Psychotherapy in the veterans health administration: Missed opportunities?

Informed by data on the dose-response effect, the authors assessed use of psychotherapy in the Veterans Health Administration (VA). The authors identified 410,923 patients with newly diagnosed depression, anxiety, or posttraumatic stress disorder using VA databases (October 2003 through September 2004). Psychotherapy encounters were identified by Current Procedural Terminology codes for the 12 months following patients' initial diagnosis. Psychotherapy was examined for session exposure received within the 12-month follow-up period and time (in days) between diagnosis and treatment. Of the cohort, 22% received at least one session of psychotherapy; 7.9% received four or more sessions; 4.2% received eight or more sessions; and 2.4% received 13 or more sessions. Delays between initial mental health diagnosis and initiation of care averaged 57 days. Patient variables including age, marital status, income, travel distance, psychiatric diagnosis, and medical-illness burden were significantly related to receipt of psychotherapy. Treatment delays and general underuse of psychotherapy services are potential missed opportunities for higher-quality psychotherapeutic care in integrated health care settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding Performance for Two 802.11 Competing Flows

It is well known that 802.11 suffers from both inefficiency and unfairness in the face of competition and interference.This paper provides a detailed analysis of the impact of topology and traffic type on network performance when two flows compete with each other for airspace.We consider both TCP and UDP flows and a comprehensive set of node topologies.We vary these topologies to consider all combinations of the following four node-to-node interactions:(1) nodes unable to read or sense each other,(2)nodes able to sense each other but not able to read each other's packets and nodes able to communicate with(3)weak and with(4)strong signal.We evaluate all possible cases through simulation and show that the cases can be reduced to 9 UDP and 10 TCP 802.11g models with similar efficiency/fairness characteristics. We also validate our simulation results with extensive experiments conducted in a laboratory testbed.These more detailed models improve on previous work such as hidden-/exposed-terminal categorization and are thus better suited as a basis for adaptive techniques to improve performance in 802.11 multi-hop WLAN or Mesh Networks.     

Highly absorptive coating for the vacuum ultraviolet range

We have developed new, highly absorptive coatings for the vacuum UV wavelength range. These coatings display two distinct granularity scales: large structures of a 10-100-mum scale form efficient light traps, upon which are superimposed structures of a submicrometer scale. We present results for the total hemispherical reflectivity at normal incidence for 121.6 nm and at a grazing angle incidence for 17.1, 30.4, 58.4, and 121.6 nm. These measurements were made for the new coatings as well as for various coatings in common use. Absorption of the new coatings is in some cases higher than for the best-known coatings and, in contrast to the latter, they are mechanically robust.     

Genetic and biochemical evidence for a novel avermectin-sensitive chloride channel in Caenorhabditis elegans. Isolation and characterization

Avermectins are a class of macrocyclic lactones that is widely used in crop protection and to treat helminth infections in man and animals. Two complementary DNAs (GluClalpha and GluClbeta) encoding chloride channels that are gated by avermectin and glutamate, respectively, were isolated from Caenorhabditis elegans. To study the role of these subunits in conferring avermectin sensitivity we isolated a mutant C. elegans strain with a Tc1 transposable element insertion that functionally inactivated the GluClalpha gene (GluClalpha::Tc1). GluClalpha::Tc1 animals exhibit a normal phenotype including typical avermectin sensitivity. Xenopus oocytes expressing GluClalpha::Tc1 strain mRNA elicited reduced amplitude avermectin and glutamate-dependent chloride currents. Avermectin binding assays in GluClalpha::Tc1 strain membranes showed the presence of high affinity binding sites, with a reduced Bmax. These experiments suggest that GluClalpha is a target for avermectin and that additional glutamate-gated and avermectin-sensitive chloride channel subunits exist in C. elegans. We isolated a cDNA (GluClalpha2) encoding a chloride channel that shares 75% amino acid identity with GluClalpha. This subunit forms homomeric channels that are gated irreversibly by avermectin and reversibly by glutamate. GluClalpha2 coassembles with GluClbeta to form heteromeric channels that are gated by both ligands. The presence of subunits related to GluClalpha may explain the low level and rarity of target site involvement in resistance to the avermectin class of compounds.     

Spatial distribution and geomorphic condition of fish habitat in streams: an analysis using hydraulic modelling and geostatistics

Reach‐scale physical habitat assessment scores are increasingly used to make decisions about management. We characterized the spatial distribution of hydraulic habitat characteristics at the reach and sub‐reach scales for four fish species using detailed two‐dimensional hydraulic models and spatial analysis techniques (semi‐variogram analyses). We next explored whether these hydraulic characteristics were correlated with commonly used reach‐scale geomorphic assessment (RGA) scores, rapid habitat assessment (RHA) scores, or indices of fish biodiversity and abundance. River2D was used to calculate weighted usable areas (WUAs) at median flows, Q₅₀, for six Vermont streams using modelled velocity, depth estimates, channel bed data and habitat suitability curves for blacknose dace (Rhinichthys atratulus), brown trout (Salmo trutta), common shiner (Notropis cornutus) and white sucker (Catostomus commersoni) at both the adult and spawn stages. All stream reaches exhibited different spatial distributions of WUA ranging from uniform distribution of patches of high WUA to irregular distribution of more isolated patches. Streams with discontinuous, distinct patches of high score WUA had lower fish biotic integrity measured with the State of Vermont's Mixed Water Index of Biotic Integrity (MWIBI) than streams with a more uniform distribution of high WUA. In fact, the distribution of usable habitats may be a determining factor for fish communities. A relationship between predicted WUAs averaged at the reach scale and RGA or RHA scores was not found. Future research is needed to identify the appropriate spatial scales to capture the connections between usable patches of stream channel habitat. Copyright © 2008 John Wiley & Sons, Ltd.     

Picrotoxin blockade of invertebrate glutamate-gated chloride channels: subunit dependence and evidence for binding within the pore

Glutamate-gated chloride channels have been described in nematodes, insects, crustaceans, and mollusks. Subunits from the nematode and insect channels have been cloned and are phylogenetically related to the GABA and glycine ligand-gated chloride channels. Ligand-gated chloride channels are blocked with variable potency by the nonselective blocker picrotoxin. The first two subunits of the glutamate-gated chloride channel family, GluClalpha and GluClbeta, were cloned from the free living nematode Caenorhabditis elegans. In this study, we analyze the blockade of these novel channels by picrotoxin. In vitro synthesized GluClalpha and GluClbeta RNAs were injected individually or coinjected into Xenopus oocytes. The EC50 values for picrotoxin block of homomeric GluClalpha and GluClbeta were 59 microM and 77 nM, respectively. Picrotoxin block of homomeric GluClbeta channels was promoted during activation of membrane current with glutamate. In addition, recovery from picrotoxin block was faster during current activation by glutamate. A chimeric channel between the N-terminal extracellular domain of GluClalpha and the C-terminal membrane-spanning domain of GluClbeta localized the higher affinity picrotoxin binding site to the membrane-spanning domains of GluClbeta. A point mutation within the M2 membrane-spanning domain of GluClbeta reduced picrotoxin sensitivity >10,000-fold. We conclude that picrotoxin blocks GluCl channels by binding to a site accessible when the channel is open.     

Dynamics of plague in a Gunnison's prairie dog colony complex from New Mexico

A plague (Yersinia pestis) epizootic spread through Gunnison's prairie dogs (Cynomys gunnisoni), and possibly other rodent species, in the Moreno Valley in north-central New Mexico between winter 1984-1985 and autumn 1987. We observed the progress of the epizootic and subsequent population recovery at four prairie dog towns within the valley during this period. At two towns (Midlake and Val Verde) the prairie dogs were marked prior to the epizootic. At two additional towns (Vega and South Entrance) prairie dogs were marked following the epizootic. In 1988, a second epizootic occurred at Vega. One hundred thirty-nine serum samples were collected from prairie dogs and other rodents and 1,750 fleas were collected from animals and burrows. Fleas infected with Y. pestis were collected from prairie dogs, deer mice (Peromyscus maniculatus), and thirteen-lined ground squirrels (Spermophilus tridecemlineatus). Prairie dog fleas included Oropsylla hirsuta, O. labis and O. tuberculata, deermouse associated fleas were Aetheca wagneri and Rhadinopsylla sectilis, and Oropsylla bacchi was associated with thirteen-lined ground squirrels. All of the above flea species were collected from prairie dog burrows. All rodent species shared some flea species. Thirteen-lined ground squirrels disappeared shortly before plague was identified in prairie dogs at Midlake. Meadow voles were rare following the epizootic at Vega in 1986, became abundant in 1987, and disappeared at the time of the second prairie dog epizootic in summer 1988. Although we collected serum from Gunnison's prairie dogs, thirteen-lined ground squirrels, deer mice, and meadow voles (Microtus pennsylvanicus), we identified elevated serum titers against Y. pestis only in Gunnison's prairie dogs. Prairie dog mortality at all towns affected by plague was in excess of 99%. Serum antibody titers indicate that more than 40% of the few prairie dogs left to establish colonies following epizootics survived plague infection.     

Empirical Performance of RSSI-Based Monte Carlo Localisation for Active RFID Patient Tracking Systems

The range of potential applications for indoor and campus based personnel localisation has led researchers to create a wide spectrum of different algorithmic approaches and systems. However, the majority of the proposed systems overlook the unique radio environment presented by the human body leading to systematic errors and inaccuracies when deployed in this context. In this paper RSSI-based Monte Carlo Localisation was implemented using commercial 868?MHz off the shelf hardware and empirical data was gathered across a relatively large number of scenarios within a single indoor office environment. This data showed that the body shadowing effect caused by the human body introduced path skew into location estimates. It was also shown that, by using two body-worn nodes in concert, the effect of body shadowing can be mitigated by averaging the estimated position of the two nodes worn on either side of the body.     

Facilitating practice changes in mental health clinics: A guide for implementation development in health care systems.

For more than a decade, health care systems have attempted to implement evidence-based practices and guidelines. These efforts have demonstrated the difficulty in making practice changes in complex systems of care. Many health care systems, including the Department of Veterans Affairs (VA) and state community mental health systems, have made adoption of evidence-based treatments, especially psychotherapies, a priority. Psychologists, as behavioral change experts and clinical leaders, are positioned to aid local implementation efforts but may have limited knowledge of the “implementation science” literature. This article provides a brief introduction to the implementation literature and offers a guide for developing an implementation plan to adopt evidence-based psychotherapies in local health care settings illustrated by a hypothetical example. Challenges to implementation are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Flow patterns of dairy wastewater constructed wetlands in a cold climate

Conservative tracer experiments, and spatial temperature and dissolved oxygen mapping within four subsurface treatment wetlands employed in this study demonstrated the importance of supplemental aeration and vegetation in reducing preferential flows in cold climate treatment wetlands. Four constructed wetlands, employing horizontal subsurface flow were used to treat dairy wastewater in a 2 x 2 factorial design consisting of two wetland cells with vegetation and two with supplemental aeration. Four tracer studies were conducted between November 2004 and May 2005. Two key observations were made, demonstrating that vegetation and aeration can be utilized in cold regions to prevent clogging and freezing, thereby reducing preferential flow paths which can reduce treatment efficiencies: (1) vegetation contributed to thermal protection and (2) aeration increased temperature and mixing. A comparison of multiple wetland cells with varying flow rates showed that the use of pore volume in tracer response curves was a better indicator of preferential flows than other indicators including volumetric efficiency, hydraulic efficiency and number of continuosly stirred tank reactors (CSTRs). This research helps further establish how constructed wetlands are a viable tool for treating wastewater in cold climates.