Examination of Cognitive Processing Therapy Outcomes in Veterans with Posttraumatic Stress Disorder, with or without Chronic Pain and with or without Pharmacological Treatment for Pain

Posttraumatic stress disorder (PTSD) and chronic pain are two of the most prevalent conditions affecting the veteran population, with approximately 20% of veterans holding a PTSD diagnosis (Fisher, 2014) and roughly 55% suffering from a chronic pain condition (National Institute of Health, 2015). It is estimated that over 60% of veterans with PTSD also hold a chronic pain diagnosis (Asmundson, 2014). Scholars have theorized about the unique relationships between PTSD and chronic pain, including a mutual maintenance model (Sharp & Harvey, 2001) and a shared vulnerability model (Asmundson et al., 2002). Given this rising comorbid prevalence and associated theoretical foundation, the present study aimed to examine treatment outcomes of cognitive processing therapy (CPT), in Veterans with PTSD, with or without chronic pain, and with or without pharmacological treatment for pain, in the reduction of both PTSD and depression symptoms, utilizing the Posttraumatic Stress Disorder Checklist (PCL) and Beck Depression Inventory, Second Edition (BDI-II). A retrospective chart review resulted in a sample of 94 veterans across three distinct cohorts; Cohort 1: veterans with a chronic pain condition and pharmacological treatment for pain, Cohort 2: veterans with a chronic pain condition and no pharmacological treatment or any other identified treatment for pain, and Cohort 3: veterans without a chronic pain condition. A MANOVA was conducted using the sample’s pre-treatment and post-treatment PCL and BDI-II scores to examine the symptom reduction across and among the three cohorts. Significant differences were observed between pre-treatment and post-treatment measures of both the PCL and BDI-II, across all cohorts. Significance in between-group differences on PCL score change across CPT was not significant, however demonstrated marginal significance. Between-cohort differences on BDI-II score changes were significant through the MANOVA analysis, however the post-hoc cohort mean comparison failed to reach significance. The study discusses the significance of results in the context of existing literature as well as future directions for research

Mapping the community : use of research evidence in policy and practice

Abstract: The use of research evidence (URE) in policy and practice is relevant to many academic disciplines, as well as policy and practice domains. Although there has been increased attention to how such evidence is used, those engaged in scholarship and practice in this area face challenges in advancing the field. This paper attempts to “map the field” with the objective of provoking conversation about where we are and what we need to move forward. Utilizing survey data from scholars, practitioners, and funders connected to the study of the use of research evidence, we explore the extent to which URE work span traditional boundaries of research, practice, and policy, of different practice/policy fields, and of different disciplines. Descriptive and network analyses point to the boundary spanning and multidisciplinarity of this community, but also suggest exclusivity, as well as fragmentation among disciplines and literatures on which this work builds. We conclude with opportunities for to improve the connectedness, inclusiveness, relationship to policy and practice, and sustainability of URE scholarship

First On-Sky Demonstration of a Scintillation Correction technique using Tomographic Wavefront Sensing

Scintillation noise significantly limits high precision ground-based photometry of bright stars. In this paper we present the first ever on-sky demonstration of scintillation correction. The technique uses tomographic wavefront sensing to estimate the spatial-temporal intensity fluctuations induced by high altitude optical turbulence. With an estimate of the altitudes and relative strengths of the turbulent layers above the telescope, the wavefront sensor data from multiple guide stars can be combined to estimate the phase aberrations of the wavefront at each altitude through the use of a tomographic algorithm. This 3D model of the phase aberrations can then be used to estimate the intensity fluctuations across the telescope pupil via Fresnel propagation. The measured photometric data for a given target within the field of view can then be corrected for the effects of scintillation using this estimate in post-processing. A simple proof-of-concept experiment using a wavefront sensor and a stereo-SCIDAR turbulence profiler attached to the 2.5m Isaac Newton Telescope was performed for a range of exposure times using the Orion Trapezium cluster as the reference stars. The results from this on-sky demonstration as well as simulations estimating the expected performance for a full tomographic AO system with laser guide stars are presented. On-sky the scintillation index was reduced on average by a factor of 1.9, with a peak of 3.4. For a full tomographic system we expect to achieve a maximum reduction in the scintillation index by a factor of ∼25

Optical sparse telescope arrays and scintillation noise

Fresnel propagation of starlight after it passes through high altitude turbulence in the Earth’s atmosphere results in random fluctuations of the intensity at ground level, known as scintillation. This effect adds random noise to photometric measurements with ground-based optical telescopes. Spatial correlation of the intensity fluctuations means that the fractional photometric noise due to scintillation may be substantially smaller for a sparse array of small aperture telescopes than for a single large aperture of the same total area. Assuming that the photometric noise for each telescope is independent, averaging the light curves measured by N telescopes reduces the noise by a factor of N−−√⁠. For example, for bright stars, the signal-to-noise ratio of a 2.54 m telescope can be achieved for an array of thirty 20 cm telescopes if the scintillation noise measured for each telescope is uncorrelated. In this paper, we present results from simulation and from observations at the Isaac Newton Telescope. These explore the impact that several parameters have on the measured correlation of the scintillation noise between neighbouring telescopes. We show that there is significant correlation between neighbouring telescopes with separations parallel to the wind direction of the dominant high altitude turbulent layer. We find that the telescopes in an array should be separated by at least twice their aperture diameter so that there is negligible correlation of the photometric noise. We discuss additional benefits of using sparse telescope arrays, including reduced cost and increased field of view

A New Approach to In-situ K-Ar Geochronology

The development of an in-situ geochronology capability for Mars and other planetary surfaces has the potential to fundamentally change our understanding of the evolution of terrestrial bodies in the Solar System. For Mars specifically, many of our most basic scientific questions about the geologic history of the planet require knowledge of the absolute time at which an event or process took place on its surface. For instance, what was the age and rate of early Martian climate change recorded in the mineralogy and morphology of surface lithologies (e.g., [1])? In-situ ages from a few select locations within the globally established stratigraphy of Mars would be transformative, enabling us to place direct chronologic constraints on the timing and rates of impact, volcanic, sedimentary, and aqueous processes on the Martian surface

Antibiotic Resistance Patterns in Invasive Group B Streptococcal Isolates

Antibiotics are used for both group B streptococcal (GBS) prevention and treatment. Active population-based surveillance for invasive GBS disease was conducted in four states during 1996–2003. Of 3813 case-isolates, 91.0% (3471) were serotyped, 77.1% (2937) had susceptibility testing, and 46.6% (3471) had both. All were sensitive to penicillin, ampicillin, cefazolin, cefotaxime, and vancomycin. Clindamycin and erythromycin resistance was 12.7% and 25.6%, respectively, and associated with serotype V (P < .001). Clindamycin resistance increased from 10.5% to 15.0% (X2 for trend 12.70; P < .001); inducible clindamycin resistance was associated with the erm genotype. Erythromycin resistance increased from 15.8% to 32.8% (X2 for trend 55.46; P < .001). While GBS remains susceptible to beta-lactams, resistance to alternative agents such as erythromycin and clindamycin is an increasing concern

Screening and brief intervention for obesity in primary care:cost-effectiveness analysis in the BWeL trial

This paper is closed access until 31 July 2019.Background: The Brief Intervention for Weight Loss Trial enrolled 1882 consecutively attending primary care patients who were obese and participants were randomised to physicians opportunistically endorsing, offering, and facilitating a referral to a weight loss programme (support) or recommending weight loss (advice). After one year, the support group lost 1.4 kg more (95%CI 0.9 to 2.0): 2.4 kg versus 1.0 kg. We use a cohort simulation to predict effects on disease incidence, quality of life, and healthcare costs over 20 years. Methods: Randomly sampling from the trial population, we created a virtual cohort of 20 million adults and assigned baseline morbidity. We applied the weight loss observed in the trial and assumed weight regain over four years. Using epidemiological data, we assigned the incidence of 12 weight-related diseases depending on baseline disease status, age, gender, body mass index. From a healthcare perspective, we calculated the quality adjusted life years (QALYs) accruing and calculated the incremental difference between trial arms in costs expended in delivering the intervention and healthcare costs accruing. We discounted future costs and benefits at 1.5% over 20 years. Results: Compared with advice, the support intervention reduced the cumulative incidence of weight-related disease by 722/100,000 people, 0.33% of all weight-related disease. The incremental cost of support over advice was £2.01million/100,000. However, the support intervention reduced health service costs by £5.86 million/100,000 leading to a net saving of £3.85 million/100,000. The support intervention produced 992 QALYs/100,000 people relative to advice. Conclusions: A brief intervention in which physicians opportunistically endorse, offer, and facilitate a referral to a behavioural weight management service to patients with a BMI of at least 30 kg/m2 reduces healthcare costs and improves health more than advising weight loss

An optically multiplexed single-shot time-resolved probe of laser–plasma dynamics

We introduce a new approach to temporally resolve ultrafast micron-scale processes via the use of a multi-channel optical probe. We demonstrate that this technique enables highly precise time-resolved, two-dimensional spatial imaging of intense laser pulse propagation dynamics, plasma formation and laser beam filamentation within a single pulse over four distinct time frames. The design, development and optimization of the optical probe system is presented, as are representative experimental results from the first implementation of the multi-channel probe with a high-power laser pulse interaction with a helium gas jet target