Using a Workbook to Support Cognitive Behavioural Therapy with Young People: A Survey of Psychological Practitioners

Practitioners have mixed views about the value of cognitive behavioural therapy (CBT) manuals, with some preferring to work based on professional judgment. The workbook represents a compromise, providing guidance and resources without prescribing standardised procedures. Workbooks have not previously been widely addressed in the CBT literature. This exploratory study analysed how practitioners use a CBT workbook (Think Good – Feel Good, TGFG) to support therapeutic work with young people (YP). Practitioners (n = 238) completed an online survey about how TGFG is used and how it supports CBT. A convergent mixed-methods design was pursued. Qualitative and quantitative data were analysed using content analysis, descriptive statistics, and chi-square tests before themes were defined to summarise the dataset. When deciding whether to use TGFG, practitioners consider YP’s presenting difficulty, level of understanding, motivation, and availability of systemic support. Practitioners use TGFG inside and outside the therapeutic space to plan sessions, revise CBT concepts, and complete worksheets (particularly those with a cognitive focus). Practitioners use TGFG flexibly and pragmatically (combining it with other therapeutic approaches), and they adapt resources to suit YP’s understanding and interests. TGFG appears to be a widely-used resource for practitioners across the range of experience

Hydraulic Modeling of Glacial Dam-Break Floods on the West Branch of the Susquehanna River, Pennsylvania

This study investigates the potential hydraulic conditions of catastrophic floods in the West Branch of the Susquehanna River (West Branch) during the middle to late Pleistocene period and the influence of these paleofloods on the current river bed form. The current channel bed form is characterized using sonar bathymetry data collection techniques. The paleofloods are hypothesized based on published geological evidence of early Pleistocene glacial Lake Lesley in the West Branch Valley, which was formed by a glacial ice dam that potentially failed during mild climate cycles in the Pleistocene period. A one-dimensional, steady hydraulic model is developed to simulate estimates of paleoflood peak discharges and the modern 100 year return period peak discharge. The computed water-surface profiles, shear stresses, and flood inundation maps could explain the erosional and depositional features identified by other researchers as being formed during the Pleistocene and could explain features revealed by the bathymetry data. Therefore, the hydraulic modeling results support previously inferred hypotheses of the occurrence of glacial dam-break floods on the West Branch of the Susquehanna River. The differences that are evident between the paleoflood simulations and the simulation of the modern 100 year peak discharge are attributable to valley constrictions that cause substantial backwater effects for the larger paleoflood discharges but not for the lower modern flood discharge volume. The ability to simulate potential paleofloods in the West Branch of the Susquehanna River complements the paleostage indicator work done by other researchers and enables innovative analysis of glaciofluvial processes and their effect on the current river bed form

Bidirectional ventricular tachycardia in cardiac sarcoidosis.

A 73-year-old man with history of pulmonary sarcoidosis was found to have runs of non-sustained bidirectional ventricular tachycardia (BVT) with two different QRS morphologies on a Holter monitor. Cardiac magnetic resonance delayed gadolinium imaging revealed a region of patchy mid-myocardial enhancement within the left ventricular basal inferolateral myocardium. An 18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased uptake in the same area, consistent with active sarcoid, with no septal involvement. Follow-up FDG-PET one year later showed disease progression with new septal involvement. Cardiac sarcoidosis, characterized by myocardial inflammation and interstitial fibrosis that can lead to conduction system disturbance and macro re-entrant arrhythmias, should be considered in differential diagnosis of BVT. BVT may indicate septal involvement with sarcoidosis before the lesions are large enough to be detected radiologically

Breast Cancer Disparities at Home and Abroad: A Review of the Challenges and Opportunities for System-Level Change

Sizeable disparities exist in breast cancer outcomes, both between Black and White patients in the United States, and between patients in the US and other high-income countries compared to low- and middle-income countries (LMICs). In both settings, health system factors are key drivers of disparities. In the US, Black women are more likely to die of breast cancer than Whites, and have poorer outcomes even among patients with similar stage and tumor subtype. Over-representation of higher-risk “triple negative” breast cancers contributes to breast cancer mortality in Black women; however, the greatest survival disparities occur within the good-prognosis hormone-receptor positive (HR+) subtypes. Disparities in access to treatment within the complex US health system may be responsible for a substantial portion of these differences in survival. In LMICs, breast cancer mortality rates are substantially higher than in the US, while incidence continues to rise. This mortality burden is largely attributable to health system factors, including late-stage presentation at diagnosis and lack of availability of systemic therapy. This article will review the existing evidence for how health-system factors in the United States contribute to breast cancer disparities, discuss methods for studying the relationship of health system factors to racial disparities, and provide examples of health system interventions that show promise for mitigating breast cancer disparities. We will then review evidence of global breast cancer disparities in low and middle income countries, the treatment factors that contribute to these disparities, and actions being taken to combat breast cancer disparities around the world

Post-Flood Cleanup Alternatives along Stream Corridors in Central Pennsylvania Helping Resolve River and Land Use Conflicts in an Economically and Ecologically Sustainable Manner

Report on managing river corridors of Central Pennsylvania in an economically and ecologically sustainable manner. Fluvial geomorphologists and civil engineers from Bucknell University present results of research and analysis of the impact of floods on Central Pennsylvania streams, bridges, dams, and roads. Ten sections cover 1. Key Concepts for Managing River Corridors in a Sustainable Manner; 2. Options for Managing the Conflict between Nature and Man; 3. The Physical Imperatives of River Systems; 4. Dynamic Equilibrium of Streams and Anticipating Adjustments in the Future; 5. The Conflict: Today’s Accounting; 6. Cost-Benefit Analysis; 7. Short vs. Long Term Solutions: A Choice of Management Scenarios; 8. “Stream-Cleaning” – allow gravel or “do nothing”? 9. Informing the Alternative Selection Process; 10. Managing Sustainably. The report focuses on the long term benefits of a geomorphic corridor management approach which can benefit both property owners and riparian ecosystems. The largest challenge is not in conducting the scientific analyses to determine the river’s slope and planform requirements, but rather in how to redefine the relationship of public and private investments with fluvial dynamics in an equitable manner over time within a watershed. The larger short term costs associated with using a geomorphic-based approach, where land conversion is necessary, become more acceptable and economically justifiable where channelization projects have failed repeatedly or in post flood remediation where major erosion, property damage, and channel avulsions have occurred. A passive geomorphic approach may be the most desirable alternative due to its lower maintenance costs but is highly dependent upon landowners willing to accept what may be significant changes in land use expectations. Concluding recommendations exhort State and Federal agencies involved with river resource management to work together to provide economic incentives and technical assistance for towns and landowners to make decisions that resolve immediate conflicts with the long term watershed solutions in mind

Fully three dimensional breather solitons can be created using Feshbach resonance

We investigate the stability properties of breather solitons in a three-dimensional Bose-Einstein Condensate with Feshbach Resonance Management of the scattering length and con ned only by a one dimensional optical lattice. We compare regions of stability in parameter space obtained from a fully 3D analysis with those from a quasi two-dimensional treatment. For moderate con nement we discover a new island of stability in the 3D case, not present in the quasi 2D treatment. Stable solutions from this region have nontrivial dynamics in the lattice direction, hence they describe fully 3D breather solitons. We demonstrate these solutions in direct numerical simulations and outline a possible way of creating robust 3D solitons in experiments in a Bose Einstein Condensate in a one-dimensional lattice. We point other possible applications.Comment: 4 pages, 4 figures; accepted to Physical Review Letter

Assessment of Stream Restoration Structures in Streams of North-Central Pennsylvania

Interest in stream restoration has increased over the last two decades, leading to a growth in the industry to the point that it has become a 1 billion dollar per year enterprise (Bernhart et al 2005, Thompson 2002). In north-central Pennsylvania alone, over $9 million has been spent since 1999 on stream restoration projects, from the designing stage to actual construction and reconstruction of the sites. Even though a extensive amount of money is being spent on the construction of these projects, very little to no post-monitoring is taking place. Without post-monitoring of the projects, it is unknown if they actually work. After a successful statewide stream restoration assessment was completed in North Carolina by the advisor of this project, it was discussed to undertake a similar one for the state of Pennsylvania starting with the north-central region. This includes Bradford, Cambria, Cameron, Centre, Columbia, Lycoming, McKean, Montour, Northumberland, Potter, Sullivan, Tioga, and Union Counties. Within these 13 counties over 60 restoration projects have been implemented since the 1990s ranging in type from FGM structures to Fish and Boat Commission habitat structures. Twenty-two of the restoration sites comprising of 58,255 feet of restoration work were selected for individual site assessment during March 2008-May 2009. Over 300 structures were assessed during this period of time for structural integrity and the degree to which the adjacent bed and banks had been affected by unintended erosion or deposition. Approximately 75% of the structures have sustained some structural damage (ranking \u3e1) or erosion or deposition (ranking \u3e1). Thirty-five percent of the structures have sustained significant damage (ranking \u3e2) or significant erosion or deposition (ranking \u3e3). Most of the damage (63% of all structures) is related to erosion or deposition which can impact the functionality of the structure. Many of the streams in north-central Pennsylvania are experiencing pulses of aggradation of gravel-cobble size clasts throughout the stream system. This pulse of gravel is contributing to the partial burial of individual structures and may fill in the pool that was created by the structure. Out of the four highly used structure types (cross vanes, j-hooks, log vanes, and rock vanes), j-hooks and rock vanes sustained the highest percentage of damage compared to the other two structures. Much more work needs to be completed in this region before we can fully grasp an understanding for failure of the various structures

THE IMPLICATIONS OF MULTIGENERATIONAL DIFFERENCES WITHIN THE WORKFORCE

This paper identifies and discusses generational effects on public administration, particularly in the field of public administration and public policy. Specifically, it is the conclusion here that identifying the different perspectives, attitudes, and behaviors exhibited by the five traditional generational groups (traditionalists/veterans, Baby Boomers, Generation X, Generation Y/Millenials, and Generation Z) will assist managers in the public sector field to better communicate with their employees, thus resulting in a more effective working environment through enhancing organizational cohesion and cooperation. A phenomenological mixed method will be employed, utilizing peer-reviewed literature and governmentally issued statistics. Discussion of these aspects follows below and includes an argument for the potential implications of these communication issues for public administration and how understanding generational differences can strengthen work relationships and maximize employee performance. The study highlights the importance of addressing the generational gap in the workplace to ensure it is an asset as opposed to a liabilit