Impacts of Lysinibacillus sphaericus on mosquito larval community composition and larval competition between Culex pipiens and Aedes albopictus.

Effectiveness of mosquito larvicide active ingredients (AI), such as Lysinibacillus sphaericus, varies between species, yet little is known regarding how differential effectiveness manifests in larval communities in applied settings. To examine how differential effectiveness of L. sphaericus influences larval community dynamics, we performed two experiments. We performed a field experiment in which containers were seeded with a standardized nutrient treatment, mosquitoes colonized the containers, and then containers received one of three L. sphaericus applications. We then performed competition assays between Culex pipiens and Aedes albopictus in low nutrient environments using multiple interspecific ratios and the presence/absence of a low dose of L. sphaericus. Field results demonstrated elimination of Culex spp. from treated containers while container breeding Aedes spp. proliferated across all treatments. Lysinibacillus sphaericus did not influence competition between Cx. pipiens and Ae. albopictus, and the L. sphaericus application eliminated Cx. pipiens in all treatment replicates while survival of Ae. albopictus was similar between treated and untreated containers across interspecific ratios. Lysinibacillus sphaericus is an effective AI for control of Culex spp. However, different AIs should be utilized in habitats containing non-Culex genera while a mix of AIs should be utilized where coexistence of multiple genera is expected or confirmed.

A new paradigm for teaching behavior change: implications for residency training in family medicine and psychiatry.

BACKGROUND: Primary care physicians (PCPs) provide ~50 % of all mental health services in the U.S. Given the widening gap between patient mental health needs and resources available to meet those needs, there is an increasing demand for family medicine and psychiatry trainees to master competencies in both behavioral medicine and primary care counseling during residency-if for no other reason than to accommodate the realities of medical practice given the oft present gap between the need for psychiatric services and the availability, quality, and/or affordability of specialized psychiatric care. To begin to address this gap, a skills-based, interactive curriculum based on motivational interviewing (MI) as a teaching method is presented. METHODS: The curriculum described in this paper is a four-week block rotation taught in the second year of residency. Motivational interviewing (MI) is used as a teaching approach toward the goal of clinical behavior change. Residents' strengths, personal choice and autonomy are emphasized. Each week of the rotation, there is a clinical topic and a set of specific skills for mastery. Residents are offered a "menu" of skills, role modeling, role/real play, practice with standardized patients (SP), and direct supervision in clinic. RESULTS: Thirty-nine residents have completed the curriculum. Based on residents' subjective reporting using pre-post scales (i.e., importance and confidence), all participants to date have reported substantial increases in confidence/self-efficacy using primary care counseling skills in their continuity clinic. CONCLUSIONS: This paper presents an innovative, empirically based model for teaching the essential skills necessary for physicians providing care for patients with mental/emotional health needs as well as health-behavior change concerns. Implications for training in the broader context, particularly as it relates to multi-disciplinary and collaborative models of teaching/training are discussed.

Religious coping and mental health outcomes: an exploratory study of socioeconomically disadvantaged patients.

OBJECTIVE: This study was designed to investigate the association between religious coping and mental health in a socioeconomically disadvantaged population. METHODS: Participants were selected as they presented for mental healthcare at a community health center for patients with little, if any, financial resources or insurance. A total of 123 patients participated in this study. Multiple regression analysis was used to identify religious coping predictors for mental health outcomes. RESULTS: Positive religious coping (PRC) was significantly associated with and predictive of better mental health (P < .01). Conversely, negative religious coping (NRC) was found to be significantly associated with poorer mental health scores (P = .031) with gender, income, and ethnicity controlled for in the model. The relationship between NRC and inferior mental health outcomes was more robust than the relationship between PRC and improved mental health scores. CONCLUSIONS: This study illustrates the important association between PRC and NRC and mental health outcomes among economically disadvantaged patients. Interpretation of these findings and clinical implications are offered.

Mind-body therapy: attitudes, beliefs and practices of graduate faculty and students from accredited marriage and family therapy programs in the U.S. and Canada.

CONTEXT: Interest in CAM and mind-body therapies (MBT) among mental health professionals has increased over the last decade. Individuals seeking treatment for mental health concerns often use MBTs and expect clinicians to be aware of such treatments. Yet, current data reveal a critical gap in training, practice, and the needs of those seeking treatment. OBJECTIVE: To determine the attitudes, beliefs, and practices of marriage and family therapists regarding MBTs. DESIGN: Electronic survey method using Likert-type scale questions. PARTICIPANTS: Clinical faculty members and graduate students (N = 140) from accredited Marriage and Family Therapy programs in the United States and Canada. RESULTS: Findings revealed that a majority of respondents believed that graduate programs should introduce MBT topics during course of training and that MBTs are valuable in the treatment of various clinical problems. Respondents were familiar with at least one form of MBT and reported using such in personal and professional settings.

The biopsychosocial milieu of type 2 diabetes: an exploratory study of the impact of social relationships on a chronic inflammatory disease.

OBJECTIVE: The aim of this study was to investigate the association between psychosocial variables, biomarker hemoglobin A1C (HbA1C), and immune modulatory cytokine mediators among diabetic patients in marital or committed long-term relationships. METHOD: This is a cross-sectional study of adult patients with Type 2 diabetes mellitus (T2DM) presenting at a university-based ambulatory medical clinic. Social/interpersonal constructs were assessed using measures of dyadic adjustment, interpersonal sensitivity and social functioning, and expressed emotion. HbA1c and cytokines were measured from blood samples using standard laboratory tests. Associations of relational systems constructs with biomarkers were assessed using bivariate tests. RESULTS: Dyadic adjustment was significantly associated with cytokine IL-8. Interpersonal relationship functioning was significantly associated with biomarker HbA1c, and cytokines TNF-alpha, and IL-1ra. Social functioning was significantly correlated with cytokines IL-17, IL-1ra, IL-2r, IL-6, and eotaxin. Depression was significantly correlated with HbA1C. CONCLUSIONS: Although preliminary in nature, findings revealed significant relationships between molecular mediators of the inflammatory and immune systems and variables measuring the relational context patients with T2DM. The initial findings suggest a next step in understanding and exploring the complex but important biopsychosocial pathways in Type 2 DM.

Outcomes of a Texas family medicine residency rural training track: 2000 through 2007.

Physician distribution nationally and in Texas trends away from rural toward more urban areas. Consequently, access to health care in rural areas is adversely affected. The University of Texas Medical Branch at Galveston (UTMB) Family Medicine Residency established a rural training track (RTT) in 2000 to combat this trend. This paper describes the graduate cohort to date, their practice locations, and strengths and limitations of the program as perceived by its participants. Data were collected from the UTMB Family Medicine Residency Alumni database and from focus group evaluations of the RTT conducted in 2004. Seven family medicine residents completed the RTT through 2007. Most graduates of the RTT (6 out of 7) entered practice in rural areas. Four of the 7 RTT graduates are Hispanic, reflecting the program's success in attracting underrepresented minority physicians.

Emotional processes following disclosure of an extramarital affair.

In-depth interviews with individuals who had experienced marital infidelity revealed a three-stage process following disclosure of an affair. The process starts with an "emotional roller coaster" and moves through a "moratorium" before efforts at trust building are recognized. Implications for the literature on forgiveness and the process of change in couples therapy are discussed as well as implications for future research and for practice.