Termination of psychotherapy : the relationship between the termination process, judgements of the client's need for further treatment and psychotherapy outcome : a thesis presented in fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

This study was based on the data gained from eighty one terminating clients and their therapists at a university Psychological Services Centre. The study investigated the frequency with which clients and therapists agreed about three components of the termination process and if agreement was related to client outcome. The three components of termination investigated were, the reasons therapy was terminated, the mutuality of termination and the degree of need for further therapy. Client narrative responses to the question "Why is your therapy ending?" were coded into categories of reason and mutuality of termination. Raters reliably coded the majority of narrative answers. No difference in the ability of raters to make a coding with regard to the raters experience in Clinical Psychology was found. In approximately fifty percent of cases, therapists and clients did not agree about these three components of termination. It was also found that in those cases where there was agreement, the clients had better psychological outcomes, than in cases where there was no agreement

Practical considerations for pathological diagnosis and molecular profiling of cholangiocarcinoma:an expert review for best practices

INTRODUCTION: Advances in precision medicine have expanded access to targeted therapies and demand for molecular profiling of cholangiocarcinoma (CCA) patients in routine clinical practice. However, pathologists face challenges in establishing a definitive intrahepatic CCA (iCCA) diagnosis while preserving sufficient tissue for molecular profiling. Additionally, they frequently face challenges in optimal tissue handling to preserve nucleic acid integrity.AREAS COVERED: This article first identifies the challenges in establishing a definitive diagnosis of iCCA in a lesional liver biopsy while preserving sufficient tissue for molecular profiling. Then, the authors explore the clinical value of molecular profiling, the basic principles of single gene and next-generation sequencing (NGS) techniques, and the challenges in tissue sampling for genomic testing. They also propose an algorithm for best practice in tissue management for molecular profiling of CCA.EXPERT OPINION: Several practical challenges face pathologists during tissue sampling and processing for molecular profiling. Optimized tissue processing, careful tissue handling, and selection of appropriate approaches to molecular testing are essential to ensure that the highest possible quality of diagnostic information is provided in the greatest proportion of cases.</p

Within China&#039;s orbit? China through the eyes of the Australian parliament

As the People’s Republic of China continues to develop as the subject of intense economic, political and cultural interest, this study examines the place ‘China’ has held in the parliamentary imagination by exploring the history of the Australian parliament’s dealings with China. The monograph’s period of historical focus is broad: it begins with an analysis of Federation debates over immigration restriction and concludes with a detailed assessment of the bilateral relationship during the 41st Parliament (November 2004–November 2007). While the monograph provides extensive coverage of the changing nature of Australia–China relations, it does not attempt a full narrative history of the period with which it is concerned; rather, it offers an analysis of a series of foundational moments in the development of the relationship. Such a methodological approach enables the research to document the profound transformation that has taken place in Australian parliamentary attitudes towards China

The morphomolecular features of cholangiocarcinoma in the personalised era

Cholangiocarcinoma is a group of diverse invasive malignancies arising along the biliary tract. The outcomes for patients with cholangiocarcinoma remain poor but an understanding of molecular aberrations and subsequent targeted therapies to these have opened up new treatment prospects. This review describes the clinical and morphological features and classifications of intrahepatic and perihilar cholangiocarcinoma in addition to laying out the related landscape of the molecular pathology within cholangiocarcinoma. The importance of both a high index of suspicion of cholangiocarcinoma and preserving tissue whilst reporting to access molecular testing and personalised treatment pathways is emphasised

A data-driven approach to decode metabolic dysfunction-associated steatotic liver disease

Metabolic dysfunction-associated steatotic liver disease (MASLD), defined by the presence of liver steatosis together with at least one out of five cardiometabolic factors, is the most common cause of chronic liver disease worldwide, affecting around one in three people. Yet the clinical presentation of MASLD and the risk of progression to cirrhosis and adverse clinical outcomes is highly variable. It therefore represents both a global public health threat and a precision medicine challenge. The use of artificial intelligence (AI) is being investigated in MASLD to develop reproducible, quantitative, and automated methods to enhance patient stratification and to discover new biomarkers and therapeutic targets in MASLD. This review details the different applications of AI and machine learning algorithms in MASLD, particularly in the context of analyzing electronic health record, digital pathology, and imaging data. Additionally, it also describes how specific MASLD consortia are leveraging multimodal data sources to spark research breakthroughs in the field. Using a new national level ‘data commons’ (SteatoSITE) as an exemplar, the opportunities as well as the technical challenges of large-scale databases in MASLD research are highlighted