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The broad area of psychotherapy research is sometimes subdivided into that which focuses on outcome and that which focuses on process. Research into the active processes of psychotherapy can sometimes be occupied with debates around common versus specific factors. At the same time, within the process literature there has been increasing focus on the qualitative accounts of the service user in therapy and what they found to be significant or useful to them. The aim of this mixed methods study was twofold: first, to identify what elements of a relatively brief CBT intervention contributed to a successful outcome from the point of view of the service user. Participants were recruited at a low-intensity Improving Access to Psychological Therapy (IAPT) service in the UK; and second, to attempt to frame those results within the common versus specific factor framework. Eight participants (5 males and 3 females) took part in this mixed methods research, which used semi-structured interviews analysed using thematic analysis and brief quantitative questionnaire completion. Five overarching qualitative themes were identified in the data: three relating to common factors ('Insight’, ‘Talking’ and ‘Therapist qualities’); and two relating to specific factors (‘Responding differently to thoughts and feelings’ and ‘Tasks/activities’). Importantly, all participants spoke about the importance of both common and specific factors. The discussion relates the findings back to existing research, highlighting the relative importance of insight within the data set and the participant led focus on talking. Future directions are discussed.

Background: The mental health of students in UK higher education (HE) is receiving increased attention, and support services for students are under increased pressure. Aims: Drawing on ecological systems theory (EST), this study sought to explore possible contextual influences, over time, on student distress within HE. Method and Samples: We conducted a two-stage Delphi study, first asking UK professionals (n=236) from primary, secondary, further education, and HE to provide possible reasons for increases in student distress. The material was reduced to 58 representative statements across all sectors with a further 10 specific to HE. In stage 2, 89 participants rated each statement in terms of whether it: (1) takes place and (2) contributes to distress. Results: The results suggest multiple contextual influences potentially contributing to student distress. They can be summarized using the words: cuts, competition, and comparison. Education professionals in our sample reported that, upstream from HE, pressures on schools and colleges have led to a narrowing of curricula, with a more singular focus on assessment. Reduced teaching teams and pressurized staff unintentionally embed an assessment focus within students who unhelpfully compare themselves with peers while also struggling with wider societal cuts, austerity, and political uncertainty. Conclusions: The discussion draws on the peer-reviewed literature and relevant reports, discussing them in the context of EST, finding considerable support for these influences. The potential importance of adopting a contextual approach and incorporating this knowledge into the way we understand and tackle students’ distress and their preparedness for HE is discussed.

OBJECTIVES: Resistant starch (RS) is a non-digestible fermentable carbohydrate found naturally in food sources such as potatoes that can lower postprandial glucose and improve insulin sensitivity. Potato RS can be increased by baking then chilling the potato. The purpose of this study is to identify which body composition and dietary outcomes affect glucose and insulin response after female subjects consume a boiled hot Russet potato (∼6 g RS) compared to a baked then chilled Russet potato (∼12 g RS). METHODS: Subjects were randomized to consume 250 g of either a chilled or boiled potato with a one week wash-out between the two visits using crossover study design. Three days prior to each visit, dietary intake was obtained from food records. Mean three-day nutrient analysis prior to each visit was analyzed by Nutrition Data System for Research. Body composition (% lean mass (%LM) and fat mass (%FM)) was measured by air displacement plethysmograph at baseline. Fasting and postprandial blood following the intake of each potato were collected for area under the curve (AUC((0–120))) glucose and insulin determination. Spearman's rho examined the relationship among %FM, %LM, and each mean three-day dietary variables on AUC((0–120)) glucose and insulin following each potato intervention. RESULTS: Healthy overweight (n = 25; mean BMI 31.8 ± 7.4 kg/m(2)) adult females (mean age 29.0 ± 5.9 years) completed the study. In both chilled and boiled potatoes, AUC((0–120)) insulin was significantly positively related to %FM, but significantly inversely related to %LM. AUC((0–120)) glucose was not related to body composition. Mean energy, macronutrients, added sugars, total sugars, soluble fiber, and glycemic index were significantly positively related to AUC((0–120)) insulin in both chilled and boiled potato; energy and most macronutrients (except fat) were significantly positively related to AUC((0–120)) glucose only after boiled potato. CONCLUSIONS: A body composition higher in %FM and lower in %LM exhibits less insulin control following potato intake. Higher energy and nutrient intake patterns contribute to less favorable glucose concentrations following boiled potato consumption, but not after chilled potato consumption. The higher RS in the chilled potato may have contributed to glucose homeostasis. FUNDING SOURCES: The Alliance for Potato Research and Education and the University's Small Grant Program.

Last year Anna Tsing, Heather Swanson, Elaine Gan and Nils Bubant compiled a collection of essays that highlight the precarious state of living on this planet. Arts of Living on a Damaged Planet is...

Phosphodiesterase 4 (PDE4) inhibitors are approved for the treatment of some moderate to severe inflammatory conditions. However, dose-limiting side effects in the central nervous system and gastrointestinal tract, including nausea, emesis, headache, and diarrhea, have impeded the broader therapeutic application of PDE4 inhibitors. We sought to exploit the wealth of validation surrounding PDE4 inhibition by improving the therapeutic index through generation of an antibody-drug conjugate (ADC) that selectively targets immune cells through the CD11a antigen. The resulting ADC consisted of a human αCD11a antibody (based on efalizumab clone hu1124) conjugated to an analog of the highly potent PDE4 inhibitor GSK256066. Both the human αCD11a ADC and a mouse surrogate αCD11a ADC (based on the M17 clone) rapidly internalized into immune cells and suppressed lipololysaccharide (LPS)-induced TNFα secretion in primary human monocytes and mouse peritoneal cells, respectively. In a carrageenan-induced air pouch inflammation mouse model, treatment with the ADC significantly reduced inflammatory cytokine production in the air pouch exudate. Overall, these results provide compelling evidence for the feasibility of delivering drugs with anti-inflammatory activity selectively to the immune compartment via CD11a and the development of tissue-targeted PDE4 inhibitors as a promising therapeutic modality for treating inflammatory diseases.

Glucagon-like peptide-1 (GLP-1) receptor (GLP-1R), glucagon (GCG) receptor (GCGR), and glucose-dependent insulinotropic polypeptide (GIP, also known as gastric inhibitory polypeptide) receptor (GIPR), are three metabolically related peptide hormone receptors. A novel approach to the generation of multifunctional antibody agonists that activate these receptors has been developed. Native or engineered peptide agonists for GLP-1R, GCGR, and GIPR were fused to the N-terminus of the heavy chain or light chain of an antibody, either alone or in pairwise combinations. The fusion proteins have similar in vitro biological activities on the cognate receptors as the corresponding peptides, but circa 100-fold longer plasma half-lives. The GLP-1R mono agonist and GLP-1R/GCGR dual agonist antibodies both exhibit potent effects on glucose control and body weight reduction in mice, with the dual agonist antibody showing enhanced activity in the latter.

OBJECTIVES: In Madagascar, over 75% of the population is impoverished and 50% of children experience stunted growth with lifelong health and developmental implications. Beyond inadequate energy intake, diet homogeneity contributes to macronutrient and micronutrient deficiencies underlying underdeveloped organ and skeletal system. Research measuring diet diversity of the rural Malagasy population is lacking. A pilot diet-diversity study was conducted in the rural village of Andasibe to identify specific dietary components missing from the Malagasy diet. METHODS: Diet diversity data were obtained using guidelines established by the Food and Agriculture Organization of the United Nations. Over a 6-week period, 24-hour dietary recalls were collected of 150 representative adult household members- typically the mother or father of the household. Subjects provided verbal accounts of food and beverages consumed the day prior. Researchers then guided participants through a list of foods to capture any forgotten items. Foods recorded in the dietary recalls were assigned to categories based on nutrients of interest related to malnutrition and other diseases of nutrition inadequacy. Diet diversity scores (DDS) were assigned corresponding to food categories included in the 24-hour recall. RESULTS: The average DDS of all surveys was 4 of a possible 9, corresponding to “medium” diet diversity. 37% of subjects received a “low” DDS and consumed between 1–3 food categories per day. 15% of participants received a “high” DDS and consumed between 6–8 categories per day. Categories unreported in the average recall were “legumes, nuts, and seeds”; “vitamin A-rich fruit and vegetable”; and “milk and milk products”. Animal protein from sources such as meat or fish, dairy products, or eggs was not reported in most recalls. CONCLUSIONS: Low consumption of protein, vitamin A, and iron-containing items on a given day may be indicative of dietary inadequacies related to stunting and morbidity. Diet diversity data allows for basic quantification of the extent of dietary homogeneity in Andasibe, which likely mimics that of other Malagasy villages and identifies priority areas for future nutrition intervention. FUNDING SOURCES: Funding was provided by Auburn University's Office of Undergraduate Research and the College of Human Sciences.

Recent studies have suggested that modulation of two or more signaling pathways can achieve substantial weight loss and glycemic stability. We have developed an approach to the generation of bi-functional antibody agonists that activate leptin receptor and GLP-1 receptor. Leptin was fused into the complementarity determining region 3 loop of the light chain alone, or in combination with exendin-4 (EX4) fused at the N-terminus of the heavy chain of Herceptin. The antibody fusions exhibit similar or increased in vitro activities on their cognate receptors, but 50~100 folder longer circulating half-lives in rodents compared to the corresponding native peptides/proteins. The efficacy of the leptin/EX4 dual antibody fusion on weight loss, especially fat mass loss, was enhanced in ob/ob mice and DIO mice compared to the antibody fusion of either EX4 or leptin alone. This work demonstrates the versatility of this combinatorial fusion strategy for generating dual antibody agonists with long half-lives.

OBJECTIVES: Resistant starch (RS) is an insoluble, fermentable, and indigestible fiber found naturally in potatoes that can improve glucose homeostasis following intake. The amount of RS in potatoes is dependent upon the type of potato, cooking method, and temperature at which it is consumed. This study examined the influence of consuming either a boiled (BP; ∼6 g RS) or baked then chilled Russet potato (BCP; ∼12 g RS) on postprandial plasma glucose, insulin, and glucose-dependent insulinotropic peptide (GIP). Subjective satiety and 48-hour subsequent food intake were also compared following the intake of each potato. METHODS: Overweight healthy females consumed 250 g of either BP or BCP on two separate visits with a one-week washout period in this randomized, crossover study. Fasted blood samples were collected upon arrival, and again after potato consumption at 15, 30, 60, and 120-minute intervals for glucose, insulin, and GIP determination. Area under the curve (AUC((0–120))) was calculated for each marker. Subject satiety was obtained from a 100 mm Visual Analogue Scale (VAS) at 15 and 60 minutes after potato intake. Subsequent 48-hour food intake was obtained via diet records following each visit and analyzed using the Nutrient Data System for Research software. Paired t-tests compared each blood collection time point and the AUC((0–120)) for glucose, insulin, and GIP, as well as mean subsequent energy and subjective satiety were compared between each potato. An alpha level of 0.05 indicates significance. RESULTS: Twenty-five females with a mean BMI of 31.8 ± 7.4 kg/m(2) and age of 29.0 ± 5.9 years completed the study. The AUC((0–120)) for insulin (P = .011) and GIP (P

Context:The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage.Objective:Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peritraumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity.Design, Setting, and Participants:Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment.Intervention(s):NoneMain Outcome Measure(s):Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation.Results:The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p p p M = 7.2 ±3.7; KY: M = 7.3 ±3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD.Conclusions:The terror of bombardment is a risk factor for PTSD among civil-ians. Although there is considerable resilience in chronically threatened commu-nities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.

Nursing home social workers were surveyed regarding facility smoking policy and its compatibility with their professional values and ethics. Respondents were randomly selected from Georgia and Minnesota nursing home associations. Almost all respondents agreed that nursing homes are the resident's home and that residents have the right to make decisions that may not be in their best interest, i.e., continuing to smoke. At smoke-free facilities, significantly more social workers believed that residents should not have the right to make their own decisions regarding smoking (chi-square = 4.90, p = 0.03). Less than 14% of these social workers struggled ethically with their facility's smoke-free policy. Social workers personal smoking behaviors had significant influence on their perception of this dilemma.

Over 225,000 independent Agrobacterium transferred DNA (T-DNA) insertion events in the genome of the reference plant Arabidopsis thaliana have been created that represent near saturation of the gene space. The precise locations were determined for more than 88,000 T-DNA insertions, which resulted in the identification of mutations in more than 21,700 of the ∼29,454 predicted Arabidopsis genes. Genome-wide analysis of the distribution of integration events revealed the existence of a large integration site bias at both the chromosome and gene levels. Insertion mutations were identified in genes that are regulated in response to the plant hormone ethylene.