Factors Associated with Non-Reimbursable Activity on an Inpatient Pediatric Consultation–Liaison Service

The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation–liaison (C–L) service. A retrospective study was conducted using inpatient C–L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C–L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C–L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.     

LIQUID TO BABY FOOD FADING IN THE TREATMENT OF FOOD REFUSAL

In the current investigation, we identified two young children who consistently consumed liquids, but not baby food, after treatment with positive reinforcement for mouth clean (an indirect measure of swallowing) and physical guidance with re‐presentation of food. We examined the effects of an 11‐step stimulus fading procedure that involved gradually altering the concentration of liquid by adding baby food to the liquid. High levels of mouth clean were maintained in both children throughout fading, and increased mouth clean during probes of 100% baby food was obtained after conducting all 11 fading steps with one child and 6 of 11 fading steps with the second child. Negative vocalizations decreased during probes of 100% baby food after conducting the remaining fading steps with the second child. Gram intake of 100% baby food increased with both children after we completed all fading steps. Copyright © 2013 John Wiley & Sons, Ltd.     

Characteristics and Effectiveness of an Intensive Military Outpatient Treatment Program for PTSD

This study describes the characteristics and global effectiveness of treatment of a military intensive outpatient treatment program for posttraumatic stress disorder (PTSD). Thirty-nine military personnel completed treatment outcome questionnaires. Results showed a statistically significant reduction in depression and PTSD symptoms after the participants completed 3 weeks of intensive outpatient therapy. The findings have clinical and research implications for the length, intensity, and focus of PTSD treatment.     

Executive Function,Intellectual Decline and Daily Living Skills

ABSTRACT

Understanding the cognitive changes associated with compromised daily living skills in elderly individuals is important for making appropriate recommendations about the capacity for independent functioning. To this end, we retrospectively examined data from 92 elderly individuals presenting with cognitive decline who were administered measures of executive functioning, general intelligence, and daily living skills. Multiple regression analyses were used to examine the relationship between executive functioning and daily living skills, while controlling for age, depression, and either IQ decline or current IQ. Executive functioning accounted for additional variance in a broad range of daily living skills after controlling for IQ decline. When FSIQ was used in the regression model rather than IQ decline, executive functioning was no longer uniquely associated with daily living skills. Executive functions appear to be important for daily living skills until a critical threshold of low intellectual functioning is reached, reflecting the combined influence of premorbid ability and the extent of intellectual decline. Our results suggest that understanding the relative contribution of different cognitive domains to functional decline in elderly individuals should take into account general intellectual functioning and estimated decline, and that the initiation and/or persistence of self-directed cognitive processes may be important for adaptive daily functioning. These findings have implications for making more evidence-based recommendations about the capacity for independent living.     

Media Coverage of Direct-to-Consumer Genetic Testing

Media coverage of Direct-to-Consumer (DTC) genetic testing shapes public perception of such testing. The purpose of this study was to determine and assess the themes presented by U.S. news media regarding DTC genetic testing. We performed a Lexis-Nexis search with the keywords “Direct-to-Consumer” and “genetic test” for news stories published from 2006–2009. The sample was coded on themes of genetic determinism, privacy, discrimination, validity, regulation, the Genetic Information Nondiscrimination Act (GINA), utility, and cost. Ninety-two news stories were included. Stories displayed moderate genetic determinism and were neutral about validity and utility. Stories indicated that insurance and employers were the most likely sources of discrimination, yet identified the physicians and DTC companies as groups most likely to violate privacy. Stories claimed lack of regulation would harm consumers, but most post-GINA stories did not discuss the law. The costs of tests were frequently included. The results of this study show a broad range of views toward DTC genetic testing and its potential impacts. The genetics community should be aware that the public has been exposed to multiple views of DTC genetic testing when discussing these tests.     

Self-disclosure in Latinos' intercultural and intracultural friendships and acquaintanceships: Links with collectivism, ethnic identity, and acculturation

Relationships among collectivism, ethnic identity, acculturation, and self-disclosure rates in Latinos' intercultural and intracultural friendships and acquaintanceships were examined. An online survey collected data from 59 international Latinos and 73 Latino American nationals. Results revealed that relationship type (friend vs. acquaintance) and relationship partner ethnicity (Latino vs. White American) had significant relationships with self-disclosure. Participants disclosed more personal information to friends than acquaintances, and they disclosed more to Latino than to White American persons. Higher collectivism was related to increased self-disclosure across all relationship types. Acculturation exerted a significant main effect only in the context of friendships but interacted significantly with ethnicity in both friendships and acquaintanceships. Ethnic identity did not display any significant direct or interaction effects.     

Can dialectical behavior therapy be learned in highly structured learning environments? Results from a randomized controlled dissemination trial

This study evaluated the efficacy of methods of training community mental health providers (N = 132) in dialectical behavior therapy (DBT) distress tolerance skills, including (a) Linehan's (1993a) Skills Training Manual for Borderline Personality Disorder (Manual), (b) a multimedia e-Learning course covering the same content (e-DBT), and (c) a placebo control e-Learning course (e-Control). Participants were randomized to a condition, and the training took place in a highly structured and controlled learning environment. Assessments were completed at baseline, post-training, and 2, 7, 11, and 15 weeks following training. The results indicate that one or both of the active DBT conditions outperformed the control condition on all outcomes except motivation to learn and use the treatment. While clinicians preferred e-DBT over the Manual and found it more helpful and engaging, the active DBT conditions generally did not differ on the primary outcomes of knowledge and self-efficacy, with the exception that e-DBT significantly outperformed the Manual on knowledge at the 15-week follow-up. E-DBT also produced the highest rate of applying and teaching the newly learned skills in clinical practice. Overall, results from this study support the efficacy of e-Learning in disseminating knowledge of empirically supported treatments to clinicians, while also indicating that treatment manuals can be effective training tools.     

When it matters how you pronounce it: the influence of regional accents on job interview outcome

The visual dimension has featured prominently in person perception in the last 25 years. Alone, this dimension cannot give the complete 'picture' of others because language and speech (i.e., the auditory dimension) are also highly informative. Social-cognition research investigates the role of auditory information for impression formation. In a series of experiments, we tested perceived competence, hirability, and socio-intellectual status of different targets based on their regional accents. Given identical content of statements in different conditions of an alleged job interview, regional German accents (Saxon, Bavarian, and Berlin) resulted in lower perceived competence and hirability than standard German, even though the Bavarian accent at the same time resulted in higher ratings of socio-intellectual status compared to other regional accents (Experiment 1). These findings were confirmed when using a broader population sample and a 'matched guise' technique (Experiment 2). Our findings indicate that regional accents, similar to faces, can be very powerful in creating differentiated pictures of individuals.     

Teachers' and education students' perceptions of and reactions to children with and without the diagnostic label "ADHD"

Thirty-four elementary school teachers and 32 education students from Canada rated their reactions towards vignettes describing children who met attention-deficit/hyperactivity disorder (ADHD) symptom criteria that included or did not include the label “ADHD.” “ADHD”-labeled vignettes elicited greater perceptions of the child's impairment as well as more negative emotions and less confidence in the participants, although it also increased participants' willingness to implement treatment interventions. Ratings were similar to vignettes of boys versus girls; however, important differences in ratings between teachers and education students emerged and are discussed. Finally, we investigated the degree to which teachers' professional backgrounds influenced bias based on the label “ADHD.” Training specific to ADHD consistently predicted label bias, whereas teachers' experience working with children with ADHD did not.