Psychotherapeutic intervention by telephone

Psychotherapy conducted over the telephone has received increasing amounts of empirical attention given practical advantages that side-step treatment barriers encountered in traditional office-based care. The utility and efficacy of telephone therapy appears generalizable across diverse clinical populations seeking care in community-based hospital settings. Treatment barriers common to older adults suggest that telephone therapy may be an efficient and effective mental health resource for this population. This paper describes empirical studies of telehealth interventions and case examples with psychotherapy conducted via telephone on the Spinal Cord Injury Unit of the Palo Alto Veterans’ Administration. Telephone therapy as appears to be a viable intervention with the aging population

L'identité poétique redéfinie en France aprés la Révolution: Alfred de Vigny et la marginalisation du poéte

Nineteenth century literature in France encapsulates many of the changes that accompanied the birth of this new era. The post-revolutionary society brought about a new conception of literature, which was particularly interested in its status within society and the relationship between author and reader. Alfred de Vigny is a poet from the early nineteenth century that devoted much of his work to examining the identity of a poet within society, and to illuminating for his readers the value in such work. The corpus of this thesis thus considers how poetical identity is defined through Vigny in the first half of the nineteenth century in France. Vigny’s conception of the poet is someone who is marginalized socially, economically, and most importantly – linguistically. The poet understands the world differently, in a highly emotive and profound manner. His creative nature separates him from a society of bourgeois, placing him on the outside of the social world. Similarly, his economic goals and habits seem to contradict the norm – he works through divine inspiration and therefore is not solely interested in monetary gain or productivity. He uses literature to create a counter-economy against a society whose goals are strictly productive; he establishes literature as an antagonistic force to this economy. Vigny is especially interested in the idea of a linguistic market (a concept that was drastically new to nineteenth century France).. Vigny finds himself in the midst of a period where the tension of these two viewpoints is beginning to appear. His art therefore is an act of opposition against the reign of economy. Much of his poetry is an attempt to verbalize this tension and to rally support for his conception of language. The corpus of the thesis is divided into three parts following three different forms of Vigny’s work: theater, poetry, and personal journals. In doing so, I examine how these various forms address questions in different manners

Exposure to dairy manure leads to greater antibiotic resistance and increased mass-specific respiration in soil microbial communities

Intensifying livestock production to meet the demands of a growing global population coincides with increases in both the administration of veterinary antibiotics and manure inputs to soils. These trends have the potential to increase antibiotic resistance in soil microbial communities. The effect of maintaining increased antibiotic resistance on soil microbial communities and the ecosystem processes they regulate is unknown. We compare soil microbial communities from paired reference and dairy manure-exposed sites across the US. Given that manure exposure has been shown to elicit increased antibiotic resistance in soil microbial communities, we expect that manure-exposed sites will exhibit 1) compositionally different soil microbial communities, with shifts toward taxa known to exhibit resistance; 2) greater abundance of antibiotic resistance genes; and 3) corresponding maintenance of antibiotic resistance would lead to decreased microbial efficiency. We found that bacterial and fungal communities differed between reference and manure-exposed sites. Additionally, β-lactam resistance gene ampC was 5.2-fold greater under manure exposure, potentially due to the use of cephalosporin antibiotics in dairy herds. Finally, ampC abundance was positively correlated with indicators of microbial stress, and microbial mass-specific respiration, which increased 2.1-fold under manure exposure. These findings demonstrate that the maintenance of antibiotic resistance associated with manure inputs alters soil microbial communities and ecosystem function

RELIABILITY AND ACCURACY OF A STANDARDIZED SHALLOW WATER RUNNING TEST TO DETERMINE CARDIORESPIRATORY FITNESS

A standardized fitness assessment is critical for the development of an individualized exercise prescription. Although the benefits of aquatic exercise have been well established, there remains the need for a standardized nonswimming protocol to accurately assess cardiorespiratory fitness (CRF) in shallow water. The present investigation was designed to assess (a) the reliability of a standardized shallow water run (SWR) test of CRF and (b) the accuracy of a standardized SWR compared with a land-based treadmill (LTM)test. Twenty-three healthy women (20 6 3 years), with body mass index (23.5 6 3 kg$m22), performed 2 shallow water peak oxygen consumption (V_ O2peak) running tests (SWRa and SWRb), and 1 V_ O2max LTM. Intraclass correlation coefficients indicated moderately strong reliability for V_ O2peak (ml$kg21$min21) (r = 0.73, p , 0.01), HR peak (b$min21) (r = 0.82; p , 0.01), and O2pulse (V_ O2 [ml$kg21$min21]$HR [b$min21]) (r = 0.77, p , 0.01). Using paired t-tests and Pearson’s correlations, SWR V_ O2peak and HR peak were significantly lower than during LTM (p # 0.05) and showed moderate correlations of 0.60 and 0.58 (p , 0.001) to LTM. O2pulse was similar (p . 0.05) for the SWR and LTM tests with a moderate correlation of 0.63. A standardized SWR test asa measure of CRF is a reliable, and to some degree, valid alternative to conventional protocols and may be used by strength and conditioning professionals to measure program outcomes and monitor training progress. Furthermore, this protocol provides a water-based option for CRF assessment among healthy women and offers insight toward the development of an effective protocol that can accommodate individuals with limited mobility, or those seeking less musculoskeletal impact from traditional land-based types of training

Berkeley Supernova Ia Program I: Observations, Data Reduction, and Spectroscopic Sample of 582 Low-Redshift Type Ia Supernovae

In this first paper in a series we present 1298 low-redshift (z\leq0.2) optical spectra of 582 Type Ia supernovae (SNe Ia) observed from 1989 through 2008 as part of the Berkeley SN Ia Program (BSNIP). 584 spectra of 199 SNe Ia have well-calibrated light curves with measured distance moduli, and many of the spectra have been corrected for host-galaxy contamination. Most of the data were obtained using the Kast double spectrograph mounted on the Shane 3 m telescope at Lick Observatory and have a typical wavelength range of 3300-10,400 Ang., roughly twice as wide as spectra from most previously published datasets. We present our observing and reduction procedures, and we describe the resulting SN Database (SNDB), which will be an online, public, searchable database containing all of our fully reduced spectra and companion photometry. In addition, we discuss our spectral classification scheme (using the SuperNova IDentification code, SNID; Blondin & Tonry 2007), utilising our newly constructed set of SNID spectral templates. These templates allow us to accurately classify our entire dataset, and by doing so we are able to reclassify a handful of objects as bona fide SNe Ia and a few other objects as members of some of the peculiar SN Ia subtypes. In fact, our dataset includes spectra of nearly 90 spectroscopically peculiar SNe Ia. We also present spectroscopic host-galaxy redshifts of some SNe Ia where these values were previously unknown. [Abridged]Comment: 34 pages, 11 figures, 11 tables, revised version, re-submitted to MNRAS. Spectra will be released in January 2013. The SN Database homepage (http://hercules.berkeley.edu/database/index_public.html) contains the full tables, plots of all spectra, and our new SNID template

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015 : a novel analysis from the Global Burden of Disease Study 2015

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Birth Order and Personality : Testing Assumptions with Independent Siblings' Reports

Color poster with images, graphs, and tables.Assumptions about the effects of birth order on personality abound in popular culture, self-help books, and the scholarly literature. Judith Rich Harris has proposed that, if birth order does affect individuals' behavior, it does so only within the family context. According to Harris, tactics that may be effective at home for a child of a given birth order are not necessarily going to be effective for that child in other contexts. There is no known study that has directly tested Harris' theory by assessing two adult siblings who were raised in the same home, and comparing their personalities as a function of their birth order. This study was designed with that specific objective, with the prediction (in accord with Harris' theory) that adult siblings' independent self-reports would not differ as a function of birth order.University of Wisconsin--Eau Claire Office of Research and Sponsored Programs

Developing Baseline Performance in an Animal Model of Learning and Memory

Color poster with text and graphs.This study looked at the chemical and neural mechanisms that underlie learning and memory. A repeated acquisition task was used to develop an animal model of learning and memory.University of Wisconsin--Eau Claire Office of Research and Sponsored Programs