Medication adherence and glycemic control in patients with psychotic disorders in the Veterans Affairs healthcare system

OBJECTIVE: To compare antihyperglycemic medication adherence and glycemic control between individuals with schizophrenia and related psychotic disorders and a nonpsychiatric comparison group. METHODS: This was a retrospective medical record review. A total of 124 subjects with diabetes (62 patients with schizophrenia or a related psychotic disorder and 62 randomly selected, age-matched patients without a psychiatric illness) receiving their medical and psychiatric care exclusively through the Kansas City Veterans Affairs healthcare system during 2008 were included in the study. Adherence to antihyperglycemic and antipsychotic medication was determined by refill records obtained through the computerized patient record system to calculate the cumulative mean gap ratio. Hemoglobin A1C values were utilized to compare glycemic control between groups and compared to glycemic goals established by diabetes treatment guidelines. RESULTS: Antihyperglycemic medication adherence was poor for both groups as approximately 60% of the psychotic disorder group and 75% of the nonpsychiatric comparison group were without antihyperglycemic medication for greater than 30 days during the 12-month period but adherence did not differ between the groups (p=0.182). Antipsychotic adherent subjects (≥80% adherent) were more likely to be adherent to their antihyperglycemic medication (p=0.0003). There were no significant differences between groups in glycemic control. CONCLUSIONS: Antihyperglycemic medication adherence and glycemic control was less than optimal for both groups. There were no significant differences in antihyperglycemic medication adherence and glycemic control between patients with a psychotic disorder and those without a psychiatric illness

Helioseismic Holography of an Artificial Submerged Sound Speed Perturbation and Implications for the Detection of Pre-Emergence Signatures of Active Regions

We use a publicly available numerical wave-propagation simulation of Hartlep et al. 2011 to test the ability of helioseismic holography to detect signatures of a compact, fully submerged, 5% sound-speed perturbation placed at a depth of 50 Mm within a solar model. We find that helioseismic holography as employed in a nominal "lateral-vantage" or "deep-focus" geometry employing quadrants of an annular pupil is capable of detecting and characterizing the perturbation. A number of tests of the methodology, including the use of a plane-parallel approximation, the definition of travel-time shifts, the use of different phase-speed filters, and changes to the pupils, are also performed. It is found that travel-time shifts made using Gabor-wavelet fitting are essentially identical to those derived from the phase of the Fourier transform of the cross-covariance functions. The errors in travel-time shifts caused by the plane-parallel approximation can be minimized to less than a second for the depths and fields of view considered here. Based on the measured strength of the mean travel-time signal of the perturbation, no substantial improvement in sensitivity is produced by varying the analysis procedure from the nominal methodology in conformance with expectations. The measured travel-time shifts are essentially unchanged by varying the profile of the phase-speed filter or omitting the filter entirely. The method remains maximally sensitive when applied with pupils that are wide quadrants, as opposed to narrower quadrants or with pupils composed of smaller arcs. We discuss the significance of these results for the recent controversy regarding suspected pre-emergence signatures of active regions

Impact of Locally Suppressed Wave sources on helioseismic travel times

Wave travel-time shifts in the vicinity of sunspots are typically interpreted as arising predominantly from magnetic fields, flows, and local changes in sound speed. We show here that the suppression of granulation related wave sources in a sunspot can also contribute significantly to these travel-time shifts, and in some cases, an asymmetry between in and outgoing wave travel times. The tight connection between the physical interpretation of travel times and source-distribution homogeneity is confirmed. Statistically significant travel-time shifts are recovered upon numerically simulating wave propagation in the presence of a localized decrease in source strength. We also demonstrate that these time shifts are relatively sensitive to the modal damping rates; thus we are only able to place bounds on the magnitude of this effect. We see a systematic reduction of 10-15 seconds in $p$-mode mean travel times at short distances ($\sim 6.2$ Mm) that could be misinterpreted as arising from a shallow (thickness of 1.5 Mm) increase ($\sim$ 4%) in the sound speed. At larger travel distances ($\sim 24$ Mm) a 6-13 s difference between the ingoing and outgoing wave travel times is observed; this could mistakenly be interpreted as being caused by flows.Comment: Revised version. Submitted to Ap

Newly identified properties of surface acoustic power

The cause of enhanced acoustic power surrounding active regions, the acoustic halo, is not as yet understood. We explore the properties of the enhanced acoustic power observed near disk center from 21 to 27 January 2002, including AR 9787. We find that (i) there exists a strong correlation of the enhanced high frequency power with magnetic-field inclination, with greater power in more horizontal fields, (ii) the frequency of the maximum enhancement increases along with magnetic field strength, and (iii) the oscillations contributing to the halos show modal ridges which are shifted to higher wavenumber at constant frequency in comparison to the ridges of modes in the quiet-Sun.Comment: 16 pages, 10 figures, submitted to solar physic

Helioseismology of Sunspots: A Case Study of NOAA Region 9787

Various methods of helioseismology are used to study the subsurface properties of the sunspot in NOAA Active Region 9787. This sunspot was chosen because it is axisymmetric, shows little evolution during 20-28 January 2002, and was observed continuously by the MDI/SOHO instrument. (...) Wave travel times and mode frequencies are affected by the sunspot. In most cases, wave packets that propagate through the sunspot have reduced travel times. At short travel distances, however, the sign of the travel-time shifts appears to depend sensitively on how the data are processed and, in particular, on filtering in frequency-wavenumber space. We carry out two linear inversions for wave speed: one using travel-times and phase-speed filters and the other one using mode frequencies from ring analysis. These two inversions give subsurface wave-speed profiles with opposite signs and different amplitudes. (...) From this study of AR9787, we conclude that we are currently unable to provide a unified description of the subsurface structure and dynamics of the sunspot.Comment: 28 pages, 18 figure

Surface-focused Seismic Holography of Sunspots: I. Observations

We present a comprehensive set of observations of the interaction of p-mode oscillations with sunspots using surface-focused seismic holography. Maps of travel-time shifts, relative to quiet-Sun travel times, are shown for incoming and outgoing p modes as well as their mean and difference. We compare results using phase-speed filters with results obtained with filters that isolate single p-mode ridges, and further divide the data into multiple temporal frequency bandpasses. The f mode is removed from the data. The variations of the resulting travel-time shifts with magnetic-field strength and with the filter parameters are explored. We find that spatial averages of these shifts within sunspot umbrae, penumbrae, and surrounding plage often show strong frequency variations at fixed phase speed. In addition, we find that positive values of the mean and difference travel-time shifts appear exclusively in waves observed with phase-speed filters that are dominated by power in the low-frequency wing of the p1 ridge. We assess the ratio of incoming to outgoing p-mode power using the ridge filters and compare surface-focused holography measurements with the results of earlier published p-mode scattering measurements using Fourier-Hankel decomposition.Comment: Solar Physics, accepte

Cross-ethnic friendship self-efficacy: A new predictor of cross-ethnic friendships among children

Across two studies (NStudy 1 = 101; NStudy 2 = 262) conducted among children in the UK, we incorporate Bandura’s (1986) self-efficacy theory to intergroup contact literature and introduce the new construct of cross-ethnic friendship self-efficacy (CEFSE), the belief that one can successfully form and maintain high-quality cross-ethnic friendships. Study 1 examined whether sources of CEFSE beliefs (prior contact, indirect contact, social norms, and intergroup anxiety) predicted higher quality cross-ethnic friendships through CEFSE. Study 2 replicated Study 1 and extended it by including perceived parental cross-ethnic friendship quality as a further predictor. In both studies, sources of self-efficacy beliefs (except social norms) were related to CEFSE, which predicted higher quality cross-ethnic friendships. Study 2 demonstrated that parental cross-ethnic friendships had direct and indirect associations with children’s cross-ethnic friendships through sources of CEFSE and CEFSE beliefs. Findings are discussed in the light of self-efficacy and intergroup contact theories

Co-Curriculum Implementation and Assessment in Accredited Doctor of Pharmacy Programs

Objective. To determine how accredited Doctor of Pharmacy programs implement and evaluate the co-curriculum requirement as mandated by the Accreditation Council for Pharmacy Education (ACPE). Methods. A survey was administered to all ACPE-accredited pharmacy programs to collect information regarding how co-curriculum models were being implemented, including types of activities, structure, learning outcomes, oversight, and assessment. The frequency of responses to items were presented to describe the general features of co-curriculum models. Results. The types of co-curricular activities reported by programs were generally consistent, with the majority of programs categorizing these activities and allowing students to choose which they would engage in. Most respondents reported that the program mapped co-curricular activities to learning outcomes, primarily ACPE Standards 1-4. The structural oversight of the co-curriculum typically included a co-curriculum committee, subcommittee, or task force, and supporting offices. The most common offices/departments involved in the co-curriculum were assessment, student affairs/services, experiential education, and academic/curricular affairs. The most common assessments were reflections, self-assessment surveys, and checklists. Conclusion. In most programs, implementation of the co-curriculum was a joint effort among various individuals, committees, and offices. Given the developing nature of programs, descriptive studies should be repeated to identify how programs develop and enhance co-curriculum models. The study results may be useful to members of the Academy when evaluating the current state of co-curriculum implementation and potential areas for program development

Co-Curriculum Implementation and Assessment in Accredited Doctor of Pharmacy Programs

Objective. To determine how accredited Doctor of Pharmacy programs implement and evaluate the co-curriculum requirement as mandated by the Accreditation Council for Pharmacy Education (ACPE). Methods. A survey was administered to all ACPE-accredited pharmacy programs to collect information regarding how co-curriculum models were being implemented, including types of activities, structure, learning outcomes, oversight, and assessment. The frequency of responses to items were presented to describe the general features of co-curriculum models. Results. The types of co-curricular activities reported by programs were generally consistent, with the majority of programs categorizing these activities and allowing students to choose which they would engage in. Most respondents reported that the program mapped co-curricular activities to learning outcomes, primarily ACPE Standards 1-4. The structural oversight of the co-curriculum typically included a co-curriculum committee, subcommittee, or task force, and supporting offices. The most common offices/departments involved in the co-curriculum were assessment, student affairs/services, experiential education, and academic/curricular affairs. The most common assessments were reflections, self-assessment surveys, and checklists. Conclusion. In most programs, implementation of the co-curriculum was a joint effort among various individuals, committees, and offices. Given the developing nature of programs, descriptive studies should be repeated to identify how programs develop and enhance co-curriculum models. The study results may be useful to members of the Academy when evaluating the current state of co-curriculum implementation and potential areas for program development

Challenges to Implementation of the Co-Curriculum in Accredited Pharmacy Programs

Objective. To determine areas of concern, and challenges to implementing and assessing the co-curriculum in accredited Doctor of Pharmacy programs, along with how confident programs are in their ability to meet the co-curriculum requirement as mandated by the Accreditation Council for Pharmacy Education (ACPE). Methods. A survey was administered to all ACPE-accredited pharmacy programs to collect information regarding areas of concern, challenges, and confidence in their ability to meet the co-curriculum requirement. The frequency of responses to items are presented along with comparisons based on characteristics, including institution type, cohort size, most recent ACPE accreditation review, and supporting offices. Results. The most common concerns centered on the documentation and assessment process. The most commonly reported challenges were lack of enthusiasm or buy-in from faculty, staff, and students; lack of a clear definition of co-curriculum; and faculty time and insufficient staff. Overall, programs had a high level of confidence in their ability to meet the requirements for co-curriculum. The only differences found were related to supporting offices and cohort size. Conclusion. The results suggest that having supporting offices may reduce the co-curriculum burden. Similarly, student cohort size may have an impact on the challenges for some programs, particularly those with moderate-sized cohorts reporting challenges related to faculty and staff. Further research is needed to determine how programs address these critical issues, and to explore whether programs report differently on these areas after completing an accreditation review. The study results may be useful to members of the Academy when evaluating co-curriculum