Publications

A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6month SDT-based intervention to 12months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30days but who are willing to reduce their cigarette use by half. The primary outcome is 12month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others.

Abstract Across three studies we explore the interface between self-determination theory (SDT) and Nussbaum’s philosophy of capabilities by exploring how societal capabilities relate to wellness via basic psychological needs. In Study 1 (N = 778, from Australia, India, Philippines, South Africa, and the United States) and Study 2 (N = 495 Americans), we examined Lorgelly et al.’s (Social Science & Medicine 142:68–81, 2015) measure of capabilities, identifying a four-factor solution yielding variables for freedom of expression, freedom from discrimination, well-being, and home safety. We assessed links between freedom of expression and freedom from discrimination and wellness outcomes via basic psychological needs in Study 1, Study 2, and Study 3 (N = 203, Indigenous Australians, 500 non-indigenous Australians). Aligned with SDT’s dual process model, need satisfaction appears to account for the paths to well-being, and need frustration may account for paths to ill-being. This work steers SDT in a new direction by extending the dual process model beyond interpersonal contexts and more fully integrating philosophical perspectives on capabilities to shed light upon how macro-level societal affordances relate to wellness through basic psychological needs.

SummaryLocal anaesthesia of surface skin has been made more acceptable to patients by the introduction of an absorbable topical anaesthetic preparation which reduces the need for infiltration anaesthesia and has been shown to be significantly effective upon the tympanic membrane. This preparation, EMLA cream, was used as the basis for establishing an outpatient-based minor operating list for performing adult myringotomy and grommet insertion. The technique and procedure adopted proved to be convenient, highly effective and economical and completely obviated the need for general anaesthesia in suitable cases. This approach has resulted in a significantly improved utilization of valuable day-case surgical facilities and has become an established feature in this department.

Designing high-throughput screens for voltage-gated ion channels has been a tremendous challenge for the pharmaceutical industry because channel activity is dependent on the transmembrane voltage gradient, a stimulus unlike ligand binding to G-protein-coupled receptors or ligand-gated ion channels. To achieve an acceptable throughput, assays to screen for voltage-gated ion channel modulators that are employed today rely on pharmacological intervention to activate these channels. These interventions can introduce artifacts. Ideally, a high-throughput screen should not compromise physiological relevance. Hence, a more appropriate method would activate voltage-gated ion channels by altering plasma membrane potential directly, via electrical stimulation, while simultaneously recording the operation of the channel in populations of cells. The authors present preliminary results obtained from a device that is designed to supply precise and reproducible electrical stimuli to populations of cells. Changes in voltage-gated ion channel activity were monitored using a digital fluorescent microscope. The prototype electric field stimulation (EFS) device provided real-time analysis of cellular responsiveness to physiological and pharmacological stimuli. Voltage stimuli applied to SK-N-SH neuroblastoma cells cultured on the EFS device evoked membrane potential changes that were dependent on activation of voltage-gated sodium channels. Data obtained using digital fluorescence microscopy suggests suitability of this system for HTS.

During the analysis cycles of Phase A-Cycle 3 (PA-C3) and the follow-on 8-wk minicycle of PA-C3', the Ares V team assessed the Ares V PA-C3D configuration to the Mars Design Reference Mission as defined in the Constellation Architecture Requirements Document and further described in Mars Design Reference Architecture 5.0 (DRA 5.0) that was publicly released in July 2009. The ability to support the reference approach for the crewed Mars mission was confirmed through this analysis (7-launch nuclear thermal propulsion (NTP) architecture) and the reference chemical approach as defined in DRA 5.0 (11- or 12-launch chemical propulsion module approach). Additional chemical propulsion options were defined that utilized additional technology investments (primarily in-space cryogenic propellant transfer) that allowed for the same mission to be accomplished with 9 launches rather than the 11 or 12, as documented in DRA 5.0 and associated follow-on activities. This nine-launch chemical propulsion approach showed a unique ability to decouple the architecture from major technological developments (such as zero-boiloff technology or the development of NTP stages) and allowed for a relaxing of the infrastructure investments required to support a very rapid launch rate (30-day launch spacing as documented in DRA 5.0). As an enhancing capability, it also shows promise in allowing for and incorporating the development of a commercial market for cryogenic propellant delivery on orbit, without placing such development on the critical path of beyond low-Earth orbit exploration. The ability of Ares V to support all of the aforementioned options and discussion of key forward work that is required to fully understand the complexities and challenges presented by the Mars mission is further documented herein.

Hello Sunday Morning (HSM) is a self-guided health promotion website with the aim to improve drinking culture. Members are encouraged to sign up for a 3-month period of alcohol abstention and record and track their progress and goals.This study used self-determination theory (SDT) to examine the nature of goals subscribed by HSM users to test the extent to which intrinsic goal pursuit was linked to lower alcohol dependency risk and higher engagement with the HSM website.HSM users (N=2216; 59.75%, 1324/2216, females; aged 18-79 years) completed the World Health Organization's Alcohol Use Disorders Identification Test (WHO-AUDIT, which measures alcohol dependence risk level) at sign-up and at 4 and 6 months after sign-up. In addition, the website had a goals-subscription feature that allowed participants to share their goals. Two independent raters classified the goals according to a coding system we devised based on SDT, which proposes that intrinsic goals (eg, growth, relationships, community, and health) better promote positive outcomes than extrinsic goals (eg, wealth, fame, and image).Although there was substantial (1016/2216, 45.84%) attrition of HSM users from sign-up to 6 months, the attrition rate could not be attributed to alcohol dependency risk because people in different WHO-AUDIT risk zones were equally likely to be missing at 4 and 6 months after sign-up. The SDT-driven coding of goals yielded the following categories: wealth and image (extrinsic goals); relationships, personal growth, community engagement, and physical health (intrinsic goals); and alcohol use-related goals (which were hard to classify as either extrinsic or intrinsic). Alcohol dependence risk level correlated positively with goals related to money (r=.16), personal growth (r=.17), relationships (r=.10), and alcohol use (r=.25). Website engagement correlated negatively with alcohol dependence risk level (r=.10) and positively with relationship (r=.10) and community goals (r=.12).HSM users with higher alcohol dependence risk tended to engage with the website less, but to the extent that they did, they tended to subscribe to goals related to alcohol use and improving their personal growth, relationships, and finances. In line with SDT, engagement with goals-particularly the intrinsic goals of connecting with close-others and the broader community-related to increased website engagement. Web-based tools intended to promote healthy behaviors in users may be effective in engaging their users if the users' experience on the website supports the pursuit of intrinsic goals.

No abstract is provided for this article.