Implementing interpersonal and social rhythm therapy for mood disorders across a continuum of care.

OBJECTIVE: Interpersonal and social rhythm therapy (IPSRT) is an evidence-based psychotherapy for mood disorders. The goal of this quality improvement initiative was to demonstrate feasibility of implementing IPSRT across the continuum of outpatient and inpatient care within an academic medical center. METHODS: A multidisciplinary work group was convened to implement IPSRT in outpatient (N=48), inpatient (N=602), and intensive outpatient (N=68) programs of an academic medical center. Quality improvement performance markers (including symptoms and group attendance rates) were collected. RESULTS: Institutional preference for group treatments required adaptation of IPSRT from an individual to group psychotherapy format. Iterative problem solving and protocol development resulted in models of group IPSRT appropriate for each level of care. Performance outcome markers were favorable, indicating feasibility of implementation. CONCLUSIONS: At a single, multisite, urban, academic medical center, IPSRT proved a feasible evidence-based psychotherapy for implementation across levels of care in routine practice.

Superoxide is a mediator of an altruistic aging program in Saccharomyces cerevisiae.

Aging is believed to be a nonadaptive process that escapes the force of natural selection. Here, we challenge this dogma by showing that yeast laboratory strains and strains isolated from grapes undergo an age- and pH-dependent death with features of mammalian programmed cell death (apoptosis). After 90-99% of the population dies, a small mutant subpopulation uses the nutrients released by dead cells to grow. This adaptive regrowth is inversely correlated with protection against superoxide toxicity and life span and is associated with elevated age-dependent release of nutrients and increased mutation frequency. Computational simulations confirm that premature aging together with a relatively high mutation frequency can result in a major advantage in adaptation to changing environments. These results suggest that under conditions that model natural environments, yeast organisms undergo an altruistic and premature aging and death program, mediated in part by superoxide. The role of similar pathways in the regulation of longevity in organisms ranging from yeast to mice raises the possibility that mammals may also undergo programmed aging.

Fiber glass and rock/slag wool exposure of professional and do-it-yourself installers.

The fiber glass (FG) and rock/slag wool (RSW) manufacturers have developed a Health and Safety Partnership Program (HSPP) with the participation and oversight of the Occupational Safety and Health Administration (OSHA). Among its many provisions the HSPP includes the continuing study of FG and RSW workplace concentrations in manufacturing facilities operated by FG/RSW producers and among their customers and end users. This analysis estimates the probable cumulative lifetime exposure (fiber-months/cubic centimeter [f-months/cc]) to those who install FG and RSW insulation in residential, commercial, and industrial buildings in Canada and the United States. Both professional and do-it-yourself (DIY) cohorts are studied and the estimated working lifetime exposures are compared with benchmark values derived from an analysis of the epidemiological studies of FG and RSW manufacturing cohorts. The key finding of this analysis is that both of these end-user cohorts are likely to have substantially lower cumulative lifetime exposures than the manufacturing cohorts. As the most recent updates of the epidemiological studies concluded that there was no significant increase in respiratory system cancer among the manufacturing cohorts, there is likely to be even less risk for the installer cohorts. This analysis also underscores the wisdom of stewardship activities in the HSPP, particularly those directed at measuring and controlling exposure.

A synthetic vitreous fiber (SVF) occupational exposure database: implementing the SVF Health and Safety Partnership Program.

The Health and Safety Partnership Program is a voluntary workplace safety program for workers involved in the manufacture, fabrication, installation, and removal of glass wool and mineral wool products. This article describes one element of this Partnership Program, the development of an occupational exposure database that characterizes exposures by fiber type, industry sector, product type, and job description. Approximately 6000 exposure samples are included in the database, most of which were collected over the past decade, making it the most extensive and recent exposure data set on record for glass wool and mineral wool. The development of this database, as well as the initial results for exposure measurements segmented by product type and/or job description, are described. The current database shows that most applications and uses of glass wool and mineral wool involve exposures below the voluntary 1 f/cc permissible exposure limit, although some specific product types and job descriptions involve average exposures approaching the 1 f/cc limit.

Pragmatic and linguistic constraints on message formulation: a cross-linguistic study of English and ASL.

This study provides a cross-linguistic replication, using American Sign Language (ASL), of the Brown and Dell (1987) finding that when relaying an action involving an instrument, English speakers are more likely to explicitly mention the instrument if it is atypically, rather than typically, used to accomplish that action. Subjects were 20 hearing-impaired users of English and 20 hearing-impaired users of ASL. Each subject read and retold, in either English or ASL, 20 short stories. Analyses of the stories revealed production decision differences between ASL and English, but no differences related to hearing status. In ASL, there is more explicitness, and importance seems to play a more pivotal role in instrument specification. The results are related to differences in the typology of English and ASL and are discussed with regard to second-language learning and translation.