Bidirectional Relationship Between Family Accommodation and Youth Anxiety During Cognitive-Behavioral Treatment

Family accommodation is associated with an increase in anxiety and has recently received attention as a target for intervention for youth anxiety. Existing theories posit that the increase in family accommodation increases youth anxiety and can attenuate the effect of psychotherapy. However, the directionality between family accommodation and youth anxiety has not been investigated. A cross-lagged cross-panel design was used to assess accommodation and anxiety for 10 sessions for 73 youths with an anxiety disorder, who were receiving cognitive-behavioral therapy. The analysis revealed a bidirectional relationship, such that to some extent previous session family accommodation increased youth anxiety symptoms (β = 0.11, 95% CI [0.06, 0.17]), but to an even greater extent previous session youth-rated anxiety symptoms increased family accommodation (β = 0.23, 95% CI [0.08, 0.38]). Family accommodation is an important target for reducing youth anxiety but should be addressed simultaneously as interventions directly targeting youth anxiety.

BCmECC: A Lightweight Blockchain-Based Authentication and Key Agreement Protocol for Internet of Things

In this paper, targeting efficient authentication and key agreement in an IoT environment, we propose an Elliptic Curve Cryptography- (ECC) based lightweight authentication protocol called BCmECC which relies on a public blockchain to validate the users’ public key to provide desired security. We evaluate the security of the proposed protocol heuristically and validate it formally, which demonstratse the high level of the security. For the formal verification we used the widely accepted formal methods, i.e., BAN logic and the Scyther tool. In this paper we also analyse the security of recently proposed blockchain-based authentication protocols and show that this protocol does not provide the desired security against known session-specific temporary information attacks in which the adversary has access to the session’s ephemeral values and aims to retrieve the shared session key. In addition, the protocol lacks forward secrecy, in which an adversary with access to the server’s long-term secret key can retrieve the previous session keys, assuming that the adversary has already eavesdropped the transferred messages over a public channel in the target session. The proposed attacks are very efficient and their success probability is `1’, while the time complexity of each attack could be negligible. Besides, we show that BCmECC is secure against such attacks.

Teaching Writing in Blended Environment

The article aims to describe the implementation blended learning environment in teaching writing skills. The research is based on the blended learning framework that integrates face-to-face methods and online learning methods. The face-to-face method is given to see students' activeness in delivering ideas and brainstorming before writing essays. The online learning method is used to see students' ability to elaborate ideas from drafting to become a complete essay. Thus, students can be effective in learning in class to discuss their draft an essay and not spend much time writing. The implementation of blended learning was distributed to three session: brainstorming, drafting, and final writing. The evaluation was done for each cycle. After the evaluation, students get feedback for their performance in the previous session. The result post-test shows that students in the experimental class have indicated a significant improvement in essay writing performance with significance 0,06>0,05 with an average score of 76,35. The result of the research is very important as a framework to develop learning models for teaching writing at universities.

Substitution of citrate with tissue plasminogen activator (rt-PA) for catheter lock does not improve patency of tunnelled haemodialysis catheters in a randomised trial

Backround The study aim was to establish if substitution of citrate with rt-PA for catheter lock once weekly can reduce the incidence of catheter-related blood stream infections (CR-BSI) or improve patency of tunneled haemodialysis catheters. Methods All incident patients undergoing insertion of a tunneled haemodialysis catheter were screened and included except those suffering infection or using oral anticoagulation. Study participants were randomized into two arms according to the solution applied as catheter lock: receiving either trisodium citrate (Citra-LockTM 4%) only or rt-PA (Actilyse® 1 mg/ml) on the middle session each week with citrate used on the first and third sessions. The incidence of CR-BSI (confirmed by positive blood culture), catheter non-function (complete obstruction), and malfunction (blood flow < 250 ml/min) was recorded. Statistical significance was tested with ANOVA, post hoc analysis was performed by means of multiple linear regression. Results Totally, 18 patients were included and followed during 655 haemodialysis sessions. No episode of CR-BSI was detected while 6 catheter non-functions (0.9% sessions) and 101 malfunctions (15.4% sessions) were recorded. The incidence of both events was equal between the study arms: 4 non-functions and 55 malfunctions in the rt-PA arm and 2 non-functions and 46 malfunctions in the citrate arm (p = 0.47 and p = 0.24, respectively). Additionally, the mean blood flow achieved did not differ significantly between the arms: 326 ± 1,8 and 326 ± 1,9 ml/min (p = 0.95) in rt-PA and citrate arms, respectively. Post hoc analysis identified time elapsed since previous session (β = 0.12, p = 0.005) and malfunction on previous session (β = 0.25, p < 0.001) as significant factors affecting the occurrence of malfunction. By contrast, the study arm, rt-PA application on previous session, and catheter vintage did not enter the model. Conclusion Substitution of citrate with rt-PA for catheter lock does not reduce the incidence of catheter malfunction neither does it affect the blood flow achieved during haemodialysis. Catheter patency is related rather to the time interval between sessions and to previous malfunction (thus probably reflecting undefined individual factors). The incidence of CR-BSI within pre-selected haemodialysis population is sporadic (less than 1 per 4.3 patient years in our sample). Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12612000152820. Retrospectively registered 03/02/2012.

Substitution of Citrate with Tissue Plasminogen Activator (rt-PA) for Catheter Lock Does Not Improve Patency of Tunneled Hemodialysis Catheters in a Randomized Trial

Background: The study aim was to establish if substitution of citrate with rt-PA for catheter lock once weekly can reduce the incidence of catheter-related blood stream infections (CR-BSI) or improve patency of tunneled hemodialysis catheters.Methods: All incident patients undergoing insertion of a tunneled hemodialysis catheter were screened and included except those suffering infection or using oral anticoagulation. Study participants were randomized into two arms according to the solution applied as catheter lock: receiving either trisodium citrate (Citra-LockTM 4%) only or rt-PA (Actilyse® 1mg/ml) on the middle session each week with citrate used on the first and third sessions. The incidence of CR-BSI (confirmed by positive blood culture), catheter non-function (complete obstruction), and malfunction (blood flow <250ml/min) was recorded. Statistical significance was tested with ANOVA, post hoc analysis was performed by means of multiple linear regression.Results: Totally, 18 patients were included and followed during 655 hemodialysis sessions. No episode of CR-BSI was detected while 6 catheter non-functions (0.9% sessions) and 101 malfunctions (15.4% sessions) were recorded. The incidence of both events was equal between the study arms: 4 non-functions and 55 malfunctions in the rt-PA arm and 2 non-functions and 46 malfunctions in the citrate arm (p=0.47 and p=0.24, respectively). Additionally, the mean blood flow achieved did not differ significantly between the arms: 326±1,8 and 326±1,9 ml/min (p=0.95) in rt-PA and citrate arms, respectively. Post hoc analysis identified time elapsed since previous session (β=0.12, p=0.005) and malfunction on previous session (β=0.25, p<0.001) as significant factors affecting the occurrence of malfunction. By contrast, the study arm, rt-PA application on previous session, and catheter vintage did not enter the model.Conclusion: Substitution of citrate with rt-PA for catheter lock does not reduce the incidence of catheter malfunction neither does it affect the blood flow achieved during hemodialysis. Catheter patency is related rather to the time interval between sessions and to previous malfunction (thus probably reflecting undefined individual factors). The incidence of CR-BSI within pre-selected hemodialysis population is sporadic (less than 1 per 4.3 patient years in our sample).Trial registration: The study was registered on the ACTRN 12612000152820

The chronicle of the society of neuropathologists and psychiatrists at the imperial Kazan University. Protocol of the meeting of the Society on March 30

Chaired by H. M. Popov, with secretary B. I. Vorotynsky; attended by: honorary member K. A. Arnstein and acting members: N. A. Mislavskiy, D. V. Polumordvinov, D. A. Timofeev, I. Ye. Egorov, P. S. Skuridin, I. I. Naumov, V.V. Nikolaev and a few people of the outside public. The protocol of the previous session was read and approved.

Losing my loss aversion: The effects of current and past environment on the relative sensitivity to losses and gains

It is often assumed that most people are loss averse, placing more weight on losses than commensurate gains; however, some research identifies variability in loss sensitivity that reflects features of the environment. We examined this plasticity in loss sensitivity by manipulating the size and distribution of possible outcomes in a set of mixed gambles, and assessing individual stability in loss sensitivity. In each of two sessions, participants made accept-reject decisions for 64 mixed-outcome gambles. Participants were randomly assigned to conditions defined by the relative range of losses and gains (wider range of losses vs. wider range of gains), and the currency-units at stake (‘pennies’ vs. ‘pounds’). Participants showed modest but non-trivial consistency in their sensitivity to losses; though loss sensitivity also varied substantially with our manipulations. When possible gains had greater range than possible losses, most participants were loss averse; however, when possible losses had the greater range, reverse loss aversion was the norm (i.e., more weight on gains than losses). This is consistent with decision-by-sampling theory, whereby an outcome’s rank within a consideration-set determines its value, but can also be explained by the gamble’s expected-value rank within the decision-set, or by adapting aspirations to the decision-environment. Loss aversion was also reduced in the second session of decisions when the stakes had been higher in the previous session. This illustrates the influence of prior context on current sensitivity to losses, and suggests a role for idiosyncratic experiences in the development of individual differences in loss sensitivity.

Session 10

This chapter builds on previous chapters that covered acceptance, defusion, mindfulness, self-as-context, and values in acceptance and commitment therapy (ACT). The emphasis in therapy now turns to using values as a foundation for behavior change and skill maintenance. It is possible that clients did not fully grasp the function of values in the previous session, so it is worth reviewing values again. The chapter also provides an outline for discussing how to structure values-consistent behavioral commitments. Some areas to cover in this discussion include emphasizing that any size step is great as long as it is a step in a valued direction, not basing the activity on distress level, and being present while engaging in the activity.

Exploring the Nature of Undergraduates’ Peer Collaboration in a PBL Writing Process

Despite the importance of writing skills to academic success, many undergraduates face a lot of challenges with writing in English. Studies have shown that engaging and supporting students in a writing process help to improve the students’ writing performance. Therefore, this study used a Problem-based learning approach (PBL) in order to give students opportunities to be engaged and support one another in a writing process through face-to-face interactions. The paper specifically reports what the students do to support their peer in the PBL writing process. An intact class of 18 second-year students in an English Composition course in Nigeria was selected to participate in the study. Data were obtained through audio- and video-recording of the students’ face-to-face interactions. The findings showed that the participants supported theirs peer through various ways in the PBL process such as modelling their facilitators, sharing tasks and responsibilities, clarifying instructions and unclear terms, using dictionary, suggesting other sources to get more information, checking for consensus, creating humour, encouraging others to participate and raise their voices while speaking, restating time given to a session and giving overview of a previous session. The support provided by the peers helped the students to improve their writing. The study has some implications for writing teachers.

Session 4: Thought-Challenging and Thought-Changing Skills

Session 4 builds on “Managing the Impact” coping skills by helping you learn to apply “Challenging Your Thoughts” skills to the stressful situations identified earlier and recorded on the “Thought-Changing Skills” Worksheet from the previous session. The goal of this session is to assist you in more accurately identifying those distortions in your assumptions, beliefs and thinking that underly distressful and uncomfortable emotions/feelings, which in turn can amplify unpleasant symptoms such as energy level and pain intensity. Common thinking errors such as hopelessness, catastrophic thinking, and mind reading are introduced and applied to your own identified automatic thoughts. This is followed by introducing strategies for challenging those often unsubstantiated and disabling thoughts that serve as barriers to setting goals, expectations, and motivation, which make it difficult to get your coping and lifestyle back on track.