Cost-Effectiveness and Health Care Utilization in a Multidisciplinary Pain Center: Comparison of Three Treatment Groups

Recent literature supports the efficacy of multidisciplinary pain management in treating persons suffering from chronic pain. However, the components of multidisciplinary pain management need to be evaluated in terms of effects on patients' quality of life as well as saving of future health care dollars. Therefore, cost-effectiveness of three treatment groups was compared by examining treatment outcome, posttreatment health care costs, and posttreatment health care visits. Results revealed that patients receiving both medical and psychological treatment (multidisciplinary pain management) exhibited the largest improvements in functional capacity, while being the least costly after their treatment program had ended. In contrast, patients who received only medical treatment exhibited significant deterioration in outcome after their treatment ended, and consumed substantially more posttreatment health care dollars.     

Relationship between clinician assessment and self-assessment of personality disorders using the SWAP-200 and PAI

The relation between self- and peer-informant reports of personality using psychometric instruments has been the focus of considerable research. The quantified judgments of clinically experienced observers such as treating clinicians have also been studied. The focus of the present article is on the measurement of 3 personality disorders (borderline, antisocial, and obsessive-compulsive) using the Shedler-Westen Assessment Procedure (SWAP-200), an instrument designed to quantify personality ratings made by clinically experienced informants, and the self-report Personality Assessment Inventory (PAI). SWAP-200 personality disorder scales showed small to medium correlations with borderline and antisocial personality disorder scales from the PAI. As predicted, SWAP-200 obsessive-compulsive personality disorder correlated negatively with these scales, suggesting discriminant validity.     

Mental Health Concerns of Older Adults Living in Long-Term Care Facilities: An Area of Expansion for MFTs

As baby boomers reach retirement age, the number of older adults living in long-term care will inevitably increase. Living in long-term care often brings psychological, relational, and emotional challenges for older adults, their families, and professional care-providers. Despite these trends and associated challenges, there appears to be an underrepresentation of attention addressing the mental health care of older adults and their families in marriage and family therapy (MFT) literature. Emphasis needs to be turned to assessing the quality and effectiveness of mental health resources for older adults in residential facilities, and to filling the gap where needed services are unavailable. The current review summarizes research addressing residential care for older adults, detailing a) mental health challenges faced by residents, families, and professional care-providers, b) effective mental health treatment options, and c) how MFTs are uniquely suited to working in long-term care settings.     

Distinctiveness-based stereotype threat and the moderating role of coaction contexts

Two experiments, using computer avatars, examined the role of coaction contexts (competition versus cooperation) in distinctiveness-based stereotype threat. In Experiment 1, African-American participants performed an anagram-solving task with two ostensible coactors either in a high-distinctiveness (participant being a numerical minority with two Caucasian coactors) or in a low-distinctiveness (racial-cues absent with silhouette-image avatars) environment; coaction contexts were structured either in terms of competition or in terms of cooperation. Participants situated in the high-distinctiveness environment performed better when they engaged in cooperation than in competition whereas those in the low-distinctive environment did not show a significant difference. In Experiment 2, which was conducted to replicate and extend Experiment 1 with a different social category/domain, females took a mathematics test with two ostensible coactors. Whereas the competition versus cooperation difference was not significant among participants placed in a low-distinctiveness (female-majority or all-female) environment, participants situated in a high-distinctiveness (female-minority) environment showed significantly lower levels of stereotype-associated concerns and better performance on the math test in cooperation than in competition. Our findings suggest that distinctiveness-based stereotype threat is less likely to occur when the context of group performance is framed as cooperation as opposed to competition.     

Increasing Sales Productivity Through Improved Sales Call Allocation Strategies

Abstract

Analytical tools have been found to greatly assist sales managers in making better sales call allocation decisions, but many of these approaches are either too simplified to provide meaningful results or too complex for many sales organizations to use. Recently a grid analysis approach has been suggested as a promising way to increase sales productivity by improving sales call allocations. We present several methodological improvements for developing the grid and report a successful application of grid analysis.     

Moral and spiritual education as an intrinsic part of the curriculum

This paper reports on a case study undertaken within a small, rural primary school in the UK to explore the extent to which it was possible to run a moral and spiritual programme as an intrinsic and inclusive part of the curriculum based on the children’s acquisition of virtues. The pupils were encouraged to build on their own experience and reflect on virtues such as ‘kindness’, ‘reliability’ or ‘responsibility’. Some positive associations were indicated between the moral and spiritual programme at the school and outcomes such as the pupil’s ability to resolve conflict and self-regulating behaviour as well as examples of empathy and altruism. The curriculum showed some effective ways of encouraging young people to be reflective and responsible for their own actions. This study was developed by observation of an assembly and targeted lessons together with semi-structured interviews. There was also a review of documentation related to the virtues programme to give a triangulated approach.     

The Effects of 10 Mgs. of Benzedrine Sulfate and Low Oxygen Tension on the Span of Attention for Letters,and Other Factors

The three wishes of a random sample of 100 subjects were obtained from each of five age groups: elementary, junior high, high school, early college (18–24 years), and late college (25–50 years). The wishes were placed in appropriate categories and into subcategories including possessions, activities, maintenance, achievement, and altruism. Exploratory measures of “confidence” and “sense of personal control” were taken for each subject. Sex and socioeconomic condition were analyzed. Results supported previously established trends of increasing generality, increasing altruism, and decreasing materialistic content up to different ages in adolescence and early adulthood depending on the data chosen to relate to the generalizations. In addition, a gradual increase in achievement wishes through middle adulthood was observed. The measure of “sense of personal control” was found to yield significant variation, while the data related to “confidence” varied only within chance limits. Comparisons with previous studies led to speculation that achievement orientations of adolescents may have lessened over the past decade.     

Detecting and identifying offset gaze

A number of experiments have demonstrated that observers can accurately identify stimuli that they fail to detect (Rollman and Nachmias, 1972; Harris and Fahle, 1995; Allik et al. 1982, 2014). Using a 2x2AFC double judgements procedure, we demonstrated an analogous pattern of performance in making judgements about the direction of eye gaze. Participants were shown two faces in succession: one with direct gaze and one with gaze offset to the left or right. We found that they could identify the direction of gaze offset (left/right) better than they could detect which face contained the offset gaze. A simple Thurstonian model, under which the detection judgement is shown to be more computationally complex, was found to explain the empirical data. A further experiment incorporated metacognitive ratings into the double judgements procedure to measure observers’ metacognitive awareness (Meta-d’) across the two judgements and to assess whether observers were aware of the evidence for offset gaze when detection performance was at and below threshold. Results suggest that metacognitive awareness is tied to performance, with approximately equal Meta-d’ across the two judgements, when sensitivity is taken into account. These results show that both performance and metacognitive awareness rely not only on the strength of sensory evidence but also on the computational complexity of the decision, which determines the relative distance of that evidence from the decision axes.