Economics and psychology practice: What we need to know and why.

Economic contexts and trends relevant to the practice of psychology in mental health and health settings are presented to help practitioners plan better for the future. Professional skills alone are no longer sufficient to thrive and deliver quality services in the current economic climate. A greater focus on understanding the economic indicators for psychology is necessary too. This includes the cost-driven policies, health and behavioral health financing, demands for accountability, losses, and opportunities inherent in the major systemic health care changes occurring in the United States. Practical questions with economic implications about the direction of psychology practices are raised, and the role of psychology initiatives designed to advance practice, which take both professional and economic factors into account, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using Rasch scaled stage scores to validate orders of hierarchical complexity of balance beam task sequences

These studies examine the relationship between the analytic basis underlying the hierarchies produced by the Model of Hierarchical Complexity and the probabilistic Rasch scales that places both participants and problems along a single hierarchically ordered dimension. A Rasch analysis was performed on data from the balance-beam task series. This yielded scaled stage of performance for each of the items. The items formed a series of clusters along this same dimension, according to their order of hierarchical complexity. We sought to ascertain whether there was a significant relationship between the order of hierarchical complexity (a task property variable) of the tasks and the corresponding Rasch scaled difficulty of those same items (a performance variable). It was found that The Model of Hierarchical Complexity was highly accurate in predicting the Rasch Stage scores of the performed tasks, therefore providing an analytic and developmental basis for the Rasch scaled stages.     

Psychology practice: Design for tomorrow.

This article offers a blueprint for modernizing the delivery of high-quality behavioral health care and for improving access to care by a public sorely in need of psychological services. The blueprint brings together disparate elements of psychology practice into a more unified structure, an updated house, based upon advances in the essential building blocks: evidence-based practice, treatment guidelines, technology, classifications of function, diagnostic systems, outcomes measurement, and integrated health care. The goal is twofold: to make psychological services more accessible to the public and to position psychology for an increasingly major role in health care in order to serve the public weal in diverse communities. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The feminization of psychology: Implications for psychotherapy.

Analyzed the distribution of male and female PhDs in psychology from 1974 to 1989. Results indicate that the number of women is increasing in psychology across the board, though the increase in clinical/counseling is more dramatic than in other specialties. The number of men in clinical/counseling is not decreasing overall, but the numbers in other specialties are. CURVEFIT models were used to make projections into the year 2000. It was found, however, that different logical models yielded different predictions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification and elaboration on evidence-based practice in psychology.

Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The goal of the task force was to create a scheme that would suggest how evidence should be used to design and offer services that will benefit patients and to assure the public and the health care system that psychologists are providing evidence-based services. There were and will continue to be many scientific and philosophical issues inherent in any such enterprise, and agreement by all psychologists with every aspect of EBPP may not be possible. Nevertheless, the APA's EBPP policy and the report that accompanied it are remarkably inclusive of various perspectives while remaining unambiguous about the need to use evidence in a way that leads to effective services. What is needed at this point are clinically relevant evidence and investigations of how such evidence can be used to best benefit those served by psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Zfx mutation results in small animal size and reduced germ cell number in male and female mice

The zinc-finger proteins ZFX and ZFY, encoded by genes on the mammalian X and Y chromosomes, have been speculated to function in sex differentiation, spermatogenesis, and Turner syndrome. We derived Zfx mutant mice by targeted mutagenesis. Mutant mice (both males and females) were smaller, less viable, and had fewer germ cells than wild-type mice, features also found in human females with an XO karyotype (Turner syndrome). Mutant XY animals were fully masculinized, with testes and male genitalia, and were fertile, but sperm counts were reduced by one half. Homozygous mutant XX animals were fully feminized, with ovaries and female genitalia, but showed a shortage of oocytes resulting in diminished fertility and shortened reproductive lifespan, as in premature ovarian failure in humans. The number of primordial germ cells was reduced in both XX and XY mutant animals at embryonic day 11.5, prior to gonadal sex differentiation. Zfx mutant animals exhibited a growth deficit evident at embryonic day 12.5, which persisted throughout postnatal life and was not complemented by the Zfy genes. These phenotypes provide the first direct evidence for a role of Zfx in growth and reproductive development.     

The Body’s Cellular and Molecular Response to Protein-Coated Medical Device Implants: A Review Focused on Fibronectin and BMP Proteins

Recent years have seen a marked rise in implantation into the body of a great variety of devices: hip, knee, and shoulder replacements, pacemakers, meshes, glucose sensors, and many others. Cochlear and retinal implants are being developed to restore hearing and sight. After surgery to implant a device, adjacent cells interact with the implant and release molecular signals that result in attraction, infiltration of the tissue, and attachment to the implant of various cell types including monocytes, macrophages, and platelets. These cells release additional signaling molecules (chemokines and cytokines) that recruit tissue repair cells to the device site. Some implants fail and require additional revision surgery that is traumatic for the patient and expensive for the payer. This review examines the literature for evidence to support the possibility that fibronectins and BMPs could be coated on the implants as part of the manufacturing process so that the proteins could be released into the tissue surrounding the implant and improve the rate of successful implantation.     

Generation of neutralizing antipeptide antibodies to the enzymatic domain of Pseudomonas aeruginosa exotoxin A

Burn patients suffer a break in the physical barrier (skin), which, when combined with their generalized state of immunodeficiency, creates an open window for opportunistic infections, mainly with Pseudomonas aeruginosa. Infection of the burn wound has always been a major factor in retardation of wound healing, and sepsis remains the leading cause of death in burn patients. Because studies have shown that topical treatment with antiexotoxin A (ETA) antibodies significantly increases survival in rats infected with toxin-producing strains of P. aeruginosa, we examined 11 synthetic peptides encompassing 12 to 45 amino acid (aa) residues, representing what were predicted by computer analysis to be the most hydrophilic and antigenic regions of ETA. These synthetic peptides were injected into rabbits for antibody production. Different groups of rabbits were immunized with a combination of peptides, with each combination representing one of the three distinct domains of ETA. Animals immunized with various peptide combinations produced peptide-specific antibodies that exhibited cross-reactivity to ETA. Two major epitopes were identified on the ETA molecule by experiments with peptide-specific antibodies in enzyme-linked immunosorbent assay and immunoprecipitation. One of these epitopes was located in the translocation domain (II) (aa 297 to 310), while the other was mapped to the last 13 aa residues at the carboxy-terminal end of the enzymatic domain (III) (aa 626 to 638). Of these two regions, the epitope in the enzymatic domain induced a much higher level of neutralizing antibodies that abrogated the cytotoxic activity of ETA in vitro. Antibodies to this epitope blocked the ADP-ribosyltransferase activity of ETA and appeared to interfere with binding of the substrate elongation factor 2 to the enzymatic active site of the ETA molecule. We conclude that polyclonal, as well as monoclonal, antibodies to short peptides, representing small regions of ETA, may have therapeutic potential in passive immunization or topical treatment of burn patients infected with toxin-producing strains of P. aeruginosa.