3,788 research outputs found
Identification in couple and family therapy
No full textThe term “identification” is etymologically linked to identity and by theoretical extension to projective identification. It indicates the process of assimilating the outside world, allowing one to shape his or her personality on the basis of others’ experiences. Identification is herein examined by following a specific evolutionary line (i.e., from within-couple to offspring-parent identification), then interpreted within the context of couple and family therapy. What is shown is the developmentally most advanced direction taken, that is – paradoxically – its counterpart (i.e., separation-differentiation), otherwise the risk of a collusive identification (i.e., adhesive, massive, or intrusive identification) may occur
A pilot telephone intervention to increase uptake of breast cancer screening in socially deprived areas in Scotland (TELBRECS):study protocol for a randomised controlled trial
No full textBackground: Breast cancer accounts for almost 30% of all cancers and is the second leading cause of cancer deaths in women in Scotland. Screening is key to early detection. The Scottish Breast Screening Programme is a nationwide, free at point of delivery screening service, to which all women aged between 50 and 70 years are invited to attend every 3 years. Currently over three-quarters of invited women regularly attend screening. However, women from more deprived areas are much less likely to attend: for example in the 3 years from 2010-2012 only 63% of women in the most deprived area attended the East of Scotland Breast Screening programme versus 81% in the least deprived. Research has suggested that reminders (telephone or letter) and brief, personalised interventions addressing barriers to attendance may be helpful in increasing uptake in low-income women. Methods/Design. We will employ a brief telephone reminder and support intervention, whose purpose is to elicit and address any mistaken beliefs women have about breast screening, with the aim that the perceived benefits of screening come to outweigh any perceived barriers for individuals. We will test whether this intervention, plus a simple anticipated regret manipulation, will lead to an increase in the uptake of breast cancer screening amongst low-income women who have failed to attend a first appointment, in a randomised controlled trial with 600 women. Participants will be randomly allocated to one of four treatment arms i.e. 1) Letter reminder (i.e. Treatment as usual: CONTROL); 2) Telephone reminder (TEL), 3) Telephone reminder plus telephone support (TEL-SUPP) and 4) Telephone reminder plus support plus AR (TEL-SUPP-AR). The primary outcome will be attendance at breast screening within 3 months of the reminder letter. Discussion. If this simple telephone support intervention (with or without AR intervention) leads to a significant increase in breast screening attendance, this would represent a rare example of a theoretically-driven, relatively simple psychological intervention that could result in earlier detection of breast cancer amongst an under-served group of lower socio-economic women
Community-based men's health promotion programs: eight lessons learnt and their caveats.
No full textLong-standing commentaries about men's reticence for accessing clinical medical services, along with the more recent recognition of men's health inequities, has driven work in community-based men's health promotion. Indeed, the 2000s have seen rapid growth in community-based programs targeting men, and across this expanse of innovative work, experiential and empirical insights afford some important lessons learnt, and caveats to guide existing and future efforts. The current article offers eight lessons learnt regarding the design, content, recruitment, delivery, evaluation and scaling of community-based men's health promotion programs. Design lessons include the need to address social determinants of health and men's health inequities, build activity-based programming, garner men's permission and affirmation to shift masculine norms, and integrate content to advance men's health literacy. Also detailed are lessons learnt about men-friendly spaces, recruitment and retention strategies, the need to incrementally execute program evaluations, and the limits for program sustainability and scaling. Drawing from diverse community-based programs to illustrate the lessons learnt, caveats are also detailed to contextualize and caution some aspects of the lessons that are shared. The express aim of discussing lessons learnt and their caveats, reflected in the purpose of the current article, is to guide existing and future work in the ever growing field of community-based men's health promotion
Reflections of a Jewish, Lesbian Author
No full textIn this essay, Jewish lesbian author Leslea Newman speaks of the importance of finding one's own identity reflected in works of literature, citing examples of her own work, and recommending the writings of other Jewish lesbian authors of merit
Parietal stimulation decouples spatial and feature-based attention
No full textEveryday visual scenes contain a vast quantity of information, only a fraction of which can guide our behavior. Properties such as the location, color and orientation of stimuli help us extract relevant information from complex scenes (Treisman and Gelade, 1980; Livingstone and Hubel, 1987). But how does the brain coordinate the selection of such different stimulus characteristics? Neuroimaging studies have revealed significant regions of overlapping activity in frontoparietal cortex during attention to locations and features, suggesting a global component to visual selection (Vandenberghe et al., 2001; Corbetta and Shulman, 2002; Giesbrecht et al., 2003; Slagter et al., 2007). At the same time, the neural consequences of spatial and feature-based attention differ markedly in early visual areas (Treue and Martinez-Trujillo, 2007), implying that selection may rely on more specific top-down processes. Here we probed the balance between specialized and generalized control by interrupting preparatory attention in the human parietal cortex with transcranial magnetic stimulation (TMS). We found that stimulation of the supramarginal gyrus (SMG) impaired spatial attention only, whereas TMS of the anterior intraparietal sulcus (aIPS) disrupted spatial and feature-based attention. The selection of different stimulus characteristics is thus mediated by distinct top-down mechanisms, which can be decoupled by cortical interference
Ursodeoxycholic acid to reduce adverse perinatal outcomes for intrahepatic cholestasis of pregnancy: the PITCHES RCT
No full textBackground:
Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and raised serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment, but without an adequate evidence base. /
Objective:
We aimed to evaluate whether or not ursodeoxycholic acid reduces adverse perinatal outcomes in affected women. /
Design:
Multicentre, masked, randomised, placebo-controlled, two-arm, parallel-group trial. /
Setting:
Thirty-three UK maternity units. /
Participants:
Women with intrahepatic cholestasis of pregnancy aged ≥ 18 years, between 20+0 and 40+6 weeks’ gestation with a singleton or twin pregnancy and no known lethal fetal anomaly. /
Interventions:
Women were randomly assigned (1 : 1 allocation ratio) to take ursodeoxycholic acid tablets or matched placebo tablets, at an equivalent dose of 1000 mg daily, titrated as needed. /
Main outcome measures:
The primary outcome was a composite of perinatal death (in utero fetal death after randomisation or known neonatal death up to 7 days) or preterm delivery (< 37 weeks’ gestation) or neonatal unit admission for at least 4 hours (from birth until hospital discharge). Each infant was counted once within this composite. Analyses were by intention to treat. /
Results:
Between 23 December 2015 and 7 August 2018, 605 women were randomised, with 305 women allocated to the ursodeoxycholic acid arm and 300 women to the placebo arm. There was no evidence of a significant difference in the incidence of the primary outcome between the groups: 23.0% (74 out of 322 infants) in the ursodeoxycholic acid group compared with 26.7% (85 out of 318 infants) in the placebo group; adjusted risk ratio 0.85 (95% confidence interval 0.62 to 1.15). There was no evidence of a significant difference in total costs (maternal, infant and the cost of ursodeoxycholic acid) between the two trial groups. There were two serious adverse events in the ursodeoxycholic acid group and six in the placebo group. /
Limitations:
Limitations include a primary outcome event rate in the control group that was lower than that estimated for the sample size calculation, but the lack of evidence of effect in all analyses suggests that it is unlikely that the trial had insufficient power. /
Conclusions:
In this clinical trial of ursodeoxycholic acid in women with intrahepatic cholestasis of pregnancy, there is no evidence that it is effective in reducing a composite of adverse perinatal outcomes. /
Future work:
Future research should aim to elucidate the aetiology and pathophysiology of adverse perinatal outcomes, particularly stillbirth, in women with intrahepatic cholestasis of pregnancy to assist the development of an effective preventative treatment. Further exploratory analyses may identify groups of women who might respond to ursodeoxycholic acid treatment. /
Trial registration:
Current Controlled Trials ISRCTN91918806. /
Funding:
This project was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 7, No. 9. See the NIHR Journals Library website for further project information
Large Eddy Simulations of gaseous flames in gas turbine combustion chambers
No full textRecent developments in numerical schemes, turbulent combustion models and the regular increase of computing power allow Large Eddy Simulation (LES) to be applied to real industrial burners. In this paper, two types of LES in complex geometry combustors and of specific interest for aeronautical gas turbine burners are reviewed: (1) laboratory-scale combustors, without compressor or turbine, in which advanced measurements are possible and (2) combustion chambers of existing engines operated in realistic operating conditions. Laboratory-scale burners are designed to assess modeling and funda- mental flow aspects in controlled configurations. They are necessary to gauge LES strategies and identify potential limitations. In specific circumstances, they even offer near model-free or DNS-like LES computations. LES in real engines illustrate the potential of the approach in the context of industrial burners but are more difficult to validate due to the limited set of available measurements. Usual approaches for turbulence and combustion sub-grid models including chemistry modeling are first recalled. Limiting cases and range of validity of the models are specifically recalled before a discussion on the numerical breakthrough which have allowed LES to be applied to these complex cases. Specific issues linked to real gas turbine chambers are discussed: multi-perforation, complex acoustic impedances at inlet and outlet, annular chambers.. Examples are provided for mean flow predictions (velocity, temperature and species) as well as unsteady mechanisms (quenching, ignition, combustion instabil- ities). Finally, potential perspectives are proposed to further improve the use of LES for real gas turbine combustor designs
Study of the bunch crossing identification at LHC using microstrip gas chambers
No full textDuring the beam test of a tracker prototype for the Compact Muon Solenoid detector proposed for the LHC, the time response of the Microstrip Gas Chambers was studied using different gases and chamber gaps. The subsequent efficiency to identify the bunch crossings at LHC is discussed for several algorithms used in the off-line signal processing of the data.0SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Performance of the CMS cathode strip chambers with cosmic rays
No full textPerformance of the CMS cathode strip chambers with cosmic ray
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