Irish General Practitioner referrals to psychological therapies.

OBJECTIVE: General Medical Practitioners play a crucial role in the detection and referral of mental health problems in primary care. This study describes the referral patterns of Irish General Practitioners (GPs) to psychological therapies and profiles the range of psychological therapies available. METHOD: A 21-item study-specific questionnaire exploring referral processes to psychological therapies was sent to all GPs listed by the Irish College of General Practitioners in one county in Ireland. A 19-item questionnaire exploring details of psychological therapies offered and referral pathways was sent to members of psychological therapy accrediting bodies in the same county. RESULTS: Of 97 GP respondents (33% response rate), their estimation of the percentage of their patients who have presenting or underlying mental health issues averaged 22%. When asked to indicate which psychological therapies they consider for referrals, psychiatric referrals was the most frequent referral option (94%), followed by Counsellors (69%), Clinical psychologist (60%) and Psychotherapists (30%). GPs indicated they had some or very little knowledge of specific psychological therapies. Of 129 psychological therapists (45% response rate), self-referral and GP referral were their main referral pathways; 80% worked in private practice; highest qualification level was Undergraduate/Higher Diploma (66%), Master Level (39%) and Doctoral Level (5%). CONCLUSION: GPs refer patients presenting with mental health problems to psychiatrists with significantly lower percentages referring to other types of psychological therapists. Findings demonstrate that there is a need for greater education and information-sharing between GPs and providers of accredited psychological therapies to increase knowledge on specific therapies and their evidence base.

Results of a self-absorption study on the Versapor 3000 47-mm filters for radioactive particulate air stack sampling.

Since the mid-1980's the Pacific Northwest National Laboratory (PNNL) has used a value of 0.85 as a correction factor for the self absorption of activity for particulate radioactive air samples collected from building exhaust for environmental monitoring. More recently, an effort was made to evaluate the current particulate radioactive air sample filters (Versapor 3000, 47-mm diameter) used at PNNL for self absorption effects. There were two methods used to characterize the samples. Sixty samples were selected from the archive for acid digestion to compare the radioactivity measured by direct gas-flow proportional counting of filters to the results obtained after acid digestion of the filter and counting again by gas-flow proportional detection. Thirty different sample filters were selected for visible light microscopy to evaluate filter loading and particulate characteristics. Mass-loading effects were also considered. Large error is associated with the sample filter analysis comparison and subsequently with the estimation of the absorption factor resulting in an inadequate method to estimate losses from self-absorption in the sample filter. The mass loading on the sample filter as determined after digestion and drying was approximately 0.08 mg cm; however, this value may not represent the total filter mass loading given that there may be undetermined losses associated with the digestion process. While it is difficult to determine how much material is imbedded in the filter, observations from the microscopy analysis indicate that the vast majority of the particles remain on the top of the filter. In comparing the results obtained, the continued use of 0.85 as a conservative correction factor is recommended.

A survey of trainees' opinions and current clinical practice after behaviour therapy training.

The widespread use of cognitive behaviour therapy principles in psychiatric/mental settings has been an ongoing feature of health and social care since at least the 1960s. The current study evaluated the training process as well as the use of the skills by course participants on a dedicated behaviour therapy course in Ireland. A cross sectional study was undertaken, using postal distribution of a questionnaire based on a similar study undertaken in the UK. The sample comprised all graduates of the course from 1986 to 1999 (N = 257). Thirty-three per cent of respondents report using their behaviour therapy skills to a high level since completion of the course. Approximately 53% of respondents reported having changed job since completion of the course. Significant differences emerged within this group in relation to their ratings of the importance of various elements of the course and also in relation to the perceived enhancement of both general clinical skills (P = 0.000) and specific behaviour therapy skills (P = 0.000) as well as the rating of current skills (P = 0.015) and the respondents' use of behaviour therapy since completing the course (P = 0.015). While a high proportion of participants had some prior theoretical or experiential exposure to behaviour therapy, the findings report high satisfaction levels with the training they received. However, the survey signals deficits in terms of the usage of the skills. While on the one hand, the general and specific skills acquired while on the course seem to transfer quite easily across functions and levels of responsibility, it is of concern that over a 13-year period, only 17% of respondents indicated that behaviour therapy was the main focus of their work. The implications of these findings are discussed in relation to policy and practice issues.

A precursor to the relational evaluation procedure: searching for the contextual cues that control equivalence responding.

The precursor to the relational evaluation procedure (pREP) is a go/no-go successive discrimination procedure for examining stimulus equivalence. Previous research has shown that it does not readily produce equivalence responding unless some matching-to-sample (MTS) procedures are incorporated into the experimental sequence. Two experiments attempted to identify contextual cues that would generate equivalence responding on the pREP. Experiment 1 examined the effects of using abstract symbols or various verbal labels as response options on the pREP. Only the words same and different, when used as response options, reliably produced equivalence responding across 4 subjects. Experiment 2 examined different pretraining preparations designed to attach the functions of the words same and different to abstract symbols that could then be used as response options on the pREP. The most effective pretraining procedure involved multiple-exemplar training during which subjects were trained to respond to abstract symbols in the presence of pairs of stimuli that were either formally the same or different. The abstract symbols were subsequently used as response options with the pREP, and all subjects reliably demonstrated equivalence responding. The findings suggest that the relations of same and different may be fundamental to equivalence responding. These findings are discussed in terms of what they suggest about the nature of the equivalence phenomenon specifically and derived relational responding more generally.

Relational frame theory and Skinner's Verbal Behavior: A possible synthesis.

The current article suggests a possible synthesis of Skinner's (1957) treatment of verbal behavior with the more recent behavioral interpretation of language known as relational frame theory. The rationale for attempting to combine these two approaches is first outlined. Subsequently, each of the verbal operants described by Skinner is examined and subjected to a relational frame analysis. In each case, two types of operants are identified; one based on direct contingencies of reinforcement and the other based on arbitrarily applicable relational responding. The latter operants are labeled verbal because they can be distinguished from other forms of social behavior, and they appear to possess the symbolic or referential qualities often ascribed to human language. By applying relational frame theory to Skinner's verbal operants, we aim to contribute towards the development of a modern behavior-analytic research agenda in human language and cognition.

The morphology and cell culture of the striated musculature of the rat azygos vein.

The azygos vein of the rat can be divided into three regions: The proximal cardiac region, where the wall is composed of two and sometimes three layers of cardiac muscle and a thin discontinuous layer of smooth muscle cells. Vascular casts of this region demonstrate layers of capillaries closely following the orientation of the cardiac fibres. A transitional zone, where both cardiac and smooth muscle cells interdigitate. In this zone, close associations between smooth muscle and cardiac muscle cells can be observed, however, gap junctions do not appear to be present. Beyond this transitional zone the vessel resembles a typical thin-walled vein. The cells of the media of the entire length of azygous vein have been isolated and grown in culture and two separate viable populations identified corresponding to smooth and cardiac muscle.