Exploring Clinician Perceptions of a Veteran Peer Support Intervention to Inform Implementation

poster abstractIntroduction Chronic pain affects a large number of veterans and negatively impacts their quality of life. To address chronic pain, peer support models have been utilized and show promising results. ECLIPSE (Evaluation of a Coach--‐Led Intervention to Improve Pain Symptoms) is focused on a peer support intervention that involves peer delivery of pain self--‐management strategies for veterans dealing with chronic musculoskeletal pain. This intervention aims to positively impact overall pain levels, as well as self--‐efficacy, social support, pain coping, patient activation, health--‐related quality of life, and health service utilization. The current study serves the pre--‐implementation aim of ECLIPSE; the purpose of this study was to explore clinician perceptions regarding ECLIPSE to inform implementation into VA clinics. Methods This study utilized a qualitative approach to interview clinicians at a single US VA Medical Center. A research assistant conducted individual, in--‐person, semi--‐structured interviews with clinicians, which fulfills the third aim of a larger research project. Analysis consisted of developing descriptive coding and themes emerged through the evaluation of coded segments. Results Preliminary results for n=9 (second round of interviews to be completed in the summer) have revealed 4 themes. Clinicians: i) have an overall positive view of this type of intervention; ii) believe peer coaches should be properly selected and supported; iii) have valuable feedback on aspects of implementing and maintaining this type of intervention within clinics; and iv) have considerations for maximizing intervention utility. Conclusions Interventions that involve peer coaching may be incredibly beneficial for those suffering with chronic pain. However, to determine the ease of implementation of these types of interventions into clinic settings, understanding clinician viewpoints is a necessary aspect to ensure success. Feedback collected in this study can also facilitate implementation on a broader scale, allowing more veterans to benefit from this peer support intervention

Therapeutic Massage Combined with Mirror Therapy for Phantom Limb Pain: Two Experimental Cases

poster abstractPhantom limb pain (PLP) is a common and difficult to treat issue for individuals with amputations. Current PLP treatments (primarily pharmaceutical) are only modestly effective and often have negative side-effects. Massage has been self-reported as beneficial for PLP but no research has examined massage specifically for PLP. Mirror therapy’s evidence base for PLP is building. Combining massage (which alone may impact PLP via Pfleger’s law of symmetry) with mirror therapy may allow practitioners to apply massage for a painful area that cannot actually be touched. The current quasi-experimental A-B-A withdrawal case series sought to descriptively examine outcomes of therapeutic massage combined with mirror therapy (TMwMT) for individuals with persistent lower limb PLP and establish feasibility of intervention delivery. Each study phase was four weeks long with bi-weekly, individualized 20-25 minute TMwMT sessions during the treatment (B) phase. TMwMT sessions were developed and applied to address the specific participant PLP experience as if the pain were experienced by the intact limb. During masked TMwMT sessions, participants viewed a real-time mirror image of their intact leg receiving massage in the place of their missing limb. Measures: bi-weekly PLP severity via VAS; PLP intensity and interference collected at beginning/end of each phase via Brief Pain Inventory. Two men completed the study protocol. PLP severity decreased during treatment for both participants with effects beginning to diminish by week two of the withdrawal phase. By the study’s conclusion, PLP severity had not elevated back to average levels of initial phase A. Pain intensity for both participants improved during phase B but results were mixed for pain interference. These individuals had not responded to previous treatments for their PLP; our experimental, non-pharmacological and targeted TMwMT treatment was beneficial in the short-term. Our intervention is theoretically sound, reflects aspects of real-world massage delivery, and needs further investigation

Allocating the Burdens of Climate Action: Consumption-Based Carbon Accounting and the Polluter-Pays Principle

Action must be taken to combat climate change. Yet, how the costs of climate action should be allocated among states remains a question. One popular answer—the polluter-pays principle (PPP)—stipulates that those responsible for causing the problem should pay to address it. While intuitively plausible, the PPP has been subjected to withering criticism in recent years. It is timely, following the Paris Agreement, to develop a new version: one that does not focus on historical production-based emissions but rather allocates climate burdens in proportion to each state’s annual consumption-based emissions. This change in carbon accounting results in a fairer and more environmentally effective principle for distributing climate duties

Microwave and Millimeter Wave Techniques

Contains reports on four research projects.Joint Services Electronics Program (Contract DAAB07-74-C-0630)National Science Foundation (Grant MPS-73-05043-A01

Chemical Beam Epitaxy of Compound Semiconductors

Contains reports on three research projects and a list of publications.3M Company Faculty Development GrantAT&T Research Foundation Special Purpose GrantCharles S. Draper Laboratories Contract DL-H-418484Defense Advanced Research Projects Agency Subcontract 216-25013Defense Advanced Research Projects Agency Subcontract 542383Joint Services Electronics Program Contract DAAL03-89-C-0001Joint Services Electronics Program Contract DAAL03-92-C-0001National Science Foundation Grant ECS 88-46919National Science Foundation Grant ECS 89-05909Defense Advanced Research Projects Agency Subcontract 5300716-07U.S. Navy - Office of Naval Research Contract N00014-88-K-0564Defense Advanced Research Projects Agency Subcontract 530-0716-07National Science Foundation Subcontract DMR 90-0789

Human rights education in Japan: An historical account, characteristics and suggestions for a better-balanced approach

Although human rights are often expressed as universal tenets, the concept was conceived in a particular socio-political and historical context. Conceptualisations and practice of human rights vary across societies, and face numerous challenges. After providing an historical account of the conceptualisation of human rights in Japanese society, this paper examines human rights education in Japan, focusing on implementation of the United Nations Decade for Human Rights Education. Whilst the Decade’s Action Plan advocates a comprehensive approach, Japanese human rights education focuses far less attention on imparting knowledge and developing learners’ attitudes, placing strong emphasis on aspects of responsibility and harmonious human relations understood in the historical context of Japanese moral education. Pedagogical proposals are made to promote a comprehensive approach, including focus on the role of empowering learners, enabling them to protect themselves by invoking human rights

Disappearance of plasmaspheric hiss following interplanetary shock

Abstract Plasmaspheric hiss is one of the important plasma waves controlling radiation belt dynamics. Its spatiotemporal distribution and generation mechanism are presently the object of active research. We here give the first report on the shock-induced disappearance of plasmaspheric hiss observed by the Van Allen Probes on 8 October 2013. This special event exhibits the dramatic variability of plasmaspheric hiss and provides a good opportunity to test its generation mechanisms. The origination of plasmaspheric hiss from plasmatrough chorus is suggested to be an appropriate prerequisite to explain this event. The shock increased the suprathermal electron fluxes, and then the enhanced Landau damping promptly prevented chorus waves from entering the plasmasphere. Subsequently, the shrinking magnetopause removed the source electrons for chorus, contributing significantly to the several-hours-long disappearance of plasmaspheric hiss

Which executive functioning deficits are associated with AD/HD, ODD/CD and comorbid AD/HD+ODD/CD?

Item does not contain fulltextThis study investigated (1) whether attention deficit/hyperactivity disorder (AD/HD) is associated with executive functioning (EF) deficits while controlling for oppositional defiant disorder/conduct disorder (ODD/CD), (2) whether ODD/CD is associated with EF deficits while controlling for AD/HD, and (3)~whether a combination of AD/HD and ODD/CD is associated with EF deficits (and the possibility that there is no association between EF deficits and AD/HD or ODD/CD in isolation). Subjects were 99~children ages 6–12 years. Three putative domains of EF were investigated using well-validated tests: verbal fluency, working memory, and planning. Independent of ODD/CD, AD/HD was associated with deficits in planning and working memory, but not in verbal fluency. Only teacher rated AD/HD, but not parent rated AD/HD, significantly contributed to the prediction of EF task performance. No EF deficits were associated with ODD/CD. The presence of comorbid AD/HD accounts for the EF deficits in children with comorbid AD/HD+ODD/CD. These results suggest that EF deficits are unique to AD/HD and support the model proposed by R. A. Barkley (1997).17 p

Human rights education in Japan: An historical account, characteristics and suggestions for a better-balanced approach

Although human rights are often expressed as universal tenets, the concept was conceived in a particular socio-political and historical context. Conceptualisations and practice of human rights vary across societies, and face numerous challenges. After providing an historical account of the conceptualisation of human rights in Japanese society, this paper examines human rights education in Japan, focusing on implementation of the United Nations Decade for Human Rights Education. Whilst the Decade’s Action Plan advocates a comprehensive approach, Japanese human rights education focuses far less attention on imparting knowledge and developing learners’ attitudes, placing strong emphasis on aspects of responsibility and harmonious human relations understood in the historical context of Japanese moral education. Pedagogical proposals are made to promote a comprehensive approach, including focus on the role of empowering learners, enabling them to protect themselves by invoking human rights

MeV magnetosheath ions energized at the bow shock

A causal relationship between midlatitude magnetosheath energetic ions and bow shock magnetic geometry was previously established for ion energy up to 200 keV e−1 for the May 4, 1998, storm event. This study demonstrates that magnetosheath ions with energies above 200 keV up to 1 MeV simply extend the ion spectrum to form a power law tail. Results of cross-correlation analysis suggest that these ions also come directly from the quasi-parallel bow shock, not the magnetosphere. This is confirmed by a comparison of energetic ion fluxes simultaneously measured in the magnetosheath and at the quasi-parallel bow shock when both regions are likely connected by the magnetic field lines. We suggest that ions are accelerated at the quasi-parallel bow shock to energies as high as 1 MeV and subsequently transported into the magnetosheath during this event