Daily micropractice can augment single-session interventions: A randomized controlled trial of self-compassionate touch and examining their associations with habit formation in US college students.

In this pre-registered study, we evaluated the effects of a single-session, self-guided intervention, leveraging daily micropractice (≤20 seconds/day practice) of self-compassionate touch to enhance self-compassion. We randomly assigned undergraduates (N = 135) to one of two conditions: a single-session intervention in which they were taught self-compassionate touch or a finger-tapping active control. Then, we instructed them to practice for 20 seconds/day for one month. At baseline (T1) and one-month follow-up (T2), participants completed assessments of self-compassion, growth mindset, positive affect, stress, psychopathology, habit formation, and more. In confirmatory, intention-to-treat analyses (N = 135), we found no significant effects on these outcomes. However, in confirmatory, per-protocol analyses (comparing the subsets from each condition who practiced>28 times, N = 45), self-compassionate touch, relative to active control, predicted T1-to-T2 increases in self-compassion (ß = 0.71, p = .025), and reductions in stress (ß = -0.62, p = .047) and psychopathology (ß = -0.61, p = .046). In exploratory intention-to-treat analyses (N = 135), we found the same pattern of effects as in the per-protocol analyses among those who practiced self-compassionate touch more frequently relative to active control. We discuss factors associated with habit formation of daily practice. Daily micropractices have the potential for augmenting single-session interventions and for offering help when more time-intensive approaches may be less accessible. CLINICAL TRIAL REGISTRATION NUMBER: NCT05199779.

Preclinical Efficacy and Safety Comparison of CD3 Bispecific and ADC Modalities Targeting BCMA for the Treatment of Multiple Myeloma.

The restricted expression pattern of B-cell maturation antigen (BCMA) makes it an ideal tumor-associated antigen (TAA) for the treatment of myeloma. BCMA has been targeted by both CD3 bispecific antibody and antibody-drug conjugate (ADC) modalities, but a true comparison of modalities has yet to be performed. Here we utilized a single BCMA antibody to develop and characterize both a CD3 bispecific and 2 ADC formats (cleavable and noncleavable) and compared activity both in vitro and in vivo with the aim of generating an optimal therapeutic. Antibody affinity, but not epitope was influential in drug activity and hence a high-affinity BCMA antibody was selected. Both the bispecific and ADCs were potent in vitro and in vivo, causing dose-dependent cell killing of myeloma cell lines and tumor regression in orthotopic myeloma xenograft models. Primary patient cells were effectively lysed by both CD3 bispecific and ADCs, with the bispecific demonstrating improved potency, maximal cell killing, and consistency across patients. Safety was evaluated in cynomolgus monkey toxicity studies and both modalities were active based on on-target elimination of B lineage cells. Distinct nonclinical toxicity profiles were seen for the bispecific and ADC modalities. When taken together, results from this comparison of BCMA CD3 bispecific and ADC modalities suggest better efficacy and an improved toxicity profile might be achieved with the bispecific modality. This led to the advancement of a bispecific candidate into phase I clinical trials.

Is improving sleep and circadian problems in adolescence a pathway to improved health? A mediation analysis.

OBJECTIVE: The present study tested whether improvements in sleep and circadian problems mediate the effect of a novel transdiagnostic sleep and circadian intervention (TranS-C) on improvements in 5 health domains (emotional, cognitive, behavioral, social, and physical) in community-residing, evening chronotype adolescents who were at risk for problems in these 5 health domains. METHOD: Participants were 176 adolescents (age mean [SD] = 14.77 [1.84] years; 58% female) who were randomized to receive 6 sessions of TranS-C or psychoeducation. Putative mediators tested were eveningness, weekday-weekend discrepancy in total sleep time and waketime, daytime sleepiness, Pittsburgh Sleep Quality Index score, and parent-reported sleep-wake problems. Risk in 5 health domains was measured using adolescent self-reported questionnaires, parent-reported Child Behavior Checklist, and ecological momentary assessment (EMA) of problems in the 5 health domains. RESULTS: Reduced eveningness mediated the effects of TranS-C on reducing both self-reported and parent-reported risk in the 5 health domains. Reduction in daytime sleepiness mediated the effects of TranS-C on parent-reported risk in the 5 health domains. Reduction in parent-reported sleep-wake problems mediated the effects of TranS-C on self-reported, parent-reported, and EMA-assessed risk in the 5 health domains. Results did not support the other hypothesized mediators. CONCLUSIONS: TranS-C exerts effects on reducing risk in multiple mental and physical health domains through reducing sleep and circadian problems in evening chronotype adolescents. Further research of TranS-C in other samples to assess its benefits for sleep and circadian problems as well as mental and physical health is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Can contaminated water be rendered safe for nasal saline irrigations?

OBJECTIVES/HYPOTHESIS: To compare sterile water to three methods of sterilization (carbon filtration, boiling, and ultraviolet [UV] light) for preparation of nasal saline irrigants free of bacterial and amebic contaminants. STUDY DESIGN: Bench-top translational research and cost comparison. METHODS: Sterile water was compared to common sterilization methods. Sterile water was contaminated with known concentrations of Staphylococcus aureus, Pseudomonas aeruginosa, Moraxella catarrhalis, Acinetobacter baumannii, Klebsiella pneumonia, Legionella pneumophila, and Naegleria fowleri. Test samples were subjected to boiling, carbon filtration, or ultraviolet light (UV) and then cultivated on appropriate media. Controls included samples of sterile water (negative control) and untreated test samples (positive control). RESULTS: Carbon filtration reduced but did not eliminate the number of organisms present in test samples. Boiling test samples for 5 minutes and UV light treatment resulted in sterilization of all organisms. Negative (sham contaminated) samples produced no growth, whereas positive (untreated) samples grew numerous organisms as expected. A cost comparison between bottled water and UV water sterilization (with SteriPEN Ultra) became equal in less than 2 years of consistent use. CONCLUSIONS: Carbon filtration reduces contamination but does not sterilize water and is thus unsafe for preparation of nasal saline irrigant. Boiling and UV treatment resulted in sterilization and are equivalent to purchased sterile water. Ultraviolet treatment was found to be safe, convenient, and a cost-effective alternative to purchased sterile water. LEVEL OF EVIDENCE: NA Laryngoscope, 127:1513-1519, 2017.

Effect of highly purified capsaicin on articular cartilage and rotator cuff tendon healing: An in vivo rabbit study.

Highly purified capsaicin has emerged as a promising injectable compound capable of providing sustained pain relief following a single localized treatment during orthopedic surgical procedures. To further assess its reliability for clinical use, the potential effect of highly purified capsaicin on articular cartilage metabolism as well as tendon structure and function warrants clarification. In the current study, rabbits received unilateral supraspinatus transection and repair with a single 1 ml injection of capsaicin (R+C), PEG-only placebo (R+P), or saline (R+S) into the glenohumeral joint (GHJ). An additional group received 1 ml capsaicin onto an intact rotator cuff (I+C). At 18 weeks post-op, cartilage proteoglycan (PG) synthesis and content as well as cell viability were similar (p>0.05) across treatment groups. Biomechanical testing revealed no differences (p>0.05) among tendon repair treatment groups. Similarly, histologic features of both cartilage and repaired tendons showed minimal differences across groups. Hence, in this rabbit model, a single injection of highly purified capsaicin into the GHJ does not induce a deleterious response with regard to cartilage matrix metabolism and cell viability, or rotator cuff healing. These data provide further evidence supporting the use of injectable, highly purified capsaicin as a safe alternative for management of postoperative pain following GHJ surgery.

Western Juniper Management: Assessing Strategies for Improving Greater Sage-grouse Habitat and Rangeland Productivity.

Western juniper (Juniperus occidentalis subsp. occidentalis) range expansion into sagebrush steppe ecosystems has affected both native wildlife and economic livelihoods across western North America. The potential listing of the greater sage-grouse (Centrocercus urophasianus) under the U.S. Endangered Species Act has spurred a decade of juniper removal efforts, yet limited research has evaluated program effectiveness. We used a multi-objective spatially explicit model to identify optimal juniper removal sites in Northeastern California across weighted goals for ecological (sage-grouse habitat) and economic (cattle forage production) benefits. We also extended the analysis through alternative case scenarios that tested the effects of coordination among federal agencies, budgetary constraints, and the use of fire as a juniper treatment method. We found that sage-grouse conservation and forage production goals are somewhat complementary, but the extent of complementary benefits strongly depends on spatial factors and management approaches. Certain management actions substantially increase achievable benefits, including agency coordination and the use of prescribed burns to remove juniper. Critically, our results indicate that juniper management strategies designed to increase cattle forage do not necessarily achieve measurable sage-grouse benefits, underscoring the need for program evaluation and monitoring.

Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning.

Mental disorders are prevalent and can lead to significant impairment. Some progress has been made toward establishing treatments; however, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for the content of sessions of psychosocial treatments, would outcome substantially improve? We leverage insights from scientific knowledge on learning and memory to derive strategies for transdiagnostic and transtreatment cognitive support interventions. These strategies can be applied within and between sessions and to interventions delivered via computer, the Internet, and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise, and using imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from different types and amounts of cognitive support.

'Folk theories' about the causes of insomnia.

The present study investigates 'folk theories' about the causes of insomnia. Participants with insomnia (n = 69) completed a qualitative and quantitative assessment of their folk theories. The qualitative assessment was to speak aloud for 1 minute in response to: 'What do you think causes your insomnia?'. The quantitative assessment involved completing the 'Causal Attributions of My Insomnia Questionnaire' (CAM-I), developed for this study. The three most common folk theories for both the causes of one's own insomnia as well as insomnia in others were 'emotions', 'thinking patterns' and 'sleep-related emotions'. Interventions targeting these factors were also perceived as most likely to be viable treatments. Seventy-five percent of the folk theories of insomnia investigated with the CAM-I were rated as more likely to be alleviated by a psychological versus a biological treatment. The results are consistent with research highlighting that folk theories are generally coherent and inform a range of judgments. Future research should focus on congruence of 'folk theories' between treatment providers and patients, as well as the role of folk theories in treatment choice, engagement, compliance and outcome.

Circadian rhythms and psychiatric illness.

PURPOSE OF REVIEW: The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. RECENT FINDINGS: In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. SUMMARY: Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions and address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes.

Adverse reactions from essential oil-containing natural flea products exempted from Environmental Protection Agency regulations in dogs and cats.

OBJECTIVE: To describe adverse effects in dogs and cats exposed to Environmental Protection Agency exempted plant-derived flea preventatives containing mixtures of essential oils. DESIGN: Retrospective study from 2006 to 2008. SETTING: Records of dog and cat cases were reviewed from the American Society for the Prevention of Cruelty to Animals, Animal Poison Control Center database. ANIMALS: Thirty-nine cats and 9 dogs with history of exposure to natural flea preventatives. MEASUREMENTS AND MAIN RESULTS: The following information was retrieved from each incident: number of animals, species involved, frequency, types, onset time, duration of clinical signs, exposure appropriateness, final outcome, and treatment information. Ninety-two percent of animals (n = 44) showed presence of one or more adverse effects. The frequency of adverse effects in dogs (n = 8; 89%) and cats (n = 36; 92%) was similar. Onset time of adverse effects in 39 of 44 animals occurred within 24 hours. The duration of signs in 24 animals ranged from 30 minutes to 149 hours. The products were used as per label in 77% animals (n = 37). Of 28 animals with known outcome, 50% (n = 14) recovered with bathing alone while others received intravenous fluids, muscle relaxants, and anticonvulsive medications. Death (1 cat; n = 1/28; 4%) or euthanasia (1 cat and 1 dog; n = 2/28; 7%) was reported in 3 animals. CONCLUSION: Dogs and cats can experience significant adverse effects when exposed to plant-derived flea preventatives even when used according to label directions. The number of reports of exposure in cats was higher than dogs, but the frequency of reported adverse effects was similar between the 2 species. Agitation and hypersalivation were common in cats, whereas lethargy and vomiting were common in dogs.

Double trouble? The effects of sleep deprivation and chronotype on adolescent affect.

BACKGROUND: Two understudied risk factors that have been linked to emotional difficulties in adolescence are chronotype and sleep deprivation. This study extended past research by using an experimental design to investigate the role of sleep deprivation and chronotype on emotion in adolescents. It was hypothesized that sleep deprivation and an evening chronotype would be associated with decreased positive affect (PA), increased negative affect (NA), and lower positivity ratios. METHODS: Forty-seven healthy adolescents (aged 10-15 for girls, 11-16 for boys) participated in a sleep deprivation and a rested condition. A subsample of 24 adolescents was selected on the basis of extreme morningness or eveningness scores (based on outer quartiles of scores on the Children's Morningness-Eveningness Preferences Scale). PA and NA were measured using the Positive and Negative Affect Schedule for Children, and positivity ratios were calculated by dividing PA by NA. RESULTS: Participants reported less positive affect and lower positivity ratios when sleep deprived, relative to when rested. Evening chronotypes reported less positive affect and lower positivity ratios than morning chronotypes in both rested and sleep deprivation conditions. CONCLUSIONS: These findings extend previous research by suggesting that adolescents are adversely impacted by sleep deprivation, and that an evening chronotype might serve as a useful marker of emotional vulnerability. Early intervention and prevention strategies can focus on improving sleep and on using chronotherapy principles to reduce eveningness.

The effects of lactoferrin on the intestinal environment of broiler chickens.

The influence of in-feed lactoferrin (Lf) on bird production, intestinal microbiota, mucosal immune system and gut microarchitecture was assessed in male Cobb 500 broiler chickens. Birds were given one of four diets from day of hatch: Control (basal diet with no additives), ZnB (basal diet + 50 mg/kg zinc bacitracin), Lf 250 mg/kg (basal diet + 250 mg/kg Lf) and Lf 500 mg/kg (basal diet + 500 mg/kg Lf); n = 24 birds/treatment. An apparent metabolisable energy study was performed between d 25-32. Lf did not affect growth rate or feed conversion in the period 0-21 d of age, nor performance or energy metabolism during the 7 d metabolism experiment which commenced at 25 d of age.The profiles of caecal microbial communities were significantly different in birds given ZnB compared with birds given a diet with no additives, or supplemented with 250 mg/kg Lf. Birds given 250 mg/kg Lf also had a different microbial profile compared with birds given 500 mg/kg Lf. In comparison to control birds, Lf treated birds showed some differences in the T cell proportions in caecal tonsil and spleen. No differences in ileal villus height, crypt depth or goblet cell proportions were observed amongst dietary treatments. Whilst Lf had little effect on the measured parameters, the use of an integrated approach to study the influence of novel feed additives may facilitate a greater understanding of the relationships between nutrition, gut health and bird performance.

Insights into the inhibition of platelet activation by omega-3 polyunsaturated fatty acids: beyond aspirin and clopidogrel.

OBJECTIVES: We sought to examine the effects of escalating doses of omega-3 polyunsaturated fatty acid (PUFA) supplements on platelet function using light transmission aggregometry (LTA) and electrophoretic quasi-elastic light scattering technology (EQELS). BACKGROUND: PUFA may inhibit platelet function through fatty acid substitution in the platelet membrane by changing the surface charge density and causing decreased production of thromboxane A2. EQELS can measure platelet surface charge density and determine whether the platelet is in resting or activated state. METHODS: A total of 30 volunteers were divided in 3 groups of 10 as follows: Group A, no antiplatelet agent; Group B, daily aspirin only, and Group C, daily aspirin and clopidogrel. All patients received escalating doses of omega-3PUFA from 1 to 8 g daily over 24 weeks. Platelet function was measured by template bleeding time, LTA, and EQELS at baseline and at 6, 12, 18 and 24 weeks. RESULTS: Mean bleeding time increased in a dose-dependent manner with escalating omega-3 PUFA doses. LTA confirmed expected antiplatelet effects of aspirin and clopidogrel, but did not detect any additional antiplatelet effects of omega-3 PUFA. EQELS showed a significant increase in the negative resting platelet charge compared to baseline and an attenuated response to arachidonic acid mediated platelet activation. No bleeding events were observed. CONCLUSIONS: In this pilot study we were able to successfully measure platelet surface charge variation as a measure of omega-3 PUFA effect on platelets. Our results suggest that omega-3 PUFA increase the total platelet surface charge and, therefore, attenuate platelet activation, even among patients taking aspirin or aspirin plus clopidogrel. Further studies are needed to determine the clinical significance of these measured effects and EQELS results.

Sensory gating in primary insomnia.

Although previous research indicates that sleep architecture is largely intact in primary insomnia (PI), the spectral content of the sleeping electroencephalographic trace and measures of brain metabolism suggest that individuals with PI are physiologically more aroused than good sleepers. Such observations imply that individuals with PI may not experience the full deactivation of sensory and cognitive processing, resulting in reduced filtering of external sensory information during sleep. To test this hypothesis, gating of sensory information during sleep was tested in participants with primary insomnia (n = 18) and good sleepers (n = 20). Sensory gating was operationally defined as (i) the difference in magnitude of evoked response potentials elicited by pairs of clicks presented during Wake and Stage II sleep, and (ii) the number of K complexes evoked by the same auditory stimulus. During wake the groups did not differ in magnitude of sensory gating. During sleep, sensory gating of the N350 component was attenuated and completely diminished in participants with insomnia. P450, which occurred only during sleep, was strongly gated in good sleepers, and less so in participants with insomnia. Additionally, participants with insomnia showed no stimulus-related increase in K complexes. Thus, PI is potentially associated with impaired capacity to filter out external sensory information, especially during sleep. The potential of using stimulus-evoked K complexes as a biomarker for primary insomnia is discussed.

Dietary omega-3 polyunsaturated fatty acid does not influence the intestinal microbial communities of broiler chickens.

The capacity for n-3 polyunsaturated fatty acids (PUFA) to improve broiler chicken growth, influence the intestinal microbial communities, and modify the PUFA content of meat was studied. Male Cobb 500 chickens were fed 1 of 4 diets from hatch: control (standard diet with no additives), ZnB (standard diet with added antibiotics), 2% SALmate (standard diet with 2% SALmate, which is composed of 42% fish oil and 58% starch), and 5% SALmate (standard diet with 5% SALmate). A 7-d energy metabolism study was conducted between d 15 and 22 posthatch. Birds were killed at d 25 and intestinal samples were collected to assess microbial communities by terminal restriction fragment length polymorphism and Lactobacillus PCR-denaturing gradient gel electrophoresis. Diet did not affect BW, feed intake, feed conversion, or ileal digestible energy (P > 0.05). Apparent ME was greater in ZnB-fed birds compared with all other diets (P < 0.05). Breast tissue levels of eicosapentaenoic acid, docosahexaenoic acid, docosapentaenoic acid, and total n-3 PUFA were elevated significantly in 2% SALmate- and 5% SALmate-fed chickens compared with control and ZnB diets (P < 0.05). No significant differences in overall microbial communities were observed in the ileum or cecum as assessed by terminal RFLP (P > 0.05). Birds fed 2% SALmate had a significantly different cecal Lactobacillus species profile compared with birds fed the control diet (P < 0.05); however, no differences were observed in birds fed 5% SALmate compared with birds fed all other diets. In addition to the expected increase in breast tissue n-3 fatty acid levels, a low level of dietary n-3 PUFA also altered the intestinal Lactobacillus species profiles. However, n-3 PUFA supplementation did not alter the overall microbial communities or broiler performance.

Relationship of dietary antimicrobial drug administration with broiler performance, decreased population levels of Lactobacillus salivarius, and reduced bile salt deconjugation in the ileum of broiler chickens.

Straight-run broiler chickens were raised either in floor pens or wire-floored cages (trial 1) or in floor pens only (trials 2, 3, and 4). Birds raised in floor pens had lower BW and feed intakes than those raised in cages. The administration of bacitracin in the feed increased feed intake from d 12 to d 35, decreased the feed conversion ratio during the same period in trial 2, and improved the weight gain of broilers from d 0 to 10 in trial 3. The concentrations of conjugated bile salts (taurocholic and taurochenodeoxycholic acids) were higher in the ileal contents of broilers administered the antimicrobials compared with untreated birds. Supplementation of the feed with monensin increased fat digestibility in the ileum of the birds. Although total numbers of bacteria in ileal contents were the same regardless of whether antimicrobials were administered or not, the bacterial community differed qualitatively. Populations of Lactobacillus salivarius were reduced in birds fed antimicrobials relative to untreated broilers. A representative ileal isolate of L. salivarius deconjugated bile salts in pure culture in the laboratory and in the ileal contents of ex-Lactobacillus-free chickens maintained in a protective environment and colonized by the Lactobacillus isolate. These observations provide a link between bile salt deconjugation in the ileum by L. salivarius and decreased weight gain of broilers. Lactobacillus salivarius populations could be targeted in future studies aimed at modification of the ileal bacterial community to achieve growth promotion of broilers without the administration of antimicrobial drugs.

Foliar mercury accumulation and exchange for three tree species.

The goals of this study were to (1) investigate plant mercury (Hg) uptake using different air and soil Hg concentrations near natural background values for three tree species, and (2) test if measured foliar Hg fluxes could explain observed foliar Hg concentrations. Plants were exposed to three soil treatments (<0.01, 0.09 +/- 0.02, and 0.92 +/- 0.27 microg Hg g(-1)), and to three atmospheric exposure concentrations (5.9 +/- 2.3, 14.3 +/- 2.7, and 30.1 +/- 3.5 ng Hg m(-3)). Foliar Hg concentrations were found to be influenced primarily by atmospheric Hg concentrations and to a lesser extent by soil Hg exposures. Data indicated that deciduous species might play a more active role in ecosystem Hg cycling than evergreen trees. Foliar mercury fluxes quantified using a dynamic single-plant gas-exchange chamber for two species were variable and accumulation rates were lower than those predicted based on foliar Hg concentrations. A hypothesis to explain this discrepancy is that the plant gas-exchange chamber measures net flux which includes emission, deposition, adsorption, and reemission of Hg at the leaf surface, while total foliar accumulation represents only deposition and assimilation.

Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part I: an analysis of depression and anxiety levels according to phase of treatment.

Purposes of this exploratory case study were: (1) to examine how anxiety and depression levels vary with phase of bone marrow transplantation (BMT) and (2) to examine the effect of the proposed music therapy treatment protocol on anxiety and depression levels. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, one-hour sessions that occurred over a three week period. The Children's Depression Inventory (CDI) was administered at the conclusion of each session to examine changes in depression levels across each phase of treatment. The State Trait Anxiety Inventory for Children (STAIC) served as a pre-/post-session measure of state anxiety. Graphic analysis of scores from the CDI and STAIC indicated a consistent trend in depression and anxiety levels according to phase of treatment for all participants. Four participants (3 music; 1 no-music) experienced decreased anxiety following a majority of sessions.

Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part II: an analysis of patient-generated songs and patient perceptions regarding intervention efficacy.

Part I of this exploratory case study examined patient anxiety levels and depressive symptoms according to phase of bone marrow transplantation (BMT). The second part of this study examines more qualitative outcomes of the music therapy intervention. Purposes of this part of the study included: (1) to examine the lyrical content of patient-generated songs and (2) to compare patient perceptions regarding the effectiveness of a 6-week music condition with a no-music contact condition. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, 1-hour sessions that occurred over a 3-week period. Content analysis of patient-generated songs revealed expression of issues related to the following themes: hope, positive coping, appreciation, mental status, control, time, bewilderment, treatment, and diagnosis. Examination of patient-generated songs provided insight into each patient's experience with transplantation and the coping strategies used during treatment. Outcomes from a poststudy questionnaire are summarized.

The differential functions of imagery and verbal thought in insomnia.

Individuals with insomnia were exposed to a stressor (speech threat) prior to getting into bed and were instructed to think about the speech and its implications in either images (Image group, n = 14) or verbal thought (Verbal group, n = 17). Participants completed questionnaires about speech anxiety, arousal, and sense of resolution. Measures were taken of subjective (sleep diary estimates) and objective (actigraphy) sleep-onset latency. In the short term, the Image group reported more distress and arousal relative to those in the Verbal group. In the longer term, the Image group estimated that they fell asleep more quickly and, the following morning, reported less anxiety and more comfort about giving the speech compared with the Verbal group.