Cognitive remediation therapy in anorexia nervosa: implications for treatment developments and research trials

Though Cognitive Remediation Therapy (CRT) for anorexia nervosa shows promising evidence, questions remain regarding specific mechanisms of change. This mixed methods study aimed to explore both longitudinal patient data (neuropsychological and self-report measures, before and after CRT) and therapist experiences of delivering CRT and their perceptions regarding what it offers. All patients had received treatment in a specialist inpatient unit. Complete data were available for both individual (n=56) and group (n=43) CRT; clinical audit data were also available. Semi-structured interviews of 11 therapists were analysed using Thematic Analysis. Statistically significant improvements were found in cognitive flexibility task performance for individual CRT (medium effect) and in self-reported cognitive flexibility for group CRT (medium effect). Three main themes were identified from the therapist interviews: “Anorexia and its treatment”, “CRT - its characteristics and delivery” and “CRT and its effectiveness”. The quantitative findings replicated some previous results and the therapist interviews provided insights regarding not only CRT’s delivery but adaptations made according to individual need and complexity. Both individual and group CRT appear to be feasible interventions for future trials but questions remain around CRT’s specific effects. Recommendations are made for future research studies on this complex intervention

Modeling secondary level of HIV contact tracing: its impact on HIV intervention in Cuba

<p>Abstract</p> <p>Background</p> <p>Universal HIV testing/treatment program has currently been suggested and debated as a useful strategy for elimination of HIV epidemic in Africa, although not without practical issues regarding the costs and feasibility of a fully implemented program.</p> <p>Methods</p> <p>A mathematical model is proposed which considers two levels of detection of HIV-infectives through contact tracing of known infectives in addition to detections through other means such as random screening. Simulations based on Cuban contact tracing data were performed to ascertain the potential impact of the different levels of contact tracing.</p> <p>Results</p> <p>Simulation studies illustrate that: (1) contact tracing is an important intervention measure which, while less effective than random screening, is perhaps less costly and hence ideal for large-scale intervention programs in developing countries with less resources; (2) the secondary level of contact tracing could significantly change the basic disease transmission dynamics, depending on the parameter values; (3) the prevalence of the epidemic at the time of implementation of contact tracing program might be a crucial factor in determining whether the measure will be effective in preventing disease infections and its eventual eradication.</p> <p>Conclusions</p> <p>Our results indicate that contact tracing for detection of HIV infectives could be suitably used to remedy inadequacies in a universal HIV testing program when designing timely and effective intervention measures.</p

Meal support using mobile technology in Anorexia Nervosa. Contextual differences between inpatient and outpatient settings

The aim of this study was to examine the impact of a " supported eating" intervention using mobile technology in patients with Anorexia Nervosa (AN). Twenty Inpatients and 18 Outpatients with AN underwent a test meal on two occasions, whilst listening to either a short video-clip ('vodcast'), or music delivered on an MP4 player. Self-report and behavioural measures were collected before and after each test meal. Differences were found between the inpatient and outpatient settings. Inpatients drank more of the test meal and had increased levels of vigilance to food after the test meal, in both conditions. When the support conditions (Vodcast vs. Music) were compared, inpatients seemed to benefit more from listening to music (reduced distress and more smoothie drunk), whereas outpatients benefitted more from using the vodcast (reduced distress, more smoothie drunk, and reduced vigilance to food). The context in which the intervention was delivered had an impact on self-report and behavioural measures collected during the test meal. This suggests that the form of meal support in AN needs to match the context. © 2012 Elsevier Ltd

Near-field plume properties of an ion beam formed by alternating extraction and acceleration of oppositely charged ions

International audienceThis paper is devoted to study the expansion of a beam composed of packets of positively and negatively charged ions generated by alternating extraction and acceleration. This beam is extracted from an ionion plasma, i.e. the electron density is negligible compared to the negative ion density. The alternating acceleration of ions is ensured by two grids placed in the ionion plasma region. The screen grid in contact with the plasma is biased with a square voltage waveform while the acceleration grid is grounded. A two-dimensional particle-in-cell (2D-PIC) code and an analytical model are used to study the properties of the near-field plume downstream of the acceleration grid. It is shown that the possible operating bias frequency is delimited by an upper limit and a lower one that are in the low MHz range. The simulations show that alternating acceleration with bias frequencies close to the upper frequency limit for the system can achieve high ion exhaust velocities, similar to traditional gridded ion thrusters, and with lower beam divergence than in classical systems. Indeed, ionion beam envelope might be reduced to 15° with 70% of ion flux contained within an angle of 3°. Thus, this alternating acceleration method is promising for electric space propulsion