos revealed that each type of mobile phone affords specific handgrips and that the user shifts these grips and consequently the tilt and rotation of the phone depending on the context of interaction. In order to further investigate the tilt and rotation effects we conducted a controlled quantitative study in which we varied the size of the phone and the type of grips (Symmetric bimanual, Asymmetric bimanual with finger, Asymmetric bimanual with thumb and Single handed) to better understand how they affect the tilt and rotation during a dual pointing task. The results showed that the size of the phone does have a consequence and that the distance needed to reach action items affects the phones’ tilt and rotation. Additionally, we found that the amount of tilt, rotation and reach required corresponded with the participant’s grip preference. We finish the paper by discussing the design lessons for mobile UI and proposing design guidelines and applications for these insights

Anti-carcinogenic effects of exercise-conditioned human serum: evidence, relevance and opportunities

Regular physical activity reduces the risk of several site-specific cancers in humans and suppresses tumour growth in animal models. The mechanisms through which exercise reduces tumour growth remain incompletely understood, but an intriguing and accumulating body of evidence suggests that the incubation of cancer cells with post-exercise serum can have powerful effects on key hallmarks of cancer cell behaviour in vitro. This suggests that exercise can impact tumour biology through direct changes in circulating proteins, RNA molecules and metabolites. Here, we provide a comprehensive narrative overview of what is known about the effects of exercise-conditioned sera on in vitro cancer cell behaviour. In doing so, we consider the key limitations of the current body of literature, both from the perspective of exercise physiology and cancer biology, and we discuss the potential in vivo physiological relevance of these findings. We propose key opportunities for future research in an area that has the potential to identify key anti-oncogenic protein targets and optimise physical activity recommendations for cancer prevention, treatment and survivorship

A protocol for the development and piloting of quality measures to support the Healthier You : The NHS Diabetes Prevention Programme

Background The increasing prevalence of type 2 diabetes in the UK creates an additional, potentially preventable burden on health care and service providers. The Healthier You: NHS Diabetes Prevention Programme aims to reduce the incidence of type 2 diabetes through identification of people at risk and the provision of intensive lifestyle change support. The provision of this care can be monitored through quality measurement at both the general practice and specialist service level. Aim To develop quality measures through piloting to assess the validity, credibility, acceptability, reliability and feasibility of any proposed measures. Design and setting The non-experimental mixed design piloting study consists of consensus testing and exploratory research with general practitioners (GPs), commissioners and patients from Herefordshire, England. Methods A mixed-method approach will be used to develop and validate measures for diabetes prevention care and evaluate their performance over a six month pilot period consisting of i) consensus testing using a modified RAND approach with GPs and commissioners, ii) four focus groups with 10-12 participants discussing experiences of non-diabetic hyperglycaemia, perceived ability to access care and prevent diabetes, and views on potential quality measures, iii) piloting final measures with at least 5 general practices for baseline and 6 month data. Results The findings will inform the implementation of the diabetes prevention quality measures on a national scale whilst addressing any issue with validity, credibility, feasibility, and cost-effectiveness. Conclusion Health care professionals and patients have the opportunity to evaluate the reliability, acceptability and validity of measure

Immobilization of anode-attached microbes in a microbial fuel cell

Current-generating (exoelectrogenic) bacteria in bioelectrochemical systems (BESs) may not be culturable using standard in vitro agar-plating techniques, making isolation of new microbes a challenge. More in vivo like conditions are needed where bacteria can be grown and directly isolated on an electrode. While colonies can be developed from single cells on an electrode, the cells must be immobilized after being placed on the surface. Here we present a proof-of-concept immobilization approach that allows exoelectrogenic activity of cells on an electrode based on applying a layer of latex to hold bacteria on surfaces. The effectiveness of this procedure to immobilize particles was first demonstrated using fluorescent microspheres as bacterial analogs. The latex coating was then shown to not substantially affect the exoelectrogenic activity of well-developed anode biofilms in two different systems. A single layer of airbrushed coating did not reduce the voltage produced by a biofilm in a microbial fuel cell (MFC), and more easily applied dip-and-blot coating reduced voltage by only 11% in a microbial electrolysis cell (MEC). This latex immobilization procedure will enable future testing of single cells for exoelectrogenic activity on electrodes in BESs