Who are we protecting? Exploring counsellors' understanding and experience of boundaries

The concept of boundary is a term often used within counselling and psychotherapy literature. However, there is a paucity of research exploring how useful and meaningful boundaries are for therapy practice. This study explored how counsellors understand and experience boundaries within their counselling practice. Seven participants, who were all qualified and practising counsellors, were interviewed about their understanding and experience of boundaries. These interviews were transcribed and then analysed using interpretative phenomenological analysis (IPA). Analysis identified one significant overarching theme entitled “Protection and Safety” which distinguished between the protection of self and other. This paper focuses solely on the Protection of Self theme because of the theme’s rich and vivid data and the theme’s overarching dominance across the accounts. Two subthemes were identified: Establishing the Self and Defending the Self. Findings indicate that there was a lack of awareness around boundaries, with some participants describing defensive responses to some boundary issues. However, participants also described using boundaries to restrict, limit and defend themselves when working with clients, and they identified this as necessary for their own safety and security. This study recommends that therapists should engage reflexively with boundaries, towards developing a more relational and/or client-focused approach

Adversarial Robustness Verification and Attack Synthesis in Stochastic Systems

Probabilistic model checking is a useful technique for specifying and verifying properties of stochastic systems including randomized protocols and reinforcement learning models. Existing methods rely on the assumed structure and probabilities of certain system transitions. These assumptions may be incorrect, and may even be violated by an adversary who gains control of system components. In this paper, we develop a formal framework for adversarial robustness in systems modeled as discrete time Markov chains (DTMCs). We base our framework on existing methods for verifying probabilistic temporal logic properties and extend it to include deterministic, memoryless policies acting in Markov decision processes (MDPs). Our framework includes a flexible approach for specifying structure-preserving and non structure-preserving adversarial models. We outline a class of threat models under which adversaries can perturb system transitions, constrained by an $\varepsilon$ ball around the original transition probabilities. We define three main DTMC adversarial robustness problems: adversarial robustness verification, maximal $\delta$ synthesis, and worst case attack synthesis. We present two optimization-based solutions to these three problems, leveraging traditional and parametric probabilistic model checking techniques. We then evaluate our solutions on two stochastic protocols and a collection of Grid World case studies, which model an agent acting in an environment described as an MDP. We find that the parametric solution results in fast computation for small parameter spaces. In the case of less restrictive (stronger) adversaries, the number of parameters increases, and directly computing property satisfaction probabilities is more scalable. We demonstrate the usefulness of our definitions and solutions by comparing system outcomes over various properties, threat models, and case studies.Comment: To Appear, 35th IEEE Computer Security Foundations Symposium (2022

Assurance Methods for designing a clinical trial with a delayed treatment effect

An assurance calculation is a Bayesian alternative to a power calculation. One may be performed to aid the planning of a clinical trial, specifically setting the sample size or to support decisions about whether or not to perform a study. Immuno-oncology (IO) is a rapidly evolving area in the development of anticancer drugs. A common phenomenon that arises from IO trials is one of delayed treatment effects, that is, there is a delay in the separation of the survival curves. To calculate assurance for a trial in which a delayed treatment effect is likely to be present, uncertainty about key parameters needs to be considered. If uncertainty is not considered, then the number of patients recruited may not be enough to ensure we have adequate statistical power to detect a clinically relevant treatment effect. We present a new elicitation technique for when a delayed treatment effect is likely to be present and show how to compute assurance using these elicited prior distributions. We provide an example to illustrate how this could be used in practice. Open-source software is provided for implementing our methods. Our methodology makes the benefits of assurance methods available for the planning of IO trials (and others where a delayed treatment expect is likely to occur)

Safeguarding children who are exposed to Abuse Linked to Faith or Belief

This is the peer reviewed version of the following article: Oakley, L., Kinmond, K. S., Humprheys, J. & Dioum, M. (2019). Safeguarding children who are exposed to Abuse Linked to Faith or Belief. Child Abuse Review. 10.1002/car.2540, which has been published in final form at https://doi.org/10.1002/car.2540. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Cases of child abuse linked to faith or belief (CALFB) continue to be documented. However, there is limited research and understanding of CALFB. Further, there is a lack of clarity of definition. These factors then impact upon effective practice. Recognising this, the National Working Group for CALFB called for research on which to develop evidence-based practice. This paper reports on key findings from a mixed-method online survey which was completed by 1361 participants from a range of practitioner and community groups. The participants identified the importance of policy and multiagency working in this area, but they acknowledged the complexity and challenges associated with developing and implementing good practice. Recommendations from the study include a review of relevant policy to evaluate its application to CALFB, the development of faith literacy training for frontline practitioners and the creation of a space in which statutory, faith and community groups can dialogue

Online health communities

Abstract Online health communities provide a means for patients and their families to learn about an illness, seek and offer support, and connect with others in similar circumstances. They are supported by a variety of technologies (e.g., email lists, forums, chat rooms) and are hosted by patients, advocacy groups, medical organizations, and corporations. They raise difficult design challenges because of the wide variability of members' medical expertise, the severity of problems due to misinformation, and the need for emotional support. The importance of on-line health communities is evidenced by their popularity, as well as the significant impact they have on the lives of their members. This Special Interest Group (SIG) will explore current trends in online health communities, as well as discuss the socio-technical design challenges and opportunities that they afford

A Model-Based Methodology for Spray-Drying Process Development

Solid amorphous dispersions are frequently used to improve the solubility and, thus, the bioavailability of poorly soluble active pharmaceutical ingredients (APIs). Spray-drying, a well-characterized pharmaceutical unit operation, is ideally suited to producing solid amorphous dispersions due to its rapid drying kinetics. This paper describes a novel flowchart methodology based on fundamental engineering models and state-of-the-art process characterization techniques that ensure that spray-drying process development and scale-up are efficient and require minimal time and API. This methodology offers substantive advantages over traditional process-development methods, which are often empirical and require large quantities of API and long development times. This approach is also in alignment with the current guidance on Pharmaceutical Development Q8(R1). The methodology is used from early formulation-screening activities (involving milligrams of API) through process development and scale-up for early clinical supplies (involving kilograms of API) to commercial manufacturing (involving metric tons of API). It has been used to progress numerous spray-dried dispersion formulations, increasing bioavailability of formulations at preclinical through commercial scales

Defining and Controlling Information Leakage in US Equities Trading

We present a new framework for defining information leakage in the setting of US equities trading, and construct methods for deriving trading schedules that stay within specified information leakage bounds. Our approach treats the stock market as an interactive protocol performed in the presence of an adversary, and draws inspiration from the related disciplines of differential privacy as well as quantitative information flow. We apply a linear programming solver using examples from historical trade and quote (TAQ) data for US equities and describe how this framework can inform actual algorithmic trading strategies

New priorities for disability research in Europe: towards a user-led agenda

This paper presents findings from participatory action research with disabled people's organisations in European countries. The project 'European Research Agendas for Disability Equality' (EuRADE) sought to engage civil society organisations as agents of change in influencing future priorities for European disability research. The paper examines findings from a consultation with 68 organisations in 25 countries and illustrates how the research priorities identified by representative organisations of disabled people were used to impact on European-level research funding. The findings demonstrate the potential for mainstreaming and targeting disability issues in research that will have an impact on the lives of Europe’s 65 million disabled people, using social model and rights-based approaches. They also demonstrate how effective partnership between academia and activism adds to the social relevance and impact of research practice

Aiming to increase birth weight: a randomised trial of pre-pregnancy information, advice and counselling in inner-urban Melbourne

BACKGROUND: In the 1980s there was substantial interest in early pregnancy and pre-pregnancy interventions to increase birth weight and reduce preterm birth. We developed an inter-pregnancy intervention, implemented in a randomised controlled trial, to be provided by midwives at home soon after women's first birth. METHODS: MCH nurses invited women to take part during their home visit to new mothers. Women's contact details, with their permission, were passed to the study midwife. She had a randomisation schedule to which women's names were added before she met the women or their partners. All women recruited had a home visit from the study midwife with a discussion of their first pregnancy, labour and birth and the postpartum experience. Women in the intervention arm received in addition a pre-pregnancy intervention with discussion of social, health or lifestyle problems, preparation and timing for pregnancy, family history, rubella immunisation, referrals for health problems, and a reminder card. The primary outcome was defined as a birth weight difference in the second birth of 100 g (one-sided) in favour of the intervention. Additional data collected were gestational age, perinatal deaths and birth defects. Analyses used EPI-INFO and STATA. RESULTS: Intervention and comparison groups were comparable on socioeconomic factors, prior reproductive history and first birth outcomes. Infant birth weight in the second birth was lower (-97.4 g,)) among infants in the intervention arm. There were no significant differences between intervention and comparison arms in the proportion of women having a preterm birth, an infant with low birthweight, or an infant with a birth weight <10(th )percentile. There were more adverse outcomes in the intervention arm: ten births <32 weeks), compared with one in standard care, and more infants with a birth weight <2000 g, 16 compared with two in standard care CONCLUSION: As the primary outcome was envisaged to be either improved birth weight or no effect, the study was not designed to identify the alternative outcome with confidence. Despite widespread support for pre-pregnancy interventions to improve maternal and perinatal health, this first randomised controlled trial of a multi-component intervention provided at home, did not have a beneficial outcome

Polychlorinated biphenyls, cytochrome P450 1A1 (CYP1A1) polymorphisms, and breast cancer risk among African American women and white women in North Carolina: a population-based case-control study

INTRODUCTION: Epidemiologic studies have not shown a strong relationship between blood levels of polychlorinated biphenyls (PCBs) and breast cancer risk. However, two recent studies showed a stronger association among postmenopausal white women with the inducible M2 polymorphism in the cytochrome P450 1A1 (CYP1A1) gene. METHODS: In a population-based case-control study, we evaluated breast cancer risk in relation to PCBs and the CYP1A1 polymorphisms M1 (also known as CYP1A1*2A), M2 (CYP1A1*2C), M3 (CYP1A1*3), and M4 (CYP1A1*4). The study population consisted of 612 patients (242 African American, 370 white) and 599 controls (242 African American, 357 white). RESULTS: There was no evidence of strong joint effects between CYP1A1 M1-containing genotypes and total PCBs in African American or white women. Statistically significant multiplicative interactions were observed between CYP1A1 M2-containing genotypes and elevated plasma total PCBs among white women (P value for likelihood ratio test = 0.02). Multiplicative interactions were also observed between CYP1A1 M3-containing genotypes and elevated total PCBs among African American women (P value for likelihood ratio test = 0.10). CONCLUSIONS: Our results confirm previous reports that CYP1A1 M2-containing genotypes modify the association between PCB exposure and risk of breast cancer. We present additional evidence suggesting that CYP1A1 M3-containing genotypes modify the effects of PCB exposure among African American women. Additional studies are warranted, and meta-analyses combining results across studies will be needed to generate more precise estimates of the joint effects of PCBs and CYP1A1 genotypes