European American Therapist Self-Disclosure in Cross-Cultural Counseling

Eleven European American psychotherapists\u27 use of self-disclosure in cross-cultural counseling was studied using consensual qualitative research. As reasons for self-disclosing, therapists reported the intent to enhance the counseling relationship, acknowledge the role of racism/oppression in clients\u27 lives, and acknowledge their own racist/oppressive attitudes. Results indicated that therapists typically shared their reactions to clients\u27 experiences of racism or oppression and that these self-disclosures typically had positive effects in therapy, often improving the counseling relationship by helping clients feel understood and enabling clients to advance to other important issues

Analyzing and Modeling the Performance of the HemeLB Lattice-Boltzmann Simulation Environment

We investigate the performance of the HemeLB lattice-Boltzmann simulator for cerebrovascular blood flow, aimed at providing timely and clinically relevant assistance to neurosurgeons. HemeLB is optimised for sparse geometries, supports interactive use, and scales well to 32,768 cores for problems with ~81 million lattice sites. We obtain a maximum performance of 29.5 billion site updates per second, with only an 11% slowdown for highly sparse problems (5% fluid fraction). We present steering and visualisation performance measurements and provide a model which allows users to predict the performance, thereby determining how to run simulations with maximum accuracy within time constraints.Comment: Accepted by the Journal of Computational Science. 33 pages, 16 figures, 7 table

Pathways and nerve densities in cerebrovascular innervation

It is gradually becoming clear that cerebrovascular nerves contribute to the control of the cerebral circulation although the knowledge of the functional mechanisms is far from complete. However, many aspects of the morphologic substrate have been identified. The basal cerebral arteries receive sympathetic, parasympathetic and sensory innervation, utilizing the superior cervical and stellate, the pterygopalatine and otic, and the trigeminal ganglia, respectively, as the main peripheral sources. Many of the neural pathways to the cerebral arteries have been elucidated. Those to the supratentorial arterial tree are distributed via the cavernous sinus and surrounding regions. Not only the "classical" neurotransmitters, but also many neuropeptides are found in cerebrovascular nerves. This will lead to new insights since the concepts of cotransmission and neuromodulation have been established now. In the arterial wall, a multilayered organization of nerves has been recognized, consisting of paravascular nerve bundles of passage, a superficial plexus and a terminal plexus located at the adventitial-medial border. Human basal cerebral arteries display a topographical heterogeneity of densities of terminal nerve plexuses. Highest nerve densities are found in arterial segments forming the circle of Willis, in the efferent part of the posterior cerebral artery and in the anterior choroidal artery. Nerve density appears to be determined by locality rather than vascular diameter. Furthermore, local decreases in nerve density are observed with ageing and disease in animals and humans.Biomedical Reviews 1995; 4: 35-46

A Systematic Review of Web-Based Interventions for Patient Empowerment and Physical Activity in Chronic Diseases: Relevance for Cancer Survivors

Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such interventions are still uncommon for cancer survivors. Objective: The objective of this study was to systematically review the literature regarding interactive Web-based interventions. We focused on interventions aimed at increasing patient empowerment and physical activity for various chronic conditions, and explored their possible relevance for cancer survivors. Methods: Searches were performed in PubMed, Embase, and Scopus to identify peer-reviewed papers reporting on randomized controlled trials that studied the effects of Web-based interventions. These interventions were developed for adults with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, heart failure, or cancer. Intervention characteristics, effects on patient empowerment and physical activity, information on barriers to and facilitators of intervention use, users’ experiences, and methodological quality were assessed. Results were summarized in a qualitative way. We used the recommendations of the Institute of Medicine (IOM) regarding cancer survivorship care to explore the relevance of the interventions for cancer survivors. Results: We included 19 papers reporting on trials with 18 unique studies. Significant, positive effects on patient empowerment were reported by 4 studies and 2 studies reported positive effects on physical activity. The remaining studies yielded mixed results or no significant group differences in these outcomes (ie, no change or improvement for all groups). Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included education, self-monitoring, feedback/tailored information, self-management training, personal exercise program, and communication (eg, chat, email) with either health care providers or patients. Limited information was found on barriers, facilitators, and users’ experiences. Methodological quality varied, with 13 studies being of moderate quality. The reported Web-based intervention elements appeared to be highly relevant to address the specific needs of cancer survivors as indicated by the IOM. Conclusions: We identified 7 common elements of interactive, Web-based interventions in chronic disease settings that could possibly be translated into eHealth recommendations for cancer survivors. While further work is needed to determine optimal intervention characteristics, the work performed in other chronic disease settings provides a basis for the design of an interactive eHealth approach to improve patient empowerment and physical activity in cancer survivors. This may subsequently improve their health status and quality of life and reduce their need for supportive car

Optimal location of tsunami warning buoys and sea level monitoring stations in the mediterranean sea

The present study determines the optimal location of detection components of a tsunami warning system in the Mediterranean region given the existing and planned infrastructure. Specifically, we examine the locations of existing tsunameters DART buoys and coastal sea-level monitoring stations to see if additional buoys and stations will improve the proportion of the coastal population that may receive a warning ensuring a timely response. A spreadsheet model is used to examine this issue. Based on the historical record of tsunamis and assuming international cooperation in tsunami detection, it is demonstrated that the existing network of sea level stations and tsunameters enable around ninety percent of the coastal population of the Mediterranean Sea to receive a 15 minute warning. Improvement in this result can be achieved through investment in additional real-time, coastal, sea level monitoring stations. This work was undertaken as a final year undergraduate research project

Specificity of psychopathology across levels of severity:a transdiagnostic network analysis

A prominent hypothesis within the field of psychiatry is that the manifestation of psychopathology changes from non-specific to specific as illness severity increases. Using a transdiagnostic network approach, we investigated this hypothesis in four independent groups with increasing psychopathology severity. We investigated whether symptom domains became more interrelated and formed more clusters as illness severity increased, using empirical tests for two network characteristics: global network strength and modularity-based community detection. Four severity groups, ranging from subthreshold psychopathology to having received a diagnosis and treatment, were derived with a standardized diagnostic interview conducted at age 18.5 (n = 1933; TRAILS cohort). Symptom domains were assessed using the Adult Self Report (ASR). Pairwise comparisons of the symptom networks across groups showed no difference in global network strength between severity groups. Similar number and type of communities detected in the four groups exceeded the more minor differences across groups. Common clusters consisted of domains associated with attention deficit hyperactivity disorder (ADHD) and combined depression and anxiety domains. Based on the strength of symptom domain associations and symptom clustering using a network approach, we found no support for the hypothesis that the manifestation of psychopathology along the severity continuum changes from non-specific to specific