bluuebunny/crossref_metadata_2025 huggingface dataset:
Deflection and stress analysis of piezoelectric laminated composite plate under variable polynomial transverse loading
Authors: Markad Kanif M. , Das Vivek , Lal Achchhe
Published: August 2022

Among many smart materials, piezoelectric materials have emerged as the most studied ones for practical applications. They owe their success to several factors, including low price, high bandwidth, availability in various formats, and ease of handling and implementation. The present study focused on the performance of piezoelectric laminated composite plate under various electromechanical loading conditions by utilizing the first-order shear deformation theory with the Newton–Raphson residual and iteration with Gauss integration point in Ansys. For the first time, the effects of electrical loading, circuit arrangement, voltage variation, and polynomial variable transverse loading are studied over piezoelectric composite plate (PCP). The effects of plate aspect ratio, thickness ratio, boundary conditions, ply orientations, nature of loading conditions, and voltage variation are presented. The study also utilized open and close circuit arrangements as sensors and actuators to gauge the performance of PCP in the form of static bending analysis. The maximum OC (open circuit) output voltage is generated with the N4 type of loading compared with Ni (i = 1–4); on the other hand, the OC output voltage is minimum with N5. The combined effect of external load and voltage presented in the study will be useful for analyzing the deflection variation, and it can further be implemented in reducing deflection or vibration. It is noted that, with a higher piezoelectric to laminate thickness (t/h) ratio, the maximum OC output voltage is observed. In addition, the rate of voltage generation observed is the highest under the N4 loading condition and the lowest under the N5 type of load.
Air thermochemistry in the converging section of de Laval nozzles on hypersonic wind tunnels
Authors: Gu Sangdi , Hao Jiaao , Wen Chih-yung
Published: August 2022

State-to-state simulations of nonequilibrium flow in nozzles are made for a range of reservoir conditions and geometries. The geometry of the converging section and throat has little influence on the thermochemistry of the flow. Higher reservoir pressure and temperature both drive the thermochemistry toward equilibrium. For reservoir temperatures of 1500, 4000, and 7000 K, the flow property that has the largest departure from equilibrium is the N2 vibrational temperature, the O mass fraction, and the N mass fraction, respectively. Even at the lowest reservoir pressure, these departures from equilibrium are only 14%, 8%, and 2% for the 1500, 4000, and 7000 K reservoirs, respectively. The differences in these flow properties at the throat between the nonequilibrium and equilibrium simulations are maintained throughout in the nonequilibrium simulations of the diverging section. Applying the simplification of equilibrium flow in the converging section and around the throat yields almost no observable errors in the vibrational population distributions in the diverging section. The simplification is recommended for most practical intents and purposes, and the current work provides important quantitative information to make informed judgments when applying it.
Physicochemical characteristics controlling the flammability of live
Authors: Campos-Ruiz Rodrigo , Parisien Marc-André , Flannigan Mike D.
Published: August 2022

Background Few studies have focused on the integral assessment of live fuel flammability in the boreal forest. Aims We aimed to examine the flammability of living needles of jack pine (Pinus banksiana) as characterised by their form, moisture and chemical content at different ages and times of the year. Methods With a calorimeter and open flame, we estimated needle ignitability, consumption rate, maximum speed and amount of energy released. We measured their form, moisture and chemical content. Key results Needle form has a major effect on ignitability, whereas chemical composition primarily influences the amount and rate of energy release. Needles <1 year old are the least flammable; they are rounder and voluminous, with higher moisture and nitrogen content. Needles ≥1 year old are more flammable; they are drier, more curved, thinner, longer, and contain more carbon and terpenes. Needles release more energy during the early growing season, when starch and lipids are at their peak concentrations. Conclusions Moisture content is not the major factor affecting the flammability of jack pine live needles; physicochemical changes specific to age and month of collection are the most influential factors. Implications Assessing the multi-faceted properties of live fuels flammability will help to comprehend stand- and landscape-scale fire behaviour.
Innovative methods and tools for obtaining pre-forecast information in the socio-economic processes research
Authors: Vasilenko I I , Kumratova A M , Semenova A N , Popova M I
Published: August 2022

By using the phase analysis algorithm mechanism and the visualization and data analysis methods, the authors clearly show the resulting synergistic effect from the complex socio-economic processes research in the context of the triad results: the initial time series, a number of its increments and aggregated data. The article is devoted to the adaptation of mathematical methods of nonlinear dynamics and the description of the tool for obtaining pre-forecast information about complex economic processes, in particular, the phase analysis algorithm testing in the research of the time series of the tourist flow to the Dombai ski village of the Karachay-Cherkess Republic. Phase analysis is the method for studying local fluctuations in a time series that are asymmetric, irregular, and have an unstable period.
Non-destructive examination (NDE) methods for dynamic subsea cables for offshore renewable energy
Authors: Nicholls-Lee R , Thies P R , Dulieu-Barton J M , Ólafsson G , Hughes R , Hernandez Arroyo A , Xu G , Cartlidge N
Published: August 2022

Offshore renewable energy installations are moving into more challenging environments where fixed foundations are not economically viable, forcing the development of floating platforms. Subsea cables are critical for transfer of the power generated back to shore. The electrical capabilities of subsea cables are well understood; however, the structural capabilities are not, subsea power cable failures accounting for a significant proportion of insurance claims. Cables are challenging to repair, with specific vessels and good weather windows required, therefore making operations very costly. A good understanding of the internal structure of a subsea cable, and interaction between the layers, is integral to the development of robust and reliable, high voltage, dynamic, subsea cables. A requirement therefore exists for non-destructive examination (NDE) of live subsea cables to determine locations, and identify the causes, of faults and classify their type. An NDE framework such as this would assist in planning operations and reduce the risk and cost inherent to delivering offshore power. Improved understanding of subsea cable failure modes and mechanisms could also be achieved through us of NDE during onshore, dry, experimental testing. Three currently available NDE methods are considered, developed for use in other disciplines, for the purpose of structural monitoring of subsea power cables during onshore evaluation testing. The NDE methods were: (a) thermography, (b) eddy current testing (ECT), (c) spread spectrum time domain reflectometry (SSTDR). The methods are assessed with regards to the information that could be obtained from both a static and oscillating cable in pilot physical tests. The results of the testing were promising, with cable motions and interlayer movements being detected by all techniques to various degrees.
Trends in wildfire-related bills in California, 2001–2020
Authors: Miller Rebecca K , Shi Lin , Wulf David A , Mach Katharine J
Published: August 2022

California has recently experienced severe and destructive wildfire seasons, prompting new policy proposals from the California State Legislature. Here, we examine proposed state wildfire-related legislation from the ten two-year legislative sessions between 2001–2002 and 2019–2020 to track trends and factors influencing wildfire-related legislative priorities. We first use Latent Dirichlet allocation topic modeling to identify 29 wildfire topics from the text of 294 bills. We next determine the degree to which legislators’ backgrounds, legislative procedures, and bill intent are correlated with bill topic. We find individual correlations but no overarching correlations between legislators’ personal and political backgrounds (e.g. political party, legislative experience, home district, bipartisanship), legislative procedures (i.e. committee review, state mandates, urgency measures), and bill intent (i.e. wildfire stage, commemorative bill, focus on specific geographic area or vulnerable group) with bill topics. However, we find that successful bills are correlated with review by Appropriations Committees, review by multiple committees, and a focus on specific geographic location. In the 2019–2020 legislative session, bill passage was correlated with Democratic sponsorship. Legislators tend to propose bills related to the dominant challenge or crisis of that legislative session (such as loss of homeowners’ insurance coverage or need for more fuels management), indicating the reactiveness of the legislature to statewide issues with new proposed legislation. These findings provide important insights into how legislative priorities change over time and the policy enablers and barriers for urgent climate change adaptation. Our results indicate a potentially fundamental policy shift in response to recent wildfires in California.
American Political Parties and Elections: A Very Short Introduction
Authors: Maisel L. Sandy
Published: August 2022

American Political Parties and Elections: A Very Short Introduction examines the electoral process in the United States and explains why it is widely misunderstood. Why is participation in elections so much lower in the United States than in other mature democracies? What role do the political parties play in the electoral process? And why do unregulated groups such as 527 advocacy organizations have as much, if not more, influence than candidates’ campaign organizations? This VSI examines these and other issues to provide an insider’s view of how the system works and why there remain only two main political parties, despite the fact that many citizens claim allegiance to neither and think badly of both.
Far from the perfect democracy
Authors: Maisel L. Sandy
Published: August 2022

Americans, even those familiar with the details of the electoral process, remain convinced that American democracy represents the ideal toward which others should strive. “Far from the Perfect Democracy” examines some of the continuing flaws in the system that sees such low levels of participation, the unsatisfactory nomination process and election campaigns, and the huge costs and lack of competition in the process. While these flaws have been pointed out by many reformers, solutions are not necessarily easy to come by without creating new problems, and few politicians relish the challenge of putting aside their own political interests to address these issues.
Anarchism today
Authors: Prichard Alex
Published: August 2022

With the relative decline of Marxist-Leninism since 1989, anarchism has moved from the fringes of the left back to the centre. This chapter discusses the return of anarchism as a response to the second wave of neoliberal globalization after the end of the Cold War. From the Zapatistas, through to the so-called Battle of Seattle, and on to the global Occupy Wall Street movement, anarchism has been at the forefront of the global anti-capitalist movement. Moving on from protest movements, the chapter then shows how ubiquitous anarchist motifs and ideas are in contemporary popular culture, in particular in contemporary art, film, and music.
Creatures of difference
Authors: Belsey Catherine
Published: August 2022

This opening chapter explains that poststructuralism groups a number of disparate theories concerning the relationship between human beings, the world, and the practice of making, reproducing, and challenging meanings. While these speculations differ from one another in important respects, they begin from certain common assumptions. On the one hand, poststructuralists affirm, consciousness is not the origin of the language we speak and the images we recognize, so much as the product of the meanings we learn and reproduce. On the other hand, communication changes all the time, with or without intervention from us, and we can choose to intervene with a view to altering the meanings—which is to say the norms and values—our culture takes for granted. The chapter proposes that poststructuralism offers a range of ways to consider our place in the world that compete with conventional explanations. It engages with the work of Ferdinand de Saussure, René Magritte, Amy Lowell, Julia Kristeva, and Roland Barthes in order to outline the importance of difference to poststructuralism.
The differed subject
Authors: Belsey Catherine
Published: August 2022

This chapter turns to the theoretical work of Michel Foucault, Julia Kristeva, Jacques Lacan, and Jacques Derrida, along with examples such as Titian’s Venus Blindfolding Cupid and Virginia Woolf’s Orlando, to examine how the subject of poststructuralism is neither unified nor an origin, and is thus a far cry from the unique individual who has traditionally represented humanity in the Free West. The difference between the terms ‘subject’ and ‘identity’ is outlined, and the chapter explores how psychoanalysis deepens poststructuralism’s questioning of the view that consciousness is an origin by redoubling consciousness with unconscious desires that exercise other determinations, according to an agenda we don’t even recognize. The free individual, poststructuralism proposes, is no longer either individual or free. Does this mean we cannot resist our own subjection and that cultural norms (about sex, gender, and binary oppositions, for example) are beyond challenge? No, though there might be a price to pay. The chapter engages with Foucault’s claim that there is by definition no power without the possibility of resistance, and it concludes with a discussion of poststructuralism’s radical edge in a world that often privileges unity and identity.
Difference or truth?
Authors: Belsey Catherine
Published: August 2022

Many people today are willing to surrender the idea that there is in all instances a single, authoritative truth to be discovered and defended. A common alternative is to hold that ‘it’s all subjective’, or that truth exists as the property of the individual. ‘It’s what I believe’, people say; ‘it’s true for me’. By this means they lay claim to a proper tolerance of other opinions, but at the same time they manage to hold on to the view that the individual consciousness is the place where ambiguities are resolved. Truth, they assume, must be a purely personal matter. Poststructuralism looks at the question differently, and this chapter examines how traditional notions of truth and knowledge are challenged by Derrida’s account of deconstruction and differance (with an a). If there are no pure, free-standing meanings, we look in vain, Derrida maintains, for the transcendental signified, the one true meaning that holds all the others in place. Metaphysical systems of belief, laying claim to the truth, appeal to a transcendental signified. But if we take meaning to be the effect of language, not its cause, these foundations lose their transcendental status. This does not reduce belief to the status of fiction, but it does undermine its anchorage in a truth beyond question. In consequence, absolute truth is no longer available as a source of authority; meaning becomes undecidable. Examples discussed include: the fiction of Jeanette Winterson, Toni Morrison, and Charles Dickens; Shakespeare’s poetry; Lévi-Strauss’s anthropology; and the art of Marcel Duchamp.
Emerging epigenetic therapies of cardiac fibrosis and remodelling in heart failure: from basic mechanisms to early clinical development
Authors: McKinsey Timothy A , Foo Roger , Anene-Nzelu Chukwuemeka George , Travers Joshua G , Vagnozzi Ronald J , Weber Natalie , Thum Thomas
Published: August 2022

Cardiovascular diseases and specifically heart failure (HF) impact global health and impose a significant economic burden on society. Despite current advances in standard of care, the risks for death and readmission of HF patients remain unacceptably high and new therapeutic strategies to limit HF progression are highly sought. In disease settings, persistent mechanical or neurohormonal stress to the myocardium triggers maladaptive cardiac remodelling, which alters cardiac function and structure at both the molecular and cellular levels. The progression and magnitude of maladaptive cardiac remodelling ultimately leads to the development of HF. Classical therapies for HF are largely protein-based and mostly are targeted to ameliorate the dysregulation of neuroendocrine pathways and halt adverse remodelling. More recently, investigation of novel molecular targets and the application of cellular therapies, epigenetic modifications, and regulatory RNAs has uncovered promising new avenues to address HF. In this review, we summarize the current knowledge on novel cellular and epigenetic therapies and focus on two non-coding RNA-based strategies that reached the phase of early clinical development to counteract cardiac remodelling and HF. The current status of the development of translating those novel therapies to clinical practice, limitations, and future perspectives are additionally discussed.
Signal transduction in non-climacteric fruit ripening
Authors: Wang Wei , Fan Dingyu , Hao Qing , Jia Wensuo
Published: August 2022

Fleshy fruit ripening involves changes in numerous cellular processes and metabolic pathways, resulting from the coordinated actions of diverse classes of structural and regulatory proteins. These include enzymes, transporters and complex signal transduction systems. Many aspects of the signaling machinery that orchestrates the ripening of climacteric fruits, such as tomato (Solanum lycopersicum), have been elucidated, but less is known about analogous processes in non-climacteric fruits. The latter include strawberry (Fragaria x ananassa) and grape (Vitis vinifera), both of which are used as non-climacteric fruit experimental model systems, although they originate from different organs: the grape berry is a true fruit derived from the ovary, while strawberry is an accessory fruit that is derived from the floral receptacle. In this article, we summarize insights into the signal transduction events involved in strawberry and grape berry ripening. We highlight the mechanisms underlying non-climacteric fruit ripening, the multiple primary signals and their integrated action, individual signaling components, pathways and their crosstalk, as well as the associated transcription factors and their signaling output.
Validation of Delvotest® Fast BT for Detection of β-Lactams and Tetracyclines in Raw Cow’s Milk: Performance Tested MethodSM 102104
Authors: Jagesar Dhiredj C , Kerkhof Jan
Published: August 2022

Background

Delvotest® Fast BT is a rapid test for qualitative detection of β-lactams and tetracycline residues in raw, comingled cow’s milk.

Objective

The test kit was validated under the AOAC Performance Tested MethodSM certification program. Detection capabilities of penicillin G and tetracycline residues were determined. Also, the test method ruggedness, cross-reactivities, interference and masking effects by other antibiotic residues, influence of bacterial and somatic cells, product consistency, and stability of the test kit were studied.

Method

The test cassette is placed in the specially designated incubator (Delvotest® Fast Start III), the milk sample is added to the loading site, and the cassette is incubated for 7 min at 50°C. The test result is read instrumentally using a specially designated reader (Delvotest® Fast Go Max).

Results

Measurements in the method developer study and subsequent confirmation during independent laboratory study showed detection capabilities of 2.1 ppb penicillin G and 95 ppb tetracycline. Regarding robustness, no false positives nor false negatives were found in the method ruggedness, cross-reactivity, masking, and interference studies. In addition, the test performance is not affected by a high number of bacterial or somatic cells present in the milk sample. Stability studies demonstrated good performance of the kit during the shelf life of 12 months.

Conclusions

The validation study demonstrates that Delvotest® Fast BT conforms to the product performance claims and confirms the robustness of the test toward small variations in the operation parameters and normally expected variations in milk samples.

Highlights

Delvotest® Fast BT provides users in the entire milk flow logistics from grass to glass (e.g. farmers and dairies) with a rapid and easy to use method for qualitative detection of β-lactams and tetracycline residues in raw cow's milk.
Role of dual anti-HER2 therapy before liver resection for rectal metastases
Authors: Dantu Siva , Khan Asama , Dhir Mashaal
Published: August 2022

This case presents a patient with a diagnosis of metastatic colon cancer on second-line chemotherapy. He demonstrated increased HER2 expression and was placed on dual HER2 antagonists. The patient had excellent repose and was ultimately able to undergo definitive liver resection for cure. We highlight the evolving use targeted therapy in metastatic colorectal cancer to not only extend progression-free survival, but act as a bridge to surgery.
Adolescent Co-Occurring Substance Use and Mental Health Disorders
Authors: Winters Ken C. , Becher-Ingwalson Ann
Published: August 2022

Adolescents differ from adults physiologically, cognitively, and emotionally. This is a unique developmental period, characterized by a time of dramatic change in the life of every person in every corner of the world. The relatively uniform growth of childhood is suddenly shifted to an increase in the speed of growth and is characterized by rapid physical and psychological changes. It is important for emerging professionals who wish to work with this population to be familiar with the developmental issues and current trends in adolescent substance use and mental health disorders. Despite improvements in prevention and treatment services, adolescent substance abuse and co-existing disorders continue to be a major public health problem. Adolescent Co-Occurring Substance Use and Mental Health Disorders is a textbook on adolescent substance abuse and co-existing mental and behavioral disorders aimed at students seeking a degree or certificate as an addiction counselor. The book’s 13 chapters consist of an Introduction and three sections: Adolescent Development, Co-Occurring Disorders, and Interventions and Treatment. Each chapter includes core content, side-bar points of interest, summary highlights, discussion questions, and recommendations for more digging and curiosity. Several chapters include case vignettes. A learner’s test question bank is also provided.
Externalizing and Related Disorders
Authors: Winters Ken C. , Ingwalson Ann
Published: August 2022

This chapter discusses the traditional disorders that comprise the cluster of externalizing disorders:—attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD)—and their prevalence among adolescents. Schizophrenia and personality disorders are also considered as affiliated externalizing disorders. Discussed are the clinical characteristics and epidemiology of each disorder, along with case studies illustrating the disorder in an adolescent. Generally, the risk of developing a substance use disorder among youth with an externalizing disorder is greater than the risk if the youth has an internalizing disorder (e.g., depression). Many treatment options are available to treat externalizing disorders, including medication, psychotherapy, and education.
Motivational Enhancement Treatment
Authors: Winters Ken C. , Ingwalson Ann
Published: August 2022

The counseling and treatment approach that promotes motivation to change is motivational enhancement therapy (MET) and related strategies. This counseling strategy helps a client to address their reluctance about participating in counseling and making a commitment to change. The theoretical underpinnings of MET is the transtheoretical Stage of Change (SOC) model. This model posits that the behavioral health change process involves progress through six stages of change: precontemplation, contemplation, preparation, action, relapse, and maintenance. A common clinical approach as part of MET is motivational interviewing: The therapist uses feedback to help elicit “change talk” from the youth and eventually have them make a commitment to change. MET is typically delivered in conjunction with other treatment approaches to treat adolescents with a substance use disorder and co-occurring disorders.
12-Step-Based Treatment
Authors: Winters Ken C. , Ingwalson Ann
Published: August 2022

Twelve-step treatment and mutual help organizations, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), are common elements in the treatment and recovery of adolescents with a substance use disorder. Adapting the 12 steps for youth is recommended; these adaptations can retain the core step concepts and yet provide a more amenable version for teenagers. There is a growing descriptive research base supporting the efficacy of 12-step programs. Whereas there are no random assignment studies of 12-step treatment when delivered in a residential setting, 12-step facilitation as an outpatient program has shown promise when studied with controlled conditions. AA/NA self-help groups are free community resources that are widely available in most parts of the country and have no restriction on length of participation. The longer and more intensive the participation, the more likely the person will remain in recovery. Participation by adolescents in self-help groups is more likely when the age composition of a meeting includes many young people.
Autism Spectrum Disorder Versus Obsessive-Compulsive Disorder and Tourette’s Disorder
Authors: McNeel Morgan M. , Grebe Stacey C. , Clayton Rebecca J. , Schneider Sophie C. , Viana Andres G. , Mire Sarah S. , Omar Yasmine , Goodman Wayne K. , Storch Eric A.
Published: August 2022

This chapter discusses considerations, methods, and procedures to assist clinicians in making differential diagnoses of autism spectrum disorder (ASD) versus obsessive-compulsive disorder (OCD) and/or Tourette’s disorder (TD). After reviewing the respective clinical presentations and comorbidities of OCD, TD, and ASD, the chapter discusses the symptom overlap of these diagnoses. The shared features among OCD, TD, and the restricted and repetitive patterns of behaviors, interests, and activities seen in ASD can make differential or dual diagnosis challenging. Two clinical case studies, assessment recommendations, and a clinical decision-making tree are included to assist readers in making accurate differential diagnoses.
Introduction
Authors: Hynan Michael T.
Published: August 2022

This chapter describes the evolution of neonatal intensive care from the 1960s to 2020. This historical progression includes the following stages: parents excluded from the neonatal intensive care unit (NICU); parents as “observers/visitors” during only a few hours of the day; parents welcome for more hours (except during shift changes and rounds) as partial care providers; parents encouraged to be primary care providers for as many hours a day as possible; NICU redesign incorporating single-family rooms to facilitate skin-to-skin contact and comfort of parents; and a newborn intensive parenting unit (NIPU) culture in which the health and emotional well-being of NIPU staff and parents are valued as much as the health of the high-risk infant. During this period, the culture of newborn intensive care has changed as parents increasingly spend more time with their infant and provide more caregiving activities. Notable changes include increased skin-to-skin contact, single-family rooms, family-centered and individualized developmental care, parent-to-parent support, and a greater emphasis on psychological services for both parents and intensive care staff.
Teaching and Training Developing Professionals in Perinatal and Neonatal Settings
Authors: Dowtin LaTrice L. , Willis Tiffany , Givrad Soudabeh , Scala Melissa
Published: August 2022

Behavioral health clinicians (BHCs) come from a variety of disciplines and have varied levels of training experiences in prenatal, fetal, neonatal, infant, and postnatal settings. Together, these areas comprise the field of perinatal/neonatal health. In order to ensure trainees or BHCs wishing to specialize in perinatal/neonatal health are adequately prepared for the spectrum of care they will provide, it is important to create and adhere to standard recommendations for training and educational experiences. Training in perinatal/neonatal settings should include all areas of infant–parent needs for developmental, psychological, and psychiatric health. This chapter discusses those needs and makes recommendations about the essential foci of training. It is vital that learners explore and process biases at the outset of their experiences in perinatal/neonatal health in order to equitably serve patients from a diversity of backgrounds.
Infant Mental Health for High-Risk Infants Across the Continuum of Care
Authors: Shivers Miller , Cunningham Annelise , Henner Natalia , Machut Kerri
Published: August 2022

Relationships are the core construct in infant mental health (IMH). Parent–infant relationships help form the basis of attachment, cognitive development, and infant behavior, which are key elements for healthy infant development. High-risk infants and their parents often spend many days in medical environments, which can add stress, lessen parental efficacy, and interfere with the necessary parent–infant relationship building and attachment. In this chapter, IMH considerations are explored from the prenatal to postnatal periods. Assessment methods that focus on understanding the parent’s perception of their role as a parent and observation of the parent–infant interaction are explained as they relate to improving infant outcomes. Intervention strategies that aim to improve the parent–infant relationship and build attachments are discussed.
Addressing Perinatal Substance Use Across the Continuum of Care
Authors: Paul Jennifer J. , Kelleher Jessalyn , Klawetter Susanne , Nagle-Yang Sarah
Published: August 2022

Substance use during the perinatal period is a critical public health concern with high potential for negative effects on maternal and infant/early childhood health and well-being. This chapter provides an introduction to the principles of trauma-informed care and highlights the importance of its use as a framework for understanding substance misuse in pregnancy and beyond. Rates, impact, assessment, and treatment of substance use disorders are explored within the context of pregnancy, the neonatal period, and early childhood utilizing an intergenerational life span lens. For families impacted by substance use, it is imperative to utilize collaborative, family-centered, and trauma-informed interventions that incorporate intentional efforts to increase access to appropriate care and reduce stigma and bias across systems to optimize positive outcomes.
The Value of Peer Support for High-Risk Pregnant Women and Their NICU Infants
Authors: Hall Sue L. , Landry Jenny , Thatcher Erin
Published: August 2022

Support from a trained volunteer who has lived through a challenging personal experience, provided to another person now going through a similar experience, is a well-recognized and viable method for augmenting and extending psychosocial support beyond what professional staff in the realms of health care and mental health care can provide. This chapter examines the rationale for and benefits of peer support programs to women with high-risk conditions of pregnancy and to parents whose infants require a stay in the neonatal intensive care unit, as well as how these programs can be started and sustained. Common questions that must be answered when starting a program are outlined, as are key factors contributing to the success of such programs. Finally, two existing programs are presented as exemplars for this important type of support.
Uncertainty and Coping in the NICU
Authors: Steinberg Zina , Kraemer Susan
Published: August 2022

Uncertainty surrounds the infant’s admission to the neonatal intensive care unit (NICU), causing stress and increased risk of postpartum mood and anxiety disorders for the family, affecting their coping capacities. Admission to the NICU is viewed as a potentially traumatic event, and relationships are known to be a significant protective force. The NICU psychologist helps mitigate these challenges to mental health with close attention to the relationships that form a resilience-fostering web supporting the parent–infant relationship. The psychologist knows that the psychological attachment to the infant begins before birth, keeping in mind the possible fragility of that attachment when the infant is critically ill. In addition, the psychologist works closely with medical staff, particularly nurses, encouraging and bolstering their essential role in supporting the parent–infant dyad.
Attending to the Positive
Authors: Craske Michelle G. , Dour Halina J. , Treanor Michael , Meuret Alicia E.
Published: August 2022

This chapter covers the skills of shifting attention toward positive stimuli and improving prospective positive mental imagery. The skills address deficits in anticipation of reward by having clients learn to attribute their actions to positivity. Target attention is vital since the evidence shows that depressed mood and anhedonia are associated with limited sustained attention to positive stimuli. Focus on past experiences is achieved by re-evaluating situations. The skill of finding the silver linings is introduced, but therapists should know this sometimes triggers trauma, panic, and anxiety. The chapter emphasizes that diminishing self-attribution for positive outcomes limits the learning of reward.
How Will This Therapy Work for You?
Authors: Meuret Alicia E. , Dour Halina J. , Guinyard Amanda G. Loerinc , Craske Michelle G.
Published: August 2022

This chapter explains the importance of fitting the right treatment. The Positive Affect Treatment (PAT) was developed to increase the number, frequency, and intensity of positive emotions. Additionally, the treatment is designed to be flexible to meet the needs of individuals with issues such as anhedonia. Anhedonia is the difficulty of noticing or appreciating positive emotions. The chapter discussed the PAT modules and their treatment skill sets. People are encouraged to stick to one treatment at a time and to continue their medications for symptoms of anxiety and depression. Additionally, calling 911 or visiting the nearest emergency room is vital for people with elevated thoughts of self-harm.
Continuing the Journey After Treatment
Authors: Meuret Alicia E. , Dour Halina J. , Guinyard Amanda G. Loerinc , Craske Michelle G.
Published: August 2022

This final chapter explores the post-treatment stage, or what happens after the participant completes the Positive Affect Treatment (PAT) program. One of the treatment’s primary goals is helping participants to notice and appreciate the positives of their accomplishments. Knowing the extent of their progress will guide decisions and will help them identify which skills learned during treatment might need additional daily practice. Progress rarely goes in a straight line, and lapses or relapses are possible. This chapter offers advice on what to do if a lapse or relapse occurs and emphasizes the importance of assessing one’s progress objectively. The importance of having long-term plans and maintaining the progress made during PAT is stressed.
Introduction
Authors: Markowitz John C.
Published: August 2022

Why is supportive psychotherapy important? Supportive psychotherapy is widespread in practice, but the term suffers from both too many meanings and too little definition. Supportive therapy has suffered an unfairly poor reputation. It employs an affect focus and the so-called “common factors” of psychotherapy that are essential to any clinician’s skill set, yet aspects of treatment too many clinicians neglect. This manual carefully defines Brief Supportive Psychotherapy (BSP), articulating the treatment we have used in multiple government-funded randomized clinical trials. BSP may be considered either an active control condition in a research study or simply an active treatment for clinical practice. Because its approach is so elemental, it helps therapists to appreciate aspects of treatment, such as an affect focus, that they can apply in delivering other treatments. This book is thus a manual for both researchers and general therapists.
Formulation
Authors: Markowitz John C.
Published: August 2022

A good Brief Supportive Psychotherapy practitioner (a) conceives an emotional portrait of his or her patient, (b) recognizes the emotional and life difficulties the patient faces and their connection, and (c) develops a therapeutic plan, a direction in which the therapy should ideally progress, even if this is not directly communicated to the patient. The portrait is based on how the patient recognizes, handles, and avoids inner emotional responses. This chapter describes how to take a history in BSP treatment, following the patient’s lead but seeking details where appropriate. It illustrates with case examples how to develop a BSP formulation and how (and how much) to describe to the patient.
Additional Information for Therapists
Authors: Pachankis John E. , Harkness Audrey R. , Jackson Skyler D. , Safren Steven A.
Published: August 2022

This chapter explains how screening all clients for emotional disorders and LGBTQ-related stress experiences can inform an initial case formulation. It cites the Mini-International Neuropsychiatric Interview (MINI), which is used to screen clients for emotional disorders, such as DSM-5 disorders. The information derived from MINI allows therapists to determine differential diagnoses and gain a clear understanding of the nature and severity of each diagnosis. The chapter describes several standardized self-report inventories of emotional disorders and cross-cutting symptoms that can provide useful information for case formulation at baseline. It recommends the Beck Depression Inventory-II and the Beck Anxiety Inventory as general measures of depressive and anxious symptoms.
Overview of General Treatment Format and Procedures
Authors: Pachankis John E. , Harkness Audrey R. , Jackson Skyler D. , Safren Steven A.
Published: August 2022

This chapter looks at the combination of cognitive-behavioral treatment with motivational interviewing, in which therapists work with clients as close collaborators rather than adopting the role of an “authority.” Both the therapist and client must work together throughout treatment to design the most effective treatment plan possible. It points out why changing patterns of behavior is difficult and requires clients to give feedback on what is helpful and what is not. The chapter advises the therapist to strive to gain a thorough understanding of the issues the client brings to treatment and work to establish good rapport, which are crucial in introducing treatment concepts and carrying out challenging treatment exercises in future sessions. It includes the home practice review, which provides the therapist with the opportunity to briefly revisit some of the content of the previous session and link that content to what occurred over the week.
Module 5: Increasing Cognitive Flexibility
Authors: Pachankis John E. , Harkness Audrey R. , Jackson Skyler D. , Safren Steven A.
Published: August 2022

In the module described in this chapter, clients are given an opportunity to connect their growing awareness of their emotional experience of LGBTQ-related stress to their negative and potentially rigid thinking patterns. This chapter details how to explore the client’s home practice, in which they were to practice nonjudgmental, present-focused emotion awareness, and describes how to introduce automatic thinking patterns and thinking traps. It also helps clients identify examples of automatic thinking and thinking traps that they commonly encounter and how these might connect to their experience with LGBTQ-related stress. The chapter discusses the concept of cognitive flexibility and various ways it can be used to combat harmful automatic thinking and thinking traps. It explains the impact of LGBTQ-related stress on LGBTQ people’s automatic thinking patterns.
Module 7: Experimenting with New Reactions to LGBTQ-Related Stress
Authors: Pachankis John E. , Harkness Audrey R. , Jackson Skyler D. , Safren Steven A.
Published: August 2022

The chapter talks about the development of the behavioral skills necessary to assert oneself in the face of difficult interpersonal situations involving LGBTQ-related stress. It introduces the concept of assertiveness and discusses what it means to assert one’s personal needs, wants, and desires. It also describes the role of LGBTQ-related stress in the development of unassertive behavioral patterns. The chapter shows how to help clients identify their personal rights in challenging interpersonal situations and identify situations in which it is most difficult for them to engage in assertive behavior. These sessions involve reviewing assertiveness home practice, reinforcing material from prior sessions, and conducting in-session assertiveness roleplays.
Module 8: Emotion Exposures for Countering LGBTQ-Related Stress
Authors: Pachankis John E. , Harkness Audrey R. , Jackson Skyler D. , Safren Steven A.
Published: August 2022

This chapter focuses on confronting both internal triggers and external triggers and provides the client with opportunities to increase their tolerance of emotions while allowing for new learning to occur. It reviews the concept of emotion exposures and how they can support learning and lasting change. It also discusses bodily feelings, how they relate to emotions and LGBTQ-related stress, and the therapist’s role in guiding the client in engaging their bodily feelings, in and out of session. The therapist helps clients who fear their bodily feelings to understand how avoiding bodily feelings maintains maladaptive emotional responses. This chapter covers introducing emotion exposures, building an emotion exposure ladder, and designing and completing an in-session emotion exposure.
Learning to Record Your Experiences
Authors: Pachankis John E. , Jackson Skyler D. , Harkness Audrey R. , Safren Steven A.
Published: August 2022

This chapter highlights the importance of recording symptoms of anxiety and depression, which can give patients an objective, scientific view of their symptoms and inform their progress throughout this treatment. It describes how to become an objective observer and how to track one’s progress throughout this program. It outlines the reasons why it is important to keep records of experiences on a regular basis, noting how intense anxiety, sadness, or other uncomfortable emotions typically feel overwhelming. The chapter explains how learning to be an observer of one’s own emotions is a first step towards understanding these experiences and feeling more in control. Keeping weekly records of emotional experiences helps patients recognize that their mood fluctuates throughout the day and the week.
Form and function when treating anxiety in youth
Authors: Crane Margaret E. , Maxwell Colleen A. , Rabner Jonathan C. , Wojcieszak Zuzanna K. , Myerberg Lindsay B. , Kendall Philip C.
Published: August 2022

Evidence-based interventions (EBIs) have demonstrated beneficial outcomes among children and adolescents. That said, not all manual-based EBIs that demonstrate efficacy in research settings have yielded the same results in community-based settings. An EBI that is found to be efficacious in research but less effective once disseminated into the community may reflect either (1) too rigid adherence to a manualized protocol that does not ‘fit’ the needs of the individuals receiving the intervention in the community or (2) overly loose application (non-adherence) of the programme that compromises fidelity. Perfect adherence to a protocol may be unattainable in any settings given the variety of factors that arise in providing mental health services (e.g. staff turnover, limited practitioner time). What has emerged is a valid tension between following an efficacious manual-based treatment and delivering an intervention that is adapted to the needs of an individual. This tension often can arise for practitioners with limited therapy experience who are delivering manual-based low intensity interventions. Intervention adaptations are necessary for widespread application, yet adaptations must be conducted thoughtfully to maintain implementation fidelity. To achieve this balance, the authors encourage practitioners to operate from a ‘flexibility within fidelity’ framework. Flexibility within fidelity requires that the active ingredients of an EBI are presented, while the ‘adaptable periphery’ (i.e. precise details or manner in which the intervention is delivered) is tailored to an individual client’s needs.
Brief behavioural activation for treating depressive symptoms in children and adolescents
Authors: Felton Julia W. , Anvari Morgan S. , Magidson Jessica F. , Lejuez Carl W.
Published: August 2022

Depressive symptoms increase dramatically over the course of adolescence and early adulthood. Depressive disorders are characterized by low affect and loss of interest in previously enjoyable experiences. Brief behavioural activation (BA) draws on reinforcement frameworks of the development of mood disorders and focuses on supporting individuals to re-engage with valued activities. Brief BA has been shown to reduce depressive symptoms among children and young people across a variety of community-based and clinical settings. This chapter provides an introduction to delivering Brief BA for youth, including session-by-session content and detailed case examples. The chapter also focuses on addressing common barriers youth face to implementing Brief BA techniques like behavioural monitoring and activity scheduling. Finally, new technology resources are reviewed and sample worksheets are provided to help practitioners utilize these techniques with young people.
Low intensity interventions for children with Tourette syndrome and tic disorders
Authors: Sanderson Charlotte , Hall Charlotte L. , Murphy Tara
Published: August 2022

This chapter provides a brief overview of the three core behavioural treatments for tics comprehensive behavioural intervention for tics, which includes habit reversal training, and exposure and response prevention. Access to therapies is more limited compared with medication which has resulted in a growing interest in adaptations to treatment. Preliminary evidence has highlighted the potential for existing effective behavioural tic treatments to be delivered in briefer formats, and via alternative modalities (e.g. online/group interventions) that may help to widen access and referral pathways. This chapter explores how these may be modified for low intensity delivery, drawing upon available evidence. It considers how co-occurring conditions may be addressed within/alongside brief tic-focused interventions, presenting a case study of a young person with tics and social anxiety. Readers less familiar with tic disorders are encouraged to consult the ‘Recommended reading’ list provided.