European guidelines for training in consultation-liaison psychiatry and psychosomatics: report of the EACLPP Workgroup on Training in Consultation-Liaison Psychiatry and Psychosomatics

OBJECTIVE: The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) has organized a workgroup to establish consensus on the contents and organization of training in consultation-liaison (C-L) for psychiatric and psychosomatic residents. METHODS: Initially, a survey among experts has been conducted to assess the status quo of training in C-L in different European countries. In several consensus meetings, the workgroup discussed aims, core contents, and organizational issues of standards of training in C-L. Twenty C-L specialists in 14 European countries participated in a Delphi procedure answering a detailed consensus checklist, which included different topics under discussion. RESULTS: Consensus on the following issues has been obtained: (1) all residents in psychiatry or psychosomatics should be exposed to C-L work as part of their clinical experience; (2) a minimum of 6 months of full-time (or equivalent part-time) rotation to a C-L department should take place on the second part of residency; (3) advanced training should last for at least 12 months; (4) supervision of trainees should be clearly defined and organized; and (5) trainees should acquire knowledge and skills on the following: (a) assessment and management of psychiatric and psychosomatic disorders or situations (e.g., suicide/self-harm, somatization, chronic pain and psychiatric disorders, and abnormal illness behavior in somatically ill patients); (b) crisis intervention and psychotherapy methods appropriate for medically ill patients; (c) psychopharmacology in physically ill patients; (d) communication with severely ill patients and dying patients, as well as with medical staff; (e) promotion of coordination of care for complex patients across several disciplines; and (f) organization of C-L service in relation to general hospital and/or primary care. In addition, the workgroup elaborated recommendations on the form of training and on assessment of competency. CONCLUSION: This document is a first step towards establishing recognized training in C-L psychiatry and psychosomatics across the European Union

Calcination/dissolution residue treatment

Currently, high-level wastes are stored underground in steel-lined tanks at the Hanford site. Current plans call for the chemical pretreatment of these wastes before their immobilization in stable glass waste forms. One candidate pretreatment approach, calcination/dissolution, performs an alkaline fusion of the waste and creates a high-level/low-level partition based on the aqueous solubilities of the components of the product calcine. Literature and laboratory studies were conducted with the goal of finding a residue treatment technology that would decrease the quantity of high-level waste glass required following calcination/dissolution waste processing. Four elements, Fe, Ni, Bi, and U, postulated to be present in the high-level residue fraction were identified as being key to the quantity of high-level glass formed. Laboratory tests of the candidate technologies with simulant high-level residues showed reductive roasting followed by carbonyl volatilization to be successful in removing Fe, Ni, and Bi. Subsequent bench-scale tests on residues from calcination/dissolution processing of genuine Hanford Site tank waste showed Fe was separated with radioelement decontamination factors of 70 to 1,000 times with respect to total alpha activity. Thermodynamic analyses of the calcination of five typical Hanford Site tank waste compositions also were performed. The analyses showed sodium hydroxide to be the sole molten component in the waste calcine and emphasized the requirement for waste blending if fluid calcines are to be achieved. Other calcine phases identified in the thermodynamic analysis indicate the significant thermal reconstitution accomplished in calcination

Swimming in a Sea of Shame: Incorporating Emotions into Explanations of Institutional Reproduction and Change

We theorize the role in institutional processes of what we call the shame nexus, a set of shame-related constructs: felt shame, systemic shame, sense of shame, and episodic shaming. As a discrete emotion, felt shame signals to a person that a social bond is at risk and catalyzes a fundamental motivation to preserve valued bonds. We conceptualize systemic shame as a form of disciplinary power, animated by persons’ sense of shame, a mechanism of ongoing intersubjective surveillance and self-regulation. We theorize how the duo of the sense of shame and systemic shame drives the self-regulation that underpins persons’ conformity to institutional prescriptions and institutional reproduction. We conceptualize episodic shaming as a form of juridical power used by institutional guardians to elicit renewed conformity and reassert institutional prescriptions. We also explain how episodic shaming may have unintended effects, including institutional disruption and recreation, when it triggers sensemaking among targets and observers that can lead to the reassessment of the appropriateness of institutional prescriptions or the value of social bonds. We link the shame nexus to three broad categories of institutional work

The function of fear in institutional maintenance: Feeling frightened as an essential ingredient in haute cuisine

Fear is a common and powerful emotion that can regulate behaviour. Yet institutional scholars have paid limited attention to the function of fear in processes of institutional reproduction and stability. Drawing on an empirical study of elite chefs within the institution of haute cuisine, this article finds that the multifaceted emotion of fear characterised their experiences and served to sustain their institution. Chefs’ individual feelings of fear prompted conformity and a cognitive constriction, which narrowed their focus on to the precise reproduction of traditional practices whilst also limiting challenges to the norms underpinning the institution. Through fear work, chefs used threats and violence to connect individual experiences of fear to the violation of institutionalized rules, sustaining the conditions in which fear-driven maintenance work thrived. The study also suggests that fear is a normative element of haute cuisine in its own right, where the very experience and eliciting of fear preserved an essential institutional ingredient. In this way, emotions such as fear do not just accompany processes of institutionalization but can be intimately involved in the maintenance of institutions

Gay male academics in UK business and management schools: negotiating heteronormativities in everyday work life

This paper contributes to a neglected topic area about lesbian, gay, bisexual and trans people’s employment experiences in UK business and management schools. Drawing on queer theory to problematize essentialist notions of sexuality, we explore how gay male academics negotiate and challenge discourses of heteronormativity within different work contexts. Using in-depth interview data, the paper shows that gay male academics are continually constrained by heteronormativity in constructing viable subject positions as ‘normal’, often having to reproduce heteronormative values that squeeze opportunities for generating non-heteronormative ‘queer’ sexualities, identities and selves. Constructing a presence as an openly gay academic can invoke another binary through which identities are (re)constructed: as either ‘gay’ (a cleaned up version of gay male sexuality that sustains a heteronormative moral order) or ‘queer’ (cast as radical, disruptive and sexually promiscuous). Data also reveal how gay men challenge organizational heteronormativities through teaching and research activities, producing reverse discourses and creating alternative knowledge/power regimes, despite institutional barriers and risks of perpetuating heteronormative binaries and constructs. Study findings call for pedagogical and research practices that ‘queer’ (rupture, destabilize, disrupt) management knowledge and the heterosexual/homosexual binary, enabling non-heteronormative voices, perspectives, identities and ways of relating to emerge in queer(er) business and management schools

Changing forest water yields in response to climate warming: results from long-term experimental watershed sites across North America

Climate warming is projected to affect forest water yields but the effects are expected to vary. We investigated how forest type and age affect water yield resilience to climate warming. To answer this question, we examined the variability in historical water yields at long-term experimental catchments across Canada and the United States over 5-year cool and warm periods. Using the theoretical framework of the Budyko curve, we calculated the effects of climate warming on the annual partitioning of precipitation (P) into evapotranspiration (ET) and water yield. Deviation (d) was defined as a catchment’s change in actual ET divided by P [AET/P; evaporative index (EI)] coincident with a shift from a cool to a warm period – a positive d indicates an upward shift in EI and smaller than expected water yields, and a negative d indicates a downward shift in EI and larger than expected water yields. Elasticity was defined as the ratio of inter annual variation in potential ET divided by P (PET/P; dryness index) to inter annual variation in the EI – high elasticity indicates low d despite large range in drying index (i.e., resilient water yields), low elasticity indicates high d despite small range in drying index (i.e., non-resilient water yields). Although the data needed to fully evaluate ecosystems based on these metrics are limited, we were able to identify some characteristics of response among forest types. Alpine sites showed the greatest sensitivity to climate warming with any warming leading to increased water yields. Conifer forests included catchments with lowest elasticity and stable to larger water yields. Deciduous forests included catchments with intermediate elasticity and stable to smaller water yields. Mixed coniferous/deciduous forests included catchments with highest elasticity and stable water yields. Forest type appeared to influence the resilience of catchment water yields to climate warming, with conifer and deciduous catchments more susceptible to climate warming than the more diverse mixed forest catchments

A novel model for cyanobacteria bloom formation: the critical role of anoxia and ferrous iron

SUMMARY 1. A novel conceptual model linking anoxia, phosphorus (P), nitrogen (N), iron (Fe) and sulphate to the formation of noxious filamentous and colonial cyanobacteria blooms is presented that reconciles seemingly contradictory ideas about the roles of P, N and Fe in bloom formation. 2. The model has several critical concepts: (i) P regulates biomass and productivity in fresh waters until excessive loading renders a system N-limited or light-limited, but it is the availability of ferrous ions (Fe 2+ ) that regulates the ability of cyanobacteria to compete with its eukaryotic competitors; (ii) Fe 2+ diffusing from anoxic sediments is a major Fe source for cyanobacteria, which acquire it by migrating downwards into Fe 2+ -rich anoxic waters from oxygenated waters; and (iii) subsequent cyanobacterial siderophore production provides a supply of Fe 3+ for reduction at cyanobacteria cell membranes that leads to very low Fe 3+ concentrations in the mixing zone. 3. When light and temperature are physiologically suitable for cyanobacteria growth, bloom onset is regulated by the onset of internal Fe 2+ loading which in turn is controlled by anoxia, reducible Fe content of surface sediments and sulphate reduction rate. 4. This conceptual model provides the basis for improving the success of approaches to eutrophication management because of its far-reaching explanatory power over the wide range of conditions where noxious cyanobacteria blooms have been observed

Peak grain forecasts for the US High Plains amid withering waters

Irrigated agriculture contributes 40% of total global food production. In the US High Plains, which produces more than 50 million tons per year of grain, as much as 90% of irrigation originates from groundwater resources, including the Ogallala aquifer. In parts of the High Plains, groundwater resources are being depleted so rapidly that they are considered nonrenewable, compromising food security. When groundwater becomes scarce, groundwater withdrawals peak, causing a subsequent peak in crop production. Previous descriptions of finite natural resource depletion have utilized the Hubbert curve. By coupling the dynamics of groundwater pumping, recharge, and crop production, Hubbert-like curves emerge, responding to the linked variations in groundwater pumping and grain production. On a state level, this approach predicted when groundwater withdrawal and grain production peaked and the lag between them. The lags increased with the adoption of efficient irrigation practices and higher recharge rates. Results indicate that, in Texas, withdrawals peaked in 1966, followed by a peak in grain production 9 y later. After better irrigation technologies were adopted, the lag increased to 15 y from 1997 to 2012. In Kansas, where these technologies were employed concurrently with the rise of irrigated grain production, this lag was predicted to be 24 y starting in 1994. In Nebraska, grain production is projected to continue rising through 2050 because of high recharge rates. While Texas and Nebraska had equal irrigated output in 1975, by 2050, it is projected that Nebraska will have almost 10 times the groundwater-based production of Texas