Results from the Field: Development and Evaluation of a Psychiatry Residency Training Rotation in Cognitive-Behavioral Therapies.

OBJECTIVE: The goal of this project was to develop and evaluate a new residency training rotation focused on cognitive-behavioral therapies (CBT) and to assess outcomes across multiple domains. METHODS: Data are presented from 30 psychiatry residents. Primary learning-related outcomes included content knowledge, self-efficacy, and attitudes and behavioral intentions towards evidence-based psychotherapies (e.g., CBT). RESULTS: Residents reported significant increases in CBT knowledge, CBT-specific self-efficacy, overall psychotherapy self-efficacy, belief in patient benefit from CBT, and behavioral intention to use CBT. However, there were almost no changes in attitudes towards evidence-based practice more broadly, with one significant finding showing an increase in skepticism towards such practices. CONCLUSIONS: This empirically based example of training program development, implementation, and evaluation appears largely successful and represents one approach for addressing the CBT competency goals outlined by the Accreditation Council for Graduate Medical Education (ACGME) and Milestone Project Guidelines. Despite these initial, positive findings, conclusions should be tempered by limitations of the project design (e.g., the lack of comparison group, absence of objective measures of resident behavioral change, or assessment of the effect of such changes on patient outcomes). Findings highlight the need for continued development and evaluation of training methods in CBT for residency programs.

Optimal pacing and carbohydrate intake strategies for ultramarathons.

PURPOSE: The purpose of this research is to determine the pacing and nutrition strategies which minimize completion time and carbohydrate intake for athletes competing in ultramarathon races. METHODS: We present the formulation of a two-phase optimization model. The first-phase mixed-integer nonlinear program (MINLP) determines the minimum completion time subject to the altitude, terrain, and distance of the race, as well as the mass and cardiovascular fitness of the athlete. The second-phase MINLP determines the minimum carbohydrate intake required for the athlete to achieve the completion time prescribed by the first-phase subject to the flow of carbohydrates through the stomach, liver, and muscles. Consequently, the second-phase model provides the optimal pacing and nutrition strategies for a particular athlete for each kilometer of a particular race. RESULTS: We validate model results for a wide range of athlete parameters by comparing completion times to those reported for two case-study events. We also compare the kilometer-by-kilometer pacing and nutrition strategies prescribed by the model to those of a particular athlete. In all cases, the model results closely match those witnessed in the actual events. CONCLUSION: We have developed a baseline metabolic model that provides athletes prescriptive guidance regarding optimal pacing and carbohydrate intake strategies prior to competing in ultramarathon races. Given the highly variable topographical characteristics common to many ultramarathon courses and the potential inexperience of many athletes with such courses, our model provides valuable insight to competitors who might otherwise fail to complete the event due to exhaustion or carbohydrate depletion.

The development of a brief acceptance and mindfulness-based program aimed at reducing sexual revictimization among college women with a history of childhood sexual abuse.

Women with a history of childhood sexual assault (CSA) are more likely to be revictimized; however, most existing programs aimed at reducing sexual victimization do not expressly address the issue of revictimization. The present study examined the efficacy of a brief mindfulness-based program in reducing rates of sexual assault and revictimization in college women over the course of an academic semester. Although the results were not statistically significant, a large-magnitude effect was noted, whereby women with a history of CSA who participated in the program were less likely to be sexually assaulted and raped at 2-month follow-up.