A Qualitative Analysis of Client Perceptions of the Effects of Helpful Therapist Self-Disclosure in Long-Term Therapy

Thirteen adult psychotherapy clients currently in long-term therapy were interviewed twice, with semistructured protocols, about their experiences with helpful instances of therapist self-disclosure. Data were analyzed with a qualitative methodology. Results indicated that helpful therapist self-disclosures (a) occurred when these clients were discussing important personal issues, (b) were perceived as being intended by therapists to normalize or reassure the clients, and (c) consisted of a disclosure of personal nonimmediate information about the therapists. The therapist self-disclosures resulted in positive consequences for these clients that included insight or a new perspective from which to make changes, an improved or more equalized therapeutic relationship, normalization, and reassurance. Implications for psychotherapy are discussed

Microbial Regulation of Allergic Inflammation

Allergic diseases have reached pandemic levels and represent a significant source of morbidity, mortality and healthcare cost. These chronic inflammatory diseases are characterized by interleukin (IL)-4, IL-5, IL-9 and IL-13 production by CD4+ T helper type 2 (TH2) cells, immunoglobulin E (IgE) production by B cells, and the recruitment of effector cells to sites of tissue inflammation. In addition to host genetic polymorphisms and environmental triggers, studies in patients and model systems suggest that commensal bacterial-derived signals influence susceptibility to TH2 cytokine-mediated allergic inflammation. For example, patients with allergies display altered commensal bacterial populations and antibiotic treatment increases allergy susceptibility. However, the influence of antibiotic treatment on intestinal bacterial communities, and subsequent effects on innate immune cells that influence the development of allergic inflammation, are poorly defined. Chapter 2 describes the development and characterization of a new murine antibiotic treatment model using 454 deep sequencing techniques and details antibiotic-induced temporal and spatial alterations to bacterial communities colonizing the murine intestine. Having characterized the effects of antibiotic treatment on commensal populations, Chapter 3 and Chapter 4 examine the cellular and molecular mechanisms through which innate immune cells respond to commensal-derived signals and regulate TH2 cytokine-mediated allergic responses. Data in Chapter 3 describe antibiotic-induced steady-state elevations in serum IgE levels and circulating basophil populations, an innate granulocyte implicated in contributing to allergic TH2 cell responses, as well as exaggerated basophil-mediated inflammation in models of allergic disease. Data in Chapter 4 indicate that circulating basophil populations correlate with serum IgE levels in mice and patients with hyper-IgE syndrome, and that B cell-intrinsic MyD88 expression limits murine IgE levels and basophil responses. These results provide novel mechanistic insights into how commensal bacterial-derived signals influence TH2 cytokine-mediated allergic inflammation, and have implications for the development of new preventative or therapeutic interventions for allergic disease

Beyond good intentions: lessons on equipment donation from an African hospital.

OBJECTIVE: In 2000, a referral hospital in the Gambia accepted a donation of oxygen concentrators to help maintain oxygen supplies. The concentrators broke down and were put into storage. A case study was done to find the reasons for the problem and to draw lessons to help improve both oxygen supplies and the success of future equipment donations. METHODS: A technical assessment of the concentrators was carried out by a biomedical engineer with relevant expertise. Semi-structured interviews were undertaken with key informants, and content analysis and inductive approaches were applied to construct the history of the episode and the reasons for the failure. FINDINGS: Interviews confirmed the importance of technical problems with the equipment. They also revealed that the donation process was flawed, and that the hospital did not have the expertise to assess or maintain the equipment. Technical assessment showed that all units had the wrong voltage and frequency, leading to overheating and breakdown. Subsequently a hospital donations committee was established to oversee the donations process. On-site biomedical engineering expertise was arranged with a nongovernmental organization (NGO) partner. CONCLUSION: Appropriate donations of medical equipment, including oxygen concentrators, can be of benefit to hospitals in resource-poor settings, but recipients and donors need to actively manage donations to ensure that the donations are beneficial. Success requires planning, technical expertise and local participation. Partners with relevant skills and resources may also be needed. In 2002, WHO produced guidelines for medical equipment donations, which address problems that might be encountered. These guidelines should be publicized and used

The Axiverse Extended: Vacuum Destabilisation, Early Dark Energy and Cosmological Collapse

A model is presented in the philosophy of the "String Axiverse" of Arvanitaki et al (arXiv:0905.4720v2 [hep-th]) that incorporates a coupling of ultralight axions to their corresponding moduli through the mass term. The light fields roll in their potentials at late times and contribute to the dark sector energy densities in the cosmological expansion. The addition of a coupling and extra field greatly enrich the possible phenomenology of the axiverse. There are a number of interesting phases where the axion and modulus components behave as Dark Matter or Dark Energy and can have considerable and distinct effects on the expansion history of the universe by modifying the equation of state in the past or causing possible future collapse of the universe. In future such a coupling may help to alleviate fine tuning problems for cosmological axions. We motivate and present the model, and briefly explore its cosmological consequences numerically.Comment: 13 pages, 17 figures, published in PRD. v3: corrected SUSY interpretation of axion potential scal

High Reynolds number tests of a Douglas DLBA 032 airfoil in the Langley 0.3-meter transonic cryogenic tunnel

A wind-tunnel investigation of a Douglas advanced-technology airfoil was conducted in the Langley 0.3-Meter Transonic Cryogenic Tunnel (0.3-m TCT). The temperature was varied from 227 K (409 R) to 100 K (180 R) at pressures ranging from about 159 kPa (1.57 atm) to about 514 kPa (5.07 atm). Mach number was varied from 0.50 to 0.78. These variables provided a Reynolds number range (based on airfoil chord) from 6.0 to 30.0 x 10 to the 6th power. This investigation was specifically designed to: (1) test a Douglas airfoil from moderately low to flight-equivalent Reynolds numbers, and (2) evaluate sidewall-boundary-layer effects on transonic airfoil performance characteristics by a systematic variation of Mach number, Reynolds number, and sidewall-boundary-layer removal. Data are included which demonstrate the effects of fixing transition, Mach number, Reynolds number, and sidewall-boundary-layer removal on the aerodynamic characteristics of the airfoil. Also included are remarks on model design and model structural integrity

Shock and Release Temperatures in Molybdenum

Shock and release temperatures in Mo were calculated, taking account of heating from plastic flow predicted using the Steinberg-Guinan model. Plastic flow was calculated self-consistently with the shock jump conditions: this is necessary for a rigorous estimate of the locus of shock states accessible. The temperatures obtained were significantly higher than predicted assuming ideal hydrodynamic loading. The temperatures were compared with surface emission spectrometry measurements for Mo shocked to around 60GPa and then released into vacuum or into a LiF window. Shock loading was induced by the impact of a planar projectile, accelerated by high explosive or in a gas gun. Surface velocimetry showed an elastic wave at the start of release from the shocked state; the amplitude of the elastic wave matched the prediction to around 10%, indicating that the predicted flow stress in the shocked state was reasonable. The measured temperatures were consistent with the simulations, indicating that the fraction of plastic work converted to heat was in the range 70-100% for these loading conditions