Evaluating Motivational Interviewing in the Physician Assistant Curriculum

Purpose Motivational interviewing (MI) is an evidence-based technique that enables clinicians to help patients modify health behaviors. Although MI is an essential tool for physician assistants (PAs), the extent to which it is addressed in PA curricula in the United States is unknown. This study is a comprehensive description of MI education in PA programs in the United States. Methods Data are from the 2014 Physician Assistant Education Association Annual Program Survey. Descriptive statistics were conducted on de-identified data from all 186 PA programs in the United States. Results Of the 186 PA programs surveyed, 72.58% (n = 135) reported at least one course providing MI training. Availability of courses providing training in skills essential to the MI process varied. Having a course with verbal communication training was most frequently endorsed, and having a course with training in developing discrepancy was least frequently endorsed. The most popular teaching modality was lecture (84.95%, n = 158), whereas only 41.40% (n = 77) and 58.60% (n = 109) reported role play with evaluation and standardized patient exercises with evaluation, respectively. Conclusions More than 70% of programs included at least one course in their curriculum that provided training in MI, suggesting that PA programs recognize the importance of MI. Instruction in change talk was not provided in nearly half of the programs. Role-play and standardized patient exercises with evaluation were underused methods despite their proven efficacy in MI education. As the first comprehensive benchmark of MI education for PAs, this study shows that although most programs address MI, opportunities exist to improve MI training in PA programs in the United States

Physical Activity Health Communication for Adults with Mood Disorders in the United States

Using national representative data, this study sought to examine receipt of physical activity communication and counseling among adults with mood disorders in comparison to the general population in the United States. The sample consisted of adult primary-care visits in the National Hospital Ambulatory Medical Care and National Ambulatory Medical Care Surveys. Multivariable logistic regression was used to examine the relationship between mental health status and receipt of physical activity communication and counseling. Overall, less than 20% of visits included physical activity communication and counseling. Controlling for covariates, visits for adults with a mood disorder diagnosis were associated with an increased odds of including physical activity communication and counseling, odds ratio = 1.25, 95% confidence interval = [1.08, 1.45]. Although adults with mood disorders were more likely to receive physical activity communication and counseling, most primary-care visits for adults in the United States did not include physical activity communication and counseling

Pressure regulating system Patent

Pressure regulating system with high pressure fluid source, adapted to maintain constant downstream pressur

Molecular orientation entanglement and temporal Bell-type inequalities

We detail and extend the results of [Milman {\it et al.}, Phys. Rev. Lett. {\bf 99}, 130405 (2007)] on Bell-type inequalities based on correlations between measurements of continuous observables performed on trapped molecular systems. We show that for some observables with a continuous spectrum which is bounded, one is able to construct non-locality tests sharing common properties with those for two-level systems. The specific observable studied here is molecular spatial orientation, and it can be experimentally measured for single molecules, as required in our protocol. We also provide some useful general properties of the derived inequalities and study their robustness to noise. Finally, we detail possible experimental scenarii and analyze the role played by different experimental parameters.Comment: 10 pages and 5 figure

ALPS generant tank and cell assembly

Diaphragm and balloon bladders for hydrazine expulsion in liquid propellant system and titanium tank fabricatio

Reconstruction of potential energy profiles from multiple rupture time distributions

We explore the mathematical and numerical aspects of reconstructing a potential energy profile of a molecular bond from its rupture time distribution. While reliable reconstruction of gross attributes, such as the height and the width of an energy barrier, can be easily extracted from a single first passage time (FPT) distribution, the reconstruction of finer structure is ill-conditioned. More careful analysis shows the existence of optimal bond potential amplitudes (represented by an effective Peclet number) and initial bond configurations that yield the most efficient numerical reconstruction of simple potentials. Furthermore, we show that reconstruction of more complex potentials containing multiple minima can be achieved by simultaneously using two or more measured FPT distributions, obtained under different physical conditions. For example, by changing the effective potential energy surface by known amounts, additional measured FPT distributions improve the reconstruction. We demonstrate the possibility of reconstructing potentials with multiple minima, motivate heuristic rules-of-thumb for optimizing the reconstruction, and discuss further applications and extensions.Comment: 20 pages, 9 figure

Adequacy of Depression Treatment in Spouses of Cancer Survivors: Findings From a Nationally Representative US Survey

Background Recent research suggests that mental health problems in spouses of cancer survivors are associated with worse mental health in the survivors themselves. Adequately treating spousal mental health problems therefore represents an opportunity to improve outcomes for both cancer survivors and their co-surviving family members. Objective Using nationally representative data, this study sought to determine how depression treatment differs between spouses of cancer survivors with depression compared to the general married population and assess rural/urban disparities in treatment. Design The design of the study is cross sectional. Participants Data are from the Medical Expenditures Panel Survey, a household-based survey of US adults; we concatenated data from 2004 to 2013. We identified spouses of cancer survivors (n = 225) and a comparison group of married adults (n = 3678). Main Measures Key measures included depression, guideline concordance of depression treatment (at least four prescriptions related to depression treatment, or at least eight psychotherapy or counseling visits), and sociodemographic characteristics. Logistic regressions evaluated the association between whether their spouse had cancer and receipt of guideline-concordant treatment, controlling for sociodemographic characteristics; secondary analyses included rurality as a moderator. Analyses were weighted to account for the complex sampling design. Key Results Spouses of cancer survivors were 33% less likely to receive guideline-concordant depression treatment than comparison spouses (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.45–0.99), controlling for covariates. Rural-urban disparities were observed: rural spouses of cancer survivors were 72% less likely to receive guideline-concordant treatment (OR 0.28, 95% CI 0.11–0.68) than rural comparison spouses. Spouses of cancer survivors and comparison spouses were no different in their receipt of any treatment versus no treatment. Conclusions Spouses of cancer survivors with depression may be at increased risk of non-guideline-concordant depression treatment, particularly in rural areas. The findings have implications for identifying and educating individuals with depression in primary care and other clinical areas

Stimulated emission and ultrafast carrier relaxation in InGaN multiple quantum wells

Stimulated emission (SE) was measured from two InGaN multiple quantum well (MQW) laser structures with different In compositions. SE threshold power densities (I_th) increased with increasing QW depth (x). Time-resolved differential transmission measurements mapped the carrier relaxation mechanisms and explained the dependence of I_th on x. Carriers are captured from the barriers to the QWs in < 1 ps, while carrier recombination rates increased with increasing x. For excitation above I_th an additional, fast relaxation mechanism appears due to the loss of carriers in the barriers through a cascaded refilling of the QW state undergoing SE. The increased material inhomogeneity with increasing x provides additional relaxation channels outside the cascaded refilling process, removing carriers from the SE process and increasing I_th.Comment: submitted to Appl. Phys. Let

An ecological study of the Klein woods, Jennings County, Indiana

The primeval forest of Indiana was without doubt representative of some of the most magnificent sections of the great eastern deciduous region. In a previous paper (9) we described briefly the fate of our hardwoods, and pointed out that only small tracts of comparatively undisturbed stands remain for observation. Since reports on the early forests are rather vague, and based on superficial observation rather than on quantitative data, it is somewhat difficult to gain from them a true picture of the phytosociology of these forests prior to time of settlement. Qualitative and quantitative studies of the remaining small stands referred to above, however, enable us to set up, or establish a fairly accurate norm with which to compare areas which have been disturbed, and see to what extent this disturbance has progressed. For detailed studies of a number of such stands, the reader is referred to the following literature references (1, 2, 5, 6, 7, 8, 9, 13, 14, 15, 16, 17, 18, 19)