Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.     

Group CBT for Externalizing Disorders in Urban Schools: Effect of Training Strategy on Treatment Fidelity and Child Outcomes

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C +) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C +. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C + delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C + resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.     

Evaluation of Breast Cancer Patients with Genetic Risk in a University Hospital: Before and After the Implementation of a Heredofamilial Cancer Unit

The identification of patients at risk for breast cancer by genetic testing has proven to reduce breast cancer mortality. In 2010, due to a lack of systematization in hereditary cancer assistance in our center, we implemented a multidisciplinary Heredofamilial Cancer Unit (HFCU). We analyze if the HFCU improved the rates of referrals and preventive management of breast cancer patients with genetic risk. We retrospectively compared family history records, referrals of high-risk patients to genetic counseling, and detection and management of patients with BRCA1/2 mutations in two cohorts of breast cancer patients diagnosed before (first period: 2007–2010) and after the creation of the HFCU (second period: 2010–2013). In the first period, 893 patients were included, and 902 were included in the second. Due to the inability to establish their genetic risk, 142 patients (15.9%) vs. 70 (7.8%) were excluded from analysis (p?<?0.001). Among the evaluable patients, 194 (25.8%) vs. 223 (26.8%) fulfilled one or more risk criteria (p?=?0.65). Family history documentation in patient’s medical records (92.4 vs. 97.8%, p?<?0.001) and referral rate (26.3 vs. 52%, p?<?0.0001) significantly increased in the second period. Eight BRCA1/2 mutations were detected among patients referred in the first period and 17 among those referred to the HFCU. The rate of preventive surgeries in patients with BRCA mutations significantly increased in the second period (25 vs. 76.5%, p?=?0.03). In conclusion, there was a clear improvement in family history records, referrals, and preventive surgeries in breast cancer patients with genetic risk after the implementation of the HFCU.     

Components of attentional effort for repeated tasks

This paper identifies four attentional processes that increase efficiency and accuracy in repeated lexicographic tasks using an instructed strategy approach. We propose a framework to decompose attentional effort used to make a decision into four components: Orientation, Wrong Target, Duration, and Repetition. Orientation assesses attention to decision rules and the location of relevant information. Wrong Target measures wasted effort on unneeded information. Duration gauges time spent on each piece of needed information. Repetition measures the number of views on each relevant item. Greater Orientation is associated with lower effort in other components and increased accuracy. Repetition is most variable across individuals but generates the greatest improvement with practice. Duration is less affected by the other components and shows minimal improvement with experience. Finally, Wrong Target is similarly resistant to practice, but it is the only component strongly and positively associated with making errors.     

Seek,and ye shall find: Differences between spontaneous and voluntary analogical retrieval

The present study tackles two overlooked aspects of analogical retrieval: (a) whether argumentation activities elicit a spontaneous search for analogical sources, and (b) whether strategic search can relax the superficial bias typically obtained in experimental studies of analogical retrieval. In Experiment 1, participants had to generate arguments for a target situation under three conditions: without indication to use analogies, with indication to use analogies, and with indication to search for sources within domains provided by the experimenters. Results showed that while voluntary search yields analogical retrievals reliably, the argumentation activity seldom elicits spontaneous remindings. A second set of results demonstrated that the superficial bias can be strategically relaxed, leading to a majority of distant retrievals. Experiment 2 replicated this result with the instruction to search within domains different from that of the target, and without providing a list of specific domains. The theoretical and educational implications of these findings are discussed.     

Profiles of emotional intelligence and demotivation to attend school in Chilean adolescents

The aim of this study was twofold: to identify different emotional intelligence (EI) profiles and to verify possible statistically significant differences in school refusal factors that result in a demotivation to attend school. Participants were 2362 Chilean adolescents aged from 13 to 17 (M?=?15.25; SD?=?1.33), who completed the Trait Meta-Mood Scale-24 (TMMS-24) and the School Refusal Assessment Scale-Revised (SRAS-R). Cluster analysis identified four EI profiles: high scores in repair and low in attention, high scores in attention and low in clarity and repair, low EI and high EI. Students with high scores in attention and low in repair scored higher in the first three factors of the SRAS-R, whereas in the fourth factor of the SRAS-R, students with high EI had significantly higher scores. Emotional regulation seems to be one of the determinant factors to prevent the appearance of school refusal. Based on these findings, we recommend that EI training be a part of future programs to overcome school attendance demotivation issues.