Integrating Geriatrics in Primary Care: Progress and Prospects

Educational Objectives 1. Demonstrate the need for primary care redesign to better meet the needs of older patients. 2. Identify prospective redesign solutions. 3. Appreciate educational implication that redesign engenders

The Impact of Therapeutic Alliance on Outcomes in Parent-Child Dyadic Interventions

An infant’s attachment relationship with primary caregivers has been demonstrated to have a long-term relationship to an individual’s social and emotional functioning throughout the lifespan. Recognizing the critical importance of this period, interventions to facilitate secure attachment are now being evaluated for treatment efficacy. Evaluation of these treatments has typically focused on the components of treatment, examining changes in maternal sensitivity, parental attachment representations, and concrete support to address basic needs, housing, or other contextual factors, and evidence has been found to support the inclusion of these factors. However, little is known regarding what elements of treatment impact the effectiveness of dyadic parent-child interventions; the research that has been completed has focused primarily on aspects of the intervention. There continues to be considerable debate in the psychotherapy literature regarding whether the specific components of an intervention, or the common factors present in all interventions, are responsible for therapeutic change. The purpose of the present study was to examine the role of one common factor, therapeutic alliance, in facilitating attachment-based protective factors in the child. It was hypothesized that therapeutic alliance, as rated by the parent, would predict improvements in attachment-related protective factors as rated by the treating interventionist following 6 months of dyadic intervention. The results of the present study found that specific subscales of the therapeutic alliance (the goal, task, and total alliance scales) predicted changes in children’s initiative behavior, but not their attachment-related engagement behavior. Therapeutic alliance also predicted treatment participation, and it was not possible to rule out treatment exposure as a mediating variable between therapeutic alliance and change in initiative behavior. Implications for future research and practice are discussed

The Impact of Therapeutic Alliance on Outcomes in Parent-Child Dyadic Interventions

An infant’s attachment relationship with primary caregivers has been demonstrated to have a long-term relationship to an individual’s social and emotional functioning throughout the lifespan. Recognizing the critical importance of this period, interventions to facilitate secure attachment are now being evaluated for treatment efficacy. Evaluation of these treatments has typically focused on the components of treatment, examining changes in maternal sensitivity, parental attachment representations, and concrete support to address basic needs, housing, or other contextual factors, and evidence has been found to support the inclusion of these factors. However, little is known regarding what elements of treatment impact the effectiveness of dyadic parent-child interventions; the research that has been completed has focused primarily on aspects of the intervention. There continues to be considerable debate in the psychotherapy literature regarding whether the specific components of an intervention, or the common factors present in all interventions, are responsible for therapeutic change. The purpose of the present study was to examine the role of one common factor, therapeutic alliance, in facilitating attachment-based protective factors in the child. It was hypothesized that therapeutic alliance, as rated by the parent, would predict improvements in attachment-related protective factors as rated by the treating interventionist following 6 months of dyadic intervention. The results of the present study found that specific subscales of the therapeutic alliance (the goal, task, and total alliance scales) predicted changes in children’s initiative behavior, but not their attachment-related engagement behavior. Therapeutic alliance also predicted treatment participation, and it was not possible to rule out treatment exposure as a mediating variable between therapeutic alliance and change in initiative behavior. Implications for future research and practice are discussed

Personality Traits and Career Decidedness: An Empirical Study of University Students

Research on vocational behavior has made progress in identifying broad personality traits associated with career indecision; however, important questions remain unanswered about the temporal stability of relationships between broad personality traits and Career Decidedness (CD), and about the role of narrow personality traits as predictors of CD, both of which were addressed in this longitudinal field study. A total of 2,046 undergraduate students completed an online personality inventory and CD questionnaire. A sub-group (N=267) responded to a follow-up questionnaire seven months later. Results indicated, as hypothesized, that CD correlated positively with the broad (Big Five) personality traits, openness, conscientiousness, and agreeableness. However, CD did not correlate as expected with the broad trait, extraversion, and correlated significantly and inversely with the broad trait, neuroticism, only for low-achievement students. Results showed that the narrow traits of optimism and work drive correlated significantly and positively with CD, and that these narrow traits accounted for more variance in CD (11.2%) than broad traits (.5%). CD correlated positively with chronological age, as predicted. However, Career Decidedness only increased through the first three of four years of college, and contrary to predictions, showed a non-significant decline in the senior year. In an unexpected finding based only on the sub-group who completed the second set of questionnaires, the relationship of personality and CD strengthened over the 7-month span of this study, yet instability within CD warrants caution. Results suggest questions for future research and implications for practice in vocational psychology

Hard x-ray polarimetry with the Ramaty High Energy Solar Spectroscopic Imager (RHESSI)

Although designed primarily as a hard X-ray imager and spectrometer, the Ramaty High Energy Solar Spectroscopic Imager (RHESSI) is also capable of measuring the polarization of hard X-rays (20-100 keV) from solar flares. This capability arises from the inclusion of a small unobstructed Be scattering element that is strategically located within the cryostat that houses the array of nine germanium detectors. The Ge detectors are segmented, with both a front and rear active volume. Low energy photons (below about 100 keV) can reach a rear segment of a Ge detector only indirectly, by scattering. Low energy photons from the Sun have a direct path to the Be and have a high probability of Compton scattering into a rear segment of a Ge detector. The azimuthal distribution of these scattered photons carries with it a signature of the linear polarization of the incident flux. Sensitivity estimates, based on simulations and in-flight background measurements, indicate that a 20-100 keV polarization sensitivity of less than a few percent can be achieved for X-class flares

Synaptic Signaling and Aberrant RNA Splicing in Autism Spectrum Disorders

Interactions between presynaptic and postsynaptic cellular adhesion molecules (CAMs) drive synapse maturation during development. These trans-synaptic interactions are regulated by alternative splicing of CAM RNAs, which ultimately determines neurotransmitter phenotype. The diverse assortment of RNAs produced by alternative splicing generates countless protein isoforms necessary for guiding specialized cell-to-cell connectivity. Failure to generate the appropriate synaptic adhesion proteins is associated with disrupted glutamatergic and gamma-aminobutyric acid signaling, resulting in loss of activity-dependent neuronal plasticity, and risk for developmental disorders, including autism. While the majority of genetic mutations currently linked to autism are rare variants that change the protein-coding sequence of synaptic candidate genes, regulatory polymorphisms affecting constitutive and alternative splicing have emerged as risk factors in numerous other diseases, accounting for an estimated 40–60% of general disease risk. Here, we review the relationship between aberrant RNA splicing of synapse-related genes and autism spectrum disorders

Development of explosive welding techniques for fabrication of regeneratively cooled thrust chambers for large rocket engine requirements Final report, 28 Jun. 1967 - 15 Sep. 1970

Explosive welding techniques in fabricating regeneratively cooled thrust chambers for large rocket engine requirements including ultrasonic inspection, metallography, and burst testin

Testing Assumptions in Deliberative Democratic Design: A Preliminary Assessment of the Efficacy of the Participedia Data Archive as an Analytic Tool

At smaller social scales, deliberative democratic theory can be restated as an input-process-output model. We advance such a model to formulate hypotheses about how the context and design of a civic engagement process shape the deliberation that takes place therein, as well as the impact of the deliberation on participants and subsequent policymaking. To test those claims, we extract and code case studies from Participedia.net, a research platform that has adopted a self-directed crowd-sourcing strategy to collect data on participatory institutions and deliberative interventions around the world. We explain and confront the challenges faced in coding and analyzing the Participedia cases, which involves managing reliability issues and missing data. In spite of those difficulties, regression analysis of the coded cases shows compelling results, which provide considerable support for our general theoretical model. We conclude with reflections on the implications of our findings for deliberative theory, the design of democratic innovations, and the utility of Participedia as a data archive

Spectral Evolution of the Extraordinary Type IIn Supernova 2006gy

We present a detailed analysis of the extremely luminous Type IIn supernova SN2006gy using spectra obtained between days 36 and 237 after explosion. We derive the temporal evolution of the effective temperature, radius, expansion speeds, and bolometric luminosity, as well as the progenitor wind density and total swept-up mass overtaken by the shock. SN2006gy can be interpreted in the context of shock interaction with a dense CSM, but with quite extreme values for the CSM mass of 20 Msun and an explosion kinetic energy of at least 5e51 erg. A key difference between SN2006gy and other SNeIIn is that, owing to its large CSM mass, the interaction region remained opaque much longer. At early times, H-alpha widths suggest that the photosphere is ahead of the shock, and photons diffuse out through the opaque CSM. The pivotal transition to optically thin emission begins around day 110, when we start to see a decrease in the blackbody radius and strengthening tracers of the post-shock shell. From the evolution of pre-shock velocities, we deduce that the CSM was ejected by the progenitor in a 1e49 erg precursor event 8yr before explosion. The large CSM mass rules out models involving stars with initial masses around 10Msun. With the full mass budget, even massive M_ZAMS=30-40 Msun progenitor stars are inadequate. At roughly solar metallicity, substantial mass loss probably occurred during the star's life, so SN 2006gy's progenitor is more consistent with LBV eruptions or pulsational pair-instability ejections in stars with initial masses above 100 Msun. This requires significant revision to current paradigms of massive-star evolution. (abridged)Comment: Really long. 30 pages, 26 figs, appendix. Submitted to ApJ - v2 corrected one referenc