Do Attitudes Matter? Evaluating the Influence of Training in CBT-p-Informed Strategies on Attitudes About Working with People Who Experience Psychosis.

Attitudes of mental health providers are an important consideration in training and delivering evidence-based practices. Treatment approaches for individuals who experience schizophrenia consistently endorse the importance of a recovery perspective. At the same time, a review of the literature suggests that the attitudes of many providers and many policies of community health care settings serving individuals who experience schizophrenia, may not align with the recovery perspective. This brief report provides a summary of the program evaluation outcomes of a wide range of mental health providers who participated in a 2-day intensive training to learn strategies informed by Cognitive Behavioral Therapy for Psychosis (CBT-p). This intensive training emphasizes engagement strategies and person-centered approaches inherent in the recovery perspective. Consistent with the aims of the training, participants' attitudes about working with people who experience psychosis appeared to be positively influenced by training.

Task-specific and general cognitive effects in Chiari malformation type I.

OBJECTIVE: Our objective was to use episodic memory and executive function tests to determine whether or not Chiari Malformation Type I (CM) patients experience cognitive dysfunction. BACKGROUND: CM is a neurological syndrome in which the cerebellum descends into the cervical spine causing neural compression, severe headaches, neck pain, and number of other physical symptoms. While primarily a disorder of the cervico-medullary junction, both clinicians and researchers have suspected deficits in higher-level cognitive function. DESIGN AND METHODS: We tested 24 CM patients who had undergone decompression neurosurgery and 24 age- and education-matched controls on measures of immediate and delayed episodic memory, as well as three measures of executive function. RESULTS: The CM group showed performance decrements relative to the controls in response inhibition (Stroop interference), working memory computational speed (Ospan), and processing speed (automated digit symbol substitution task), but group differences in recall did not reach statistical significance. After statistical control for depression and anxiety scores, the group effects for working memory and processing speed were eliminated, but not for response inhibition. This response inhibition difference was not due to overall general slowing for the CM group, either, because when controls' data were transformed using the linear function fit to all of the reaction time tasks, the interaction with group remained statistically significant. Furthermore, there was a multivariate group effect for all of the response time measures and immediate and delayed recall after statistical control of depression and anxiety scores. CONCLUSION: These results suggest that CM patients with decompression surgery exhibit cognitive dysfunction compared to age- and education-matched controls. While some of these results may be related to anxiety and depression (likely proxies for chronic pain), response inhibition effects, in particular, as well as a general cognitive deficit persisted even after control for anxiety and decompression.

Simulation of potential oyster density with variable freshwater inflow (1965-2000) to the Caloosahatchee River Estuary, southwest Florida, USA.

Oyster beds are disappearing worldwide through a combination of over-harvesting, diseases, and salinity alterations in the coastal zone. Sensitivity of oysters to variable discharge and salinity is particularly acute in small sub-tropical estuaries subject to regulated freshwater releases. South Florida has sub-tropical estuaries where watershed flood control sometimes results in excessive freshwater inflow to estuaries during the wet season (May-Oct) and reduced discharge and increased salinities in the dry season (Nov-Apr). The potential to reserve freshwater accumulated during the wet season could offer the capacity to regulate freshwater at different temporal scales, thus optimizing salinity conditions for estuarine biota. The goal of this study was to use simulation modeling to explore the effects of freshwater inflows and salinity on adult oyster survival in the Caloosahatchee River Estuary (CRE) in southwest Florida. Water managers derived three different freshwater inflow scenarios for the CRE based on historical and modified watershed attributes for the time period of 1965-2000. Three different salinity time series were generated from the inflow scenarios at each of three sites in the lower CRE and used to conduct nine different oyster simulations. Overall, the predicted densities of adult oysters in the upstream site were 3-4 times greater in seasons that experienced reduced freshwater inflow (e.g., increased salinity) with oyster density in the lower estuary much less influenced by the inflows. Potential storage of freshwater reduced the frequency of extreme flows in the wet season and helped to maintain minimum inflow in the dry season near the estuarine mouth. Analyses of inflows indicated that discharges ranging from 0 to 1,500 cfs could promote favorable salinities of 10-25 in the lower CRE depending on wet versus dry season climatic conditions. This range of inflows is similar to that derived in other studies of the CRE and emphasizes the value of simulation models to help prescribe freshwater releases which benefit estuarine biota.