This article outlines the evidence base for the use of paradoxical interventions (PIs) in individual psychotherapy. Often misunderstood, PIs have shown long-term (distal) impacts on clinical ...outcomes, yet a review of the existing literature on these interventions illustrates a trending decline in consideration and use within both research and applied settings. Definitions of PIs and their constituent elements are presented along with clinical examples. We conducted one meta-analysis comparing PIs with a placebo or control and another comparing PIs to other therapeutic methods. PIs demonstrated a large effect (d = 1.1, k = 17 studies) compared to controls and a medium effect size (d = .49, k = 17 studies) compared to other therapeutic methods. We included a review of several case studies using PIs as well. Among the salient findings, there is a lack of assessment measure to track the implementation of PIs in session or a method to track their in-session effects. Further, there is a dearth of contemporary quantitative experimental research and development of PIs. We further advocate for the development and integration of PI training and supervision into clinical education and posteducation programs, given the current data demonstrating clinical utility.
Clinical Impact Statement
Question: This article provides a review of the existing research investigating the clinical utility and efficacy of paradoxical interventions (PI) in psychotherapy. Findings: PIs were shown to have positive effects on patients' symptoms compared to either a control group or when compared to other techniques. Meaning: PIs are useful techniques that can be employed by clinicians in appropriate settings. Next Steps: Based on this study, the researchers advocate for continued research on and the development of PIs for modern practice, as well as the inclusion of PIs in modern training and supervision programs.
Plant flavonoids are widely distributed polyphenolic compounds of the human diet. They consist of six major classes based on specific structural differences: flavonols, flavones, flavanones, ...catechins, anthocyanidins, and isoflavones. All of the major classes of flavonoids are comprised of three six-membered rings: an aromatic A-ring fused to a heterocyclic C-ring that is attached through a single carbon-carbon bond to an aromatic Bring. Population studies have shown that flavonoid intake is inversely correlated with mortality from cardiovascular disease, and numerous flavonoids of dietary significance have been shown to beneficially impact parameters associated with atherosclerosis, including lipoprotein oxidation, blood platelet aggregation, and vascular reactivity. Therapeutic effects of flavonoids on platelet aggregability and blood pressure have been attributed to competitive inhibition of cyclic nucleotide phosphodiesterase (PDE), an elevation in cAMP level, and subsequent activation of protein kinase A (cAMP-dependent protein kinase). In addition, flavonoids may induce neutral lipid hydrolysis from lipid stores through PDE inhibition in adipose tissue and liver. Indeed, the three-dimensional structure of many flavonoids is sterically and electrostatically compatible with the catalytic site of cAMP PDE3 and PDE4. Flavonoids have also been reported to suppress pathways of lipid biosynthesis and of very low-density lipoprotein production in cultured hepatocytes. Continued studies of the biochemical mechanisms underlying the biological effects of plant flavonoids may uncover new strategies for the treatment of cardiovascular disease, as well as associated conditions such as obesity, hepatic steatosis, and Type 2 diabetes.
The hypocholesterolemic and anti-atherosclerotic mechanism by which soy may exert a beneficial effect remains unclear. Peroxisome-proliferator activated receptors (PPAR) are promiscuous nuclear ...receptors that regulate the transcription of genes involved in lipid and glucose homeostasis and lipid metabolism within the cell. We hypothesize that the isoflavones improve lipid and glucose metabolism by acting as an antidiabetic PPAR agonist. Male and female obese Zucker rats (OZR) were used as a model of Type 2 diabetes, and OZR fed a high isoflavone soy protein diet displayed improvements in lipid metabolism consistent with results in humans treated with antidiabetic PPAR agonists such as the fibrates or glitazones. Liver triglyceride and cholesterol concentrations were lower in all OZR fed high-isoflavone soy protein diets than in rats fed low-isoflavone and casein diets (P < 0.05). Concurrently, PPAR-directed gene expression was evaluated in a cell culture model. An isoflavone-containing soy extract doubled PPAR-directed gene expression (P < 0.05) in RAW 264.7 cells containing either a PPARα or PPARγ expression plasmid. A similar induction was observed when the soy isoflavones genistein or daidzein were used to treat cells. Both isoflavones doubled PPARα-directed gene expression (P < 0.05), whereas they increased PPARγ-directed gene expression 200–400% (P < 0.05). This study suggests that soy isoflavones improve lipid metabolism, produce an antidiabetic effect, and activate PPAR receptors.
Volcanoes in Italy and the role of muon radiography D'Alessandro, Raffaello; Ambrosino, F; Baccani, G ...
Philosophical transactions of the Royal Society of London. Series A: Mathematical, physical, and engineering sciences,
12/2018, Letnik:
377, Številka:
2137
Journal Article
Recenzirano
Odprti dostop
Cosmic-ray muon radiography (muography), an imaging technique that can provide measurements of rock densities within the top few 100 m of a volcanic cone, has now achieved a spatial resolution of the ...order of 10 m in optimal detection conditions. Muography provides images of the top region of a volcano edifice with a resolution that is considerably better than that typically achieved with other conventional methods (i.e. gravimetric). We expect such precise measurements, to provide us with information on anomalies in the rock density distribution, which can be affected by dense lava conduits, low-density magma supply paths or the compression with the depth of the overlying soil. The MUon RAdiography of VESuvius (MURAVES) project is now in its final phase of construction and deployment. Up to four muon hodoscopes, each with a surface of roughly 1 m
, will be installed on the slope of Vesuvius and take data for at least 12 months. We will use the muographic profiles, combined with data from gravimetric and seismic measurement campaigns, to determine the stratigraphy of the lava plug at the bottom of the Vesuvius crater, in order to infer potential eruption pathways. While the MURAVES project unfolds, others are using emulsion detectors on Stromboli to study the lava conduits at the top of the volcano. These measurements are ongoing: they have completed two measurement campaigns and are now performing the first data analysis.This article is part of the Theo Murphy meeting issue 'Cosmic-ray muography'.
The therapeutic relationship continues to be one of the most important factors in therapeutic outcomes. Given the place of emotion in the definition of the therapeutic relationship, as well as the ...demonstrated positive impact that emotional expression has on therapeutic process and outcome, it stands to reason that studying the emotional exchange between the therapist and client further would be warranted.
This study used a validated observational coding system--the Specific Affect Coding System (SPAFF) and a theoretical mathematical model to analyze behaviors which make up the therapeutic relationship. Specifically, the researchers used to codify relationship-building behaviors between an expert therapist and his client over the course of six sessions. Dynamical systems mathematical modeling was also employed to create "phase space portraits" depicting the relational dynamics between the master therapist and his client over six sessions.
Statistical analysis was used to compare SPAFF codes and model parameters between the expert therapist and his client. The expert therapist showed stability in affect codes over six sessions while the client's affect codes appeared to be more flexible over time, though model parameters remained stable across the six sessions. Finally, phase space portraits depicted the evolution of the affective dynamics between the master therapist and his client as the relationship matured.
The clinician's ability to stay emotionally positive and relatively stable across the six sessions (relative to the client) was noteworthy. It formed the basis for a stable base from which she could explore alternative methods to relate to others that she had allowed to dictate her actions, which is in keeping with previous research on the role of therapist facilitation of the therapeutic relationship, emotional expression within the therapeutic relationship, and influence of these on client outcomes. These results provide a valuable foundation for future research on emotional expression as a key component of the therapeutic relationship in psychotherapy.
The primary objectives of the study were to evaluate the efficacy and safety of tofacitinib and baricitinib up to 24 months of follow-up in patients with rheumatoid arthritis (RA) treated in Southern ...Italy. Patients' data, activity index, and clinimetric scores were collected at baseline (T0), six (T6), twelve (T12), and twenty-four (T24) months following treatment initiation. At six, twelve, and twenty-four months, adverse events and treatment cessation were also recorded. Sixty-eight patients (mean age: 62.2±10.9 years; mean RA duration: 15±9.6 years) were enrolled over a period of 12 weeks. At baseline, twenty-four patients (35.3%) were treated with tofacitinib, and forty-four patients (64.7%) were treated with baricitinib. The baseline mean disease activity was moderate as measured by DAS28- ESR (5.0±1.0), DAS 28 CRP (4.69±0.94), and SDAI (26.87±10.73) score. Before beginning JAKinhibs therapy, thirty-two patients (61.8%) were taking bDMARDs, while the remaining thirty-six (38.2%) were bDMARDs-naïve. The 24-month retention rate for JAKinhibs was 91.1%. Six months after beginning treatment with JAKinhibs, a statistically significant improvement was observed in all evaluated activity indices and clinimetric scores. Improvement was confirmed during the 12- and 24-month follow-up evaluations. The positive correlation between baseline-T6 SDAI delta and discontinuation of JAKinhibs (p=0.02) suggests that RA worsening in the first six months may be a predictor of therapy withdrawal. Patients with RA responded favorably to tofacitinib and baricitinib in this prospective, real-world study from a single center in Southern Italy. Efficacy was observed despite an underlying persistent and treatment-resistant disease.
Although emotion has long been considered important to psychotherapeutic process, empirical assessment of its impact has emerged only recently. The present study applied two meta-analyses to explore ...the association between therapist expression of emotion and psychotherapy outcome, and client expression of emotion and psychotherapy outcome. Overall, 66 studies (13 for the therapist meta-analysis and 43 for the client meta-analysis) were included. A significant medium effect size was found between the therapist's emotional expression and outcomes (d = 0.56) and a significant medium-to-large effect size between the client's emotional expression and outcomes (d = 0.85). Third-party rating of emotional expression emerged as a significant moderator of outcomes. Limitations of the research, diversity considerations, and therapeutic practices that conclude the article are then presented.
Clinical Impact Statement
Question: We attempted to address the question of what the relationship between client and therapist expressions of affect on therapeutic outcomes was. Findings: Therapist expression of affect had a medium effect on client outcome, whereas client expression of affect had a medium-to-large effect on client outcome. Meaning: Clinicians may wish to reexamine the role of the expression of affect in the therapeutic relationship. Next Steps: Training to recognize and facilitate client emotional expression, as well as training focused on appropriate therapist emotional expression, would be warranted.
The paper presents the application of some Virtual Reality technologies developed in the Horizon 2020 i-MARECulture project to the case study of the sunken “Villa con ingresso a protiro”, dated ...around the II century AD, and located in the Marine Protected Area - Underwater Park of Baiae (Naples).The i-MARECulture project (www.imareculture.eu), in fact, aims to improve the public awareness about the underwater cultural heritage by developing new tool and techniques that take advantage of the virtual reality technologies to allow the general public to explore the archaeological remains outside of the submerged environment.To this end, the paper details the techniques and methods adopted for the development of an immersive virtual tour that allow users to explore, through a storytelling experience, a virtual replica and a 3D hypothetical reconstruction of the complex of the “Villa con ingresso a protiro”.
Muon radiography is a technique based on the measurement of absorption profiles of muons as they pass through matter. This measurement allows to obtain an image of the inner structure of large volume ...objects and is suitable to be applied in several fields, such as volcanology, archaeology and civil engeneering. One of the main applications concerns the study of volcanic structures; indeed it is possible to use this technique to measure the mass distribution inside the edifice of a volcano providing useful information to better understand the possible eruption mechanisms. The MURAVES (MUon RAdiography of VESuvius) project aims to the study of the summital cone of Mt. Vesuvius near Naples in Italy, one of the most dangerous active volcanoes in the world. The MURAVES apparatus is a modular, robust muon hodoscope system with a low power consumption, optimized to be used in inhospitable environments like the surroundings of volcanoes. The complete detection system is an array of identical tracking modules, each with an area of 1 m2, based on the use of plasic scintillators. The technologies, the status and the data analysis strategy of the experiment will be presented in this paper.
Muon Radiography or muography is based on the measurement of the absorption or scattering of cosmic muons, as they pass through the interior of large scale bodies, In particular, absorption muography ...has been applied to investigate the presence of hidden cavities inside the pyramids or underground, as well as the interior of volcanoes’ edifices. The MURAVES project has the challenging aim of investigating the density distribution inside the summit of Mt. Vesuvius. The information, together with that coming from gravimetric measurements, is useful as input to models, to predict how an eruption may develop. The MURAVES apparatus is a robust and low power consumption muon telescope consisting of an array of three identical and independent muon trackers, which provide in a modular way a total sensitive area of three square meters. Each tracker consists of four doublets of planes of plastic scintillator bars with orthogonal orientation, optically coupled to Silicon photomultipliers for the readout of the signal. The muon telescope has been installed on the slope of the volcano and has collected a first set of data, which are being analyzed.
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