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Objectives: Clinical perfectionism, characterised by stringent standards and persistent striving, correlates with self-criticism and poor wellbeing. In this study we explored the mediating roles of psychological flexibility and inflexibility, and self-compassion, in the relationships of clinical perfectionism with distress, and clinical perfectionism and wellbeing. Methods: We used a cross-sectional correlational study design. A non-clinical sample of 210 Australian residents aged between 18 to 65 years old completed an online survey. Data were analysed using correlational, multiple regression, and parallel mediation analysis. Results: Heightened clinical perfectionism was associated with lower wellbeing and increased distress. Regression models revealed significant mediation by psychological inflexibility processes (self-as-content, experiential avoidance, cognitive fusion) and self-compassion. Cognitive fusion and inaction mediated clinical perfectionism-distress, while self-compassion and inaction mediated clinical perfectionism-psychological wellbeing. Conclusions: These findings support clinical perfectionism as a transdiagnostic predictor of distress and reduced wellbeing. Those with high clinical perfectionism tend to rigidly respond to perfectionistic thoughts, avoid uncomfortable emotions, and engage in value-disconnected inaction. Associations between psychological flexibility and inflexibility processes emphasise their multidimensional nature, distinct yet interrelated. Inaction emerges as a common process in clinical perfectionism-distress and clinical perfectionism-wellbeing, while cognitive fusion specifically influences distress, and limited self-compassion affects wellbeing. Key Points: What is already known about this topic: Clinical perfectionism is linked to psychopathology and transdiagnostic mechanisms, impacting distress and psychological wellbeing. Psychological inflexibility provides a transdiagnostic framework for understanding how rigid and self-limiting responses to feelings and thoughts are maintained despite negative consequences. Clinical perfectionism may be a form of psychological inflexibility, with rigid responses to perfectionistic thoughts, avoidance of uncomfortable emotions, and value-disconnected inaction. What this topic adds: Cognitive fusion and inaction are crucial for understanding clinical perfectionism's impact on distress. Self-compassion and inaction play a key role in understanding the relationship between clinical perfectionism and wellbeing. Understanding the functions of inaction is vital for fostering flexible responses to perfectionistic thoughts. [ABSTRACT FROM AUTHOR]

Cardiac substructure dose metrics are more strongly linked to late cardiac morbidities than to whole-heart metrics. Magnetic resonance (MR)–guided radiation therapy (MRgRT) enables substructure visualization during daily localization, allowing potential for enhanced cardiac sparing. We extend a publicly available state-of-the-art deep learning framework, "No New" U-Net, to incorporate self-distillation (nnU-Net.wSD) for substructure segmentation for MRgRT. Eighteen (institute A) patients who underwent thoracic or abdominal radiation therapy on a 0.35 T MR-guided linear accelerator were retrospectively evaluated. On each image, 1 of 2 radiation oncologists delineated reference contours of 12 cardiac substructures (chambers, great vessels, and coronary arteries) used to train (n = 10), validate (n = 3), and test (n = 5) nnU-Net.wSD by leveraging a teacher-student network and comparing it to standard 3-dimensional U-Net. The impact of using simulation data or including 3 to 4 daily images for augmentation during training was evaluated for nnU-Net.wSD. Geometric metrics (Dice similarity coefficient, mean distance to agreement, and 95% Hausdorff distance), visual inspection, and clinical dose-volume histograms were evaluated. To determine generalizability, institute A's model was tested on an unlabeled data set from institute B (n = 22) and evaluated via consensus scoring and volume comparisons. nnU-Net.wSD yielded a Dice similarity coefficient (reported mean ± SD) of 0.65 ± 0.25 across the 12 substructures (chambers, 0.85 ± 0.05; great vessels, 0.67 ± 0.19; and coronary arteries, 0.33 ± 0.16; mean distance to agreement, <3 mm; mean 95% Hausdorff distance, <9 mm) while outperforming the 3-dimensional U-Net (0.583 ± 0.28; P <.01). Leveraging fractionated data for augmentation improved over a single MR simulation time point (0.579 ± 0.29; P <.01). Predicted contours yielded dose-volume histograms that closely matched those of the clinical treatment plans where mean and maximum (ie, dose to 0.03 cc) doses deviated by 0.32 ± 0.5 Gy and 1.42 ± 2.6 Gy, respectively. There were no statistically significant differences between institute A and B volumes (P >.05) for 11 of 12 substructures, with larger volumes requiring minor changes and coronary arteries exhibiting more variability. This work is a critical step toward rapid and reliable cardiac substructure segmentation to improve cardiac sparing in low-field MRgRT. [ABSTRACT FROM AUTHOR]

AbstractProblem, research strategy, and findingsTakeaways for practiceCovid-19 significantly altered work, out-of-home activity participation, and travel, with much activity time being moved into the home. If these patterns hold, they could imply significant long-term changes for homes, businesses, cities, and transportation. We examined data for 34,000 respondents to the American Time Use Survey from 2019 (the pre-pandemic period), 2021 (the pandemic period), and 2022 and 2023 (the post-pandemic period). We used ordinary least squares (OLS) regressions to study participation in 12 out-of-home activities, travel (by auto, transit, and walking), and 16 in-home activities. We observed sharp declines in overall out-of-home activity, travel by all modes, and 10 of the 12 specific out-of-home activities in 2021 compared with 2019, whereas time spent on 13 of the 16 in-home activities rose during that period. By 2023, most of these changes persisted: Time spent out-of-home, traveling by all modes, and on six out-of-home activities remained notably lower in 2023 than in 2019, whereas time spent on nine in-home activities remained higher. The trend away from out-of-home activities and travel appears to be persisting.First, given elevated remote work and shopping, planners should consider repurposing some office and retail land uses. Second, with fewer office workers, center cities may have to capitalize on other strengths such as recreational and residential desirability for some market segments, such as young people or others who prefer urban living. Third, more time at home may increase demand for more spacious and affordable housing, perhaps in lower-cost outlying suburbs of large metros and in smaller metropolitan areas. Finally, an end to ever-rising personal travel may lessen the need for costly interventions to increase the capacity of highway and transportation systems. [ABSTRACT FROM AUTHOR]

Effective interventions that facilitate adjustment following acquired brain injury (ABI) are needed to improve long-term outcomes and meaningful reengagement in life. VaLiANT is an 8-week group intervention that combines cognitive rehabilitation with Acceptance and Commitment therapy to improve valued living, wellbeing, and adjustment. This study explored participant experiences of VaLiANT to optimize its ongoing development. This included characterization of individually meaningful treatment outcomes, mechanisms of action, and intervention acceptability. Qualitative interviews and quantitative ratings were collected from 39 ABI survivors (Mage = 52, SD = 15; 54% stroke) following their participation in VaLiANT. Participants reported diverse outcomes which resulted in three themes being generated following reflexive thematic analysis. “A fuller toolkit for life with brain injury” indicated increased strategy usage and better daily functioning; “The value of connection and belonging” captured the importance of social experiences in shaping recovery; and “Finding the me I can be” represented cognitive, behavioural, and emotional aspects of identity reconstruction post-ABI. The content and delivery of the intervention were rated highly but participants desired greater follow-up and tailoring of the intervention. Overall, VaLiANT appears to facilitate adjustment through several mechanisms, but greater intervention individualization and dosage may be required to enhance the treatment impact. [ABSTRACT FROM AUTHOR]

Purpose: Acceptance and Commitment Therapy for psychosis (ACTp) is a contextual behavioural intervention that promotes psychological flexibility by fostering active acceptance, cognitive defusion, values construction and committed action to enhance well‐being and recovery. Multiple studies have shown that ACTp is acceptable and efficacious, but questions remain as to its distinction from similar approaches and the conditions under which it would be implemented most effectively. Methods: We present the current evidence for processes and outcomes of ACTp and summarise the qualitative findings of experiences of service users in ACT programmes. We compare ACTp with other cognitive behavioural therapies and mindfulness‐informed interventions for psychosis. Results: Acceptance and commitment therapy for psychosis is promising as a pragmatic, process‐driven intervention model. Further efforts are needed to investigate psychological flexibility in the context of psychosis with observational, experimental and intervention studies that will inform model scope and treatment refinement. Additionally, implementation research is the necessary next step, including how support persons can be trained in ACTp. Lower intensity and technology‐assisted approaches have the potential to reduce barriers to accessing ACTp and extend impact. Conclusions: Over the last 20 years, ACTp has demonstrated meaningful effects in individual and group formats in a range of settings, targeting outcomes such as rehospitalisation, depression, psychotic symptom distress and impact. Future work should focus on how best to integrate ACTp with other current evidence‐based interventions for psychosis. [ABSTRACT FROM AUTHOR]

Simple Summary: The segmentation of the ventricular tachycardia target is complex, error-prone, and time-consuming when performed manually. Currently, target generation for ventricular tachycardia is performed manually through viewing electro-anatomic mapping which is incredibly error-prone due to the current lack of a method to directly register electro-anatomic data to radiation therapy planning images. This work presents a novel model to automatically provide the 17 segments of the left ventricle as defined by the American Heart Association on any imaging modality for radiation therapy planning. This is completed through the use of principal component analysis. These segments can then be used as an aid for radiation therapy planning for physicians and physicists in numerous ways. Namely, by offering significant improvements to target generation consistency and time-saving measures which in turn offers strong potential for widespread application to institutions conducting radio-ablation of the left ventricular myocardium. There has been a recent effort to treat high-risk ventricular tachycardia (VT) patients through radio-ablation. However, manual segmentation of the VT target is complex and time-consuming. This work introduces ASSET, or Auto-segmentation of the Seventeen SEgments for Tachycardia ablation, to aid in radiation therapy (RT) planning. ASSET was retrospectively applied to CTs for 26 thoracic RT patients (13 undergoing VT ablation). The physician-defined parasternal long-axis of the left ventricle (LV) and the axes generated from principal component analysis (PCA) were compared using mean distance to agreement (MDA) and angle of separation. The manually selected right ventricle insertion point and LVs were used to apply the ASSET model to automatically generate the 17 segments of the LV myocardium (LVM). Physician-defined parasternal long-axis differed from PCA by 1.2 ± 0.3 mm MDA and 6.9 ± 0.7 degrees. Segments differed by 0.69 ± 0.29 mm MDA and 0.89 ± 0.03 Dice similarity coefficient. Running ASSET takes <5 min where manual segmentation took >2 h/patient. Agreement between ASSET and expert contours was comparable to inter-observer variability. Qualitative scoring conducted by three experts revealed automatically generated segmentations were clinically useable as-is. ASSET offers efficient and reliable automatic segmentations for the 17 segments of the LVM for target generation in RT planning. [ABSTRACT FROM AUTHOR]

People with disabilities tend to participate in fewer out-of-home activities, raising concerns about their well-being. This paper investigates travel and activity barriers faced by people with disabilities using data from the American Time Use Survey from 2008 to 2019. Our dependent variable of interest is a measure of realized accessibility known as a travel time price: that is, the number of travel minutes associated with each minute of out-of-home activity time. In using this measure, we first confirm that out-of-home activities are associated with greater subjective well-being, that travel is associated with relatively low well-being, and that travel time prices are negatively associated with life satisfaction. We next find that people with disabilities typically pay a travel time price premium 50 percent higher than those without disabilities for all out-of-home activities, and 11 percent higher for work trips. These premiums narrow but persist when accounting for personal characteristics and travel mode. We discuss the unique contributions of simple linear and multiple regression results, given that disability is so closely linked to personal characteristics like employment, income, and marital status. We then disaggregate the results by type of disability and close by presenting ideas for removing transportation and activity barriers for the heterogenous population of people with disabilities. [ABSTRACT FROM AUTHOR]

Background: This study aimed to generate a grounded theory of change processes as experienced by people with psychosis who engaged in an Acceptance and Commitment Therapy (ACT) group program. A secondary aim was to identify how participants described changes in their relationship to distress following the groups. Methods: The study used a qualitative research methodology, grounded theory. This was used to explore emergent themes in the participants' subjective experiences of group ACT delivered in community mental health services. The experience of the ACT group process was investigated for nine participants. Semi-structured interviews were used to explore how the group experience and the exercises, metaphors and skills promoted by ACT were used by participants in their daily lives. Results: There were four main themes emerging from the interviews: awareness, relating differently, reconnection with life, leaning on others. Conclusions: The participants all described experiencing subjective benefits from being involved in the ACT groups, along with perspectives on processes of change. These reports of changes were consistent with the model and extend our understanding of the lived experience of engaging in ACT for psychosis groups. [ABSTRACT FROM AUTHOR]

Given the urgency of addressing transportation's contribution to climate change, this new history of the electric vehicle (EV) by Matthew Eisler of the University of Strathclyde is both timely and relevant. Eisler argues that a host of U.S. government-led efforts to fund EV research had very mixed results. Eisler argues that EVs were held back by a failure of governments and private firms to focus on purpose-built EV power sources. [Extracted from the article]

Statistics anxiety is a significant problem for students' learning experience in the psychological sciences. This article explores a novel teaching methodological approach during the global pandemic to improve students' performance by reducing their statistics anxiety. The subject design and teaching methodological approach were developed based on twenty years of experience taking into consideration the student feedback, while its implementation was aligned with the 5-E's Victorian Teaching and Learning pedagogical Model (VTLM). Moreover, to reduce the statistics anxiety, two sections were embedded in the Learning Management System of the subject: (1) an interactive web-based mindfulness intervention and (2) a head-start 'Ready, Set, Go' information pack. The implementation of these approaches resulted in a better understanding of statistical concepts and utilization of the SPSS software by the majority of the students (80% pass-rate). Consequently, a 6% increase in pass rates and an average of 32% increase in satisfaction scores for each item in the university central survey were observed. While the uniqueness of the first year of COVID-period makes comparisons difficult, it is matched by the urgency of the need for effective interventions to support student success. [ABSTRACT FROM AUTHOR]

The transportation network companies (TNCs) Uber and Lyft have introduced shared ride services, called "UberPool" and "Lyft Shared," which use real-time cyber-connectivity to match travelers with similar origins and destinations so they can share discounted rides. It is hoped this will reduce the amount of vehicle miles traveled that TNCs are adding to the roads. However, previous evidence suggests that drivers and passengers have some dissatisfaction with these services. This paper uses a survey of 309 TNC drivers to examine the driver experience with providing shared rides. We find that in the aggregate drivers are considerably less satisfied with providing shared trips compared to solo trips with services such as UberX and Lyft Classic. There are a number of sources of dissatisfaction. Although some feel shared services add to their earnings, more drivers perceive their compensation for shared rides to be unfair. Further, although drivers sometimes enjoy the social interactions that Pool and Shared generate, many drivers complain that customers are often unhappy due to issues like trips taking longer than expected and friction between passengers. Finally, drivers feel serving shared trips is difficult and stressful work, due to things like routing and pick-up instructions that sometimes seem irrational and change frequently, difficult pick-ups and drop-offs, and long trips. We offer suggestions for improving driver satisfaction with Pool/Shared by raising and restructuring driver compensation, better publicizing the ways in which Pool/Shared increase driver incomes, increasing ridership through means such as better advertising of shared services and raising the price of solo travel, improving the information given to drivers, incentivizing good passenger behavior, and improving the passenger experience. • UberPool and Lyft Shared drivers tend to be less satisfied providing shared trips compared with solo trips. • UberPool and Lyft Shared drivers tend to view their compensation for providing shared trips as inadequate. • UberPool and Lyft Shared drivers often find the work of providing shared trips difficult and stressful. • UberPool and Lyft Shared drivers sometimes face problems with customers dissatisfied with shared service. • Driver morale could be improved by increasing pay, giving drivers better information, and incentivizing good rider behavior. [ABSTRACT FROM AUTHOR]

Private vehicle travel entails costs to society. However, in a world designed around the automobile, adults who lack access to a vehicle for economic reasons may experience a significant handicap due to constrained mobility and accessibility. This paper examines whether private vehicle access is associated with the quantity and quality of out-of-home activities in which low-income individuals participate. We use pooled data from multiple time use surveys drawn from the Netherlands, Canada, Spain, and the United Kingdom, and employ Cragg two-part hurdle modeling to determine whether there is an association between household vehicle access and participation in twelve out-of-home activity types. As a robustness check, we also estimate multiple discrete continuous extreme value (MDCEV) models. Further, we examine travel time by mode for those with and without vehicles. Finally, we use American Time Use Survey data and fixed-effects panel models to determine the subjective well-being that is associated with our out-of-home activity types. A lack of private vehicle access is associated with significantly less frequent out-of-home activity participation, both in the aggregate and for seven of the twelve individual activities. Moreover, the activities most likely to be foregone are generally associated with high subjective well-being, suggesting that constrained mobility comes with significant emotional costs. We find a greater "activity penalty" for rural residents and for Canadian residents without vehicle access; urbanites without vehicles in the U.K. are the only geographic group which do not exhibit an activity penalty. Finally, respondents with vehicle access spend more total time traveling, although those without private vehicles partially offset spending less time in them with higher use of alternative modes. Overall, the findings suggest that the lack of a private vehicle is deleterious for quality of life, raising troubling questions about inequity possibly arising when people are denied access to vehicles for economic reasons. [ABSTRACT FROM AUTHOR]

Purpose: Radiation dose to cardiac substructures is related to radiation‐induced heart disease. However, substructures are not considered in radiation therapy planning (RTP) due to poor visualization on CT. Therefore, we developed a novel deep learning (DL) pipeline leveraging MRI's soft tissue contrast coupled with CT for state‐of‐the‐art cardiac substructure segmentation requiring a single, non‐contrast CT input. Materials/methods: Thirty‐two left‐sided whole‐breast cancer patients underwent cardiac T2 MRI and CT‐simulation. A rigid cardiac‐confined MR/CT registration enabled ground truth delineations of 12 substructures (chambers, great vessels (GVs), coronary arteries (CAs), etc.). Paired MRI/CT data (25 patients) were placed into separate image channels to train a three‐dimensional (3D) neural network using the entire 3D image. Deep supervision and a Dice‐weighted multi‐class loss function were applied. Results were assessed pre/post augmentation and post‐processing (3D conditional random field (CRF)). Results for 11 test CTs (seven unique patients) were compared to ground truth and a multi‐atlas method (MA) via Dice similarity coefficient (DSC), mean distance to agreement (MDA), and Wilcoxon signed‐ranks tests. Three physicians evaluated clinical acceptance via consensus scoring (5‐point scale). Results: The model stabilized in ~19 h (200 epochs, training error <0.001). Augmentation and CRF increased DSC 5.0 ± 7.9% and 1.2 ± 2.5%, across substructures, respectively. DL provided accurate segmentations for chambers (DSC = 0.88 ± 0.03), GVs (DSC = 0.85 ± 0.03), and pulmonary veins (DSC = 0.77 ± 0.04). Combined DSC for CAs was 0.50 ± 0.14. MDA across substructures was <2.0 mm (GV MDA = 1.24 ± 0.31 mm). No substructures had statistical volume differences (P > 0.05) to ground truth. In four cases, DL yielded left main CA contours, whereas MA segmentation failed, and provided improved consensus scores in 44/60 comparisons to MA. DL provided clinically acceptable segmentations for all graded patients for 3/4 chambers. DL contour generation took ~14 s per patient. Conclusions: These promising results suggest DL poses major efficiency and accuracy gains for cardiac substructure segmentation offering high potential for rapid implementation into RTP for improved cardiac sparing. [ABSTRACT FROM AUTHOR]

Abstract Critics deride American suburbs as dull, aesthetically displeasing, socially isolating, unhealthy, environmentally unsound, and lacking in accessibility. However, the dramatic shift of the American population to the suburbs in the post-WWII period suggests suburban living may have advantages. Using data from the American Time Use Survey, this paper examines whether residence in a principal city versus the suburbs offers a more emotionally satisfying lifestyle. First, the findings show that demographically similar city residents and suburbanites engage in a very similar amount and composition of out-of-home activities. Second, the ratio of travel time to activity time for specific travel/activity couplets is lower for city residents for a few activities, and lower for suburbanites for others, but on the whole the differences in accessibility implied by these travel time prices are minor. Third, the activities in which city residents and suburbanites engage are associated with very similar degrees of subjective well-being (SWB), including both life satisfaction and affect. The most noteworthy difference between the two geographies is that suburbanites have modestly but measurably higher SWB than demographically similar urbanites in terms of feelings of happiness (hedonic affect), a sense of meaning (eudaimonic affect), and life satisfaction. These findings suggest that there may be advantages to suburban living. Highlights • Demographically similar city residents and suburbanites are predicted to engage invery similar out-of-home activities. • The ratio of travel time to activity time is similar for demographically similar city residents and suburbanites. • The activities in which city residents and suburbanites engage are associated with very similar degrees of subjective well-being. • Suburban living is associated with better feelings of happiness, a sense of meaning, and life satisfaction than city living. [ABSTRACT FROM AUTHOR]

• Twitter commentary about shared TNC services is more negative than positive. • Users of shared TNC services frequently tweet humorous stories about other passengers. • Twitter is a good medium for communicating about how and why to use shared services. Uber and Lyft offer services, entitled UberPool and Lyft Shared (formerly Lyft Line), which allow passengers to share rides with other travelers for a discounted price. These services may reduce the number of vehicles on the road by increasing vehicle occupancy. However, there are drawbacks, including increased and unpredictable travel time and the social implications of sharing a confined space with strangers. To understand how travelers, drivers, and others understand and communicate about these services, we study online commentary about UberPool and Lyft Line on the popular micro-blogging site Twitter. We analyzed more than 2000 "tweets" about the services, coding for who tweets, the emotional tone of the tweets, and what aspects of the services are tweeted about. We find that positive tweets are quite rare and are outnumbered by negative tweets. However, the most common tone is humorous. As expected, there is considerable negative tweeting about service characteristics such as routing and travel time, and tweeters comment about how happy they are when another passenger is not picked up. However, most tweets are about other passengers and their behavior. Negative tweets about other passengers outnumber positive ones, but most tweets about other passengers feature humor about their conversation, behavior, and interactions with the tweeter. Passing on humorous observations and stories about UberPool and Lyft Line experiences with other passengers appears to be a substantial subgenre of the public discourse about sharing rides. This suggests that in many cases sharing with others may be leading to a rich cultural experience. [ABSTRACT FROM AUTHOR]

Purpose: Radiation dose to the heart and cardiac substructures has been linked to cardiotoxicities. Because cardiac substructures are poorly visualized on treatment-planning computed tomography (CT) scans, we used the superior soft-tissue contrast of magnetic resonance (MR) imaging to optimize a hybrid MR/CT atlas for substructure dose assessment using CT.Methods and Materials: Thirty-one patients with left-sided breast cancer underwent a T2-weighted MR imaging scan and noncontrast simulation CT scans. A radiation oncologist delineated 13 substructures (chambers, great vessels, coronary arteries, etc) using MR/CT information via cardiac-confined rigid registration. Ground-truth contours for 20 patients were inputted into an intensity-based deformable registration atlas and applied to 11 validation patients. Automatic segmentations involved using majority vote and Simultaneous Truth and Performance Level Estimation (STAPLE) strategies with 1 to 15 atlas matches. Performance was evaluated via Dice similarity coefficient (DSC), mean distance to agreement, and centroid displacement. Three physicians evaluated segmentation performance via consensus scoring by using a 5-point scale. Dosimetric assessment included measurements of mean heart dose, left ventricular volume receiving 5 Gy, and left anterior descending artery mean and maximum doses.Results: Atlas approaches performed similarly well, with 7 of 13 substructures (heart, chambers, ascending aorta, and pulmonary artery) having DSC >0.75 when averaged over 11 validation patients. Coronary artery segmentations were not successful with the atlas-based approach (mean DSC <0.3). The STAPLE method with 10 matches yielded the highest DSC and the lowest mean distance to agreement for all high-performing substructures (omitting coronary arteries). For the STAPLE method with 10 matches, >50% of all validation contours had centroid displacements <3.0 mm, with the largest shifts in the coronary arteries. Atlas-generated contours had no statistical difference from ground truth for left anterior descending artery maximum dose, mean heart dose, and left ventricular volume receiving 5 Gy (P > .05). Qualitative contour grading showed that 8 substructures required minor modifications.Conclusions: The hybrid MR/CT atlas provided reliable segmentations of chambers, heart, and great vessels for patients undergoing noncontrast CT, suggesting potential widespread applicability for routine treatment planning. [ABSTRACT FROM AUTHOR]

The inexorable rise in personal travel in the 20th century has given way to stagnation in the 21st, a phenomenon some call "peak travel." We use 2003–2019 data from the American Time Use Survey to explore whether and why personal travel per capita has stopped growing. We show that time spent on personal travel has been dropping consistently over these years, and suggest that one important cause is likely a dramatic and ongoing decline in the time Americans spend on out-of-home activities. We find significant changes in time spent on many of the 34 activities conducted inside and outside of the home that we examine. Many of these changes appear related to advances in information and communications technology (ICT), as this period saw the quality of in-home ICT continually rising and its real cost falling, resulting in ever-improving gaming, surfing, watching, and streaming options. For example, our data suggest that out-of-home work and shopping time fell significantly during our study period, while in-home time spent on work and education rose. Game playing (presumably mostly computer games) and TV watching in the home both increased dramatically, while attendance at live entertainment, arts, and sports activities fell. Reading and writing fell substantially both inside and outside the home, perhaps replaced by electronic communication. Our findings suggest that increased in-home ICT use may have been associated with 25–30% of the reduction of out-of-home time. We also find a significant increase in sleeping, and a decrease in time spent eating and drinking both inside and outside of the home. Although we deliberately chose to examine time use and travel prior to the COVID-19 pandemic, we suspect that, even as the pandemic fades, the trend toward more time at home and less time spent traveling may well increase further. [ABSTRACT FROM AUTHOR]

Objective In this article, we describe a pragmatic framework for supporting supervision, based on a contextual behavioural perspective. Method The development of psychological skills to a competent level requires didactic and experiential learning, and supervision is agreed to be a central vehicle for the integration of these experiences. Alongside engaging in problem-solving and giving instructions (to build adherence), supervisors can reasonably expect supervisees to learn from experience by attending closely to influences and effects of their choices. Experiential learning can help the psychologist to develop sensitivity in applying knowledge and skills in effective and safe ways for clients (thus demonstrating competence). Results We argue that contingency-shaped learning is strengthened by including supervision elements that promote psychological flexibility (the capacity to actively embrace one's private experiences in the present moment and engage or disengage in patterns of behaviour in the service of chosen values). Psychological flexibility has been found to foster wellbeing, work effectiveness, openness to new learning, compassion, and acceptance of difference and diversity, in workplace settings. Moreover, the psychological flexibility of psychologists has been found to predict the use of evidence-based interventions, such as exposure. Conclusion The SHAPE framework identifies five features (Supervision values; Hold stories lightly; Assessment of function; Perspective-taking; Experiential methods) likely to promote psychologists' psychological flexibility and experiential learning in the supervision context. These five features are extensions of agreed supervision best practices, enhanced by developments in contextual behavioural science (perspective-taking, cognitive defusion, and acceptance). We describe examples of using SHAPE, and present research directions, to assess whether these features promote experiential learning in supervision. [ABSTRACT FROM AUTHOR]

Purpose: Deep neural nets have revolutionized the science of auto‐segmentation and present great promise for treatment planning automation. However, little data exists regarding clinical implementation and human factors. We evaluated the performance and clinical implementation of a novel deep learning‐based auto‐contouring workflow for 0.35T magnetic resonance imaging (MRI)‐guided pelvic radiotherapy, focusing on automation bias and objective measures of workflow savings. Methods: An auto‐contouring model was developed using a UNet‐derived architecture for the femoral heads, bladder, and rectum in 0.35T MR images. Training data was taken from 75 patients treated with MRI‐guided radiotherapy at our institution. The model was tested against 20 retrospective cases outside the training set, and subsequently was clinically implemented. Usability was evaluated on the first 30 clinical cases by computing Dice coefficient (DSC), Hausdorff distance (HD), and the fraction of slices that were used un‐modified by planners. Final contours were retrospectively reviewed by an experienced planner and clinical significance of deviations was graded as negligible, low, moderate, and high probability of leading to actionable dosimetric variations. In order to assess whether the use of auto‐contouring led to final contours more or less in agreement with an objective standard, 10 pre‐treatment and 10 post‐treatment blinded cases were re‐contoured from scratch by three expert planners to get expert consensus contours (EC). EC was compared to clinically used (CU) contours using DSC. Student's t‐test and Levene's statistic were used to test statistical significance of differences in mean and standard deviation, respectively. Finally, the dosimetric significance of the contour differences were assessed by comparing the difference in bladder and rectum maximum point doses between EC and CU before and after the introduction of automation. Results: Median (interquartile range) DSC for the retrospective test data were 0.92(0.02), 0.92(0.06), 0.93(0.06), 0.87(0.04) for the post‐processed contours for the right and left femoral heads, bladder, and rectum, respectively. Post‐implementation median DSC were 1.0(0.0), 1.0(0.0), 0.98(0.04), and 0.98(0.06), respectively. For each organ, 96.2, 95.4, 59.5, and 68.21 percent of slices were used unmodified by the planner. DSC between EC and pre‐implementation CU contours were 0.91(0.05*), 0.91*(0.05*), 0.95(0.04), and 0.88(0.04) for right and left femoral heads, bladder, and rectum, respectively. The corresponding DSC for post‐implementation CU contours were 0.93(0.02*), 0.93*(0.01*), 0.96(0.01), and 0.85(0.02) (asterisks indicate statistically significant difference). In a retrospective review of contours used for planning, a total of four deviating slices in two patients were graded as low potential clinical significance. No deviations were graded as moderate or high. Mean differences between EC and CU rectum max‐doses were 0.1 ± 2.6 Gy and −0.9 ± 2.5 Gy for pre‐ and post‐implementation, respectively. Mean differences between EC and CU bladder/bladder wall max‐doses were −0.9 ± 4.1 Gy and 0.0 ± 0.6 Gy for pre‐ and post‐implementation, respectively. These differences were not statistically significant according to Student's t‐test. Conclusion: We have presented an analysis of the clinical implementation of a novel auto‐contouring workflow. Substantial workflow savings were obtained. The introduction of auto‐contouring into the clinical workflow changed the contouring behavior of planners. Automation bias was observed, but it had little deleterious effect on treatment planning. [ABSTRACT FROM AUTHOR]

Field-level exercises with the purpose to assess remediation following the deliberate release of a highly toxic chemical in an indoor environment can be conducted using low-(er) toxicity simulants if they are closely linked to the behavior of the toxic chemical itself. Chemical warfare agent (CWA) simulants have been identified on their suitability based on chemical structural similarities and associated physical and chemical properties. However, there are no reported studies that combine measurement of simulant parameters like persistence on surfaces, ability to sample for, and capability to degrade during the decontamination phase such that the level of success of a field-level exercise can be quantified. Experimental research was conducted to assess these gaps using a select number of CWA simulants. The organophosphate pesticide malathion was found to be a suitable simulant for use in field-level exercises that simulate the release of the highly persistent nerve agent VX based on its high persistence, effective surface sampling and analysis using standard analytical equipment, and the in situ degradation in the presence of different oxidizing decontaminants. [ABSTRACT FROM AUTHOR]

Objective:The present paper attempts to differentiate client involvement from other, similar process variables and presents a pan-theoretical conceptualization of client involvement.Method:A modified Delphi poll was conducted with 20 experienced clinicians and researchers. In two rounds of data collection, the experts completed a questionnaire designed to elicit their feedback on whether a variety of involvement items were representative of our pan-theoretical definition of client involvement.Results:The results of the survey provide insight into which types of client activities are good representations of client involvement.Conclusion:We propose that client involvement can be understood as being comprised of behavioral, cognitive, and emotional elements, and we provide concrete examples of these activities. [ABSTRACT FROM AUTHOR]

Los Angeles lacks a natural harbor. Moreover, in the 1880s, the rail line to its inadequate port at San Pedro was controlled by railroad magnate Collis P. Huntington. When his monopoly was threatened, Huntington planned a new port at Santa Monica built with federal money wrested from San Pedro. Huntington chose a site that guaranteed he would dominate the Santa Monica port. Congress ultimately chose to fund San Pedro instead. Hence, San Pedro Bay grew into one of the world’s great ports and Santa Monica was transformed into a glamorous beach resort, with powerful impacts on the region’s urban geography. [ABSTRACT FROM AUTHOR]

Are longer trips more strenuous or unpleasant than shorter ones? This paper examines this question using data from the American Time Use Survey’s well-being module, which queried individuals about the extent to which they felt happiness, pain, sadness, stress, and fatigue during three randomly selected daily activities. Over 22,000 instances of individuals traveling are observed, including their trip duration, mode, purpose, and demographic and geographic information. Each emotion, plus a constructed, composite mood variable, is regressed on trip duration. Overall, the relationship between trip duration and traveler mood is not strong, which is unsurprising given prior findings on the limited impact of activities on mood. However, there is a statistically significant and negative association between trip duration and mood, primarily because of rising stress, fatigue and sadness on long trips. This is particularly true for drivers, while negative emotions do not rise with increasing trip duration for auto passengers. This suggests strain rises as the result of operating the vehicle for long periods, not traveling in an auto per se. Long bicycle trips are more painful than shorter ones, probably due to the physical demands of the mode, and long train trips are associated with less sadness. For commutes, long trips significantly degrade the mood of both drivers and bus riders, in the latter case probably due in part to vehicle crowding and standing. The findings imply that reducing the duration of trips, for example through land use policies that reduce trip distances, or congestion reduction, would have emotional benefits. Policies to promote ridesharing instead of solo driving for long trips may increase traveler mood in the aggregate. Improving bus service or substituting rail for bus for long commute trips may also improve traveler mood. [ABSTRACT FROM AUTHOR]

How and why travel contributes to our life satisfaction is of considerable import for transportation policy and planning. This paper empirically examines this relationship using data from the American Time Use Survey. It finds that, controlling for relevant demographic, geographic, and temporal covariates, travel time per day is significantly and positively associated with life satisfaction. This relationship is attenuated, but still significant, when the amount of time spent participating in out-of-home activities is controlled for. Time spent bicycling is strongly associated with higher life satisfaction, though it attains significance only in some models; time spent walking is also quite positive, though it is not significant. However, both walking and bicycling are positively and significantly associated with life satisfaction when time spent on purely recreational walking and bicycling is included. Life satisfaction is positively and significantly associated with time spent traveling for the purposes of eating and drinking, religious activities, volunteering, and playing and watching sports. Travel time exhibits a strong positive relationship with life satisfaction in smaller towns and cities, but in large cities the association weakens, and for very large cities travel time may actually not be associated with life satisfaction at all. This may be due to the costs of traffic congestion, which disproportionately exists in large cities. In all, while the associations between travel and life satisfaction are clear, the causal story is complex, with the positive relationships potentially being explained by (1) travel allowing us to access destinations that make us happy, (2) the act of travel itself being fulfilling, and/or (3) intrinsically happier people being more likely to travel. In all likelihood, all three factors are at play. [ABSTRACT FROM AUTHOR]

The article offers information on a study involving the psychological flexibility model of understanding clinical disorders and problems from chronic pain, anxiety to substance misuse, and its applicability to patients hearing distressing voices. Topics include differential contributions of nonjudgemental acceptance and psychological flexibility in voice hearers, their impact on general emotional well being and resistance response styles of voice hearers

The rapid movement toward paperless debate enables pre-speech sharing with opponents, but norms about the scope of sharing beyond those actively debating have been slower to evolve. This paper will explore the implications of widening the circle, both during and after the round, with wider audiences including: judges, official scouts, unofficial scouts, those in the policy community not present, and those beyond the community. It will also explore possible technologies for broader sharing, such as Dropbox, email, flash drives, PADS, and the debate citation wiki. It will specifically advocate including at least the judge in real time sharing, and creation of a norm allowing the widest possible sharing, and utilizing an opt-out system instead of an opt-in system. The costs and benefits of extending these norms to debaters remaining tied to paper will also be explored. [ABSTRACT FROM AUTHOR]

Using oil-sands petroleum coke as the raw material andsulfur dioxideas the activating agent at 700 °C, the process of pore developmentin dense carbonaceous materials was studied. The time dependence ofporosity was established from measured values of specific surfacearea (SSA), which could not be explained using conventional porouslayer theories. Incorporating the Random Pore Model with measurementsof particle size and porous layer thickness, a model was developedbased on the existence of a porous layer of constant thickness. Themodel was found to accurately reproduce experimental time dependenceof SSA. The results confirm a constant thickness of the porous layerfor the activation conditions studied, which results from competingeffects of carbon gasification reaction and penetration of the activatingagent into the carbon particle interior. The model predicts a higherachievable SSA for a greater constant porous layer thickness, smallerinitial particle size, and lower inorganic ash content. This modelwas found to be useful in predicting the maximum porous layer thicknessof a dense material undergoing activation or gasification using onlymeasured values of SSA, pore size distribution, and particle sizeas inputs. [ABSTRACT FROM AUTHOR]

This work addresses the discrepancy in the literature regarding the effects of sulfuric acid (H2SO4) on elemental Hg uptake by activated carbon (AC). H2SO4 in AC substantially increased Hg uptake by absorption particularly in the presence of oxygen. Hg uptake increased with acid amount and temperature exceeding 500 mg-Hg/g-AC after 3 days at 200 °C with AC treated with 20% H2SO4. In the absence of other strong oxidizers, oxygen was able to oxidize Hg. Upon oxidation, Hg was more readily soluble in the acid, greatly enhancing its uptake by acid-treated AC. Without O2, S(VI) in H2SO4 was able to oxidize Hg, thus making it soluble in H2SO4. Consequently, the presence of a bulk H2SO4 phase within AC pores resulted in an orders of magnitude increase in Hg uptake capacity. However, the bulk H2SO4 phase lowered the AC pore volume and could block the access to the active surface sites and potentially hinder Hg uptake kinetics. AC treated with SO2 at 700 °C exhibited a much faster rate of Hg uptake attributed to sulfur functional groups enhancing adsorption kinetics. SO2-treated carbon maintained its fast uptake kinetics even after impregnation by 20% H2SO4. [ABSTRACT FROM AUTHOR]

Abstract: We explore whether experts’ perceptions of risk differ systematically from those of the public. To do so, we examine whether experts and non-experts make different location decisions in response to ground-level ozone pollution, one of the byproducts of motorized transportation. Physicians are experts in the field of health, and thus may differ from their lay neighbors in their knowledge of and attitude toward pollution and its health risks. If so, it is possible that they value locations with cleaner air differently than their neighbors do. Here we use hedonic price models based on willingness to bear housing and commute burdens to examine the differential valuation of clean air by doctors and laypeople in the Los Angeles region between 1980 and 2000. We find no evidence that doctors are more or less more willing than comparable lay residents to trade off time or money to live in cleaner-air neighborhoods. [Copyright &y& Elsevier]

Background: There is emerging evidence that mindfulness groups for people with distressing psychosis are safe and therapeutic. Aims: The present study aimed to investigate the feasibility of running and evaluating a mindfulness group on an inpatient ward for individuals with chronic and treatment resistant psychosis. Method: Eight participants attended a 6-week mindfulness group on a specialist tertiary inpatient ward. Results: This study demonstrated that mindfulness exercises were acceptable and well-tolerated by participants. Measuring outcome, systemic challenges and participant experience are discussed. [ABSTRACT FROM AUTHOR]

Application of the pragma-dialectic perspective, and particularly, strategic maneuvering, to political argumentation remains sparse. To address the issue in the context of the 2008 campaigns, the clash strategies of Barack Obama and John McCain during the debates were coded using the same content analysis codebook as prior analyses of presidential debates, allowing comparison between 2008 and the other nine electoral cycles with general election debates. The 2008 debates included significant shifts in the candidates’ use of ritualistic discourse, direct statements to opponent, self-analysis, opponent analysis, policy statements, comparison, and cooption. Although structural elements continue to serve as a corrective to functional theory, it appeared that the political climate, more than format, explained these changes. The findings suggest that candidates engage in strategic maneuvering consistent with the focal-points perspective and that campaigns engage in competitive learning in an attempt to master format modifications. [ABSTRACT FROM PUBLISHER]

Fluid coke is a by-product of bitumen upgrading process and a stockpiled industrial waste produced in large quantities in Alberta, Canada (overall 10,000 tonnes per day). It has been used as a raw material for manufacturing sulfur-impregnated activated carbon (SIAC). Properties of sulfur in the SIAC are critical to the effectiveness of SIAC in adsorbing mercury at ppb levels. K-edge X-ray absorption near edge structure (XANES) spectroscopy was employed to characterize sulfur in two fluid coke samples and their activation products. It was found that about 90% of sulfur in two coke samples is of organic nature, with over 50% of sulfur in the form of thiophene and the rest 40% being organic sulfide. About 10% of sulfur is in the form of oxides, i.e. sulfate. To simulate the coke samples and validate the analytical technique, a mixture of pure sulfur compounds and graphite was prepared and examined with XANES; the results showed good agreement between the actual and measured sulfur contents in specific forms. XANES results were found to be consistent with X-ray photoelectron spectroscopy (XPS) results. The two techniques are complementary to each other; XANES is capable of distinguishing sulfur species at low oxidation states whereas XPS is able to separate some sulfur species with higher oxidation state. The activation process with KOH and SO2 affected the chemistry of sulfur in fluid coke. XANES surface analysis identified disulfide, sulfide, sulfonate, and sulfate in SIACs and found no thiophene, suggesting a complete removal of thiophene from carbon surface by KOH. [ABSTRACT FROM AUTHOR]

Background: The co-morbidity between social phobia and alcohol disorder is well established.Aims: This study investigated the nature of the relationship between traits associated with these disorders.Method: A total of 157 undergraduate drinkers (112 women; 45 men) completed measures tapping aspects of social phobia (i.e., the Social Avoidance and Distress Scale and the Brief Fear of Negative Evaluation scale) and drinking behavior (i.e., the Drinking Motives Questionnaire – Revised, quantity and frequency of alcohol consumption, and the Rutgers Alcohol Problem Index).Results: Correlational analyses (controlling for gender) revealed that: (i) social avoidance and distress was significantly negatively related to drinking frequency; (ii) fear of negative evaluation and social avoidance and distress were both significantly positively related to drinking to cope with negative emotions and to conform to peer pressure; and (iii) fear of negative evaluation was also significantly positively related to drinking to socialize and to drinking problems. The relationship between fear of negative evaluation and drinking problems was mediated by coping and conformity drinking motives.Conclusions: Implications for developing effective integrated treatments for co-occurring social anxiety and alcohol problems are discussed, as are preventative implications. [ABSTRACT FROM AUTHOR]

The article discusses the digital recording of debates. The author recounts his experience of videotaping debates. He cites three major purposes that motivated his digital recording endeavors, namely to improve the skills of debate students by giving them a chance to view their performance after the debate, to educate people who are not able to directly observe the debate and to study the strategies of competing debaters. The implications of recording to debate practice are discussed, including its use to challenge the decision of a jury.

Abstract: Objective: Even though many young addicted smokers profess a desire to quit, majority of them are unsuccessful in their attempts. A major goal was to determine whether successful quitters are better equipped cognitively and behaviorally to deal with the adverse effects associated with the cessation process than unsuccessful quitters, because they possess a larger repertoire of learned resourcefulness skills. Method: Undergraduate university students, consisting of 69 never-smokers, 59 successful quitters and 61 unsuccessful quitters, completed Rosenbaum''s (1980) Self-Control Schedule assessing one''s general repertoire of learned resourcefulness skills. Daily smoking rate, age started smoking, years smoking, quit attempts, difficulty quitting, quitting importance, motivation, self-efficacy and use of smoking self-regulatory strategies also were compared for the smoking groups. Results: Never-smokers and successful quitters were significantly more resourceful than unsuccessful quitters. Even though both smoking groups smoked the same daily rate and started smoking at the same age, unsuccessful quitters in comparison to successful quitters viewed quitting smoking as less important and as more difficult, were more extrinsically motivated to quit, less efficacious, and used fewer self-regulatory strategies during their quit attempts. Discussion: The discussion highlights the prominent role that SCS scores, self-efficacy and especially perceived quitting difficulty play in the smoking cessation process. Conclusions and practical implications: Low resourceful smokers having difficulty quitting may find workshops on general life skills beneficial. Concurrently providing them with specific smoking cessation strategies may further serve to enhance these smokers’ self-efficacy. [Copyright &y& Elsevier]

Abstract: Epidemiological studies have demonstrated a significant co-morbidity between social anxiety disorder (SAD) and alcohol use disorders (AUDs). Despite the fact that many studies have demonstrated strong relationships between SAD and AUD diagnoses, there has been much inconsistency in demonstrating causality or even directionality of the relationship between social anxiety and alcohol-related variables. For example, some studies have showed a positive relationship between social anxiety and alcohol-related variables, while others have shown a negative relationship or no relationship whatsoever. In an attempt to better understand the relationship between social anxiety and alcohol, some researchers have explored potential moderating variables such as gender or alcohol expectancies. The present review reports on what has been found with regard to explaining the high co-morbidity between social anxiety and alcohol problems, in both clinical and non-clinical socially anxious individuals. With a better understanding of this complex relationship, treatment programs will be able to better target specific individuals for treatment and potentially improve the efficacy of the treatments currently available for individuals with co-morbid SAD and AUD. [Copyright &y& Elsevier]

Building on past content analyses of presidential debates to determine how format affects the levels of clash and candidate's strategies, this study answers three questions about the 2000 presidential debates: (a) Do candidates differ in their use of clash and nonclash argument strategies? (b) Does format affect candidates' strategic choices? and (c) Does the structure of questions explain strategic choices? Results of the content analysis suggest that format and question content affect candidate's strategic choices; however, other factors including the larger campaign strategy, polling data, and performance in previous debates also influence strategies. [ABSTRACT FROM AUTHOR]

Background: Personal recovery is a persisting concern for people with psychotic disorders. Accordingly, mental health services have adopted frameworks of personal recovery, prioritizing adaptation to psychosis alongside symptom remission. Group acceptance and commitment therapy (ACT) for psychosis aims to promote personal recovery alongside improved mood and quality of life. Aims: The objectives of this uncontrolled, prospective pilot study were to determine whether 'Recovery ACT' groups for adults are a feasible, acceptable and safe program within public mental health services, and assess effectiveness through measuring changes in personal recovery, wellbeing, and psychological flexibility. Method: Program feasibility, acceptability and safety indicators were collected from referred consumers (n =105). Adults (n =80) diagnosed with psychotic disorders participated in an evaluation of 'Recovery ACT' groups in Australian community public mental health services. Participants completed pre- and post-group measures assessing personal recovery, wellbeing, and psychological flexibility. Results: Of 101 group enrollees, 78.2% attended at least one group session (n =79); 73.8% attended three or more, suggesting feasibility. Eighty of 91 first-time attendees participated in the evaluation. Based on completer analyses (n =39), participants' personal recovery and wellbeing increased post-group. Outcome changes correlated with the linear combination of psychological flexibility measures. Conclusions: 'Recovery ACT' groups are feasible, acceptable and safe in Australian public mental health services. 'Recovery ACT' may improve personal recovery, wellbeing, and psychological flexibility. Uncontrolled study design, completer analyses, and program discontinuation rates limit conclusions. [ABSTRACT FROM AUTHOR]

How might rising urbanization be affecting ethical norms and beliefs? This paper uses new World Values Survey data from 40 countries to answer this question. We find that living in more populous places is associated with greater exposure to crime and neighborhood disorder, lower likelihood of membership in charitable organizations, and lower religiosity. Residents of more populous places are no more likely to approve of ethically questionable behavior surrounding violence or money but may be more permissive in terms of sexual behavior. Contrary to the stereotype, we find no link between city size and the perceived importance of family. When imparting values to children, those in more populous places emphasize personal responsibility, individualism, and determination more, and obedience and work less. Finally, residents of more populous places are more tolerant of groups such as gays, immigrants, and those of other nationalities and religions. In all, bigger city ethics are associated with greater independence and personal freedom, though this may be both a good thing (greater tolerance of differences) and a bad one (higher crime). • Crime and disorder are higher in more urbanized places. • Those in more urbanized places tend to be more tolerant of others. • Those in more urbanized places are less likely to be religious. • Those in more urbanized places are less likely to participate in charities. • Those in more urbanized places place more emphasis on individualism and independence. [ABSTRACT FROM AUTHOR]

Adjustment to life with acquired brain injury (ABI) requires self-identity and behaviour to be updated, incorporating injury-related changes. Identifying and enabling new values-consistent behaviours could facilitate this process. We evaluated the feasibility, acceptability, and preliminary efficacy of VaLiANT, a new group intervention that aims to enhance "valued living" following ABI. We used a non-concurrent multiple baseline single-case experimental design (SCED) with an 8-week follow-up phase and randomization to multiple baseline lengths (5–7 weeks). Eight participants (50% women, aged 26–65; 4 Stroke, 3 Traumatic Brain Injury, 1 Epilepsy) attended eight group sessions with assessments before, during, and after the group. Target behaviour was valued living, assessed weekly by the Valued Living Questionnaire. Secondary outcomes included measures of wellbeing, mood, psychological acceptance, self-efficacy regarding ABI consequences, cognitive complaints, and intervention acceptability. Target behaviour was analysed through visual and statistical analysis while secondary outcome data were analysed via reliable change indices and descriptive statistics. Target behaviour data displayed no convincing patterns of improvement. Reliable improvements were found for most participants on secondary outcomes, particularly subjective wellbeing and anxiety. Intervention delivery was feasible with high acceptability ratings. Further investigation of VaLiANT is warranted, based on the feasibility and acceptability of intervention delivery and signals of efficacy identified across adjustment-related secondary outcomes. [ABSTRACT FROM AUTHOR]

Transgenes inserted into the telomeric regions of Drosophila melanogaster chromosomes exhibit position effect variegation (PEV), a mosaic silencing characteristic of euchromatic genes brought into juxtaposition with heterochromatin. Telomeric transgenes on the second and third chromosomes are flanked by telomeric associated sequences (TAS), while fourth chromosome telomeric transgenes are most often associated with repetitious transposable elements. Telomeric PEV on the second and third chromosomes is suppressed by mutations in Su(z)2, but not by mutations in Su(var)2-5 (encoding HP1), while the converse is true for telomeric PEV on the fourth chromosome. This genetic distinction allowed for a spatial and molecular analysis of telomeric PEV. Reciprocal translocations between the fourth chromosome telomeric region containing a transgene and a second chromosome telomeric region result in a change in nuclear location of the transgene. While the variegating phenotype of the white transgene is suppressed, sensitivity to a mutation in HP1 is retained. Corresponding changes in the chromatin structure and inducible activity of an associated hsp26 transgene are observed. The data indicate that both nuclear organization and local chromatin structure play a role in this telomeric PEV. [ABSTRACT FROM AUTHOR]

We aimed to demonstrate the clinical feasibility and safety of simulation-free hippocampal avoidance whole brain radiation therapy (HA-WBRT) in a pilot study (National Clinical Trial 05096286). Ten HA-WBRT candidates were enrolled for treatment on a commercially available computed tomography (CT)-guided linear accelerator with online adaptive capabilities. Planning structures were contoured on patient-specific diagnostic magnetic resonance imaging (MRI), which were registered to a CT of similar head shape, obtained from an atlas-based database (AB-CT). These patient-specific diagnostic MRI and AB-CT data sets were used for preplan calculation, using NRG-CC001 constraints. At first fraction, AB-CTs were used as primary data sets and deformed to patient-specific cone beam CTs (CBCT) to give patient-matched density information. Brain, ventricle, and brain stem contours were matched through rigid translation and rotation to the corresponding anatomy on CBCT. Lens, optic nerve, and brain contours were manually edited based on CBCT visualization. Preplans were then reoptimized through online adaptation to create final, simulation-free plans, which were used if they met all objectives. Workflow tasks were timed. In addition, patients underwent CT-simulation to create immobilization devices and for prospective dosimetric comparison of simulation-free and simulation-based plans. Median time from MRI importation to completion of "preplan" was 1 weekday (range, 1-4). Median on-table workflow duration was 41 minutes (range, 34-70). NRG-CC001 constraints were achieved by 90% of the simulation-free plans. One patient's simulation-free plan failed a planning target volume coverage objective (89% instead of 90% coverage); this was deemed acceptable for first-fraction delivery, with an offline replan used for subsequent fractions. Both simulation-free and simulation CT-based plans otherwise met constraints, without clinically meaningful differences. Simulation-free HA-WBRT using online adaptive radiation therapy is feasible, safe, and results in dosimetrically comparable treatment plans to simulation CT-based workflows while providing convenience and time savings for patients. [ABSTRACT FROM AUTHOR]

Background: With efforts increasing worldwide to understand and treat paranoia, there is a pressing need for cross-culturally valid assessments of paranoid beliefs. The recently developed Revised Green et al., Paranoid Thoughts Scale (R-GPTS) constitutes an easy to administer self-report assessment of mild ideas of reference and more severe persecutory thoughts. Moreover, it comes with clinical cut-offs for increased usability in research and clinical practice. With multiple translations of the R-GPTS already available and in use, a formal test of its measurement invariance is now needed. Methods: Using data from a multinational cross-sectional online survey in the UK, USA, Australia, Germany, and Hong Kong (N = 2510), we performed confirmatory factory analyses on the R-GPTS and tested for measurement invariance across sites. Results: We found sufficient fit for the two-factor structure (ideas of reference, persecutory thoughts) of the R-GPTS across cultures. Measurement invariance was found for the persecutory thoughts subscale, indicating that it does measure the same construct across the tested samples in the same way. For ideas of reference, we found no scalar invariance, which was traced back to (mostly higher) item intercepts in the Hong Kong sample. Conclusion: We found sufficient invariance for the persecutory thoughts scale, which is of substantial practical importance, as it is used for the screening of clinical paranoia. A direct comparison of the ideas of reference sum-scores between cultures, however, may lead to an over-estimation of these milder forms of paranoia in some (non-western) cultures. [ABSTRACT FROM AUTHOR]

Subcutaneous (SC) administration of rituximab provides an opportunity for reduced patient treatment burden and increased healthcare efficiencies as an alternative to intravenous (IV) rituximab. There is minimal evidence comparing costs associated with SC and IV rituximab in a US setting. This research assessed the impact of transitioning patients from IV to SC rituximab for treatment of non-Hodgkin's lymphoma (NHL) from the US payer, provider, and patient perspective. We developed a model to estimate cost differences for transitioning 20% of a patient cohort from IV to SC rituximab. We included patients with incident diffuse large B-cell lymphoma, incident and recurrent follicular lymphoma, and incident and recurrent chronic lymphocytic leukemia. In the model, each patient received the same number of doses and that there was no difference in discontinuation between cohorts due to non-inferior efficacy and a similar safety profile. Model inputs were collected from published literature and publicly available data. Scenario analyses tested the impact of availability of low-cost biosimilars. In the base case (1,000,000 covered lives), we estimated a total of 157 patients, with 769 total drug administrations. A transition of 20% of patients from IV to SC was projected to generate $153,000 in payer savings, increase provider capacity by 270 hours, and free 470 hours of patient time. Scenario analyses suggest SC administration will be cost saving for payers even with a market where biosimilars approach 50% market share. A 20% transition to SC rituximab in a single cohort of patients has the potential to generate significant US health system value in the form of payer savings, increased practice capacity, and patient time. [ABSTRACT FROM AUTHOR]

Objective: To evaluate graduates' experiences in Australian postgraduate training programs and the registrar program in clinical psychology and clinical neuropsychology, and to identify which components of training were most useful in preparing graduates for the workforce. Method: An anonymous online survey was distributed among recent (2013-2018) graduates of clinical psychology and clinical neuropsychology training programs. Results: 170 graduates (95 clinical psychology, 75 neuropsychology; 82% female) responded to the survey. Ninety-six percent of respondents were working in a clinical or academic setting that utilised their postgraduate qualifications, though 4% had not yet obtained work in their specific desired role. Neuropsychology graduates were more likely to report a lack of relevant professional development. Both disciplines wanted increased focus on interventions in their training, including a broad range of psychological therapy approaches. Both disciplines consistently rated the practical elements of their training (clinical work on placement, roleplays, case discussions) the most valuable preparation for their current roles. Conclusions: Universities should maximise practical training and assessment methods, and provide comprehensive therapy training for clinical psychologists and neuropsychologists in preparation for the types of roles in which they are likely to be employed. Employers may need to ensure that access to supervisors and professional development is provided through the workplace. Key Points What is already known about this topic: Clinical psychologists and clinical neuropsychologists tend to report learning best through practical forms of learning and observation. It is unclear whether Australian postgraduate psychology training programs are preparing graduates adequately for the modern workplace. The Psychology Board of Australia registrar program has been in place for over 10 years, and not been systematically evaluated in terms of its impact on recent graduates' capabilities and confidence in transitioning to the workforce. What this topic adds: The vast majority of recent graduates of Australian clinical psychology and clinical neuropsychology programs are employed in roles that utilise their postgraduate qualifications. While the quality of Australian postgraduate programs was rated highly by recent graduates, they wanted greater focus on a broader range of psychological interventions. Psychology registrars should be provided more support to meet their professional development and clinical supervision needs. [ABSTRACT FROM AUTHOR]

Although mostly considered distinct, conspiracy mentality and paranoia share conceptual similarities (e.g., persecutory content, resistance to disconfirming evidence). Using self-report data from a large and multinational online sample (N = 2510; from the UK, the US, Hong Kong, Germany, and Australia), we examined whether paranoia and conspiracy mentality represent distinct latent constructs in exploratory and confirmatory factor analyses. Utilising network analysis, we then explored common and unique correlates of paranoia and conspiracy mentality while accounting for their shared variance. Across sites, paranoia and conspiracy mentality presented distinct, yet weakly correlated (r = 0.26), constructs. Both were associated with past traumatic experiences, holding negative beliefs about the self and other people, sleep problems, and a tendency to worry. However, paranoia was related to increased negative affect (i.e., anxiety) and decreased social support, whereas the opposite pattern was observed for conspiracy mentality (i.e., decreased anxiety and depression, increased social support). Paranoia and conspiracy mentality are related but not the same constructs. Their similar and distinct correlates point to common and unique risk factors and underlying mechanisms. [ABSTRACT FROM AUTHOR]

The public's adherence to recommended COVID-19 preventative behaviors, including vaccinations and social distancing, has been low in certain groups and has contributed to many preventable deaths worldwide. An examination of general and pandemic-specific aspects of nonclinical paranoid ideation may aid in the understanding of the public's response to the pandemic, given that it is a global threat event. A representative international sample of general adults (N = 2,510) from five international sites were recruited with stratified quota sampling. Structural equation modeling (SEM) was used to examine the relationships among general paranoid ideation, pandemic paranoid ideation (interpersonal mistrust, conspiratorial thinking, and persecutory threat), general distress (depression, anxiety), vaccine willingness, and other preventative behaviors (masking, social distancing, hygiene). Although general distress and paranoid ideation were associated with vaccination willingness and preventative behaviors, their effects were inconsistent or weak. Pandemic paranoid ideation showed robust direct and indirect effects that differentially predicted COVID-19 preventative behaviors, with higher interpersonal mistrust associated with higher adherence to all behaviors, higher conspiratorial thinking related to lower adherence to all behaviors, and higher persecutory threat related to higher vaccine willingness, but lower adherence to other preventative behaviors. Examination of pandemic-specific paranoid ideation leads to more precise prediction of the public's adherence to recommended health behaviors during the COVID-19 outbreak. This information could be used to inform intervention strategies for micro-targeting different subgroups with nonclinical paranoid thinking, as well as for improving responses to future pandemics and vaccination efforts for other common illnesses. [ABSTRACT FROM AUTHOR]