Hospital to community: Changes in practice and outcomes.

This article describes the need for psychologists working with persons with disabilities to establish validity procedures within research findings and clinical practices. It highlights the importance of providing a contextual framework for behavior by adopting a socioecological paradigm of disability. Theoretical, research, and clinical practice implications are discussed, such as the evolution of paradigms guiding rehabilitation, the need to move research out of the laboratories and into the field, and the importance of focusing on the broader socioenvironmental needs of persons with disabilities. The author also offers specific recommendations for psychologists engaged in activities across education, research, and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Judgments about estrogen replacement therapy: The role of age, cognitive abilities, and beliefs.

This study investigated age, cognitive abilities, health beliefs, and other factors in women's judgments about effective treatments for menopause. Women (N?=?102) ranging in age from 20 to 79 read a vignette about a woman facing a decision about Estrogen Replacement Therapy (ERT) and then made judgments about what should be done. Participants also completed a battery of questions pertaining to ERT and cognitive abilities. Path-analytic techniques were used to determine the role of specific cognitive abilities and the representation of menopause and its treatment in making judgments about ERT treatments. Cognitive abilities had direct effects on treatment decisions. Education affected the number of perceived options for treatment. Age and education indirectly affected treatment decisions, operating through cognitive abilities. Factors related to the mental representation of menopause had no direct effects and few indirect effects on treatment decisions. Potential mechanisms that can help older adults compensate for declines in cognitive abilities in medical decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of grief therapy: A meta-analysis.

This meta-analysis addressed the question of how effective grief therapy is and for whom, using B. J. Becker's (1988) techniques for analyzing standardized mean-change scores. Analyses were based on 35 studies (N?=?2,284), with a weighted mean effect size (ES) of δ+?=?0.43 (95% confidence interval?=?0.33 to 0.52). Clients in no-treatment control groups showed little improvement (d=?=?0.06), possibly because of the relatively long delay between loss and treatment in most studies (mean delay?=?27 months). Moderators of treatment efficacy included time since loss and relationship to the deceased. Client selection procedures, a methodological factor not originally coded in this meta-analysis, appeared to contribute strongly to variability in ESs: a small number of studies involving self-selected clients produced relatively large ESs, whereas the majority of studies involving clients recruited by the investigators produced ESs in the small to moderate range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Psychotherapy with HIV-infected clients: Factors influencing notification of third parties": Comment.

Comments on the article by N. F. Kozlowski et al (see record 1998-10341-011) about HIV infected clients and whether or not there ought to be notification. Kozlowski et al cite the California case of Tarasoff v. Regents of University of California (1976) 9 times, however, they never officially cite it, nor do they put it in their reference section. Without going into a refresher course about the meaning of Tarasoff, when employing this case law in a study it is important to (1) carefully read the case, (2) become familiar with the case law in your state or states, (3) shepardize all relevant cases to make sure that they are still good law (there has been a lot of movement with Tarasoff over the years), and (4) have at least a consultation with an attorney who is familiar with this area of law. Legal accuracy is extremely important and without it, our studies cannot withstand interdisciplinary scrutiny. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interface states and traps in thin N2O-grown oxynitride/oxide di-layer for PowerMOSFET devices

A detailed study of the interface state properties shown by the silicon/oxynitride/oxide gate layers used in Vertically Diffused PowerMOSFET (PowerVDMOS) technologies is reported. A quantitative analysis of interface states versus the specific N₂O based nitridation process, extracted from current–voltage characteristics in depletion regime, provided a clear trend and turns to be of great importance for reliability performances of the final device.     

Improving outcome research in rehabilitation psychology: Some methodological recommendations.

Reviews the value of null statistical hypothesis testing and discuss its limitations and misuses. It is contended that this method is of nominal utility in outcomes research, that rehabilitation researchers should focus on the calculation and interpretation of statistical power and effect size. During this era when outcomes are paramount, researchers in rehabilitation psychology cannot afford to conduct studies where significant methodological shortcomings compromise the validity of the results. Study design, evaluation, and presentation recommendations for the appropriate use and interpretation of statistical analysis in outcomes research are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fruit‐based functional foods II: the process for identifying potential ingredients

Developing functional food products requires a structured approach for screening potential ingredients. Using the development of a product with antioxidant properties as a model, eight fruit juice concentrates were screened, including New Zealand fruits. The total phenolic content and the antioxidant capacity, using chemical‐based assays (ferric reducing antioxidant power and oxygen radical absorbance capacity assays), were determined. The potential to protect against oxidative stress in Jurkat cells was also determined. Results indicate that the total phenolic content and antioxidant capacity in chemical‐based assays were strongly correlated. However, the total phenolic content did not dictate the level of protection from oxidative stress in this cell‐based model, suggesting that the type of phenolic compounds present and interactions between them may be important, although the activity of other compounds, such as vitamin C or carotenoids, may also be implicated. This model for screening ingredients may be used to design synergistic combinations of ingredients, and results may provide supportive evidence in the development of functional foods for this and other health targets.     

Overexpression of TcNTPDase-1 Gene Increases Infectivity in Mice Infected with Trypanosoma cruzi

Ecto-nucleoside triphosphate diphosphohydrolases (NTPDases) are enzymes located on the surface of the T. cruzi plasma membrane, which hydrolyze a wide range of tri-/-diphosphate nucleosides. In this work, we used previously developed genetically modified strains of Trypanosoma cruzi (T. cruzi), hemi-knockout (KO +/−) and overexpressing (OE) the TcNTPDase-1 gene to evaluate the parasite infectivity profile in a mouse model of acute infection (n = 6 mice per group). Our results showed significantly higher parasitemia and mortality, and lower weight in animals infected with parasites OE TcNTPDase-1, as compared to the infection with the wild type (WT) parasites. On the other hand, animals infected with (KO +/−) parasites showed no mortality during the 30-day trial and mouse weight was more similar to the non-infected (NI) animals. In addition, they had low parasitemia (45.7 times lower) when compared with parasites overexpressing TcNTPDase-1 from the hemi-knockout (OE KO +/−) group. The hearts of animals infected with the OE KO +/− and OE parasites showed significantly larger regions of cardiac inflammation than those infected with the WT parasites (p < 0.001). Only animals infected with KO +/− did not show individual electrocardiographic changes during the period of experimentation. Together, our results expand the knowledge on the role of NTPDases in T. cruzi infectivity, reenforcing the potential of this enzyme as a chemotherapy target to treat Chagas disease (CD).     

Tumor-Microenvironment Characterization of the MB49 Non-Muscle-Invasive Bladder-Cancer Orthotopic Model towards New Therapeutic Strategies

Bacillus Calmette-Guérin (BCG) instillations for the treatment of non-muscle-invasive bladder cancer patients can result in significant side effects and treatment failure. Immune checkpoint blockade and/or decreasing tumor-infiltrating myeloid suppressor cells may be alternative or complementary treatments. Here, we have characterized immune cell infiltration and chemoattractant molecules in mouse orthotopic MB49 bladder tumors. Our data show a 100-fold increase in CD45⁺ immune cells from day 5 to day 9 tumors including T cells and mainly myeloid cells. Both monocytic myeloid-derived suppressor-cells (M-MDSC) and polymorphonuclear (PMN)-MDSC were strongly increased in day 9 tumors, with PMN-MDSC representing ca. 70% of the myeloid cells in day 12 tumors, while tumor associated macrophages (TAM) were only modestly increased. The kinetic of PD-L1 tumor expression correlated with published data from patients with PD-L1 expressing bladder tumors and with efficacy of anti-PD-1 treatment, further validating the orthotopic MB49 bladder-tumor model as suitable for designing novel therapeutic strategies. Comparison of chemoattractants expression during MB49 bladder tumors grow highlighted CCL8 and CCL12 (CCR2-ligands), CCL9 and CCL6 (CCR-1-ligands), CXCL2 and CXCL5 (CXCR2-ligands), CXCL12 (CXCR4-ligand) and antagonist of C5/C5a as potential targets to decrease myeloid suppressive cells. Data obtained with a single CCR2 inhibitor however showed that the complex chemokine crosstalk would require targeting multiple chemokines for anti-tumor efficacy.     

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.