Cumene Contamination in Groundwater: Observed Concentrations, Evaluation of Remediation by Sulfate Enhanced Bioremediation (SEB), and Public Health Issues.

Isopropylbenzene (cumene) is commonly encountered in groundwater at petroleum release sites due to its natural occurrence in crude oil and historical use as a fuel additive. The cumene concentrations detected at these sites often exceed regulatory guidelines or standards for states with stringent groundwater regulations. Recent laboratory analytical data collected at historical petroleum underground storage tank (UST) release sites have revealed that cumene persists at concentrations exceeding the default cleanup criterion, while other common petroleum constituents are below detection limits or low enough to allow natural attenuation as a remediation strategy.

Trends and Factors Associated With Physician Burnout at a Multispecialty Academic Faculty Practice Organization.

Importance: Physician burnout is common, and prevalence may differ throughout a clinician's career. Burnout has negative consequences for physician wellness, patient care, and the health care system. Identifying factors associated with burnout is critical in designing and implementing initiatives to reduce burnout.

Behavioral Health Factors as Predictors of Emergency Department Use in the High-Risk, High-Cost Medicare Population.

Objective: This study measured the presence, extent, and type of behavioral health factors in a high-cost Medicare population and their association with the probability and intensity of emergency department (ED) use.

Methods: Retrospective claims analysis and a comprehensive electronic medical record-based review were conducted for patients enrolled in a 65-month prospective care management program at an academic tertiary medical center (N=3,620). A two-part model used multivariable logistic regression to evaluate the effect of behavioral health factors on the probability of ED use, complemented by a Poisson model to measure the number of ED visits.

National Sleep Foundation's updated sleep duration recommendations: final report.

Objective: To make scientifically sound and practical recommendations for daily sleep duration across the life span.

Methods: The National Sleep Foundation convened a multidisciplinary expert panel (Panel) with broad representation from leading stakeholder organizations. The Panel evaluated the latest scientific evidence and participated in a formal consensus and voting process.

Attention Deficit/Hyperactivity Disorder and Sleep in Children.

Basic assumptions about ADHD in children and sleep are not supported by research. It is unclear that children with hyperactivity or inattention have disrupted sleep. Parents of children with ADHD consistently report more bedtime resistance, but there is no objective evidence that sleep is subsequently disrupted.

National Sleep Foundation's sleep time duration recommendations: methodology and results summary.

Objective: The objective was to conduct a scientifically rigorous update to the National Sleep Foundation's sleep duration recommendations.

Methods: The National Sleep Foundation convened an 18-member multidisciplinary expert panel, representing 12 stakeholder organizations, to evaluate scientific literature concerning sleep duration recommendations. We determined expert recommendations for sufficient sleep durations across the lifespan using the RAND/UCLA Appropriateness Method.

Interprofessional differences in disposition decisions: results from a standardized web-based patient assessment.

Objective: This study examined differences in disposition decisions among mental health professionals using a standardized Web-based simulation.

Methods: Using a Web-based simulation that described, across users, the same complex psychiatric patient, credentialed clinicians in a psychiatry department conducted a violence risk assessment and selected a level of follow-up care.

Results: Of 410 clinicians who completed the simulation, 60% of psychiatrists were more likely than other types of clinicians to select higher levels of care (inpatient or emergency services) for the standardized virtual patient (odds ratio=2.

Simulation-based ongoing professional practice evaluation in psychiatry: a novel tool for performance assessment.

Background: Ongoing professional practice evaluation (OPPE) activities consist of a quantitative, competency-based evaluation of clinical performance. Hospitals must design assessments that measure clinical competencies, are scalable, and minimize impact on the clinician's daily routines. A psychiatry department at a large academic medical center designed and implemented an interactive Web-based psychiatric simulation focusing on violence risk assessment as a tool for a departmentwide OPPE.

Measuring outcomes in adult outpatient psychiatry.

Despite growing pressure for accountability, mental health professionals continue to debate the value of routinely measuring treatment outcomes. This paper sought to move the outcomes measurement debate forward by reviewing some of the current limitations in outcomes methodology and by providing initial strategies to address them. Using these strategies, we evaluated outcomes for a large diagnostically diverse group of adult outpatients receiving treatment as usual (TAU) within an academic medical centre.

Prevalence of lid wiper epitheliopathy in subjects with dry eye signs and symptoms.

Purpose: The purpose of this study was to investigate the prevalence of lid wiper epitheliopathy (LWE) in patients diagnosed with dry eye disease (DED).

Methods: Patients were recruited for two groups. Inclusion criteria for the DED group (n = 50) was: a score greater than 10 with the Standard Patient Evaluation of Eye Dryness questionnaire, fluorescein break-up time 5 seconds or less, corneal and conjunctival staining with fluorescein, lissamine green Grade 1 or greater (scale 0-3), and Schirmer test with anesthesia 5 mm or less.

Secondary nocturnal enuresis caused by central sleep apnea from Chiari malformation type 1.

Objective: To report a novel cause of nocturnal enuresis (NE) and highlight the literature giving insight into this novel mechanism.

Patient: A 12-year-old morbidly obese female with 2-year history of nightly secondary monosymptomatic NE.

Results: On evaluation, a history of severe sleep disturbed breathing was elicited.

Teaching the teachers: a model course for psychodynamic psychotherapy supervisors.

Objective: There are no standard training programs for teaching psychotherapy supervisors effective, ethical, and legal aspects of supervision. This article describes an eight session training course containing essential information for supervisors.

Methods: The literature on psychotherapy supervision was reviewed and an evening seminar series was offered to veteran supervisor.

An evaluation of the efficacy of fluorescein, rose bengal, lissamine green, and a new dye mixture for ocular surface staining.

Purpose: Sodium fluorescein is considered the premier dye for corneal staining and, similarly, rose bengal (RB) for conjunctival staining. A mixture of 1% fluorescein and 1% rose bengal has been reported as advantageous in daily practice. Mixtures of lissamine green with other ocular stains have not been reported.

Warm compress induced visual degradation and Fischer-Schweitzer polygonal reflex.

Purpose: To document adverse visual effects of warm compress therapy and determine potential etiologies in subjects with dry eye symptoms.

Methods: Subjects (n = 24) with dry eye symptoms were recruited. Group 1 (n = 13): baseline measurements for each eye included subjective blur, visual acuity (VA), autorefraction (AR), corneal topography (CT), central corneal curvature (CCC), lipid layer thickness (LLT), and evaluation for corneal striae and edema.

The effect of two novel lubricant eye drops on tear film lipid layer thickness in subjects with dry eye symptoms.

Purpose: Because the lipid layer of the tear film is recognized as a critical component in dry eye disease, this study was designed to determine if a single eye drop of either Soothe or Systane produces a significant increase in lipid layer thickness (LLT) for subjects reporting symptoms indicative of dry eyes.

Methods: A double-blind, internally paired study was performed. A custom-built lipid layer interferometer, enabling characterization of lipid layer interference patterns, was used to quantify baseline LLT (OU) of eligible subjects.