Relationship between expectation management and client retention in online Cognitive Behavioural Therapy

Background Engaging clients from the outset of psychotherapy is important for therapeutic success. However, there is little research evaluating therapists’ initial attempts to engage clients. This article reports retrospective analysis of data from a trial of online Cognitive Behavioural Therapy (CBT) for depression. Qualitative and quantitative methods were used to evaluate how therapists manage clients’ expectations at the outset of therapy and its relationship with client retention in the therapeutic intervention. Aims To develop a system to codify expectation management in initial sessions of online CBT and evaluate its relationship with retention. Method Initial qualitative research using conversation analysis identified three different communication practices used by therapists at the start of first sessions: no expectation management, some expectation management, and comprehensive expectation management. These findings were developed into a coding scheme that enabled substantial inter-rater agreement (weighted Kappa = 0.78; 95% CI: 0.52 to 0.94) and was applied to all trial data. Results Adjusting for a range of client variables, primary analysis of data from 147 clients found comprehensive expectation management was associated with clients remaining in therapy for 1.4 sessions longer than those who received no expectation management (95% CI: -0.2 to 3.0). This finding was supported by a sensitivity analysis including an additional 21 clients (1.6 sessions, 95% CI: 0.2 to 3.1). Conclusions Using a combination of qualitative and quantitative methods, this study suggests a relationship between expectation management and client retention in online CBT for depression, which has implications for professional practice. A larger prospective study would enable a more precise estimate of retention.

Surface chemical modification of carbon nanowalls for wide-range control of surface wettability

Carbon nanowalls (CNWs) are self-assembled, free-standing, few-layered graphenenano-structures with large surface area, and thin graphene edges. For their application to nanobiotechnology, the effects of chemisorbed species on surface wettability were investigated. The surfaces of as-grown CNWs obtained using CH4/H2 mixture were hydrophilic. After Ar atmospheric pressure plasma treatments for up to 30 s, the contact angles of water droplets on the CNWs decreased from 51° to 5°, owing to a result of oxidation only at edges and surface defects. They increased up to 147° by CF4 plasma treatment at low pressure. The wide-range control of surface wettability of CNWs was realized by post-growth plasma treatments. We also demonstrated detection of bovine serum albumin using surface-modified CNWs as electrodes.

User-led innovation in call center knowledge work

So called “knowledge work” is seen as integral to post-industrial society and, for some, information and communications technologies (ICTs) are critical enablers of the associated practices. Many still propose the technologically deterministic route of rolling out ICTs and expecting that users will, and indeed can, “download” what they know into a system that can then be used in a number of ways. This approach is usually underpinned by the predominant assumption that the system will be developed by one group (developers) and used by another group (users). In this paper, we report on an exploratory case study of the enactment of ICT supported knowledge work in a human resources contact center which illustrates the negotiable boundary between the developer and user in local level innovation processes. Drawing upon ideas from the social shaping of technology, we examine how discussions regarding producer-user relations in innovation processes require a degree of greater sophistication as we show how users often develop (or produce) technologies and work practices in situ—in this case, to enable knowledge work practices and contribute to the project of constructing the knowledge component of professional identity. Much has been made of contextualizing the user; further work is required to contextualize the developer as a user and understand the social actors in ICT innovation environments who straddle both domains

Knowledge Transfer in Transnational Programmes : Opportunities and Challenges for the Pacific Region

The globalised world: The current higher education community The last decade has seen rapid changes in the landscape of higher education (HE) throughout the world, largely as a product of globalisation. A major effect has been to propel the interconnectedness between nations and people across the globe (Scholte, 2005). The use of information and communication technology (ICT) has diminished the distance between countries. The world’s economies are becoming more integrated and interrelated through neoliberal economic policies, free trade agreements and open access of goods and services beyond national borders, policies promulgated by organisations such as the World Trade Organization and The World Bank (Marginson & Ordorika, 2011; Mok, 2011). As a consequence, universities are operating at global, national and local levels simultaneously. In the Pacific region, new universities are emerging. For example, Fiji now has one regional and two national universities; Samoa has a national university and Solomon Islands has an institute of higher education. These new players add to regional competition as they open opportunities for global partnerships and transnational programmes. Thus, participating at these multiple levels is inevitable, and no university is immune to these changes (Marginson, Kaur & Sawir, 2011a). Universities are now part of the global HE community that cannot be confined within a nation’s borders. Transitional HE programmes are perhaps one of the most evident demonstrations of the interconnectedness of universities across countries in this global era.

Experimental colonization of the canine urinary tract with the asymptomatic bacteriuria Escherichia coli strain 83972

Establishment of asymptomatic bacteriuria (ABU) with Escherichia coli 83972 is a viable prophylactic alternative to antibiotic therapy for the prevention of recurrent bacterial urinary tract infection in humans. Approximately 2 x 108 viable E. coli 83972 cells were introduced into the bladder of six healthy female dogs via a sterile urinary catheter. The presence of pyuria, depression, stranguria, pollakiuria and haematuria was documented for 6 weeks and urinalysis and aerobic bacterial cultures were performed every 24–72 h. Pyuria was present in all dogs on day 1 post-inoculation and 4/6 dogs (67%) had a positive urine culture on this day. Duration of colonization ranged from 0 to 10 days (median 4 days). Four dogs were re-inoculated on day 20. Duration of colonization following the second inoculation ranged from 1 to 3 days. No dog suffered pyrexia or appeared systemically unwell but all dogs initially exhibited mild pollakiuria and a small number displayed gross haematuria and/or stranguria. By day 3 of each trial all clinical signs had resolved. Persistent bacteriuria was not achieved in any dog but two dogs were colonized for 10 days following a single inoculation. Further research is required to determine whether establishment of ABU in dogs with recurrent urinary tract infection is a viable alternative to repeated doses of antimicrobial agents.

Supporting collaboration on very large-scale interactive wall surfaces

In this paper we describe CubIT, a multi-user presentation and collaboration system installed at the Queensland University of Technology’s (QUT) Cube facility. The ‘Cube’ is an interactive visualisation facility made up of five very large-scale interactive multi-panel wall displays, each consisting of up to twelve 55-inch multi-touch screens (48 screens in total) and massive projected display screens situated above the display panels. The paper outlines the unique design challenges, features, implementation and evaluation of CubIT. The system was built to make the Cube facility accessible to QUT’s academic and student population. CubIT enables users to easily upload and share their own media content, and allows multiple users to simultaneously interact with the Cube’s wall displays. The features of CubIT were implemented via three user interfaces, a multi-touch interface working on the wall displays, a mobile phone and tablet application and a web-based content management system. Each of these interfaces plays a different role and offers different interaction mechanisms. Together they support a wide range of collaborative features including multi-user shared workspaces, drag and drop upload and sharing between users, session management and dynamic state control between different parts of the system. The results of our evaluation study showed that CubIT was successfully used for a variety of tasks, and highlighted challenges with regards to user expectations regarding functionality as well as issues arising from public use.

Q&A : Christy Dena

Dr. Christy Dena is a noted academic and transmedia writer, experience designer, and director whose work includes the 2011 Digital Emmy-nominated Conspiracy for Good and The Hunt for Cisco. Dena is currently working on AUTHENTIC IN ALL CAPS, an online comedy/drama. Q: How did you get into transmedia? Q: What would you recommend that transmedia creators learn about to improve their craft? Q: What are the most important things to keep in mind when you’re designing an interactive element...

Collection and determination of nucleotide metabolites in neonatal and adult saliva by high performance liquid chromatography with tandem mass spectrometry

Saliva contains a number of biochemical components which may be useful for diagnosis/monitoring of metabolic disorders, and as markers of cancer or heart disease. Saliva collection is attractive as a non-invasive sampling method for infants and elderly patients. We present a method suitable for saliva collection from neonates. We have applied this technique for the determination of salivary nucleotide metabolites. Saliva was collected from 10 healthy neonates using washed cotton swabs, and directly from 10 adults. Two methods for saliva extraction from oral swabs were evaluated. The analytes were then separated using high performance liquid chromatography (HPLC) with tandem mass spectrometry (MS/MS). The limits of detection for 14 purine/pyrimidine metabolites were variable, ranging from 0.01 to 1.0 mu M. Recovery of hydrophobic purine/pyrimidine metabolites from cotton tips was consistently high using water/acetonitrile extraction (92.7-111%) compared with water extraction alone. The concentrations of these metabolites were significantly higher in neonatal saliva than in adults. Preliminary ranges for nucleotide metabolites in neonatal and adult saliva are reported. Hypoxanthine and xanthine were grossly raised in neonates (49.3 +/- 25.4; 30.9 +/- 19.5 mu M respectively) compared to adults (4.3 +/- 3.3; 4.6 +/- 4.5 mu M); nucleosides were also markedly raised in neonates. This study focuses on three essential details: contamination of oral swabs during manufacturing and how to overcome this; weighing swabs to accurately measure small saliva volumes; and methods for extracting saliva metabolites of interest from cotton swabs. A method is described for determining nucleotide metabolites using HPLC with photo-diode array or MS/MS. The advantages of utilising saliva are highlighted. Nucleotide metabolites were not simply in equilibrium with plasma, but may be actively secreted into saliva, and this process is more active in neonates than adults. (C) 2013 Elsevier B.V. All rights reserved.

Is there such a thing as an “irrevocable authority”?

The Queensland Court of Appeal decision of FTV Holdings Cairns Pty Ltd v Smith [2014] QCA 217 analysed many issues concerning the enforceability of an “irrevocable authority” signed by clients directed to their solicitors regarding the payment of money to a third party. The action also drew those solicitors into the litigation as they acted contrary to that “irrevocable authority” by paying the money concerned directly to their clients but upon their clients’ later instructions. The result probably confirmed what many solicitors have believed to be the case for some time but which had never been considered in legal analysis in an appellate court. The facts of the case would be common to many day to day transactions.

Levels and trends of PBDEs and HBCDs in the global environment : status at the end of 2012

In this paper, we have compiled and reviewed the most recent literature, published from January2010 to December 2012, relating to the human exposure, environmental distribution, behaviour, fate and concentration time trends of polybrominated diphenyl ether (PBDE) and hexabromocyclododecane (HBCD) flame retardants, in order to establish their current trends and priorities for future study. Due to the large volume of literature included, we have provided full detail of the reviewed studies as Electronic Supplementary Information and here summarise the most relevant findings. Decreasing time trends for penta-mix PBDE congeners were seen for soils in northern Europe, sewage sludge in Sweden and the USA, carp from a US river, trout from three of the Great Lakes and in Arctic and UK marine mammals and many birds, but increasing time trends continue in Arctic polar bears and some birds at high trophic levels in northern Europe. This is a result of the time delay inherent in long-range atmospheric transport processes. In general, concentrations of BDE209 (the major component of the deca-mix PBDE product) are continuing to increase. Of major concern is the possible/likely debromination of the large reservoir of BDE209 in soils and sediments worldwide, to yield lower brominated congeners which are both more mobile and more toxic, and we have compiled the most recent evidence for the occurrence of this degradation process. Numerous studies reported here reinforce the importance o f this future concern. Time trends for HBCDs are mixed, with both increases and decreases evident in different matrices and locations and, notably, with increasing occurrence in birds of prey.

Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes : Development of a potential measure of diabetic peripheral neuropathy

Purpose To investigate longitudinal changes of subbasal nerve plexus (SNP) morphology and its relationship with conventional measures of neuropathy in individuals with diabetes. Methods A cohort of 147 individuals with type 1 diabetes and 60 age-balanced controls underwent detailed assessment of clinical and metabolic factors, neurologic deficits, quantitative sensory testing, nerve conduction studies and corneal confocal microscopy at baseline and four subsequent annual visits. The SNP parameters included corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL) and were quantified using a fully-automated algorithm. Linear mixed models were fitted to examine the changes in corneal nerve parameters over time. Results At baseline, 27% of the participants had mild diabetic neuropathy. All SNP parameters were significantly lower in the neuropathy group compared to controls (P<0.05). Overall, 89% of participants examined at baseline also completed the final visit. There was no clinically significant change to health and metabolic parameters and neuropathy measures from baseline to the final visit. Linear mixed model revealed a significant linear decline of CNFD (annual change rate, -0.9 nerve/mm2, P=0.01) in the neuropathy group compared to controls, which was associated with age (β=-0.06, P=0.04) and duration of diabetes (β=-0.08, P=0.03). In the neuropathy group, absolute changes of CNBD and CNFL showed moderate correlations with peroneal conduction velocity and cold sensation threshold, respectively (rs, 0.38 and 0.40, P<0.05). Conclusion This study demonstrates dynamic small fiber damage at the SNP, thus providing justification for our ongoing efforts to establish corneal nerve morphology as an appropriate adjunct to conventional measures of DPN.

Queensland's budget austerity and its impact on social welfare : is the cure worse than the disease?

While considerable attention has been paid to the austerity experiments in Europe, much less attention has been paid to austerity case studies from other parts of the world. This paper examines the case of Queensland, Australia, where the government has pursued austerity measures, while making dire warnings that unless public debt was slashed and the public service sector downsized,Queensland risked becoming the Spain of Australia. The comparison is incomprehensible, given the very different economic situation in Queensland compared with Spain. This comparison constructed a sense of crisis that helped to mask standard neoliberal economic reform. While pursuing neoliberal economic policies,the Queensland Government has also been introducing draconian laws that limit civil liberties and political freedoms for ordinary citizens. This mix of authoritarianism and austerity has met considerable resistance, and this dynamic is discussed in the paper, along with the predictable and unequal impact that austerity measures have had on the general population and social services.