Shared Screens: A Qualitative Study of Therapist Self-Disclosure Over Telehealth

The following qualitative study explored how psychodynamic clinicians approach and use self-disclosure with patients over telehealth platforms. There is an abundance of research on therapist self-disclosure, with discussion of this topic dating back as early as Freud (1912) and Ferenczi (1933), and since spanning the spectrum of theoretical orientation and practice. There is some literature on psychotherapy over telehealth, with a recent surge in research as a response to the COVID-19 pandemic. There is less research on psychodynamic therapy or psychoanalysis over telehealth (Wolson, 2021), and to the author’s knowledge, no research on therapist self-disclosure and telehealth. This study aimed to uncover what clinicians are actually doing on the other side of the screen and will hopefully inform future therapists working over telehealth, as teletherapy appears to be a wave of the future. For this study, 11 doctoral level clinical psychologists and psychoanalysts participated in individual interviews with the author via online video conferencing. Individual interviews were conducted to: (a) investigate whether clinicians’ use of self-disclosure changes when using telehealth, (b) explore whether telehealth creates greater opportunities for both deliberate and inevitable disclosures, and (c) better understand the way clinicians process the impact of self-disclosure. Using a grounded theory approach to qualitative research (Auerbach and Silverstein, 2003), all interviews were transcribed, coded, and analyzed to extrapolate themes and theoretical constructs, and to create a narrative. Results yielded five theoretical constructs, 12 themes, and 56 repeating ideas that combine to create the narrative. Discussion contextualizes the data using aspects of relational theory, particularly mutuality in psychoanalysis (Aron, 1996)

Macroborer Presence on Corals Increases with Nutrient Input and Promotes Parrotfish Bioerosion

Bioerosion by reef-dwelling organisms influences net carbonate budgets on reefs worldwide. External bioeroders, such as parrotfish and sea urchins, and internal bioeroders, including sponges and lithophagid bivalves, are major contributors to bioerosion on reefs. Despite their importance, few studies have examined how environmental (e.g., nutrients) or biological drivers (e.g., the actions of other bioeroders) may influence bioeroder dynamics on reefs. For example, internal bioeroders could promote external bioerosion by weakening the coral skeletal matrix. Our study investigated: ( 1) whether nutrient supply influences the dynamics between internal and external bioeroders and ( 2) how the presence of a boring bivalve, Lithophaga spp., influences parrotfish bioerosion on massive Porites corals. We hypothesized that nutrient supply would be positively correlated with Lithophaga densities on massive Porites colonies, and that as bivalve density increased, the frequency and intensity of parrotfish bioerosion would increase. To test these hypotheses, we analyzed six time points over a 10-yr period from a time series of benthic images and nitrogen content of a dominant macroalga from the fringing reefs around Moorea, French Polynesia. We found Lithophaga densities were positively correlated with nitrogen availability. Further, massive Porites that are more infested with Lithophaga had both a higher probability of being bitten by parrotfish and a higher density of bite scars from parrotfishes. Our findings indicate that increasing nutrient availability may strengthen the relationship between internal and external bioeroders, suggesting that colonies at more eutrophic sites may experience higher bioerosion rates

Performance of the subcutaneous implantable cardioverter-defibrillator in patients with a primary prevention indication with and without a reduced ejection fraction versus patients with a secondary prevention indication

Background: The subcutaneous implantable defibrillator (S-ICD) provides an alternative to the transvenous ICD for the prevention of sudden cardiac death, but has not been well studied in the most commonly treated transvenous ICD patient population, namely, primary prevention (PP) patients with left ventricular dysfunction. Objective: The analyses in the present study were designed to compar

Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis

Pirfenidone is one of two approved therapies for the treatment of idiopathic pulmonary fibrosis (IPF). Randomised controlled clinical trials an

First Light And Reionisation Epoch Simulations (FLARES) XI: [OIII] emitting galaxies at 5<z<105<z<10

JWST has now made it possible to probe the rest-frame optical line emission of high-redshift galaxies extending to z~9, and potentially beyond. To aid in the interpretation of these emerging constraints, in this work we explore predictions for [OIII] emission in high-redshift galaxies using the First Light and Reionisation Epoch Simulations (FLARES). We produce predictions for the [OIII] luminosity function, its correlation with the UV luminosity, and the distribution of equivalent widths (EWs). We also explore how the [OIII] EW correlates with physical properties including specific star formation rate, metallicity, and dust attenuation. Our predictions are largely consistent with recent observational constraints on the luminosity function, average equivalent widths, and line ratios. However, they fail to reproduce the observed tail of high-EW sources and the number density of extreme line emitters. Possibilities to explain these discrepancies include an additional source of ionising photons and/or greater stochasticity in star formation in the model or photometric scatter and/or bias in the observations. With JWST now rapidly building larger samples and a wider range of emission lines the answer to this remaining discrepancy should be available imminently.Comment: 15 pages, accepted for publication in MNRAS, minor changes from original versio

Workplace productivity and office type: an evaluation of office occupier differences based on age and gender

Purpose Open plan office environments are considered to offer workplace productivity benefits because of the opportunities that they create for interaction and knowledge exchange, but more recent research has highlighted noise, distraction and loss of privacy as significant productivity penalties with this office layout. This study aims to investigate if the purported productivity benefits of open plan outweigh the potential productivity penalties. Design/methodology/approach Previous research suggests that office environments are experienced differently according to the gender and age of the occupier across both open-plan and enclosed configurations. Empirical research undertaken with office occupiers in the Middle East (N=220) led to evaluations to establish the impact different offices had on perceived productivity. Factor analysis was used to establish five underlying components of office productivity. The five factors are subsequently used as the basis for comparison between office occupiers based on age, gender and office type. Findings This research shows that benefits and penalties to workplace productivity are experienced equally across open-plan and enclosed office environments. The greatest impact on perceived workplace productivity however was availability of a variety of physical layouts, control over interaction and the 'downtime' offered by social interaction points. Male occupiers and those from younger generations were also found to consider the office environment to have more of a negative impact on their perceived workplace productivity compared to female and older occupiers. Originality/value The originality of this paper is that it develops the concept of profiling office occupiers with the aim of better matching office provision. This paper aims to establish different occupier profiles based on age, gender and office type. Data analysis techniques such as factor analysis and t-test analysis identify the need for different spaces so that occupiers can choose the most appropriate space to best undertake a particular work task. In addition, it emphasises the value that occupiers place on ‘downtime’ leading to the need for appropriate social space

Printing bio-hybrid materials for bioelectronic cardio-3D-cellular constructs

Conductive hydrogels are emerging as promising materials for bioelectronic applications as they minimise the mismatch between biological and electronic systems. We propose a strategy to bioprint bio-hybrid conductive bioinks based on decellularized extracellular matrix (dECM) and multi-walled carbon nanotubes. These inks contained conductive features and morphology of the dECM fibres. Electrical stimulation (ES) was applied to bioprinted structures containing human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs). It was observed that in the absence of external ES, the conductive properties of the materials can improve the contractile behaviour of the hPSC-CMs and this effect is enhanced under the application of external ES. Genetic markers indicated a trend towards a more mature state of the cells with upregulated calcium handling proteins and downregulation of calcium channels involved in the generation of pacemaking currents. These results demonstrate the potential of our strategy to manufacture conductive hydrogels in complex geometries for actuating purposes

Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes

BACKGROUND Data are lacking on the comparative effectiveness of commonly used glucose-lowering medications, when added to metformin, with respect to microvascular and cardiovascular disease outcomes in persons with type 2 diabetes. METHODS We assessed the comparative effectiveness of four commonly used glucose-lowering medications, added to metformin, in achieving and maintaining a glycated hemoglobin level of less than 7.0% in participants with type 2 diabetes. The randomly assigned therapies were insulin glargine U-100 (hereafter, glargine), glimepiride, liraglutide, and sitagliptin. Prespecified secondary outcomes with respect to microvascular and cardiovascular disease included hypertension and dyslipidemia, confirmed moderately or severely increased albuminuria or an estimated glomerular filtration rate of less than 60 ml per minute per 1.73 m2 of body-surface area, diabetic peripheral neuropathy assessed with the Michigan Neuropathy Screening Instrument, cardiovascular events (major adverse cardiovascular events [MACE], hospitalization for heart failure, or an aggregate outcome of any cardiovascular event), and death. Hazard ratios are presented with 95% confidence limits that are not adjusted for multiple comparisons. RESULTS During a mean 5.0 years of follow-up in 5047 participants, there were no material differences among the interventions with respect to the development of hypertension or dyslipidemia or with respect to microvascular outcomes; the mean overall rate (i.e., events per 100 participant-years) of moderately increased albuminuria levels was 2.6, of severely increased albuminuria levels 1.1, of renal impairment 2.9, and of diabetic peripheral neuropathy 16.7. The treatment groups did not differ with respect to MACE (overall rate, 1.0), hospitalization for heart failure (0.4), death from cardiovascular causes (0.3), or all deaths (0.6). There were small differences with respect to rates of any cardiovascular disease, with 1.9, 1.9, 1.4, and 2.0 in the glargine, glimepiride, liraglutide, and sitagliptin groups, respectively. When one treatment was compared with the combined results of the other three treatments, the hazard ratios for any cardiovascular disease were 1.1 (95% confidence interval [CI], 0.9 to 1.3) in the glargine group, 1.1 (95% CI, 0.9 to 1.4) in the glimepiride group, 0.7 (95% CI, 0.6 to 0.9) in the liraglutide group, and 1.2 (95% CI, 1.0 to 1.5) in the sitagliptin group. CONCLUSIONS In participants with type 2 diabetes, the incidences of microvascular complications and death were not materially different among the four treatment groups. The findings indicated possible differences among the groups in the incidence of any cardiovascular disease