Acknowledgment by the commission on accreditation.

The Commission on Accreditation would like to thank the following individuals who contributed to the work of the commission by serving on site visit teams and appeal panels during the 2007-2008 academic/training year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acknowledgment by the Commission on Accreditation.

Presents a list of individuals the Commission on Accreditation would like to thank for their contributions to the work of the commission by serving on site visit teams and appeal panels during the 2008–2009 academic/training year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acknowledgment by the commission on accreditation.

This acknowledgment from the Commission on Accreditation thanks individuals who contributed to the work of the Commission by serving on site visit teams and appeal panels during the 2009–2010 academic/training year in the field of psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of managed care on clinical research: a preliminary investigation

Rapid growth in managed care enrollment is likely to affect clinical research at the nation's academic medical centers (AMCs). Our site visit interviews indicate that managed care has not markedly reduced coverage for research-related care. However, market competition in some areas has limited AMCs' ability to subsidize research activities with clinical revenues. As they gain market share, managed care organizations will have a growing influence on research priorities. Therefore, it is important for the academic community to work with managed care leaders to identify areas for collaboration and an agenda for moving forward in the future.     

Who seeks psychotherapy?

Data from several large epidemiologic surveys (the National Health Interview Survey; D. A. Regier et al, 1984; C. A. Taube et al, 1984; H. E. Freeman, 1989) were combined to examine sociodemographic characteristics of adults who make mental health visits. Within each sociodemographic category, probability of making a mental health visit and probability of subsequently entering psychotherapy were calculated. Results indicate that about two-thirds of outpatients are female, about 50% have some college education, about 50% are married, 9 out of 10 are White, and about 80% are between the ages of 21 and 50 yrs. Females; the most educated; those divorced, separated, or never married; and Whites are most likely to enter psychotherapy once a mental health visit has been made. Those most likely to be suffering from a Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III) disorder may be the least likely to seek and receive such services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enantiomeric determination of amphetamine and methamphetamine in urine by precolumn derivatization with Marfey''s reagent and HPLC

In this report we (i) measure the strength of the association between paediatric trauma visit rates and regional socioeconomic and demographic variables, and (ii) quantify any selective impact of user charges on service demand in socioeconomically and demographically different areas. During the period 1989-94, a total of 30,362 home and leisure injury visits were made to the Aurora City Hospital. The visit rates are analysed using a random effects model. In addition, the areas are ranked into three groups in accordance with a socioeconomic index measure, and the annual visit rates of the three groups are calculated. We found fairly minor differences in children's visit rates between unequal socioeconomic areas, and it is apparent that socioeconomic status cannot explain the change in visit rates as a result of the introduction of user charges. We speculate that these changes in emergency visit rates will not lead to long-term health problems among any segment of the city population.     

Unilateral cricothyroid contraction and glottic configuration

The outpatient population using the emergency department (ED) is increasing and so is the risk of not admitting people who need it. There is, thus, one important question: are the services delivered appropriate to the needs of these ED outpatients? Follow-up of non-admitted patients after a visit to the ED is a prerequisite for the evaluation of these health services. A multicentric follow-up study was thus performed in order to assess the possibility of contacting outpatients after a visit to the ED. Three randomized follow-up methods were compared: (1) telephone call 1 week after the emergency department visit; (2) telephone call 2 weeks after the visit; (3) telephone call 4 weeks after the visit. The follow-up rate did not change depending on whether patients were contacted at 1, 2 or 4 weeks after the visit. The success rate was 78.6%, 85.6% and 74% respectively (NS). In each strategy, 50% of patients were contacted at the first telephone call, 20% at the second telephone call and 10% by mail. Thus, in a group of outpatients who gave their consent to be called, the follow-up was found to be feasible with a high success rate whatever the time between the visit and the phone recall.     

APA-accredited doctoral programs in professional psychology: 1996.

Lists the institutions whose doctoral training programs in clinical, counseling, school, and combined professional-scientific psychology have been accredited by the American Psychological Association's Committee on Accreditation. The original date of accreditation as well as the date of the next regularly scheduled site visit are provided. Following the list of institutions is an acknowledgement by the Committee on Accreditation. In the acknowledgement, the Committee on Accreditation recognizes members of the Association who contributed to the work of the Committee by serving on site visiting teams during the 1995–1996 academic/training year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Undercover careseekers: simulated clients in the study of health provider behavior in developing countries

The simulated client method (SCM) has been used for over 20 years to study health care provider behavior in a first-hand way while minimizing observation bias. In developing countries, it has proven useful in the study of physicians, drug retailers, and family planning services. In SCM, research assistants with fictitious case scenarios (or with stable conditions or a genuine interest in the services) visit providers and request their assistance. Providers are not aware that these clients are involved in research. Simulated clients later report on the events of their visit and these data are analyzed. This paper reviews 23 developing country studies of physician, drug retail, and family planning services in order to draw conclusions about (1) the advantages and limitations of the methods; (2) considerations for design and implementation of a simulated client study; (3) validity and reliability; and (4) ethical concerns. Examples are also drawn from industrialized countries, related methodologies, and non-health fields to illustrate the issues surrounding SCM. Based on this review, we conclude that the information gathered through the use of simulated clients is unique and valuable for managers, intervention planners and evaluators, social scientist, regulators, and others. Areas that need to be explored in future work with this method include: ways to ensure data validity and reliability; research on additional types of providers and health care needs; and adaptation of the technique for routine use.     

The hunt: Job hunting for the PhD psychologist.

Considers that paradoxically, one of the most trying but also exhilarating experiences in a PhD psychologist's life comes when he or she searches for and obtains a first job. The process of job hunting is discussed, and such facets as the history of job hunting, the "word" (who needs psychologists), the "fit," letters of recommendation, copies of one's work, conventions, timing, the visit and interview, the wait, and questions that the applicant may be asked and may want to ask are described. Personal experiences of being in the "hunt" for 2 consecutive years are presented, and information and several maxims felt to be invaluable to the new job applicant are supplied. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychologist in the Arctic.

In this article I recount a 1-month consultant visit to Barrow, Alaska. I tell why the trip came about, how it was arranged and financed, and what activities transpired. I offer this account in the belief that some readers may be stimulated to arrange similar experiences for themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HLA-DRB1 genes and disease severity in rheumatoid arthritis. The MIRA Trial Group. Minocycline in Rheumatoid Arthritis

OBJECTIVE: To examine the effect of alleles encoding the "shared"/"rheumatoid" epitope on rheumatoid arthritis (RA) disease severity in patients who participated in the minocycline in RA (MIRA) trial. METHODS: Of 205 patients with a week-48 visit, blood was available for typing of HLA-DRB1 and HLA-DQB1 in 174 (85%) and successfully completed in 169 (82%). Baseline erosions were used to assess disease severity and new erosions at the last visit served as a proxy for progression. RESULTS: At baseline, there was no association between the presence of erosive disease or rheumatoid factor status and the dose of rheumatoid epitope (homozygous, heterozygous, none) or the specific alleles identified. At the final visit, a gradient was observed for the 3 allelic subgroups (and their gene doses) in the occurrence of new erosions among the Caucasian placebo-treated, but not the minocycline-treated, patients. A treatment group/HLA-DR4 epitope interaction was demonstrated in multivariate analyses. Approximately two-thirds of African-American patients did not have the rheumatoid epitope. CONCLUSION: HLA-DRB1 oligotyping may be useful in predicting the progression of disease in some Caucasian patients. Our study corroborates the infrequency of the epitope among African-American patients with RA.     

Utilization of outpatient diagnostic imaging. Does the physician's gender play a role?

OBJECTIVE: To examine physician and patient characteristics related to the ordering of imaging studies in a general medicine practice and to determine whether physician gender influences ordering patterns. DESIGN: Retrospective cohort study. SETTING: Hospital-based academic general medicine practice of 29 attending physicians. PATIENTS: All 8,203 visits by 5,011 patients during a 6-month period. METHODS: For each visit the following variables were abstracted from the electronic patient record: patient age, patient gender, visit urgency, visit type, and physician seen. All diagnostic imaging studies performed within 30 days of each outpatient visit were identified from the hospital's Radiology Information System. Screening mammography was not included in the analysis. Physician variables included gender and years since medical school graduation. Logistic regression analysis was used to evaluate the effect of various patient, physician, and visit characteristics on the probability of a diagnostic imaging study being ordered. RESULTS: Patient age, urgent visits, visit frequency, and the gender of the physician were all significantly related to the ordering of an imaging study. Correcting for all other factors, the ordering of an imaging study during an outpatient medical visit was 40% more likely if the physician was female (odds ratio = 1.40; 95% confidence interval [CI] 1.01, 1.95). Female physicians were 62% more likely (95% CI 0.99, 2.64) than male physicians to order an imaging study for a male patient and 21% more likely (95% CI 0.87, 1.69) to order an imaging study for a female patient. CONCLUSIONS: Physician gender is a predictor of whether an outpatient medical visit generates an imaging study. Reasons for this observation are unclear, but may be the result of different practice styles of male and female physicians or unmeasured patient characteristics.     

A brief report of my visit to the psychological facilities in the Soviet Union.

This report describes the author's impressions of his visit to psychology departments, institutions and laboratories in Moscow and Leningrad in May 1969. During his tour, he visited facilities for the care of mentally and physically handicapped and mentally ill, and observed the teaching and research facilities in the Leningrad University and Patrice Lumumba University. The author was very much impressed with the experimental work going on in the psychological laboratories and institutions, and found a keen desire among Soviet psychologists to exchange their views and findings with the Western psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of Chlamydia trachomatis infection among female adolescents: a longitudinal analysis

Screening guidelines recommend testing all sexually active female adolescents for Chlamydia trachomatis during a pelvic examination at each clinic visit. Such criteria have been based on cross-sectional studies; new evaluations should take into account multiple clinic visits and assess whether criteria are appropriate when a prior test is negative and risk factors are absent. Because repeated observations on an individual may be correlated, the authors used the generalized estimating equation method. Little information exists on subsequent risk of infection; as control programs develop, approaches targeting high-risk populations for recurrent infections are needed. Using data on females aged 15-19 years who visited family planning clinics more than once from 1988 to 1992 (n = 26,921) in Region X (Alaska, Idaho, Oregon, and Washington), the authors constructed a retrospective cohort. Teens with chlamydia at their first visit were at high risk for subsequent infection (odds ratio = 1.6, 95% confidence interval 1.4-1.7). Among teens uninfected at the first visit and without risk factors at the second, prevalence at the second visit was 6%. When intervisit correlations using the generalized estimating equation method were taken into account, predictors of chlamydial infection were consistent with those in previous cross sectional studies cervicitis, friable cervix, and multiple, new, or symptomatic sex partner(s). These findings support screening sexually active female adolescents at each visit, even if prior tests results are available.     

Strategy planning in cats (Felis catus) in a progressive elimination task.

Domestic cats (Felis catus) were administered a progressive elimination task in which they had to visit and deplete 3 baited sites. Cats were brought back to the starting point after each visit to any site whether the visit represented a correct or an incorrect choice. The results revealed that cats organized search as a function of the least distance principle whether they had to assess starting point to target distances (Experiment 1, n=12) or adjacent bowl distances (Experiment 2, n=12). The results also revealed that the starting point to target distance factor was the most influential in determining the initial choice (Experiment 3, n=6) and in producing errors. Errors were also linked to the antero-posterior bodily axis of the cat. Results are discussed in terms of the predatory behavior of the cat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Legal and ethical issues in debt collection strategies of professional psychologists.

Maintains that the improper use of aggressive collection techniques (e.g., by collection agencies or small claims court) presents an ethical and legal risk to psychologists. Clinical accounts are viewed as confidential information that may not be ethically released to collection services without the permission of the client—a form of consent probably rarely obtained by therapists. Moreover, previous work has shown that fee disputes represent one of the major forms of legal action taken against psychologists. A survey of 148 clinical psychologists revealed that a majority have used collection services and that a minority of clinicians routinely inform clients on the limitations of confidentiality. Specific recommendations, such as the use of credit cards or payment at time of visit, are offered on how to avoid the potential legal and ethical risks associated with these collection techniques. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric complications of family reunion after four decades of separation

OBJECTIVE: After four decades of separation due to civil war, many people who had migrated to Taiwan from mainland China had the unexpected opportunity to briefly visit their families in mainland China. A study was conducted to examine psychiatric complications associated with these family reunions following long involuntary separation. METHOD: Eighty subjects who made the journey were given semistructured interviews investigating their psychological experiences relating to the family reunion. The variables investigated were sociodemographic characteristics, the subject's previsit emotional condition, factors related to the family reunion experience, and stress encountered during the visit. RESULTS: The survey indicated that more than one-fifth of the subjects (22.5%) developed psychiatric complications, mainly depression, immediately after the visit. Determinants found to contribute significantly to the occurrence of emotional disorders were previous ways of expressing homesickness, family members seen during the reunion, family misfortunes that the subjects discovered, family conflict encountered at the reunion, and tactics for coping with such stressors. CONCLUSIONS: The study results suggest that family reunions after long-term separation can be trauma-repairing experiences for some but for others can lead to trauma reexperiencing and psychiatric complications requiring mental health intervention.     

Estimated gains in birth weight associated with reductions in smoking during pregnancy

OBJECTIVE: To compare the estimated effect on birth weight of reductions in maternal cigarette consumption and urinary cotinine during pregnancy. STUDY DESIGN: An observational study of 641 women with complete data on cigarette consumption, urinary cotinine and infant birth weight. Correlation and regression analyses were used to examine relationships between birth weight, cigarette consumption and urinary cotinine at first and last prenatal visits. RESULTS: Correlations of cigarette consumption and urinary cotinine with infant birth weight were -.23 and -.30 (first visit) and -.26 and -.31 (last visit); all P values were < .001. The regression equation relating urinary cotinine concentrations at first and last visits to infant birth weight explained a significantly larger proportion of the variability in birth weight than the equation relating cigarette consumption at these visits to infant birth weight, 11% vs. 7%, P = .04. Among continuing smokers, both equations predicted gains in birth weight in association with reductions in cigarette consumption, but quitting smoking before the first visit was associated with the most weight gain. As compared to the average infant birth weight of a woman who smoked 20 cigarettes per day throughout pregnancy, the estimated gain in birth weight would be 105 g if she cut down by 10 cigarettes per day after the first visit, 210 g if she quit after this visit and 310 g if she quit before the first visit. CONCLUSION: For women still smoking at their first prenatal visit, infant birth weight is already compromised, but subsequent reductions in cigarette consumption are associated with gains in birth weight. For women who cannot quit smoking, these reductions need to be substantial if increases in birth weight of > 100 g are to be achieved.     

Dental visits by income and race in ten urban and two rural areas

Household surveys in 12 low income areas found large differences in dental visit rates after control for income and race. The dental visit rate for Red Hook (NYC) exceeded the national rate whereas in seven of the areas the rate was below national averages by 40 per cent or more. The ranges in dental visit rate for low income Blacks was from two-thirds the national rate (in two areas of the South) to two to three times greater than the comparable national rate (in three areas of the Northeast). Lesser but nevertheless large variations among area dental visit rates existed for other race and income groups.