Novice Therapist Responsiveness: Description and Development

There is increasing empirical evidence that psychotherapy is very effective when therapists tailor interventions in ways that fit their clients’ difficulties and needs (Kramer, 2009; Snyder & Silberschatz, 2017), a concept that has been named “therapist responsiveness” in the psychotherapy literature (Bacal, 1985; Stiles, Honos-Webb, & Surko, 1998). However, the question of how therapists learn to be responsive rarely has been addressed in research (Hatcher, 2015). The central question of this study was, “How did you learn how to be responsive to clients as a novice therapist, and in what ways are you responsive?” Eleven graduate student therapist trainees were recruited. Phone interviews were conducted in a semi-structured style to ask novice therapists from clinical and counseling psychology Masters-level and doctoral programs to describe their experiences. A grounded-theory approach was used to create themes from the qualitative data. The analysis showed that trainees learned to improve their responsiveness to clients by: (1) becoming more aware of cues related to psychotherapy processes, in client-therapist dynamics, and clients’ identities and contexts; (2) managing their own emotions and engaging in self-care; and (3) adopting mindsets that facilitated trying new relational or therapy approaches while also considering professional boundaries. The implications of these findings to help training programs improve teaching about responsiveness and optimize supports for trainees’ providing responsive treatment were discussed

Quantum Quenches in a Holographic Kondo Model

We study non-equilibrium dynamics and quantum quenches in a recent gauge/gravity duality model for a strongly coupled system interacting with a magnetic impurity with $SU(N)$ spin. At large $N$, it is convenient to write the impurity spin as a bilinear in Abrikosov fermions. The model describes an RG flow triggered by the marginally relevant Kondo operator. There is a phase transition at a critical temperature, below which an operator condenses which involves both an electron and an Abrikosov fermion field. This corresponds to a holographic superconductor in AdS$_2$ and models the impurity screening. We study the time dependence of the condensate induced by quenches of the Kondo coupling. The timescale for equilibration is generically given by the lowest-lying quasinormal mode of the dual gravity model. This mode also governs the formation of the screening cloud, which is obtained as the decrease of impurity degrees of freedom with time. In the condensed phase, the leading quasinormal mode is imaginary and the relaxation of the condensate is over-damped. For quenches whose final state is close to the critical point of the large $N$ phase transition, we study the critical slowing down and obtain the combination of critical exponents $z\nu=1$. When the final state is exactly at the phase transition, we find that the exponential ringing of the quasinormal modes is replaced by a power-law behaviour of the form $\sim t^{-a}\sin(b\log t)$. This indicates the emergence of a discrete scale invariance.Comment: 23 pages + appendices, 11 figure

The Cure: Making a game of gene selection for breast cancer survival prediction

Motivation: Molecular signatures for predicting breast cancer prognosis could greatly improve care through personalization of treatment. Computational analyses of genome-wide expression datasets have identified such signatures, but these signatures leave much to be desired in terms of accuracy, reproducibility and biological interpretability. Methods that take advantage of structured prior knowledge (e.g. protein interaction networks) show promise in helping to define better signatures but most knowledge remains unstructured. Crowdsourcing via scientific discovery games is an emerging methodology that has the potential to tap into human intelligence at scales and in modes previously unheard of. Here, we developed and evaluated a game called The Cure on the task of gene selection for breast cancer survival prediction. Our central hypothesis was that knowledge linking expression patterns of specific genes to breast cancer outcomes could be captured from game players. We envisioned capturing knowledge both from the players prior experience and from their ability to interpret text related to candidate genes presented to them in the context of the game. Results: Between its launch in Sept. 2012 and Sept. 2013, The Cure attracted more than 1,000 registered players who collectively played nearly 10,000 games. Gene sets assembled through aggregation of the collected data clearly demonstrated the accumulation of relevant expert knowledge. In terms of predictive accuracy, these gene sets provided comparable performance to gene sets generated using other methods including those used in commercial tests. The Cure is available at http://genegames.org/cure

Multifocal High-Grade Pancreatic Precursor Lesions: A Case Series and Management Recommendations

Background: The risk of developing invasive cancer in the remnant pancreas after resection of multifocal high-grade pancreatic precursor lesions is not well known. We report three patients who were followed up after resection of multifocal high-grade pancreatic intraepithelial neoplasia (PanIN)-3 or intraductal papillary mucinous neoplasia (IPMN), two of whom eventually developed invasive carcinoma. Presentation: 1) 68-year-old woman who had a laparoscopic distal pancreatectomy for multifocal mixed-type IPMN, identified as high-grade on final pathology, with negative surgical margins. During semiannual monitoring, eight years from the first surgery, the patient developed suspicious features prompting surgical resection of the body with final pathology revealing invasive ductal adenocarcinoma in the setting of IPMN. 2) 48-year-old woman who had a distal pancreatectomy for severe acute/chronic symptomatic pancreatitis, with final pathology revealing multifocal high-grade PanIN-3, with negative surgical margins. Despite semiannual monitoring, two years from the first surgery, the patient developed pancreatic adenocarcinoma with liver metastasis. 3) 55-year-old woman who had a Whipple procedure for symptomatic chronic pancreatitis, with multifocal PanIN-3 on final pathology. The patient underwent completion pancreatectomy due to symptomatology and her high-risk profile, with final pathology confirming multifocal PanIN-3. Conclusion: Multifocal high-grade dysplastic lesions of the pancreas might benefit from surgical resection

Hydrogen site occupancy and strength of forces in nano-sized metal hydrides

The dipole force components in nano-sized metal hydrides are quantitatively determined with curvature and x-ray diffraction measurements. Ab-initio density functional theory is used to calculate the dipole components and the symmetry of the strain field. The hydrogen occupancy in a 100 nm thick V film is shown to be tetrahedral with a slight asymmetry at low concentration and a transition to octahedral occupancy is shown to take place at around 0.07 [H/V] at 360 K. When the thickness of the V layer is reduced to 3 nm and biaxially strained, in a Fe_0.5V_0.5/V superlattice, the hydrogen unequivocally occupies octahedral z-like sites, even at and below concentrations of 0.02 [H/V]