The Role of Relapse Prevention and Goal Setting in Training Transfer Enhancement

This article reviews the effect of two post-training transfer interventions (relapse prevention [RP] and goal setting [GS]) on trainees’ ability to apply skills gained in a training context to the workplace. Through a review of post-training transfer interventions literature, the article identifies a number of key issues that remain unresolved or underexplored, for example, the inconsistent results on the impact of RP on transfer of training, the lack of agreement on which GS types are more efficient to improve transfer performance, the lack of clarity about the distinction between RP and GS, and the underlying process through which these two post-training transfer interventions influence transfer of training. We offer some recommendations to overcome these problems and also provide guidance for future research on transfer of training

Interbacterial signaling via Burkholderia contact-dependent growth inhibition system proteins

How bacteria interact with one another has implications for human health and disease because complex bacterial communities like biofilms can impact agriculture, infection transmission, and disease progression. Contact-dependent growth inhibition systems are proteins produced by many bacteria that deliver toxins to neighboring bacteria, allowing the producing cell to inhibit competitors that do not make the correct antidote. Here, we show that these systems not only antagonize competitors but also mediate communication and cooperation between bacteria that produce identical toxin/antidote pairs. Antidote-containing bacteria that are targeted by toxins change their gene expression to promote biofilm formation. Leading to a more complete understanding of how these antibacterial protein systems function, this study will inform future development of therapeutics, vaccines, and decontaminants

Schizophrenia syndrome due to C9ORF72 mutation case report: a cautionary tale and role of hybrid brain imaging!

Background: Frontal variant frontotemporal dementia is a common cause of presenile dementia. A hexanucleotide expansion on chromosome 9 has recently been recognized as the most common genetic mutation cause of this illness. This sub-type tends to present psychiatrically with psychosis being a common presenting symptom before the onset of cognitive changes or brain atrophy. A few case series have been published describing the prominence of early psychotic symptoms, and lack of clear brain atrophy on clinical brain imaging imposing a challenge in reaching early accurate diagnosis. In this report, we present a case whereby the diagnosis of Schizophrenia syndrome was made and the patient was treated for years with multiple interventions for that syndrome before reaching the accurate diagnosis of Frontal variant frontotemporal dementia due to hexanucleotide expansion on chromosome 9. This diagnosis was confirmed after genetic testing and findings on a hybrid Positron Emission Tomography/Magnetic Resonance Imaging scanning. Case summary: A 60-year-old female diagnosed with schizophrenia at age 50 after presenting with delusions and hallucinations, which proved to be refractor to several lines of pharmacological and non-pharmacological interventions including electroconvulsive therapy. Patient had a history of post-partum psychosis in her 20s. She was referred to cognitive neurology due to progressive decline in function. While clinical structural brain imaging data were not adequate to support an alternative neurological diagnosis, careful inquiry elicited a history of psychotic illness followed by progressive decline in a sister. Genetic testing confirmed hexanucleotide expansion on chromosome 9 mutation. The patient was offered a state-of-the-art FD-Glucose Positron Emission Tomography/Magnetic Resonance Imaging scan available at our centre. While volumetric Magnetic Resonance Imaging scan did not show volume loss in frontotemporal areas, the hybrid scan showed regionally specific deficit in FD-Glucose Positron Emission Tomography affecting medial superior frontal, insula, inferior temporal, thalamus, and anterior cingulate cortex consistent with behavioral variant frontotemporal dementia. Conclusions: This case highlights the importance of considering Frontal variant frontotemporal dementia due to hexanucleotide expansion on chromosome 9 when facing relatively late-onset, refractory schizophrenia-like syndrome. Careful history from all available sources to elicit family history of similar presentation is very important. Genetic testing and functional brain imaging can aid in confirming the diagnosis and potentially streamlining the management of these cases

The effect of pre-treatment psychoeducation on eating disorder pathology among patients with anorexia nervosa and bulimia nervosa

Pre-treatment psychoeducation can be effective for bulimic groups, but little is known about its effect on patients with anorexia nervosa. This study investigated the impact of a pre-treatment psychoeducational intervention on outpatients with diagnoses of full or atypical anorexia nervosa (N = 54) or bulimia nervosa/atypical eating disorder at a normal weight (N = 43). Each attended a four-session psychoeducational group whilst awaiting outpatient treatment. They completed measures of eating and personality disorder pathology pre-intervention, repeating the measures of eating pathology post-intervention. Effectiveness was tested for each diagnostic group using intention-to-treat analyses. Results confirm that such psychoeducational groups reduce unhealthy eating attitudes among bulimic patients, regardless of initial levels of eating and personality pathology. In contrast, the groups were not effective for anorexia nervosa sufferers. Such groups should be considered routinely during waiting periods for bulimia nervosa treatment, but further research is needed to determine how to help anorexia nervosa patients at this stage

Bilateral sequential theta burst stimulation for multiple-therapy-resistant depression: A naturalistic observation study

Depression is a significant health issue with treatment resistance reported in about one third of patients. Treatment resistance results in significant disability, impaired quality of life, and increased healthcare costs. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for treatment resistant depression (TRD) with response and remission rates in open-label studies being as high as 58% and 37% respectively. Theta-burst is a faster and novel rTMS paradigm that has shown promise as a treatment for TRD in some preliminary studies. In a naturalistic design, we evaluated the response, remission and tolerability of bilateral sequential (right then left) prefrontal theta-burst rTMS (bsTBS) in 50 patients with TRD (600 pulses/session, 20 sessions, 100% of resting motor threshold (80% if intolerant to 100%, n = 2), F4/F3 of 10-20-20 EEG localization). Data was collected over 36 months from a specialized academic TMS clinic. Patients had multiple-treatment resistance with at least two failed trials of different antidepressants with 20% also having failed electroconvulsive therapy and 66% having received professional therapy. We found a 28% remission rate (HAMD-17 score of ≤7) and a 52% response rate (≥50% reduction in HAMD-17) with a 42% reduction in average HAMD-17 score. The treatment was well tolerated, with muscle contractions, mild pain or discomfort, headache, scalp irritation, and changes to vitals being captured as occasional adverse events with two instances of syncope (0.22% of treatments). This naturalistic study shows that bsTBS is a promising paradigm for a multiple-TRD patient population with approximately one-third of treatments achieving remission and over half achieving significant response

Understanding Individual Differences for Tailored Smoking Cessation Apps

Finding ways to help people quit smoking is a high priority in health behavior change research. Recent HCI studies involving technologies using specific quitting techniques such as social support and SMS messaging to help people quit have reported some success. Early studies using computer generated print material report significant success of tailored versus non-tailored material, however, there is limited understanding on what aspects of digitally delivered quitting assistance should be tailored and how. To address this, we have conducted an empirical investigation with smokers to identify perceived importance of different types of help when quitting and the potential role of technology in providing such help. We found that people are highly individual in their approach to quitting and the kind of help they regard as relevant to their situation. Our contribution is a collection of empirically derived themes for tailoring smoking cessation apps to individual quitting needs. Author Keywords Smoking cessation; tailoring; individual differences; healt

Redefining smoking relapse as recovered social identity – secondary qualitative analysis of relapse narratives

Although many people in the general population manage to quit smoking, relapse is common. Theory underpinning the determinants of smoking relapse is under-developed. This article aims to specify theoretical insight into the process of relapse to smoking, to underpin effective intervention development. Secondary qualitative analysis of extended narratives of smoking relapse (n=23) were inductively coded within our conceptual framework of a socially situated narrative theoretical approach to identity. Smoking relapse is conceptualised as a situated rational response to a ‘disruption’ in individual narrative identity formation, and an attempt to recover a lost social identity. Emotional reactions to relapse, such as pleasure, but also guilt and shame, support this assertion by demonstrating the ambivalence of re-engaging in a behaviour that is situated and rational in terms of individual identity formation, yet ostracised and stigmatised by wider culture

Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents

Peer reviewedPostprin

Alcohol and remembering a hypothetical sexual assault: Can people who were under the influence of alcohol during the event provide accurate testimony?

We examined the influence of alcohol on remembering an interactive hypothetical sexual assault scenario in the laboratory using a balanced placebo design. Female participants completed a memory test 24 hours and 4 months later. Participants reported less information (i.e., responded ‘don’t know’ more often to questions) if they were under the influence of alcohol during scenario encoding. The accuracy of the information intoxicated participants reported did not differ compared to sober participants, however, suggesting intoxicated participants were effectively monitoring the accuracy of their memory at test. Additionally, peripheral details were remembered less accurately than central details, regardless of intoxication level; and memory accuracy for peripheral details decreased by a larger amount compared to central details across the retention interval. Finally, participants were more accurate if they were told they were drinking alcohol rather than a placebo. We discuss theoretical implications for alcohol myopia and memory regulation, together with applied implications for interviewing intoxicated witnesses