Interpersonal psychotherapy for co-occurring depression and chronic pain.

Up to 37% of individuals experience chronic pain during their lifetimes. Approximately one fourth of primary care patients with chronic pain also meet criteria for major depression. Many of these individuals fail to receive psychotherapy or other treatment for their depression; moreover, when they do, physical pain is often not addressed directly. Women, socioeconomically disadvantaged individuals, African Americans, and Latinos all report higher rates of pain and depression compared with other groups. This article describes a version of interpersonal psychotherapy tailored for patients with comorbid depression and chronic pain, interpersonal psychotherapy for depression and pain (IPT-P). IPT-P potentially could be delivered to many patient populations in a range of clinical settings, but this article focuses on its delivery within primary care settings for socioeconomically disadvantaged women. Adaptations include a brief 8-session protocol that incorporates strategies for anticipating barriers to psychotherapy, accepting patients' conceptualization of their difficulties, encouraging patients to consider the impact of their pain on their roles and relationships, emphasizing self-care, incorporating pain management techniques, and flexible scheduling. In addition, IPT-P is designed as an adjunct to usual medical pain treatment, and seeks to engage non–treatment-seeking patients in psychotherapy by focusing on accessibility and relevance of the intervention to concerns common among patients with pain. Identifying patients with comorbid depression and chronic pain and offering IPT-P as a treatment option have the potential to improve clinical outcomes for individuals with depression and chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Application of remote sensing to parks and protected area monitoring: Introduction to the special issue

This special issue is the result of sustained and highly collaborative efforts to improve the use of remotely sensed data to inform management of protected areas. The 15 papers in the issue address a diverse range of topics. These papers provide a conceptual basis and a framework for establishing monitoring programs, techniques and methods to make operational the use of remotely sensed data, case studies, and synthesis papers liking remotely sensed data to models used to inform ecological assessments. Studies in this issue necessarily confront the universal challenges of scale, both spatial and temporal, and the sometimes tenuous link between observed patterns and significant ecological process. A clear message is that the information needs of resource managers require information across scales, and these information demands will continue to motivate advances in the collection and analysis of remotely sensed data. This compilation of papers is unusual in (1) articulating a basic, if somewhat technical, foundation of remote sensing that is required for resource managers to effectively collaborate with remote sensing specialists, and (2) providing a framework for addressing monitoring resource issues that is likely to be of interest to many remote sensing specialists. We hope these papers inspire broader use of remotely sensed data to manage the increasingly rare and valuable resources in protected areas around the world.     

What footdrumming signals in kangaroo rats (Dipodomys heermanni).

Footdrumming during social interaction was studied in kangaroo rats (Dipodomys heermanni). Behaviors that elicited and followed footdrumming during mixed-sex encounters between adults were examined. Females spent more time in the burrow and footdrummed. Males showed higher rates of digging and approaching the females' burrow: these acts were reliably followed by female footdrumming. Footdrumming was associated with male retreat. The authors then tested whether this effect reflected a difference in sex or in social status, using each possible dyad in triads (adult male, adult female, juvenile male). Juvenile males drummed to all adults, but females only drummed to adult males; relationships were transitive. Social context and initial approach tendencies account for the occurrence of footdrumming, which communicates unwillingness to interact, particularly from within the burrow. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonlinear modeling of transformers

The performance of classical transformer models under nonsinusoidal excitation is investigated and two novel models for such analysis, both of which account for the transformer core magnetic nonlinearities, are presented. All analytical results are compared with experimental data     

A nurse practitioner intervention model to maximize efficient use of telemetry resources

BACKGROUND: Telemetry monitoring is widely used in hospitals; the importance of being able to monitor and examine dysrhythmias has been universally accepted. Yet it is often used for patients who do not actually require this technology. A model to improve the efficiency of telemetry use entailed the use of an advanced practice nurse (APN; identical to a nurse practitioner) to provide concurrent review and intervention of floating telemetry, which is available for patients independently of the floor location and who do not need an intensive care unit bed. ADDRESSING OVERUSE: The demand for floating telemetry at Hackensack University Medical Center had equaled or exceeded the telemetry availability virtually 100% of the time, even after local guidelines had been disseminated in 1998. The APN carried out concurrent monitoring and intervened with the attending physician when patients were on telemetry for longer than 48 hours and did not meet the local telemetry guidelines. RESULTS: The mean number (standard error [SE]) of hours per patient declined from 65.2 +/- 0.7 hours (95% confidence interval, 63.8 to 66.6 hours) for the 11 months before the intervention to a mean of 49.6 +/- 0.4 hours (95% confidence interval, 48.7 to 50.2 hours) for the 29 months after intervention--representing a decrease of 34% (p < 0.0001). This decrease led to an increase in the number of patients per month put on telemetry. DISCUSSION: The APN model, an aggressive approach that induced change almost immediately, was then applied to other quality improvement projects.     

Estimating the Hydraulic Conductivity of Landfilled Municipal Solid Waste Using the Borehole Permeameter Test

This paper reports the in situ field saturated hydraulic conductivity of municipal solid waste at a landfill in Florida. The saturated hydraulic conductivity (Ks) was estimated at 23 locations using the borehole permeameter test, a method commonly used for determination of the Ks of unsaturated soil. The Ks of the landfilled waste was found to range from 5.4×10?6 to 6.1×10?5?cm/s. The Ks was found to be on the lower end of the range of Ks reported by previous studies. The hydraulic conductivity of the waste decreased with depth, the likely result of greater overburden pressures associated with deep locations of the landfill. Permeability values (kw) of the landfilled waste calculated based on Ks were compared with permeability values estimated using air as the fluid (air permeability, ka). Values of ka were found to be approximately three orders of magnitude greater than those of kw. The lower permeability of the waste to water was primarily attributed to entrapped gas. Other factors such as potential clogging of media and short-circuiting of air along the well may also have contributed to the differences in ka and kw.     

Weight suppression is a robust predictor of outcome in the cognitive-behavioral treatment of bulimia nervosa.

This study examined weight suppression (difference between highest premorbid weight and pretreatment weight) as a predictor of outcome in 188 outpatients with bulimia nervosa enrolled in a cognitive- behavioral therapy intervention. Participants who dropped out of treatment had significantly higher levels of weight suppression than treatment completers. Of participants who completed treatment, those who continued to engage in binge eating or purging had significantly higher levels of weight suppression than those who were abstinent from bingeing and purging. Results did not change when body mass index, dietary restraint, weight and shape concerns, or other relevant variables were controlled. Relinquishing bulimic behaviors and adopting normal eating patterns may be most feasible for patients who are closest to their highest premorbid weights. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incorporating social anxiety into a model of college problem drinking: Replication and extension.

Although research has found an association between social anxiety and alcohol use in noncollege samples, results have been mixed for college samples. College students face many novel social situations in which they may drink to reduce social anxiety. In the current study, the authors tested a model of college problem drinking, incorporating social anxiety and related psychosocial variables among 228 undergraduate volunteers. According to structural equation modeling (SEM) results, social anxiety was unrelated to alcohol use and was negatively related to drinking consequences. Perceived drinking norms mediated the social anxiety-alcohol use relation and was the variable most strongly associated with problem drinking. College students appear to be unique with respect to drinking and social anxiety. Although the notion of social anxiety alone as a risk factor for problem drinking was unsupported, additional research is necessary to determine whether there is a subset of socially anxious students who have high drinking norms and are in need of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementing evidence-based recommendations for health care: a roundtable comparing European and American experiences

BACKGROUND: A roundtable held October 5-6 1999, in Maidstone, Kent, United Kingdom, was convened to identify current strategies and ongoing challenges in implementing evidence-based practice guidelines in health care. Despite numerous new medical research findings for improving health care and despite the dissemination of many practice guidelines, the recommendations from these efforts are not being uniformly adopted. Overuse, underuse, and misuse plague the practice of medicine today. IMPLEMENTING GUIDELINES: Multiple implementation strategies are more likely to succeed that a single implementation method; local selection and adaptation of guidelines are critical; and reminders, educational outreach (for prescribing), and interactive educational workshops are generally effective. EXPERIENCE IN EUROPE: In most countries, guideline development has progressed from consensus conference, to evidence-based statements, and finally to evidence-based guidelines that also consider cost-effectiveness. Guideline development is the most advanced in The Netherlands, where physicians have coordinated their efforts with the government to achieve more uniformity than is found elsewhere. EXPERIENCE IN THE UNITED STATES: Designing systems that will facilitate change--not changing physician behavior--should be the focus. The concern for effecting improvement in health care is now more acute because of the increased attention being given to medical errors and patient safety. SUMMARY STATEMENT: Multifaceted approaches are clearly the most important method for improving care. Such approaches may include many improvement methods, none of which work well alone most of the time or any of the time.