Clients\u27 Internal Representations of Their Therapists

Thirteen adults in long-term individual psychotherapy were interviewed regarding their internal representations (defined as bringing to awareness the internalized image ) of their therapists. Results indicated that in the context of a good therapeutic relationship, clients\u27 internal representations combined auditory, visual, and kinesthetic (i.e., felt presence) modalities; were triggered when clients thought about past or future sessions, or when distressed; occurred in diverse locations; and varied in frequency, duration, and intensity. Clients felt positively about their representations and used them to introspect or influence therapy within sessions, beyond sessions, or both. The frequency of, comfort with, and use of clients\u27 internal representations increased over the course of therapy, and the representations benefited the therapy and therapeutic relationship. Therapists tended not to take a deliberate role in creating clients\u27 internal representations, and few clients discussed their internal representations with their therapists

Epidemiology and Health Policy Imperatives for AIDS

The purpose of this article is to describe the statistics and epidemiological facts about the most virulent epidemic of our age, acquired immunodeficiency syndrome (AIDS). The discussion argues for broadened public policy to promote the surveillance of communities in order to enhance the effectiveness of data gathering for epidemiological reasoning, analysis, and control measures. To accomplish these goals, the essential characteristics of epidemiology are defined. The use of deductive and inductive reasoning is applied to describe and analyze known facts concerning the AIDS epidemic. Hypotheses are suggested from current amorphous and continually changing information to assist in further explanations of the epidemic and in the evaluation of methods of prevention and control. Current policies for sexually transmitted diseases are reviewed briefly to identify epidemiological concerns, with the aim of assisting policymakers. Implications for public policy are discussed in the context of seeking epidemiological information for the ultimate protection of the public good

Mass production of volume phase holographic gratings for the VIRUS spectrograph array

The Visible Integral-field Replicable Unit Spectrograph (VIRUS) is a baseline array of 150 copies of a simple, fiber-fed integral field spectrograph that will be deployed on the Hobby-Eberly Telescope (HET). VIRUS is the first optical astronomical instrument to be replicated on an industrial scale, and represents a relatively inexpensive solution for carrying out large-area spectroscopic surveys, such as the HET Dark Energy Experiment (HETDEX). Each spectrograph contains a volume phase holographic (VPH) grating with a 138 mm diameter clear aperture as its dispersing element. The instrument utilizes the grating in first-order for 350-550 nm. Including witness samples, a suite of 170 VPH gratings has been mass produced for VIRUS. Here, we present the design of the VIRUS VPH gratings and a discussion of their mass production. We additionally present the design and functionality of a custom apparatus that has been used to rapidly test the first-order diffraction efficiency of the gratings for various discrete wavelengths within the VIRUS spectral range. This device has been used to perform both in-situ tests to monitor the effects of adjustments to the production prescription as well as to carry out the final acceptance tests of the gratings' diffraction efficiency. Finally, we present the as-built performance results for the entire suite of VPH gratings.Comment: 16 pages, 11 figures, 2 tables. To be published in Proc. SPIE, 2014, "Advances in Optical and Mechanical Technologies for Telescopes and Instrumentation", 9151-53. The work presented in this article follows from arXiv:1207:448

Oral complementary medicine and alternative practitioner use varies across chronic conditions and attitudes to risk

Objectives: To determine whether chronic conditions and patient factors, such as risk perception and decision-making preferences, are associated with complementary medicine and alternative practitioner use in a representative longitudinal population cohort. Participants and setting: Analysis of data from Stage 2 of the North West Adelaide Health Study of 3161 adults who attended a study clinic visit in 2004–2006. The main outcome measures were the medications brought by participants to the study clinic visit, chronic health conditions, attitudes to risk, levels of satisfaction with conventional medicine, and preferred decision-making style. Results: At least one oral complementary medicine was used by 27.9% of participants, and 7.3% were visiting alternative practitioners (naturopath, osteopath). Oral complementary medicine use was significantly associated with arthritis, osteoporosis, and mental health conditions, but not with other chronic conditions. Any pattern of complementary medicine use was generally significantly associated with female gender, age at least 45 years, patient-driven decision-making preferences(odds ratio [OR] 1.38, 95% confidence interval [CI]: 1.08–1.77), and frequent general practitioner visits (.five per year; OR 3.62, 95% CI: 2.13–6.17). Alternative practitioner visitors were younger, with higher levels of education (diploma/trade [OR 1.88, 95% CI: 1.28–2.76], bachelor’s degree [OR 1.77, 95% CI: 1.11–2.82], income . $80,000 (OR 2.28, 95% CI: 1.26–4.11), female gender (OR 3.15, 95% CI: 2.19–4.52), joint pain not diagnosed as arthritis (OR 1.68, 95% CI: 1.17–2.41), moderate to severe depressive symptoms (OR 2.15, 95% CI: 1.04–4.46), and risk-taking behaviour (3.26, 1.80–5.92), or low-to-moderate risk aversion (OR 2.08, 95% CI: 1.26–4.11). Conclusion: Although there is widespread use of complementary medicines in the Australian community, there are differing patterns of use between those using oral complementary medicines and those using alternative practitioners.Robert J Adams, Sarah L Appleton, Antonia Cole, Tiffany K Gill, Anne W Taylor and Catherine L Hil

Can Increased Training and Awareness Take Forest Research to New Heights?

Forest canopies contribute significantly to global forest biodiversity and ecosystem functioning, yet are declining and understudied. One reason for a knowledge gap is that accessing forest canopies can be difficult and dangerous. Thus, lack of relevant canopy access skills may compromise knowledge gain and personal safety. We assessed skill levels in canopy access methods and self-perception of skills amongst ecologists worldwide via a web-based survey, available in four languages. We obtained responses from expert arborists as a control group. From 191 respondents who said canopy access is relevant to their research (of 1,070 total responses), we found that ecologists are not attaining the full potential provided by existing methods of canopy access. Specifically, most respondents are unable to access much of the forest canopy, especially areas away from the trunk and between trees. The survey further revealed the common use of unsafe and inefficient practices among ecologists and that few are adequately equipped with aerial rescue skills. Importantly, ecologists with the lowest skill levels overestimate their expertise the most. Proper field techniques are key components of good science: they can improve study design, increase potential for data collection, and ultimately reveal greater knowledge on canopy organisms and processes. By safely allowing greater access to the forest canopy, proper techniques can reduce bias in our scientific understanding of forest ecology. To facilitate safe and effective canopy access for ecological research, we recommend increasing instruction and collaboration, implementing certification programs, and conducting audits of canopy research programs. With increased access to such opportunities, ecologists will acquire improved skills in accessing forest canopies, develop a greater appreciation for the full breadth of possibilities among methods of canopy access, and more safely and effectively gather the data needed to better understand forest ecosystems

Design and construction progress of LRS2-B: a new low resolution integral field spectrograph for the Hobby-Eberly Telescope

The upcoming Wide-Field Upgrade (WFU) has ushered in a new era of instrumentation for the Hobby-Eberly Telescope (HET). Here, we present the design, construction progress, and lab tests completed to date of the blue-optimized second generation Low Resolution Spectrograph (LRS2-B). LRS2-B is a dual-channel, fiber fed instrument that is based on the design of the Visible Integral Field Replicable Unit Spectrograph (VIRUS), which is the new flagship instrument for carrying out the HET Dark Energy eXperiment (HETDEX). LRS2-B utilizes a microlens-coupled integral field unit (IFU) that covers a 7"x12" area on the sky having unity fill-factor with ~300 spatial elements that subsample the median HET image quality. The fiber feed assembly includes an optimized dichroic beam splitter that allows LRS2-B to simultaneously observe 370 nm to 470 nm and 460 nm to 700 nm at fixed resolving powers of R \approx 1900 and 1200, respectively. We discuss the departures from the nominal VIRUS design, which includes the IFU, fiber feed, camera correcting optics, and volume phase holographic grisms. Additionally, the motivation for the selection of the wavelength coverage and spectral resolution of the two channels is briefly discussed. One such motivation is the follow-up study of spectrally and (or) spatially resolved Lyman-alpha emission from z ~ 2.5 star-forming galaxies in the HETDEX survey. LRS2-B is planned to be a commissioning instrument for the HET WFU and should be on-sky during quarter 4 of 2013. Finally, we mention the current state of LRS2-R, the red optimized sister instrument of LRS2-B.Comment: 22 pages, 12 figures, 2 tables. To be published in Proc. SPIE, 2012, "Ground-Based and Airborne Instrumentation for Astronomy IV", 8446-103. In v2, a note has been added indicating that this paper has been superseded by arXiv:1407:601

Multimodal perioperative pain protocol for gynecologic oncology laparotomy is associated with reduced hospital length of stay and improved patient pain scores

The primary objective was to evaluate the impact of a multimodal perioperative pain regimen on length of hospital stay for patients undergoing laparotomy with a gynecologic oncologist

Improving Experiences of the Menopause for Women in Zimbabwe and South Africa:Co-Producing an Information Resource

Women in sub-Saharan Africa report multiple impacts of menopause on daily life and have requested further information to support themselves. This study co-produced contextually relevant resources—booklets and poster—about menopause with women in Zimbabwe and South Africa. The study was conducted in four stages: interviews with women about the menopause; the development of prototype information resources; workshops with women to discuss country-specific resources; and the refinement of resources. During the interviews, women explained that they had not received or accessed much information about the menopause and thought the physical and psychological issues associated with the menopause had to be “endured”. Prototype information resources comprised booklets and a poster with contextually relevant images and information. Workshop participants suggested several changes, including the addition of more diverse images and further information about treatments. The resources were refined, translated into several African languages, and endorsed by the Ministry of Health in Zimbabwe and the South African Menopause Society in South Africa. Women will be able to access resources through healthcare clinics, community groups and churches. Working with women and other stakeholders enabled a development that was cognisant of experiences and needs. Work is now needed to improve access to treatments and support for menopause to reduce health inequities

Eliciting willingness-to-pay to prevent hospital medication administration errors in the UK: a contingent valuation survey.

Medication errors are common in hospitals. These errors can result in adverse drug events (ADEs), which can reduce the health and well-being of patients', and their relatives and caregivers. Interventions have been developed to reduce medication errors, including those that occur at the administration stage. OBJECTIVE: We aimed to elicit willingness-to-pay (WTP) values to prevent hospital medication administration errors. DESIGN AND SETTING: An online, contingent valuation (CV) survey was conducted, using the random card-sort elicitation method, to elicit WTP to prevent medication errors. PARTICIPANTS: A representative sample of the UK public. METHODS: Seven medication error scenarios, varying in the potential for harm and the severity of harm, were valued. Scenarios were developed with input from: clinical experts, focus groups with members of the public and piloting. Mean and median WTP values were calculated, excluding protest responses or those that failed a logic test. A two-part model (logit, generalised linear model) regression analysis was conducted to explore predictive characteristics of WTP. RESULTS: Responses were collected from 1001 individuals. The proportion of respondents willing to pay to prevent a medication error increased as the severity of the ADE increased and was highest for scenarios that described actual harm occurring. Mean WTP across the scenarios ranged from £45 (95% CI £36 to £54) to £278 (95% CI £200 to £355). Several factors influenced both the value and likelihood of WTP, such as: income, known experience of medication errors, sex, field of work, marriage status, education level and employment status. Predictors of WTP were not, however, consistent across scenarios. CONCLUSIONS: This CV study highlights how the UK public value preventing medication errors. The findings from this study could be used to carry out a cost-benefit analysis which could inform implementation decisions on the use of technology to reduce medication administration errors in UK hospitals