Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists

The integration of mental health services in primary care settings has expanded rapidly in recent years with psychologists being at the forefront of efforts to promote healthy behaviors, reduce disease, and care for behavioral, emotional, and developmental needs to promote overall health and well-being for children and families (Asarnow, Kolko, Miranda,&Kazak, 2017; Stancin& Perrin, 2014). While there are many psychologists working in pediatric primary care (PPC), little is known about the specific activities that these psychologists engage in, the training they receive, or funding mechanisms that support their work. This study sought to address this gap in the literature through a survey of psychologists working in PPC. An anonymous online survey was disseminated to members of professional organizations and listservs who were identified as having interest in PPC. Psychologists (N-65) currently practicing in PPC completed the survey by reporting on clinical roles and practices, professional training, practice settings, and funding supports in PPC settings. Results indicate that psychologists assume a number of roles in PPC including providing individual and family therapy, conducting screenings for child mental health concerns, and providing consultation to medical colleagues. Many psychologists also provide supervision and offer educational opportunities for those in related fields, such as medicine and social work. Engagement in research activities was identified as a secondary activity. It was reported that a number of clinical activities were not billed for on a regular basis. Additional areas of research will be discussed along with implications for clinical services in PPC.. © 2017 American Psychological Association

Random Walks Along the Streets and Canals in Compact Cities: Spectral analysis, Dynamical Modularity, Information, and Statistical Mechanics

Different models of random walks on the dual graphs of compact urban structures are considered. Analysis of access times between streets helps to detect the city modularity. The statistical mechanics approach to the ensembles of lazy random walkers is developed. The complexity of city modularity can be measured by an information-like parameter which plays the role of an individual fingerprint of {\it Genius loci}. Global structural properties of a city can be characterized by the thermodynamical parameters calculated in the random walks problem.Comment: 44 pages, 22 figures, 2 table

Relation of microvascular dysfunction to exercise capacity and symptoms in patients with severe aortic stenosis

Objective: The aim of this study was to assess the impact of left ventricular hypertrophy, myocardial fibrosis, myocardial perfusion reserve (MPR) and diastolic dysfunction on objectively measured aerobic exercise capacity (peak VO$_{2}$) in severe aortic stenosis (AS). Background: The management of asymptomatic patients with severe AS remains controversial and clinical practice varies. Echocardiographic measures of severity do not discriminate between symptomatic status or predict exercise capacity. The purpose of this study was to investigate the mechanisms contributing to symptom generation and exercise intolerance. This needs to be fully understood to optimise the management of asymptomatic AS. Methods: Patients were prospectively enrolled from a single cardiac surgical centre. Inclusion criteria: age 18-85, isolated severe AS referred for valve replacement. Exclusion criteria: syncope; other moderate/severe valve disease, previous valve surgery, obstructive coronary artery disease (>50% luminal stenosis on invasive angiography), chronic obstructive pulmonary disease, atrial fibrillation, estimated glomerular filtration rate <30mL/min. Investigations and primary outcome measures; cardiac magnetic resonance (CMR) - left ventricular mass index (LVMI), MPR (calculated from absolute myocardial blood flow during adenosine hyperaemia and rest determined by model-independent deconvolution of signal intensity curves with an arterial input function), late gadolinium enhancement (LGE); echocardiography - AS severity, tissue Doppler-derived diastolic function; symptom-limited bicycle ergometer cardiopulmonary exercise testing (CPEX) - peak VO$_{2}$. Linear regression investigated possible predictors of continuous outcome measures. Stepwise selection methods were used to determine the most important predictors of outcome. Results: Four patients with variable LVMI, LGE and MPR are shown, Figure 1. Univariate analyses and results from the stepwise model selection for peak VO$_{2}$ are summarised in Table 1. Only MPR was of independent significance in predicting age and sex corrected peak VO$_{2}$. The relationship between peak VO$_{2}$ and MPR is shown, Figure 2. Patients with higher NYHA Class had lower MPR (p=0.001). Examining predictors of MPR the best stepwise model contained LVMI and LGE category as independent predictors, Table 2. Conclusions: MPR is a novel independent predictor of peak VO$_{2}$ and is inversely related to NYHA functional class in severe AS. Microvascular dysfunction is determined by a combination of factors including AS severity, LVMI, diastolic perfusion time, myocardial fibrosis and LV filling pressure. Further work is required to determine the clinical significance of microvascular dysfunction in AS

New perspectives on an old fishing practice: Scale, context and impacts of bottom trawling

This report seeks to provide new perspectives on this historical controversy by presenting the most up-todate synthesis of available data and evidence on bottom trawling's extent, impacts, and solutions in order to inform constructive policy-making. Specifically, it uses novel data analysis from Sea Around Us to map the global extent of bottom trawling; a synthesis of peer-reviewed literature to elucidate environmental, social, and climate impacts; and insights from more than 40 global experts on what a constructive future might look like that manages or severely. limits the worst impacts of this practice, while also ensuring a just and equitable society and a healthy food system

Selected Soybean Plant Introductions with Partial Resistance to \u3ci\u3eSclerotinia sclerotiorum\u3c/i\u3e

Sclerotinia stem rot, caused by Sclerotinia sclerotiorum, is a major soybean (Glycine max) disease in north-central regions of the United States and throughout the world. Current sources of resistance to Sclerotinia stem rot express partial resistance, and are limited in number within soybean germ plasm. A total of 6,520 maturity group (MG) 0 to IV plant introductions (PIs) were evaluated for Sclerotinia stem rot resistance in the United States and Canada in small plots or in the greenhouse from 1995 to 1997. Selected PIs with the most resistance were evaluated for resistance in the United States and Canada in replicated large plots from 1998 to 2000. The PIs in the MG I to III tests in Urbana, IL were evaluated for agronomic traits from 1998 to 2000. The selected PIs also were evaluated with an excised leaf inoculation and petiole inoculation technique. After the 1995 to 1997 evaluations, all but 68 PIs were eliminated because of their susceptibility to Sclerotinia stem rot. In field tests in Urbana, higher disease severity in selected MG I to III PIs was significantly (P \u3c 0.05) associated with taller plant heights and greater canopy closure. All other agronomic traits evaluated were not associated or were inconsistently associated with disease severity. MG I to III PIs 153.282, 189.931, 196.157, 398.637, 417.201, 423.818, and 561.331 had high levels of resistance and had canopies similar to the resistant checks. The resistance ratings from the petiole inoculation technique had a high and significant (P \u3c 0.01) correlation with disease severity in the MG I and II field tests. The partially resistant PIs identified in this study can be valuable in incorporating Sclerotinia stem rot resistance into elite germ plasm

Ratios of charged antiparticles to particles near mid-rapidity in Au+Au collisions at sqrt(s_NN) = 130 GeV

We have measured the ratios of antiparticles to particles for charged pions, kaons and protons near mid-rapidity in central Au+Au collisions at sqrt(s_NN) = 130 GeV. For protons, we observe pbar/p = 0.60 +/- 0.04 (stat.) +/- 0.06 (syst.) in the transverse momentum range 0.15 < p_T < 1.0 GeV/c. This leads to an estimate of the baryo-chemical potential mu_B of 45 MeV, a factor of 5-6 smaller than in central Pb+Pb collisions at sqrt(s_NN) = 17.2 GeV.Comment: 4 page

Pseudorapidity and centrality dependence of the collective flow of charged particles in Au+Au collisions at sqrt{s_NN} = 130 GeV

This paper describes the measurement of collective flow for charged particles in Au+Au collisions at sqrt{s_NN}} = 130 GeV using the PHOBOS detector at the Relativistic Heavy Ion Collider (RHIC). An azimuthal anisotropy is observed in the charged particle hit distribution in the PHOBOS multiplicity detector. This anisotropy is presented over a wide range of pseudorapidity (eta) for the first time at this energy. The size of the anisotropy (v_{2}) is thought to probe the degree of equilibration achieved in these collisions. The result here,averaged over momenta and particle species, is observed to reach 7% for peripheral collisions at mid-rapidity, falling off with centrality and increasing |eta|. Data are presented as a function of centrality for |eta|<1.0 and as a function of eta, averaged over centrality, in the angular region -5.0<eta<5.3. These results call into question the common assumption of longitudinal boost invariance over a large region of rapidity in RHIC collisions.Comment: 5 pages, 4 figures, submitted to Physical Review Letter

The significance of the fragmentation region in ultrarelativistic heavy ion collisions

We present measurements of the pseudorapidity distribution of primary charged particles produced in Au+Au collisions at three energies, sqrt(s_{NN}) = 19.6, 130, and 200 GeV, for a range of collision centralities. The centrality dependence is shown to be non-trivial: the distribution narrows for more central collisions and excess particles are produced at high pseudorapidity in peripheral collisions. For a given centrality, however, the distributions are found to scale with energy according to the "limiting fragmentation" hypothesis. The universal fragmentation region described by this scaling grows in pseudorapidity with increasing collision energy, extending well away from the beam rapidity and covering more than half of the pseudorapidity range over which particles are produced. This approach to a universal limiting curve appears to be a dominant feature of the pseudorapidity distribution and therefore of the total particle production in these collisions.Comment: 5 pages, 4 figure