Digital passband processing of wideband-modulated optical signals for enhanced underwater imaging.

Radar modulation, demodulation, and signal processing techniques have been merged with laser imaging to enhance visibility in murky underwater environments. The modulation provides a way to reject multiple scattered light that would otherwise reduce image contrast and resolution. Recent work has focused on the use of wideband modulation schemes and digital passband processing to resolve range details of an underwater scene. Use of the CLEAN algorithm has also been investigated to extract object features that are obscured by scattered light. Results from controlled laboratory experiments show an improvement in the range resolution and accuracy of underwater imagery relative to data collected with a conventional short pulse system.

Preparing psychologists in academic health centers for the rapidly changing health care environment.

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3-5 2011. The conference and its theme, "Preparing Psychologists for a Rapidly Changing Health Care Environment," brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference. The conference theme is framed in the historical context of the four national conferences that preceded it. In examining the focus and topics of the preceding conferences, recurrent themes are identified and progress in certain areas is highlighted.

Functional roles and foundational characteristics of psychologists in integrated primary care.

Psychologists are presented with unprecedented opportunities to integrate their work in primary care settings. Although some roles of psychologists in primary care overlap with those in traditional psychology practice settings, a number are distinct reflecting the uniqueness of the primary care culture. In this paper, we first describe the integrated primary care setting, with a focus on those settings that have components of patient centered medical home. We then describe functional roles and foundational characteristics of psychologists in integrated primary care. The description of functional roles emphasizes the diversity of roles performed. The foundational characteristics identified are those that we consider the 'primary care ethic,' or core characteristics of psychologists that serve as the basis for the various functional roles in integrated primary care. The 'primary care ethic' includes attitudes, values, knowledge, and abilities that are essential to the psychologist being a valued, effective, and productive primary care team member.

Health disparity and COVID-19-A retrospective analysis.

BACKGROUND AND AIMS: According to the World Health Organization (WHO), more than 75.7 million confirmed cases of coronavirus disease 2019 (COVID-19), a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been reported so far. Researchers are working relentlessly to find effective solutions to this catastrophe, using genomic sequence-based investigation, immunological analysis, and more. The role of health disparity has also emerged as an intriguing factor that made a huge impact on the lives of people. METHODS: We analyzed various factors that triggered the health disparity in the United States of America along with the rate of COVID-19 morbidity and mortality. Furthermore, we have also focused on the State of Mississippi, which is suffering from an extreme health disparity. Data have been obtained from publicly available data sources including, Center for Disease Control and Prevention and Mississippi State Department of Health. Correlation analysis of the dataset has been performed using R software. RESULTS: Our analysis suggested that the COVID-19 infection rate per 100 000 people is directly correlated with the increasing number of the African American population in the United States. We have found a strong correlation between the obesity and the COVID-19 cases as well. All the counties in Mississippi demonstrate a strong correlation between a higher number of African American population to COVID-19 cases and obesity. Our data also indicate that a higher number of African American populations are facing socioeconomic disadvantages, which enhance their chances of becoming vulnerable to pre-existing ailments such as obesity, type-2 diabetes, and cardiovascular diseases. CONCLUSION: We proposed a possible explanation of increased COVID-19 infectivity in the African American population in the United States. This work has highlighted the intriguing factors that increased the health disparity at the time of the COVID-19 pandemic.

Spp24 is associated with endocytic signalling, lipid metabolism, and discrimination of tissue integrity for 'leaky-gut' in inflammatory bowel disease.

Epithelial barrier injury allows contaminants to cross-over into the blood stream and trigger an inflammatory response, contributing to inflammatory bowel disease (IBD). Currently there is no single test that can reliably diagnose intestinal mucosal barrier function or measure impaired epithelial cell integrity associated with increasing permeability. Here, we assess the association between serum proteins and small intestinal permeability as detected by confocal laser endomicroscopy (CLE); in particular the known IBD marker-secreted phosphoprotein 24 (SPP24) and its binding partners; and use developed monoclonal antibodies to assess the role of SPP24 in mucosal healing. Sera were obtained from 28 IBD patients and non-IBD controls undergoing CLE with scores ranging from low to high permeability, as well as active ulcerative colitis from 53 patients undergoing fecal microbiota transplant therapy (FMT). Higher permeability associated with altered lipid metabolism, heightened innate immune response and junctional protein signalling in UC patients. A correlation between increasing leak and SPP24 peptide was observed. There is a strong indication of the novel role of SPP24 in gut barrier dysfunction particularly in ulcerative colitis. Its correlation to the established CLE for monitoring permeability has the potential to provide a blood based parallel to monitor and guide therapy more readily across a broad spectrum of illnesses for which 'leak' dominates the pathology.

Exercise and relaxation intervention for breast cancer survivors: feasibility, acceptability and effects.

OBJECTIVE: Although evidence mounts regarding the beneficial effects of physical activity (PA) interventions for breast cancer survivors, not all interventions have produced significant improvement in mood. Relaxation training may be a promising strategy for enhancing mood effects from these interventions. The goals of Be Calm and Move On were to assess the feasibility, acceptability and preliminary effects of a 12-week combined PA and relaxation intervention for breast cancer survivors. METHODS: Twenty-three early-stage breast cancer survivors were enrolled and 19 were retained for the intervention and 12- and 24-week follow-ups. Participants received a theoretically grounded intervention delivered via telephone. RESULTS: Participant evaluations of the intervention indicated that it was feasible and acceptable (e.g. 100% would recommend it to others); objective data further supported its feasibility (e.g. 83% completed the trial, 91% of intervention calls were received). In addition, when comparing 12- and 24-week follow-up data to baseline data, participants demonstrated significantly increased PA, improved mood and sleep quality, and reduced fatigue (p's<0.05). CONCLUSION: Thus, this pilot study suggests that the intervention is feasible and acceptable and produces promising effects on mood, sleep, and fatigue.

Transdisciplinary training: key components and prerequisites for success.

The training of transdisciplinary science is distinct in its intention to develop scientists who synthesize the theoretical and methodologic approaches of different disciplines. As a result, transdisciplinary scientists are better prepared to address the complexities of health problems. The most common form of transdisciplinary training is the multi-mentor apprenticeship model, with each mentor training from his or her own discipline. The transdisciplinary trainee is faced with many challenges, including learning the languages and cultures of different disciplines along with learning how to navigate within and between disciplines. The trainee also confronts unique career development risks. The climb up the academic ladder can be slower, rougher, and less linear than that of the trainee's single-disciplinary-trained peers. A number of factors can help the trainee in overcoming the challenges: being able to develop a core set of values and behaviors that are essential for transdisciplinary scientists; having the commitment and support of training institutions, training directors, and mentors; and having training structures and processes in place to prevent the training and trainee from naturally regressing back to familiar single-disciplinary approaches. There is relatively little known empirically about transdisciplinary training. Future efforts can focus on developing a better understanding of the unique characteristics of transdisciplinary training, identifying the effective elements that relate to training outcomes, defining the critical outcome metrics at different time points during and following training, and creating toolkits to help with training processes.

Integrated Primary Care Readiness and Behaviors Scale: Development and validation in behavioral health professionals.

INTRODUCTION: Although integrated primary care (IPC) is growing, several barriers remain. Better understanding of behavioral health professionals' (BHPs') readiness for and engagement in IPC behaviors could improve IPC research and training. This study developed measures of IPC behaviors and stage of change. METHOD: The sample included 319 licensed, practicing BHPs with a range of interests and experience with IPC. Sequential measurement development procedures, with split-half cross-validation were conducted. RESULTS: Exploratory principal components analyses (N = 152) and confirmatory factor analyses (N = 167) yielded a 12-item scale with 2 factors: consultation/practice management (CPM) and intervention/knowledge (IK). A higher-order Integrated Primary Care Behavior Scale (IPCBS) model showed good fit to the data, and excellent internal consistencies. The multivariate analysis of variance (MANOVA) on the IPCBS demonstrated significant large-sized differences across stage and behavior groups. DISCUSSION: The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record

Effect of personal cancer history and family cancer history on levels of psychological distress.

This study examined the impact of personal and family cancer history on psychological distress. Regression analyses were conducted on a nationally representative sample of adult individuals who participated in the 2000 National Health Interview Survey, USA. Effects on distress of a personal cancer history, any family cancer history, or mother, father, sister or brother with a cancer history were examined. The interaction of personal and family cancer histories and three-way interactions with gender were also assessed. Analyses indicate that having either a personal or family cancer history is linked with significantly greater psychological distress and there is evidence of an interaction. Three-way interactions with gender were not found. Consistent with prior research, results demonstrated that cancer survivors are more distressed than the general population. Results extend prior research by indicating that having a first-degree relative with cancer increases risk for distress, and having personal and family cancer histories may exert a synergistic effect on distress.

Psychologists in patient-centered medical homes (PCMHs): Roles, evidence, opportunities, and challenges.

The patient-centered medical home (PCMH) is an increasingly common model of health care delivery with many exciting opportunities for psychologists. The PCMH reflects a philosophy and model of care that is highly consistent with psychological science and practice. It strives to provide patient-centered, comprehensive, team-based, coordinated, accessible, and quality and safety-oriented health care delivery to individuals and families. Moreoever, in keeping with changes in the health care system more broadly, the PCMH model prioritizes the integration of behavioral and physical health care, and this emphasis lays the foundation for active and full engagement of psychologists in this context. This article provides an overview of the PCMH and the evidence and roles for psychologists across a range of pediatric, adult, and geriatric health care populations and settings. Current challenges to the necessary expansion of psychology in the PCMH are discussed, with particular attention to the needs for training and advocacy to support the contributions of behavioral health care in the PCMH. Psychology must embrace its rightful place as a health profession and appreciate and highlight the ways in which psychologists can play unique and critical roles in transforming present and future health care delivery models. (PsycINFO Database Record

Open Trial of Integrated Primary Care Consultation for Medically Unexplained Symptoms.

Within primary care settings, patients with medically unexplained symptoms (MUS) are common, often present with comorbid psychopathology, and have high rates of healthcare utilization. Despite increased healthcare utilization, these patients often have poor outcomes that frustrate patients and providers alike. A behavioral consultation intervention for primary care patients with MUS (n = 10) was developed and assessed. All participants completed all intervention and assessment sessions and rated the intervention favorably. Participants self-report scores revealed statistically significant improvements from baseline to 3-month follow-up on physical functioning, mental functioning, and physical symptoms. Notwithstanding the limitations of open trial designs, these findings demonstrate high feasibility for a behavioral health consultation treatment model for patients with MUS and highlight the need for further research.

Transitions of care and changes in distressing pain.

This study employed a 22-state mortality follow-back survey to examine bereaved family members' perception of the level and pattern of distressing pain in decedents with cancer at the last two sites of care. Of the 1,578 individuals interviewed, 423 of their family members had cancer listed as the leading cause of death on the decedent's death certificate. Decedents were treated at home, hospitals, hospices, or nursing homes, with more than half of the respondents (n = 216) reporting that the decedent was at more than one site of care in the last month. Forty-two percent of decedents had distressing pain (defined as "quite a bit" or "very much") at their second to last place of care, with 40% having distressing pain at the last place. There was some variation in the degree of change depending on the transition between the second to last and last places of care. For many individuals, however, the transition to another place of care did not result in an improvement in the level of distressing pain. No significant differences were found in the change in distressing pain by transition of care. Increased attention is needed not only on how to adequately manage pain and pain-related distress but also on how to improve pain reduction measures in transitions between health care settings at the end of life.

Implementation of an acceptance- and mindfulness-based group for depression and anxiety in primary care: Initial outcomes.

INTRODUCTION: Depression and anxiety disorders are highly prevalent among primary care patients. Group visits provide a way of delivering interventions to multiple patients at the same time. Group visits for depression and anxiety present an opportunity to expand the reach of behavioral health services for primary care patients. The goal of the current study was to evaluate the implementation of an acceptance and mindfulness-based group for primary care patients with depression and anxiety. METHODS: Adult family medicine patients with Patient Health Questionnaire-9 (PHQ-9) and/or Generalized Anxiety Disorder Scale-7 (GAD-7) scores > 5 were eligible for the group. The group was held biweekly in the family medicine practice with rolling enrollment. The PHQ-9 and GAD-7 were administered at every visit, and changes in depression and anxiety symptoms were analyzed using multilevel modeling. We evaluated feasibility, acceptability/satisfaction, penetration, and sustainability. RESULTS: Over the course of 19 months, 50 patients were referred to the group, and 29 enrolled. The median number of visits attended was four among those who attended more than one group visit. Results revealed that depression and anxiety symptoms decreased significantly over the first four visits attended (d = -.26 and -.19, respectively). Patients who attended more than one group reported high satisfaction. The group was sustainable after the research funding ended; however, penetration was low. DISCUSSION: A rolling enrollment group for patients with depression and anxiety that utilized mindfulness- and acceptance-based treatment principles is feasible to implement in a primary care setting but is not without challenges. Recommendations for ways to enhance implementation and future research are provided. (PsycINFO Database Record

Cancer screening practices among cancer survivors.

BACKGROUND: Cancer survivors are more vulnerable to future cancers than individuals without cancer. As such, it is important to understand whether survivors are engaging in cancer screenings. METHODS: The screening practices reported in response to the 2000 Health Interview Survey of 2151 individuals with cancer were examined and compared to those of 30,195 individuals without cancer. RESULTS: The proportion of cancer survivors obtaining screenings ranged from 21% to 77%. Compared to individuals without cancer, women with cancer were more likely to have had a mammogram (odds ratio [OR]=1.8, 95% CI=1.5-2.1), a clinical breast exam (OR=2.2, 95% CI=1.9-2.5), and/or a Papanicolaou test (OR=1.3, 95% CI=1.1-1.5) in the recommended timeframe. Similarly, men with cancer were more likely than men without cancer to have had a prostate-specific antigen test performed (OR=2.5, 95% CI=2.0-3.0). All cancer survivors were more likely than individuals without a cancer diagnosis to have had a total body skin exam (OR=4.0, 95% CI=3.5-4.6), a fecal occult blood test (OR=1.4, 95% CI=1.2-1.6), and/or a colorectal exam (OR=2.2, 95% CI=1.9-2.5). Similar results were obtained when individuals diagnosed with the cancer for which the screen was designed to detect were excluded. CONCLUSIONS: The results demonstrate that cancer survivors have higher screening rates than individuals without a cancer diagnosis. Despite this, the proportion of survivors obtaining screenings varies considerably by the type of screen. An understanding of the impact of cancer screening in cancer survivors, as well as the reasons for and against obtaining cancer screenings, is necessary.

Physician actions following a positive PHQ-2: implications for the implementation of depression screening in family medicine practice.

Systematic screening of depression in primary care settings that have adequate follow-up and treatment is recommended. The Patient Health Questionnaire (PHQ-9) was developed as a depression screening measure for use in primary care. The PHQ-2, which includes just 2 items from the PHQ-9, is designed to be used as a first line depression screening measure, to be followed by the full PHQ-9 when a patient screens positive. However, completion of the first step in the process (PHQ-2) does not necessarily lead to completion of the second step (administration of the PHQ-9 when the PHQ-2 is positive), even when treatment and follow-up are available. The objective of the current study was to describe family medicine physicians' actions following a positive PHQ-2 and factors that affect their use of depression screening measures and treatment decisions. A retrospective chart review of 200 family medicine patients who screened positive on the PHQ-2 during an office visit was conducted. Additionally, 26 family medicine physicians in the practice were surveyed. Only 5% of patients with positive PHQ-2 scores were administered a PHQ-9. Physicians relied on their clinical judgment and prior knowledge about the patient's depression status to inform treatment decisions and cited time constraints and competing demands as reasons for not administered the PHQ-9. Physicians tended to treat depression with adequate doses of antidepressants and counseling. PHQ-2 screening did not necessarily lead to further evaluation, systematic follow-up, or changes in treatment. Implications for the implementation of depression screening in primary care settings are discussed.

Pain state as artifact in the psychological assessment of recurrent headache sufferers.

The finding that recurrent headache sufferers, particularly tension headache sufferers, obtain higher scores on psychological symptoms measures than controls was replicated in 262 recurrent (tension, mixed, and migraine) headache sufferers and 26 controls. However, closer examination of the data revealed that psychological symptoms were elevated only in patients who experienced head pain at the time of assessment. This finding raises the possibility that previously reported elevations in psychological symptoms have resulted from uncontrolled differences in the pain state of respondents. Retrospective reports of headache activity also were related to pain state. In contrast, a measure of perceived control of factors affecting headaches was unrelated to pain state. As a result, locus of control (but not psychological symptoms) successfully differentiated recurrent headache sufferers from controls even when headache sufferers were tested when pain free. These results suggest that psychological symptom measures may yield misleading results when used with individuals with pain disorders.

The influence of placebo awareness on stimulant drug response in a double-blind trial.

RATIONALE: Critics have called into question findings from double-blind placebo-controlled studies because subjects are given drug administration instructions informing them of a placebo condition. The assertion that these drug administration instructions bias estimates of effectiveness has undergone surprisingly little empirical investigation. OBJECTIVES: The primary objective of this study was to determine whether drug administration instructions informing subjects of a placebo condition affect the drug response and affect the saliva concentration of the stimulant. METHODS: We assessed caffeine responses and levels of saliva concentration of caffeine in 52 subjects who were randomly assigned to receive one of two drug administration instructions: (a) placebo-informed instructions (i.e., individuals informed of the placebo) analogous to those used in double-blind studies and (b) placebo-uninformed instructions (i.e., individuals informed they are taking an active stimulant). RESULTS: On most measures (systolic blood pressure, heart rate, hand steadiness, reaction time, fatigue, and tension), drug administration instructions did not significantly influence caffeine response. Instructions also had no significant effect on saliva concentration of caffeine. However, only individuals who were uninformed of the placebo condition showed significant diastolic blood pressure and vigor increases with 125 mg caffeine, and significant hand steadiness impairment and vigor increases with 325 mg caffeine compared to placebo. CONCLUSIONS: These overall findings suggest that a limited bias is introduced by drug administration instructions. The results do not support any suggestion that information about the existence of a placebo condition dramatically influences conclusions drawn about drug responses in placebo-controlled trials.

The impact of apathy and depression on quality of life in patients infected with HIV.

Apathy refers to decreased self-initiation and goal-directed behavior. Apathy is a relatively common neuropsychiatric symptom associated with HIV, yet the impact of apathy on health-related quality of life (QOL) has not been investigated. We examined the relationship between apathy, depression, and QOL among individuals infected with HIV. Apathy was quantified using the Marin Apathy scale and QOL was measured with the Medical Outcomes Study Short-Form 36 (SF-36). Results of the study revealed that both apathy and depression were more common among patients with HIV than healthy control subjects. Twenty-six percent of the patients with HIV reported clinically significant apathy while 80% of the patients reported clinically significant depression. Apathy did not relate to ratings of overall QOL, but it was modestly associated with ratings of mental health and role disruption secondary to mental health. By contrast, ratings of depression were strongly related to overall QOL and most indices of SF-36. Regression equations revealed that depression and apathy independently contributed to mental health and role disruption secondary to mental health. Importantly, ratings of depression accounted for the majority of variance for ratings of QOL. The findings indicate that while apathy is more common among individuals with HIV compared to healthy control subjects, the impact of apathy on QOL is less significant than depression. Clinicians should continue to focus on depression as an important neuropsychiatric symptom associated with HIV.

Competencies for psychology practice in primary care.

This article reports on the outcome of a presidential initiative of 2012 American Psychological Association President Suzanne Bennett Johnson to delineate competencies for primary care (PC) psychology in six broad domains: science, systems, professionalism, relationships, application, and education. Essential knowledge, skills, and attitudes are described for each PC psychology competency. Two behavioral examples are provided to illustrate each competency. Clinical vignettes demonstrate the competencies in action. Delineation of these competencies is intended to inform education, practice, and research in PC psychology and efforts to further develop team-based competencies in PC.