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Akansha Vaswani-Bye, Chris McCain, Jennifer M Blank, Mackenzie E Tennison, Sarah L Kopelovich Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USACorrespondence: Akansha Vaswani-Bye, Department of Psychiatry and Behavioral Sciences, University of Washington, Box 359911, 325 Ninth Ave, Seattle, WA, 98104, USA, Tel +1 206-744-9346, Fax +(206) 744-3236, Email avb9@uw.eduPurpose: Caregivers of loved ones with psychosis are tasked with navigating a barren care landscape for their loved ones and for themselves. The dearth of resources they face has a negative impact on outcomes for caregivers and their loved ones. The Psychosis REACH program, based on principles from Cognitive Behavioral Therapy for psychosis was developed as a community-based resource for families to address this care gap. A role for family peers called the Psychosis REACH Family Ambassadors (pRFAs) was developed to reinforce skill learning for caregivers by utilizing a task-sharing approach. This qualitative study sought to better understand pRFAs’ experiences in the inaugural training cohort of this program.Patients and Methods: Eleven pRFAs participated in semi-structured interviews with research coordinators via teleconference. Questions assessed the quality of the training, challenges and facilitators experienced in their role, and ways in which the program could be improved and expanded. Using thematic analysis, members of the research team coded interviews individually, discussed codes until consensus was reached, and iteratively developed themes based on codes that clustered based on meaning or content.Results: This process identified 5 key themes: The development of hope and recovery, the development of solidarity networks, the challenges of navigating boundaries, preferred pedagogical strategies, and the need for more support.Conclusion: Overall, the themes developed from this qualitative analysis demonstrate the value and feasibility of developing a caregiver peer network of pRFAs trained in recovery-oriented care and CBTp-informed skills to support other caregivers. Additionally, they highlight the challenges associated with being in the role of a pRFA and further efforts needed to align training content and learning management systems to the needs of pRFA trainees. These findings highlight the importance of expanding access to family peer training programs for the wellbeing of caregivers and loved ones with psychosis alike.Keywords: family interventions for psychosis, task-sharing, peer workforce development, family caregivers, cognitive behavioral therapy for psychosis

With an increasing number of libraries implementing federated searching to help users negotiate the complex electronic database environment, it is important to note how users are being instructed to use these resources. This article presents the results of examinations of the Web sites of Association of Research Libraries (ARL) member institutions that currently use federated search products. It analyzes help guides and search tips related to federated searching to determine what concepts are being explained to users and how the information is being communicated. The result of the evaluation of these Web sites is a list of 'best practice' guidelines that may be used by librarians creating their own federated searching guides. [ABSTRACT FROM AUTHOR]

Intermediary-purveyor organizations (IPOs) are a type of dissemination support system that are intended to enhance the adoption and sustainment of empirically supported treatments (ESTs) by deploying empirically supported strategies to remediate implementation challenges. Despite the recent proliferation of government-funded IPOs for other psychiatric populations, IPOs that can redress the substantial science-to-practice gap among clients who experience psychotic disorders are not well documented. This article provides an overview of an IPO in an R1 academic medical center whose mission is to enhance access to evidence-based interventions for individuals who have or are at risk for a psychotic disorder. The article spotlights the functions of an IPO and illustrates these functions with a use case, cognitive behavioral therapy for psychosis. We highlight IPO-led activities related to cognitive behavioral therapy for psychosis purveyance, professional development, quality improvement, public awareness education and training, research and evaluation, as well as program and policy development. Finally, we address the advantages and disadvantages of establishing IPOs of this nature in academic medical centers, the importance of academic-community partnerships in advancing EST implementation, and present considerations for replication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Project Extension for Community Healthcare Outcomes (ECHO) is a teleconsultation model that leverages technology to sustain specialized interventions in underresourced settings. We present the application of the ECHO model to longitudinal training and consultation for community behavioral health providers learning to deliver cognitive behavioral therapy for psychosis, an evidence-based psychotherapy for individuals with psychotic disorders that has poorly penetrated the US mental health system., Methods: We analyzed within-group change over practitioners' 6-month ECHO participation cycle using the Expanded Outcomes Framework. We evaluated outcomes associated with participation, satisfaction, knowledge acquisition, performance, patient symptom severity, and functional impairment., Results: In the first 3 years, the cognitive behavioral therapy for psychosis ECHO Clinics supported 150 providers from 12 community agencies. Forty percent did not complete the 6-month ECHO calendar, most commonly due to separation from their agency. Participants reported high degrees of satisfaction. Declarative and procedural knowledge increased over the 6-month period. Of the 24 providers who received a fidelity review, 87.5% met or exceeded the competency benchmark within the 6-month period. Clinical outcomes reflected reductions in hallucinations, negative symptoms, depression, mania, and functional impairment, but no reductions were detected in delusions, disorganized speech, or abnormal psychomotor behavior., Discussion: ECHO Clinics offer a mode of providing continuous access to expert instruction, peer-to-peer consultation, and case-based learning that other workforce training models lack. Our evaluation suggests that the ECHO model supports continuous professional development for practitioners, most of whom had indicated inadequate preparation for their role. We observed improved learner and select patient outcomes., Competing Interests: Disclosures: The authors declare no conflict of interest. This work was made possible by funding from the Washington State Health Care Authority to the University of Washington (Principal Investigator: Dr. Kopelovich)., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.)

Carbon-concentrating mechanisms (CCMs) are a widespread phenomenon in photosynthetic organisms. In vascular plants, the evolution of CCMs ([C44-carbon compound] and crassulacean acid metabolism [CAM]) is associated with significant shifts, most often to hot, dry and bright, or aquatic environments. If and how CCMs drive distributions of other terrestrial photosynthetic organisms, remains little studied. Lichens are ecologically important obligate symbioses between fungi and photosynthetic organisms. The primary photosynthetic partner in these symbioses can include CCM-presenting cyanobacteria (as carboxysomes), CCM-presenting green algae (as pyrenoids) or green algae lacking any CCM. We use an extensive dataset of lichen communities from eastern North America, spanning a wide climatic range, to test the importance of CCMs as predictors of lichen ecology and distribution. We show that the presence or absence of CCMs leads to opposite responses to temperature and precipitation in green algal lichens, and different responses in cyanobacterial lichens. These responses contrast with our understanding of lichen physiology, whereby CCMs mitigate carbon limitation by water saturation at the cost of efficient use of vapor hydration. This study demonstrates that CCM status is a key functional trait in obligate lichen symbioses, equivalent in importance to its role in vascular plants, and central for studying present and future climate responses., (© 2023 The Authors. Ecology published by Wiley Periodicals LLC on behalf of The Ecological Society of America.)

Managing wildlife populations in the face of global change requires regular data on the abundance and distribution of wild animals, but acquiring these over appropriate spatial scales in a sustainable way has proven challenging. Here we present the data from Snapshot USA 2020, a second annual national mammal survey of the USA. This project involved 152 scientists setting camera traps in a standardized protocol at 1485 locations across 103 arrays in 43 states for a total of 52,710 trap-nights of survey effort. Most (58) of these arrays were also sampled during the same months (September and October) in 2019, providing a direct comparison of animal populations in 2 years that includes data from both during and before the COVID-19 pandemic. All data were managed by the eMammal system, with all species identifications checked by at least two reviewers. In total, we recorded 117,415 detections of 78 species of wild mammals, 9236 detections of at least 43 species of birds, 15,851 detections of six domestic animals and 23,825 detections of humans or their vehicles. Spatial differences across arrays explained more variation in the relative abundance than temporal variation across years for all 38 species modeled, although there are examples of significant site-level differences among years for many species. Temporal results show how species allocate their time and can be used to study species interactions, including between humans and wildlife. These data provide a snapshot of the mammal community of the USA for 2020 and will be useful for exploring the drivers of spatial and temporal changes in relative abundance and distribution, and the impacts of species interactions on daily activity patterns. There are no copyright restrictions, and please cite this paper when using these data, or a subset of these data, for publication., (© 2022 The Authors. Ecology © 2022 The Ecological Society of America.)

Background: Videoconferencing platforms are being used for the purposes of interviewing in academic medicine because of the coronavirus disease 2019 pandemic. We present considerations applicable to interviewers and interviewees in the virtual space, with a focus on medical school and residency applicants. Methods: We reviewed the literature regarding the virtual interview process for medical school and residency by searching PubMed using the following keywords and terms: "interview," "academic medicine," "medical school application," "residency application," "virtual interviews," and "videoconferencing." Our search identified 701 results, from which we selected 36 articles for review. Results: The garnered information focuses on strategies for optimizing the virtual interview process from the standpoint of both the interviewer and the interviewee. We discuss the advantages and disadvantages of the virtual interview process and present recommendations. Conclusion: While the future of the interview process for medical school and residency is uncertain, virtual interviewing is a common and growing practice that will continue to be at least part of the medical interview process for years to come. Interviewers and interviewees should prepare to adapt to the evolving changes in the process., (©2022 by the author(s); Creative Commons Attribution License (CC BY).)

The rush to assess species' responses to anthropogenic climate change (CC) has underestimated the importance of interannual population variability (PV). Researchers assume sampling rigor alone will lead to an accurate detection of response regardless of the underlying population fluctuations of the species under consideration. Using population simulations across a realistic, empirically based gradient in PV, we show that moderate to high PV can lead to opposite and biased conclusions about CC responses. Between pre- and post-CC sampling bouts of modeled populations as in resurvey studies, there is: (i) A 50% probability of erroneously detecting the opposite trend in population abundance change and nearly zero probability of detecting no change. (ii) Across multiple years of sampling, it is nearly impossible to accurately detect any directional shift in population sizes with even moderate PV. (iii) There is up to 50% probability of detecting a population extirpation when the species is present, but in very low natural abundances. (iv) Under scenarios of moderate to high PV across a species' range or at the range edges, there is a bias toward erroneous detection of range shifts or contractions. Essentially, the frequency and magnitude of population peaks and troughs greatly impact the accuracy of our CC response measurements. Species with moderate to high PV (many small vertebrates, invertebrates, and annual plants) may be inaccurate 'canaries in the coal mine' for CC without pertinent demographic analyses and additional repeat sampling. Variation in PV may explain some idiosyncrasies in CC responses detected so far and urgently needs more careful consideration in design and analysis of CC responses., (© 2016 John Wiley & Sons Ltd.)

Blaschkitis is an acquired, rare dermatosis distributed along the lines of Blaschko. The papulovesicular eruption generally resolves in weeks and shows minimal response to topical steroids. Herein, we present a case of blaschkitis in an adult male who had lesions present for one year, which showed significant improvement after two weeks of topical clobetasol ointment.

After several decades of declining rates, maternal mortality climbed in California from a three-year moving average of 9.4 deaths per 100,000 live births in 1999-2001 to a high of 14.0 deaths per 100,000 live births in 2006-2008 (p < 0.001). The Maternal, Child and Adolescent Health Division of the California Department of Public Health developed a mixed method approach to identify and investigate maternal deaths to inform prevention strategies. This paper describes the methodology of the California Pregnancy-Associated Mortality Review (CA-PAMR) and its advantages for improved surveillance, cause of death analysis, and translation of findings. From 2002 to 2004, 1,598,792 live births occurred in California and 555 women died while pregnant or within one year of pregnancy. A screening algorithm identified cases for review that were likely to be pregnancy-related. Medical records were then abstracted and reviewed by a multidisciplinary committee to determine cause of death, contributing factors, and opportunities for quality improvement. Mixed methods were used to analyze, synthesize and translate Committee recommendations for improved care. Of 211 cases selected for review, 145 deaths were determined to be pregnancy-related. CA-PAMR methods corrected misclassification of cases and more accurately identified the leading causes of death. Cardiovascular disease emerged as the leading cause of pregnancy-related deaths (20%), and African-American women were disproportionately represented among cardiovascular deaths. Overall, the chance to prevent the fatal outcome appeared good or strong in 40% of cases reviewed. The CA-PAMR methodology resulted in additional case finding, improved accuracy of the causes of pregnancy-related deaths, and evidence to guide development of prevention and quality improvement efforts.

The increasing popularity of standardized patients is helping Emergency Medical Services (EMS) educators to develop (and reinforce) good professional behaviors among EMS students before they hit the streets to serve our communities.

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would "sometimes" or "maybe" engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.

The extinction of dinosaurs at the Cretaceous/Paleogene (K/Pg) boundary was the seminal event that opened the door for the subsequent diversification of terrestrial mammals. Our compilation of maximum body size at the ordinal level by sub-epoch shows a near-exponential increase after the K/Pg. On each continent, the maximum size of mammals leveled off after 40 million years ago and thereafter remained approximately constant. There was remarkable congruence in the rate, trajectory, and upper limit across continents, orders, and trophic guilds, despite differences in geological and climatic history, turnover of lineages, and ecological variation. Our analysis suggests that although the primary driver for the evolution of giant mammals was diversification to fill ecological niches, environmental temperature and land area may have ultimately constrained the maximum size achieved.

A method for selecting mobile phases for either one-dimensional (1-D) or two-dimensional (2-D) planar chromatography is described and is applied to the separation of steroids by overpressured layer chromatography [Formula: see text] a form of forced-flow thin-layer chromatography [Formula: see text] using both normal- and reversed-phase chromatography. Two metrics are used for evaluating the separation quality of simulated chromatograms for each of 100 (or more) subsets of a set of 30 steroids in each of 15 1-D, and 105 2-D systems. The subsets vary in size between five and 25 steroids. Butyl acetate/toluene on silica gel and aqueous 2,2,2-trifluoroethanol are, on average, the highest and second highest ranked 1-D systems, respectively, for separating all subset sizes. These two systems are the constituent members of the system that is, on average, the highest ranked 2-D system for all subset sizes. The probability of the above systems being highest ranked decreases with decreasing subset size. There is only a 17% probability of butyl acetate/toluene on silica being the best system for separating a subset of five steroids, while there is a 3% probability of this being the worst system for this subset size. The spot capacity of each system can be estimated by considering 100 subsets of each size and noting the largest subset size that yields an acceptable value of one of the metrics used for measuring separation quality. The mobile phase selectivity may be quantified using the actual values of either of the two separation metrics, or by a nonparametric approach. The latter is used in such a way that a difference of unity in the ranking (for a given subset size) of two systems corresponds to a 95% probability that the higher ranked system will yield the better separation.