Management of Mental Health Illness: an Actionable Non-Pharmacologic Approach

Mental health illness is a pervasive and incurs tremendous cost onto society. Patients benefit from a multi factorial approach to treatment including non-pharmacological methods. This project includes development of a handout utilizing compiled resources and motivational interviewing to facilitate patient use of these interventions.https://scholarworks.uvm.edu/fmclerk/1378/thumbnail.jp

Restoring betatron phase coherence in a beam-loaded laser-wakefield accelerator

Matched beam loading in laser wakefield acceleration (LWFA), characterizing the state of flattening of the acceleration electric field along the bunch, leads to the minimization of energy spread at high bunch charges. Here, we demonstrate by independently controlling injected charge and acceleration gradients, using the self-truncated ionization injection scheme, that minimal energy spread coincides with a reduction of the normalized beam divergence. With the simultaneous confirmation of a constant beam radius at the plasma exit, deduced from betatron radiation spectroscopy, we attribute this effect to the reduction of chromatic betatron decoherence. Thus, beam loaded LWFA enables highest longitudinal and transverse phase space densities

Diagnostic Medical Errors: Patient\u27s Perspectives on a Pervasive Problem

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient\u27s health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition. Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies. Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative analysis using Grounded Theory. Results. In the past five years, 39% of interviewed patients experienced diagnostic error. The errors mapped to the following categories: accuracy (30%), communication (34%) and timeliness (36%). Poor communication (13 responses) and inadequate time with doctors (7) were the most identified causes of errors. Impacts of errors included emotional distress (17 responses), adverse health outcomes (7) and impaired activities of daily living (6). Patients suggested improved communication (11 responses), clinical management (7) and access to doctors (5) as prevention strategies. For communication, patients rated talk to your doctor highest (mean 8.4, on 1-10 Likert scale) and text message lowest (4.8). Conclusions/Recommendations. Diagnostic errors are common and have dramatic impact on patients\u27 well-being. We suggest routine surveillance to identify errors, support for patients who have experienced errors, and implementation of patient and provider checklists to enhance communication. Future studies should investigate strategies to allow care providers adequate time with patients.https://scholarworks.uvm.edu/comphp_gallery/1246/thumbnail.jp

Onderzoek naar bijvangst bruinvissen in de Nederlandse visserij

Het aantal gestrande bruinvissen langs de Nederlandse kust is de laatste jaren sterk toegenomen. Het grootste aantal strandingen vond plaats in 2006: 546 geregistreerde dieren, waarvan naar schatting 7 - 70% stierven als gevolg van verdrinking. Intensieve studies elders en anekdotische informatie, beschikbaar voor Nederland, wijzen erop dat bruinvissen onder andere verstrikt raken in staandwantnetten. Er is echter grote variatie in de plaats en tijd dat de verschillende varianten staandwant worden ingezet. Het doel van dit vergelijkend onderzoek is om een beter beeld te krijgen van ruimtelijke en tijdelijke variatie in bruinvisstrandingen, en hoe dit samenhangt met veranderingen in het aantal bruinvissen waargenomen voor de kust en de inzet van staandwan

ICES coordinated acoustic survey of ICES divisions IIIa, IVa, IVb AND Via (North) 2002 Results and long term trends

Six surveys were carried out during late June and July covering most of the continental shelf north of 54oN in the North Sea and to the west of Scotland to a northern limit of 62oN. The eastern edge of the survey area was bounded by the Norwegian and Danish, Swedish and German coasts, and to the west by the shelf edge between 200 and 400 m depth. The surveys are reported individually in the report of the planning group for herring surveys, and a combined report has been prepared from the data from all surveys. The combined survey results provide spatial distributions of herring abundance by number and biomass at age by statistical rectangle; and distributions of mean weight and fraction mature at age. The estimates of North Sea autumn spawning herring are consistent with previous years at 2.9 million tonnes and 17,200 million herring. The survey also shows two exceptional year classes of herring (the 1998 and 2000 year classes) in the North Sea, which is consistent with the observation of exceptionally large year classes observed in the MIK and IBTS surveys. The estimates of Western Baltic spring spawning herring SSB are 255,000 tonnes and 2.9 millions (Table 2) and show a large increase compared with the previous year. The Western Baltic survey produces a rather noisy signal but the indications are of a stock that is higher now than between 1996 to 2000. The West of Scotland survey estimates of 548,000 tonnes and 2,900 million and shows the high 1995 year class again this year. The 1998 year class now (3 ring) is also a large one. Total adult mortality shows much lower mortality than last year (0.1 compared to 0.5 ) but the mean mortality over the last 4 years has been 0.3: this is consistent with the 2002 assessment that the stock is lightly exploited. The overall time series of abundance by age from 1989 to 2002 are summarised by simple models describing the spatial distribution over time. The changes over time with latitude, longitude and area occupied are compared with changes in abundance

ICES coordinated acoustic survey of ICES divisions IIIa, IVa, IVb AND Via (North) 2002 Results and long term trends

Six surveys were carried out during late June and July covering most of the continental shelf north of 54oN in the North Sea and to the west of Scotland to a northern limit of 62oN. The eastern edge of the survey area was bounded by the Norwegian and Danish, Swedish and German coasts, and to the west by the shelf edge between 200 and 400 m depth. The surveys are reported individually in the report of the planning group for herring surveys, and a combined report has been prepared from the data from all surveys. The combined survey results provide spatial distributions of herring abundance by number and biomass at age by statistical rectangle; and distributions of mean weight and fraction mature at age. The estimates of North Sea autumn spawning herring are consistent with previous years at 2.9 million tonnes and 17,200 million herring. The survey also shows two exceptional year classes of herring (the 1998 and 2000 year classes) in the North Sea, which is consistent with the observation of exceptionally large year classes observed in the MIK and IBTS surveys. The estimates of Western Baltic spring spawning herring SSB are 255,000 tonnes and 2.9 millions (Table 2) and show a large increase compared with the previous year. The Western Baltic survey produces a rather noisy signal but the indications are of a stock that is higher now than between 1996 to 2000. The West of Scotland survey estimates of 548,000 tonnes and 2,900 million and shows the high 1995 year class again this year. The 1998 year class now (3 ring) is also a large one. Total adult mortality shows much lower mortality than last year (0.1 compared to 0.5 ) but the mean mortality over the last 4 years has been 0.3: this is consistent with the 2002 assessment that the stock is lightly exploited. The overall time series of abundance by age from 1989 to 2002 are summarised by simple models describing the spatial distribution over time. The changes over time with latitude, longitude and area occupied are compared with changes in abundance