Theoretical and Empirical Integration of "Dark" Traits and Socially Aversive Personality Psychopathology.

Conceptual work integrating constructs from mainstream personality research (especially so-called "dark" traits) and clinical psychopathology research has been limited. Herein, we propose all socially and/or ethically aversive traits as "flavored" manifestations of the D factor of personality (D). We argue that the D framework provides the commonality of all aversive traits, including the aversive traits from the DSM-5 Alternative Model for Personality Disorders (AMPD), a more thorough theoretical foundation. Moreover, D covers aspects that are not captured by any of the aversive AMPD traits directly (e.g., greed), thus offering indications for possible expansions to the AMPD. We tested our predictions in two online studies (N = 1,781 and N = 2,006) using quota-representative samples of the German population regarding age and gender. Twelve aversive traits from mainstream personality research and eight aversive AMPD traits were assessed together with consequential behavior in an economic game. Analyses using structural equation modeling overall confirmed predictions.

Testing the equivalence of the aversive core of personality and a blend of agreeableness(-related) items.

OBJECTIVE: There is an ongoing debate in personality research whether the common core of aversive ("dark") traits can be approximated by or even considered equivalent to one of the constructs that have been labeled "Agreeableness". In particular, it has been suggested that the low pole of (what we term) AG+, a broad blend of Big Five Agreeableness and the HEXACO factors Honesty-Humility, Agreeableness, and Altruism, is essentially equivalent to the Dark Factor of Personality (D). Based on theoretical differences, we herein test empirically whether D and AG+ are isomorphic. METHODS: Self-report data on D, AG+, and eight criterion measures reflecting justifying beliefs, inflicting disutility on others, and affiliative tendencies were collected in a pre-registered study (N = 1156) and analyzed via confirmatory factor modeling. RESULTS: Results speak against unity of D and AG+ (35% shared variance) and support the notion that D subsumes a broader range of aversive content (i.e., justifying beliefs and inflicting disutility on others) than AG+, which, in turn, subsumes a slightly broader range of non-aversive, affiliative tendencies. CONCLUSION: We conclude that AG+ is non-equivalent to the common core of aversive traits, D.

The moderating role of trust in pandemic-relevant institutions on the relation between pandemic fatigue and vaccination intentions.

This research helps to clarify the relation between pandemic fatigue (PF) and vaccination intentions (VI). Theoretically, two patterns seem plausible. First, as with any other health protective measure, PF might reduce the motivation to get vaccinated. Second, PF might increase the motivation to get vaccinated because vaccination reduces the number of (other) health protective measure needed. We tested these two opposing predictions and further explored the moderating role of trust in pandemic-relevant institutions on the link between PF and VI in two large-scale survey studies from Denmark and Germany (collected between 2020 and 2021; total N > 22,000). Data was analyzed using multiple regression models. Analyses reveal a negative link between PF and VI that is less pronounced for people high in trust. Results remain stable when accounting for covariates and quadratic trends. Thus, trust might buffer the negative relation between PF and VI.

Beyond (low) Agreeableness: Toward a more comprehensive understanding of antagonistic psychopathology.

In clinical psychopathology research, up to seven traits have been suggested as instances of antagonistic psychopathology. Those antagonistic traits, in turn, are commonly viewed as reflections of low Agreeableness as per the Big Five (BF-AG). However, specific theoretical differences between antagonistic traits suggest that other broad, basic dimensions beyond BF-AG ought to provide further points of correspondence. Specifically, whereas primarily affective antagonistic traits are closely aligned with BF-AG, primarily behavioral antagonistic traits are better aligned with Honesty-Humility (HH) from the HEXACO model and primarily cognitive antagonistic traits are better aligned with the common core of aversive traits (the Dark Factor of Personality, D). Indeed, from a theoretical perspective, D seems to be the only candidate sufficiently covering all aspects of antagonistic traits (affect, behavior, and cognition) to a comparable extent and thus affording a balanced representation of antagonistic psychopathology. We critically test these conjectures in a large and heterogeneous online sample (N = 3,396), investigating the overlap between antagonistic traits and basic personality via structural equation modeling. Results show that BF-AG, HH, and D each yield particularly strong ties to one group of antagonistic traits (affective, behavioral, and cognitive, respectively), while D offers the most balanced representation of all (groups of) antagonistic traits.

What's Driving Me? Exploration and Validation of a Hierarchical Personality Model for Trust in Automated Driving.

OBJECTIVE: This paper presents a comprehensive investigation of personality traits related to trust in automated vehicles. A hierarchical personality model based on Mowen's (2000) 3M model is explored in a first and replicated in a second study. BACKGROUND: Trust in automation is established in a complex psychological process involving user-, system- and situation-related variables. In this process, personality traits have been viewed as an important source of variance. METHOD: Dispositional variables on three levels were included in an exploratory, hierarchical personality model (full model) of dynamic learned trust in automation, which was refined on the basis of structural equation modeling carried out in Study 1 (final model). Study 2 replicated the final model in an independent sample. RESULTS: In both studies, the personality model showed a good fit and explained a large proportion of variance in trust in automation. The combined evidence supports the role of extraversion, neuroticism, and self-esteem at the elemental level; affinity for technology and dispositional interpersonal trust at the situational level; and propensity to trust in automation and a priori acceptability of automated driving at the surface level in the prediction of trust in automation. CONCLUSION: Findings confirm that personality plays a substantial role in trust formation and provide evidence of the involvement of user dispositions not previously investigated in relation to trust in automation: self-esteem, dispositional interpersonal trust, and affinity for technology. APPLICATION: Implications for personalization of information campaigns, driver training, and user interfaces for trust calibration in automated driving are discussed.

Convergence of surface energy calculations for various methods: (0 0 1), (0 1 2), (1 0 0) hematite and the applicability of the standard approach.

Three different methods for the calculation of the surface energy, namely the standard approach, the Boettger relation and the linear-fit method, are applied to the (0 0 1), (0 1 2) and (1 0 0) hematite surfaces. The standard approach was previously shown to suffer from a divergence problem, and the Boettger relation was shown to exhibit quantum size effects. While the linear-fit method, in general, leads to a good convergence behavior of the surface energy, the questions arise whether the relative order of the calculated surface energies depends on the chosen calculation method, and whether there is any merit at all in employing the standard approach. The present work investigates these questions with hematite as a benchmark material system. The simulations show that, for the surface facets and slab thicknesses studied here, the relative order of the surface energies is unaffected by the chosen calculation method. A regime is found where the three methods are in reasonably good agreement with respect to the obtained surface energies. Finally, a procedure is put forward to extract meaningful surface energy values from the standard approach.

The More You Know: Trust Dynamics and Calibration in Highly Automated Driving and the Effects of Take-Overs, System Malfunction, and System Transparency.

OBJECTIVE: This paper presents a theoretical model and two simulator studies on the psychological processes during early trust calibration in automated vehicles. BACKGROUND: The positive outcomes of automation can only reach their full potential if a calibrated level of trust is achieved. In this process, information on system capabilities and limitations plays a crucial role. METHOD: In two simulator experiments, trust was repeatedly measured during an automated drive. In Study 1, all participants in a two-group experiment experienced a system-initiated take-over, and the occurrence of a system malfunction was manipulated. In Study 2 in a 2 × 2 between-subject design, system transparency was manipulated as an additional factor. RESULTS: Trust was found to increase during the first interactions progressively. In Study 1, take-overs led to a temporary decrease in trust, as did malfunctions in both studies. Interestingly, trust was reestablished in the course of interaction for take-overs and malfunctions. In Study 2, the high transparency condition did not show a temporary decline in trust after a malfunction. CONCLUSION: Trust is calibrated along provided information prior to and during the initial drive with an automated vehicle. The experience of take-overs and malfunctions leads to a temporary decline in trust that was recovered in the course of error-free interaction. The temporary decrease can be prevented by providing transparent information prior to system interaction. APPLICATION: Transparency, also about potential limitations of the system, plays an important role in this process and should be considered in the design of tutorials and human-machine interaction (HMI) concepts of automated vehicles.

Convergence of surface energy calculations for various methods: (0 0 1) hematite as benchmark.

Different methods for calculating the surface energy from ab initio simulations are applied to the relaxed (0 0 1) surface of the metal oxide hematite ([Formula: see text]-Fe2O3). The simulations are carried out with a rather moderate k-point grid with shrinking factors of (6 6 6) for all bulk and (6 6) for all slab simulations. Very good convergence is obtained if a linear fit of the slab energies with respect to the number of layers in the slab is performed. In comparison to the other methods employed, this procedure is ultimately the most accurate and reliable method for extracting convergent surface energies from (0 0 1) hematite slabs. Additionally, we propose a way to determine the least possible starting point for calculating the surface energy by the linear-fit method. Furthermore, we find the Boettger method to perform nearly equally well, if the bulk energy is extracted from the energy difference per layer between the slabs with 12 and 18 layers thickness. Both methods give a surface energy of 2.43 J m-2 with a deviation of less than [Formula: see text]0.005 J m-2. The standard approach, which uses a separate bulk simulation, instead shows a significant linear divergence with increasing number of layers in the slab. We also carried out bulk simulations with a surface-oriented bulk unit cell, but found it in our case not to improve the convergence of the standard approach.

Mechanochemistry-assisted hydrolysis of softwood over stable sulfonated carbon catalysts in a semi-batch process.

The hydrolysis of lignocellulose is the first step in saccharide based bio-refining. The recovery of homogeneous acid catalysts imposes great challenges to the feasibility of conventional hydrolysis processes. Herein, we report a strategy to overcome these limitations by using stable sulfonated carbons as solid acid catalysts in a two-step process, composed of mechanocatalytic pretreatment and secondary hydrolysis in a semi-batch reactor. Without mechanocatalytic pre-treatment the hydrolysis of the insoluble substrate largely occurs through homogeneously catalyzed reactions. Ball-milling induced amorphization promotes a substantially higher substrate reactivity, because homogeneous hydrolysis occurs preferentially from less ordered structural domains in cellulose. In contrast, concerted ball-milling (CBM) of cellulose with the sulfonated carbon promotes a heterogeneously catalyzed hydrolysis to soluble oligosaccharides. By performing an in-depth physicochemical characterization of cellulose subjected to CBM treatment with different carbons, we reveal the crucial role of strong Brønsted acid sites in facilitating mechanocatalytic depolymerization. Recyclability experiments confirmed that despite being subject to profound structural changes during repeated pre-treatment/semi-batch hydrolysis cycles, the sulfonated carbon retained its catalytic activity. The combination of mechanocatalytic pretreatment with strong solid acids and hydrolysis in the semi-batch reactor was successfully extrapolated for the first time to the hydrolysis of real lignocellulose to achieve quantitative yields in C5 and high yields in C6 derived products.

Scared to Trust? - Predicting Trust in Highly Automated Driving by Depressiveness, Negative Self-Evaluations and State Anxiety.

The advantages of automated driving can only come fully into play if these systems are used in an appropriate way, which means that they are neither used in situations they are not designed for (misuse) nor used in a too restricted manner (disuse). Trust in automation has been found to be an essential psychological basis for appropriate interaction with automated systems. Well-balanced system use requires a calibrated level of trust in correspondence with the actual ability of an automated system. As for these far-reaching implications of trust for safe and efficient system use, the psychological processes, in which trust is dynamically calibrated prior and during the use of automated technology, need to be understood. At this point, only a restricted body of research investigated the role of personality and emotional states for the formation of trust in automated systems. In this research, the role of the personality variables depressiveness, self-efficacy, self-esteem, and locus of control for the experience of anxiety before the first experience with a highly automated driving system were investigated. Additionally, the relationship of the investigated personality variables and anxiety to subsequent formation of trust in automation was investigated. In a driving simulator study, personality variables and anxiety were measured before the interaction with an automated system. Trust in the system was measured after participants drove with the system for a while. Trust in the system was significantly predicted by state anxiety and the personality characteristics self-esteem and self-efficacy. The relationships of self-esteem and self-efficacy were mediated by state anxiety as supported by significant specific indirect effects. While for depression the direct relationship with trust in automation was not found to be significant, an indirect effect through the experience of anxiety was supported. Locus of control did not show a significant association to trust in automation. The reported findings support the importance of considering individual differences in negative self-evaluations and anxiety when being introduced to a new automated system for individual differences in trust in automation. Implications for future research as well as implications for the design of automated technology in general and automated driving systems are discussed.

Deactivation and Regeneration of Sulfonated Carbon Catalysts in Hydrothermal Reaction Environments.

The deactivation pathways of sulfonated carbon catalysts prepared from different carbons were studied during the aqueous-phase hydrolysis of cellobiose under continuous-flow conditions. The sulfonation of carbon materials with a low degree of graphitization introduced sulfonic acid groups that are partially stable even during prolonged exposure to harsh hydrothermal treatment conditions (180 °C). The physicochemical characterization of hydrothermally treated materials coupled with the treatment of model compounds for sulfonic acids demonstrated that the stability is related to the presence of activating and deactivating substituents on the aromatic system. Besides sulfonic acid group leaching, a hitherto unknown mode of deactivation was identified that proceeds by the ion exchange of cations contained in the aqueous feed and protons of the sulfonic acid groups. Proton leaching is a fully reversible mode of deactivation by the treatment of the spent catalysts with strong Brønsted acids. Through a combined approach of physicochemical characterization, catalytic testing, and hydrothermal treatment, a methodology for the preparation of catalytically stable carbon materials that bear sulfonic acid groups was established.

Parameterization of hyperpolarized (13)C-bicarbonate-dissolution dynamic nuclear polarization.

OBJECTIVE: (13)C metabolic MRI using hyperpolarized (13)C-bicarbonate enables preclinical detection of pH. To improve signal-to-noise ratio, experimental procedures were refined, and the influence of pH, buffer capacity, temperature, and field strength were investigated. MATERIALS AND METHODS: Bicarbonate preparation was investigated. Bicarbonate was prepared and applied in spectroscopy at 1, 3, 14 T using pure dissolution, culture medium, and MCF-7 cell spheroids. Healthy rats were imaged by spectral-spatial spiral acquisition for spatial and temporal bicarbonate distribution, pH mapping, and signal decay analysis. RESULTS: An optimized preparation technique for maximum solubility of 6 mol/L and polarization levels of 19-21% is presented; T1 and SNR dependency on field strength, buffer capacity, and pH was investigated. pH mapping in vivo is demonstrated. CONCLUSION: An optimized bicarbonate preparation and experimental procedure provided improved T1 and SNR values, allowing in vitro and in vivo applications.

Quantified pH imaging with hyperpolarized (13) C-bicarbonate.

PURPOSE: Because pH plays a crucial role in several diseases, it is desirable to measure pH in vivo noninvasively and in a spatially localized manner. Spatial maps of pH were quantified in vitro, with a focus on method-based errors, and applied in vivo. METHODS: In vitro and in vivo (13) C mapping were performed for various flip angles for bicarbonate (BiC) and CO2 with spectral-spatial excitation and spiral readout in healthy Lewis rats in five slices. Acute subcutaneous sterile inflammation was induced with Concanavalin A in the right leg of Buffalo rats. pH and proton images were measured 2 h after induction. RESULTS: After optimizing the signal to noise ratio of the hyperpolarized (13) C-bicarbonate, error estimation of the spectral-spatial excited spectrum reveals that the method covers the biologically relevant pH range of 6 to 8 with low pH error (< 0.2). Quantification of pH maps shows negligible impact of the residual bicarbonate signal. pH maps reflect the induction of acute metabolic alkalosis. Inflamed, infected regions exhibit lower pH. CONCLUSION: Hyperpolarized (13) C-bicarbonate pH mapping was shown to be sensitive in the biologically relevant pH range. The mapping of pH was applied to healthy in vivo organs and interpreted within inflammation and acute metabolic alkalosis models.

Winning the game: brain processes in expert, young elite and amateur table tennis players.

THIS STUDY TESTED TWO HYPOTHESES: (1) compared with amateurs and young elite, expert table tennis players are characterized by enhanced cortical activation in the motor and fronto-parietal cortex during motor imagery in response to table tennis videos; (2) in elite athletes, world rank points are associated with stronger cortical activation. To this aim, electroencephalographic data were recorded in 14 expert, 15 amateur and 15 young elite right-handed table tennis players. All subjects watched videos of a serve and imagined themselves responding with a specific table tennis stroke. With reference to a baseline period, power decrease/increase of the sensorimotor rhythm (SMR) during the pretask- and task period indexed the cortical activation/deactivation (event-related desynchronization/synchronization, ERD/ERS). Regarding hypothesis (1), 8-10 Hz SMR ERD was stronger in elite athletes than in amateurs with an intermediate ERD in young elite athletes in the motor cortex. Regarding hypothesis (2), there was no correlation between ERD/ERS in the motor cortex and world rank points in elite experts, but a weaker ERD in the fronto-parietal cortex was associated with higher world rank points. These results suggest that motor skill in table tennis is associated with focused excitability of the motor cortex during reaction, movement planning and execution with high attentional demands. Among elite experts, less activation of the fronto-parietal attention network may be necessary to become a world champion.

Catalytic transfer hydrogenation/hydrogenolysis for reductive upgrading of furfural and 5-(hydroxymethyl)furfural.

The sequential transfer hydrogenation/hydrogenolysis of furfural and 5-hydroxymethylfurfural to 2-methylfuran and 2,5-dimethylfuran was studied over in situ reduced, Fe2 O3 -supported Cu, Ni, and Pd catalysts, with 2-propanol as hydrogen donor. The remarkable activity of Pd/Fe2 O3 in both transfer hydrogenation/hydrogenolysis is attributed to a strong metal-support interaction. Selectivity towards hydrogenation, hydrogenolysis, decarbonylation, and ring-hydrogenation products is shown to strongly depend on the Pd loading. A significant enhancement in yield to 62%, of 2-methylfuran and 2-methyltetrahydrofuran was observed under continuous flow conditions.

Metal-free aerobic alcohol oxidation: intensification under three-phase flow conditions.

The selective oxidation of alcohols is a pivotal transformation within industrial and synthetic chemistry. In this contribution we use O2 as terminal oxidant and (H)NO(x) species as oxygen shuttle in order to mediate the oxidation of primary and secondary alcohols under the influence of a solid acid catalyst. Process optimization and intensification through the use of a continuous three-phase flow reactor is demonstrated. Space-time yields were found to increase by two orders of magnitude with respect to batch experiments, along with additional gains in selectivity and a decrease of N2O formation.

A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections.

OBJECTIVE: We evaluated 4 important outcomes associated with postoperative nosocomial infection: costs, mortality, excess length of stay, and utilization of healthcare resources. DESIGN: The outcomes for patients who underwent general, cardiothoracic, and neurosurgical operations were recorded during a previous clinical trial. Multivariable analyses including significant covariates were conducted to determine whether nosocomial infection significantly affected the outcomes. SETTING: A large tertiary care medical center and an affiliated Veterans Affairs Medical Center. PATIENTS: A total of 3,864 surgical patients. RESULTS: The overall nosocomial infection rate was 11.3%. Important covariates included age, Karnofsky score, McCabe and Jackson classification of the severity of underlying disease, National Nosocomial Infection Surveillance system risk index, and number of comorbidities. After accounting for covariates, nosocomial infection was associated with increased postoperative length of stay, increased costs, increased hospital readmission rate, and increased use of antimicrobial agents in the outpatient setting. Nosocomial infection was not associated independently with a significantly increased risk of death in this surgical population. CONCLUSION: Postoperative nosocomial infection was associated with increased costs of care and with increased utilization of medical resources. To accurately assess the effects of nosocomial infections, one must take into account important covariates. Surgeons seeking to decrease the cost of care and resource utilization must identify ways to decrease the rate of postoperative nosocomial infection.

Extent of services provided by pharmacists in the Iowa Medicaid Pharmaceutical Case Management program.

OBJECTIVE: To summarize the start-up experience with patients identified as eligible during the first four quarters of the Iowa Pharmaceutical Case Management (PCM) program and to characterize the extent of the services proved by pharmacists in the program. DESIGN: Prospective pharmaceutical care intervention project. SETTING: One hundred seventeen community pharmacies in Iowa. PATIENTS: Medicaid patients at high risk for drug-related problems based on using 4 or more nontopical medications and having 1 of 12 specific disease states. INTERVENTION: To become eligible to provide PCM services, licensed pharmacists had to undergo training and submit five care plans to the Iowa Department of Human Services. Community pharmacists were provided names of newly eligible patents each calendar quarter for 1 year. For each patient, pharmacists were asked to indicate by fax whether they had met with the patient, performed a written work-up of the patient, sent recommendations to the patient's physician, and whether the physician replied. When pharmacists were unable to provide the service, they were asked to state the reason. Both the pharmacist and the physician receive $75 for the initial assessment, with additional payments after each follow-up visit performed. MAIN OUTCOME MEASURES: An intensity score and the percentage of eligible patients for whom all steps were completed were calculated for each pharmacy. RESULTS: Fax survey results were retumed for 2,834 (96.7%) of the 2,931 patients eligible for PCM services. Pharmacists met with 943 (33.3%), worked up 763 (26.9%), sent recommendations to physicians for 500 (17.6%), and received replies from physicians for 327 (11.5%) patients. Pharmacists were unable to provide PCM services for 1,891 (66.7%) patients. The primary reasons given for this inability to provide services were patient access issues for 438 (23.2%) patients, pharmacy staffing or start-up issues for 419 (22.2%) patients, or no reason specified for 575 (30.4%) patients. A PCM intensity score was developed to represent the scope of services provided and the number of patients served. A higher intensity score indicated pharmacies that provided PCM to more patients and/or that offered higher levels of care (e.g., provided a written set of recommendations to the physician rather than simply assessing the patient without preparing or sending recommendations). Future evaluations will determine the validity of the score on the basis of patient outcomes. CONCLUSION: Some pharmacies implemented PCM services very effectively. However, 40% to 60% of the pharmacies provided little or no PCM services within 3 months of notification of patient eligibility. Future investigations will evaluate the quality of prescribing and quality of life for patients who received PCM services.

Hemorrhage after coronary artery bypass graft procedures.

OBJECTIVES: To identify risk factors for excessive bleeding after coronary artery bypass graft (CABG) procedures and to quantify the outcomes related to this complication. DESIGN: We conducted a case-control study to identify risk factors for hemorrhage following CABG surgery and a historical cohort study to quantify outcomes of hemorrhage. SETTING: The cardiothoracic surgery service of a university hospital. RESULTS: Factors associated with excessive blood loss were recent catheterization (odds ratio [OR] = 0.44; 95% confidence interval [CI95], 0.21 to 0.91); age older than 65 years (OR = 1.94; CI95, 0.96 to 3.93); bypass time of 150 minutes or more (OR = 2.91; CI95, 1.09 to 7.81); and postoperative platelet count of 160,000/mm3 or less (OR = 2.36; CI95, 1.06 to 5.22). The attributable cost of a postoperative hemorrhage was $3,866 (P = .0002) overall, $9,912 (P = .0001) for patients who required reoperation, and $3,316 (P = .03) for those treated medically. The median attributable postoperative length of stay was 1 day longer for cases than for controls (P = .011). Postoperatively, patients who hemorrhaged received significantly larger volumes of packed red blood cells (P < .0001), fresh frozen plasma (P < .0001), platelets (P < .0001), plasminate (P = .007), protamine sulfate (P < .0001), desmopressin acetate (P < .0001), and epsilon-aminocaproic acid (P < .0001) than did controls. CONCLUSIONS: Age, duration of bypass, and postoperative platelet count were associated with excessive bleeding. Hemorrhage after CABG surgery significantly increased the length of stay and cost of care.

Extent of services provided by pharmacists in the iowa medicaid pharmaceutical case management program.

OBJECTIVE To summarize the start-up experience with patients identified as eligible during the first four quarters of the Iowa Pharmaceutical Case Management (PCM) program and to characterize the extent of the services proved by pharmacists in the program. DESIGN Prospective pharmaceutical care intervention project. SETTING One hundred seventeen community pharmacies in Iowa. PATIENTS Medicaid patients at high risk for drug-related problems based on using 4 or more nontopical medications and having 1 of 12 specific disease states. INTERVENTION To become eligible to provide PCM services, licensed pharmacists had to undergo training and submit five care plans to the Iowa Department of Human Services. Community pharmacists were provided names of newly eligible patients each calendar quarter for 1 year. For each patient, pharmacists were asked to indicate by fax whether they had met with the patient, performed a written work-up of the patient, sent recommendations to the patient's physician, and whether the physician replied. When pharmacists were unable to provide the service, they were asked to state the reason. Both the pharmacist and the physician receive $75 for the initial assessment, with additional payments after each follow-up visit performed. MAIN OUTCOME MEASURES An intensity score and the percentage of eligible patients for whom all steps were completed were calculated for each pharmacy. RESULTS Fax survey results were returned for 2,834 (96.7%) of the 2,931 patients eligible for PCM services. Pharmacists met with 943 (33.3%), worked up 763 (26.9%), sent recommendations to physicians for 500 (17.6%), and received replies from physicians for 327 (11.5%) patients. Pharmacists were unable to provide PCM services for 1,891 (66.7%) patients. The primary reasons given for this inability to provide services were patient access issues for 438(23.2%) patients, pharmacy staffing or start-up issues for 419(22.2%) patients, or no reason specified for 575(30.4%) patients. A PCM intensity score was developed to represent the scope of services provided and the number of patients served. A higher intensity score indicated pharmacies that provided PCM to more patients and/or that offered higher levels of care (e.g., provided a written set of recommendations to the physician rather than simply assessing the patient without preparing or sending recommendations). Future evaluations will determine the validity of the score on the basis of patient outcomes. CONCLUSION Some pharmacies implemented PCM services very effectively. However, 40% to 60% of the pharmacies provided little or no PCM services within 3 months of notification of patient eligibility. Future investigations will evaluate the quality of prescribing and quality of life for patients who received PCM services.