Phases of the work of Maurice Barrès

Thesis (M.A.)--Boston Universit

Reply to Gennaro

Last year Charlotte Shreve and I presented an argument that synesthesia contains evidence against higher order thought theories of consciousness. Rocco Gennaro took up the challenge and argued that H.O.T. theories like his could handle the example and dismiss the argument. Below we suggest otherwise. We think the traditional versions of H.O.T. theory are still vulnerable to our argument and we maintain that Gennaro’s version is as well

Evaluating the Feasibility and Efficacy of a Brief Motivational Interviewing Nutrition Intervention for Women with Type 2 Diabetes in Primary Care

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes. Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this site. Methods: The design of this study was a quasi-experimental posttest intervention design guided by the PDSA model for improvement. The study took place in two phases at a women’s health primary care clinic. In phase one, providers at the clinic were surveyed assessing current nutrition counseling practices for patients with type two diabetes. The primary provider measure includes survey responses. In phase two, a brief motivational interviewing intervention was carried out for eligible patients at the clinic. Participant demographics and body mass index were collected at baseline. The primary patient measure is a diet modification SMART goal identified during the intervention. Secondary patient measure includes subjective evaluation of the intervention. Results: Nearly 80% of providers reported having adequate knowledge of MI and felt that MI is useful for eliciting behavior change in patients with T2DM. About 50% of providers reported feeling confident in using MI in their practice. Barriers to delivering nutrition counseling included time and one provider desired more information about MI. Three of the four patient participants identified a SMART goal during the intervention. The intervention was delivered in less than six minutes for three of the four patient participants and less than ten minutes for one patient participant. Patient participant SMART goals included increasing vegetable servings, portion control, and cooking at home. None of the participants completed the follow up survey. Conclusions: The findings from this study support that a brief motivational interviewing intervention can be feasible for primary care providers to deliver and an effective method for delivering nutritional counseling and facilitating nutritional goal setting for patients with type two diabetes and body mass index greater than 30. Additional PDSA cycles are needed before full implementation. Study limitations are presented and practice recommendations are discussed

Exploring the experiences of paediatric diabetes professionals : the therapeutic relationship, compassion fatigue and compassion satisfaction

This portfolio thesis comprises of three parts: a systemic literature review, an empirical paper and the corresponding appendices.Part one is a literature review exploring the literature surrounding the development and maintenance of the therapeutic relationship between patients, families and health care professionals in type 1 diabetes. The results suggest a variety of factors which affect the development and maintenance of the therapeutic relationship primarily from the parents and young adult’s perspectives.Part two is an empirical paper which investigated compassion fatigue and compassion satisfaction in professionals who work with children with type 1 diabetes. Using an online survey and quantitative methodology, the following information was collected: profession, years working in diabetes, caseload size, percentage of caseload classed as complex, percentage of caseload with HbA1c above 69 mmol/mol and personal stressors. General linear regression models were completed with all work related factors not statistically significant apart from personal stressors.Part three has the Appendices from part one and two

Final Project Report Will Power Africa, Year 2

This report outlines the process that the Will Power Africa Year 2 team used to design and evaluate a backup power generator for a remote village in Tsholotsho, Zimbabwe. Year 1 of this project focused on the design of an electric fence to repel elephants. The original prototype is designed around the use of solar panels for power; however, due to the inconsistencies of solar power, the Year 2 team was tasked with creating a secondary power system to connect to the previous year’s system. We completed four tests that evaluated the major functionality and safety of our sub-systems. Due to the working criteria and requirements set by our sponsor, it was decided that a thermoelectric generator (TEG), fueled by a wood-fired rocket stove, would be ideal for the project. This design consisted of an alarm system which would alert the villagers if the battery passed a minimum threshold, a TEG that would be connected should the solar panel fail to produce the needed power, and a rocket stove to power said generator. The system is able to produce 12V, however, the 8.31 Watts of power generated during charging is less than the 15 Watt goal for the design. The system does meet the safety requirements for international standards and travel capacity. The final design was tested and can function in a multitude of different weather conditions including high humidity, high winds, cloud cover, sunny, below 50°F and above 90°F. While the system does effectively charge the battery with an 8.31 Watt power, this is lower than our original requirement. Despite this, the system is capable of charging the lithium ion battery in Tsholotsho. The generator successfully generates enough power to charge the electric fence during normal use, but may not be able to keep up with other high-power demands. Each subsystem has been designed to operate even in suboptimal power generation. The rocket stove heat source is also designed to be recreateable by the villagers in Zimbabwe to meet international air travel weight requirements. During the completion of this report, it became evident that there was an issue in the TEG data sheet which prevented us from maximizing power output. Future adjustments will include lowering the rocket stove height to approach a more effective operating temperature. Future iterations may also consider a convection-based pump-cooled thermoelectric generator

Road user charging and social exclusion: The impact of congestion charges on at-risk groups.

The importance of social exclusion in the context of congestion charging is discussed, and the groups most particularly at-risk identified. A new technique, based on generation and investigation of a synthetic population is introduced and used to establish the impacts on at-risk groups of six congestion charging schemes in Leeds. The distribution and severity of impacts are seen to depend crucially on the precise definition of the charge area, the basis of the charges and exemptions provided. Using the new technique, it can be seen how the impact on at-risk groups could be minimized without compromising the overall objectives of congestion charging. Further potential applications of the new technique are outlined

Training response inhibition to reduce food consumption: Mechanisms, stimulus specificity and appropriate training protocols

Training individuals to inhibit their responses towards unhealthy foods has been shown to reduce food intake relative to a control group. Here we aimed to further explore these effects by investigating the role of stimulus devaluation, training protocol, and choice of control group. Restrained eaters received either inhibition or control training using a modified version of either the stop-signal or go/no-go task. Following training we measured implicit attitudes towards food (Study 1) and food consumption (Studies 1 and 2). In Study 1 we used a modified stop-signal training task with increased demands on top-down control (using a tracking procedure and feedback to maintain competition between the stop and go processes). With this task, we found no evidence for an effect of training on implicit attitudes or food consumption, with Bayesian inferential analyses revealing substantial evidence for the null hypothesis. In Study 2 we removed the feedback in the stop-signal training to increase the rate of successful inhibition and revealed a significant effect of both stop-signal and go/no-go training on food intake (compared to double-response and go training, respectively) with a greater difference in consumption in the go/no-go task, compared with the stop-signal task. However, results from an additional passive control group suggest that training effects could be partly caused by increased consumption in the go control group whereas evidence for reduced consumption in the inhibition groups was inconclusive. Our findings therefore support evidence that inhibition training tasks with higher rates of inhibition accuracy are more effective, but prompt caution for interpreting the efficacy of laboratory-based inhibition training as an intervention for behaviour change