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Demografischer Wandel, Digitalisierung und Dekarbonisierung der Wirtschaft erfordern umfassende Reformen. Was kann Deutschland dabei von anderen Ländern lernen? Die Klima-Governance Dänemark zeichnet sich durch breite Beteiligung aller parlamentarischen und gesellschaftlichen Gruppen und eine starke Einbindung wissenschaftlicher Beratung und Evaluierung in den Gesetzgebungsprozess aus. Schweden ist bei der Bepreisung von Umweltexternalitäten frühzeitig mit gutem Beispiel vorangegangen; Norwegen bei Investitionen in Ladeinfrastruktur. Auch für Rentensparpläne, leicht erreichbare Weiterbildungsberatung und flexible, modulare Fortbildung lässt sich viel von anderen Ländern lernen, auch wenn Erfolgsbeispiele immer an den lokalen Kontext angepasst werden müssen.

Acoustic phonons play a special role in lattice heat transport, and confining these low-energy modes in low-dimensional materials may enable nontrivial transport phenomena. By applying lowest-order anharmonic perturbation theory to an atomistic model of a carbon nanotube, we investigate numerically and analytically the spectrum of three-phonon scattering channels in which at least one phonon is of low energy. Our calculations show that acoustic longitudinal (LA), flexural (FA), and twisting (TW) modes in nanotubes exhibit a distinct dissipative behavior in the long-wavelength limit, $|k|\ensuremath{\rightarrow}0$, which manifests itself in scattering rates that scale as ${\mathrm{\ensuremath{\Gamma}}}_{\mathrm{LA}}\ensuremath{\sim}{|k|}^{\ensuremath{-}1/2}, {\mathrm{\ensuremath{\Gamma}}}_{\mathrm{FA}}\ensuremath{\sim}{k}^{0}$, and ${\mathrm{\ensuremath{\Gamma}}}_{\mathrm{TW}}\ensuremath{\sim}{|k|}^{1/2}$. These scaling relations are a consequence of the harmonic lattice approximation and critically depend on the condition that tubes are free of mechanical strain. In this regard, we show that small amounts of tensile lattice strain $\ensuremath{\epsilon}$ reduce the strength of anharmonic scattering, resulting in strain-modulated rates that, in the long-wavelength limit, obey $\mathrm{\ensuremath{\Gamma}}\ensuremath{\sim}{\ensuremath{\epsilon}}^{r}{|k|}^{s}$ with $r\ensuremath{\le}0$ and $s\ensuremath{\ge}1$, irrespectively of acoustic mode polarization. Under the single-mode relaxation time approximation of the linearized Peierls-Boltzmann equation (PBE), the long-tube limit of lattice thermal conductivity in stress-free and stretched tube configurations can be unambiguously characterized. Going beyond relaxation time approximations, analytical results obtained in the present study may help to benchmark numerical routines which aim at deriving the thermal conductivity of nanotubes from an exact solution of the PBE.

In this paper, we address lattice heat transport in single-walled carbon nanotubes (CNTs) by a quantum mechanical calculation of three-phonon scattering rates in the framework of the Boltzmann transport equation (BTE) and classical molecular dynamics (MD) simulation. Under a consistent choice of an empirical, realistic atomic interaction potential, we compare the tube-length dependence of the lattice thermal conductivity (TC) at room temperature determined from an iterative solution of the BTE and from a nonequilibrium MD (NEMD) approach. Qualitatively similar trends are found in the limit of short tubes, where an extensive regime of ballistic heat transport prevailing in CNTs of lengths $L\ensuremath{\lesssim}1\phantom{\rule{0.28em}{0ex}}\ensuremath{\mu}\mathrm{m}$ is independently confirmed. In the limit of long tubes, the BTE approach suggests a saturation of TC with tube length, whereas direct NEMD simulations of tubes extending up to $L=10\phantom{\rule{0.28em}{0ex}}\ensuremath{\mu}\mathrm{m}$ are demonstrated to be insufficient to settle the question of whether a fully diffusive heat transport regime and an intrinsic value of TC exist for CNTs. Noting that acoustic phonon lifetimes lie at the heart of a saturation of TC with tube length as per the BTE framework, we complement the quantum mechanical prediction of acoustic phonon lifetimes with an analysis of phonon modes in the framework of equilibrium MD. A normal mode analysis with an emphasis on long-wavelength acoustic modes corroborates the BTE prediction that heat transport in CNTs in the long tube limit is governed by the low attenuation rates of longitudinal and twisting phonons.

Background: Most breakthrough pain (BTP) studies assess patients with advanced cancer or those receiving inpatient care. Studies in noncancer populations are limited to surveys of pain clinics and patients with other advanced diseases. To better understand BTP, data are needed from less selected populations.Aim: The aim of this study was to evaluate BTP in opioid-treated ambulatory patients with chronic cancer or noncancer pain treated in community practices.Methods: Primary care physicians or community-based oncologists recruited a convenience sample for a cross-sectional study of BTP at 17 sites in the United States. Physicians could not be pain specialists. Patients were eligible if they had any type of pain for ≥3 months and were receiving an opioid drug on a regular basis that controlled the pain. The patients responded to a structured interview comprising items that assessed the baseline pain and items that assessed BTP, if present.Results: In total, 355 patients were screened, 191 were eligible and 177 (93 percent) provided data for analysis. Seventy-eight patients had cancer pain and 99 had noncancer pain. Patients with cancer were older (mean ± SD age 61.3 ± 11.2 years vs 51.4 ± 13.6 years, p < 0.001), and patients without cancer had more neuropathic pain (21 vs 12 percent, p < 0.05) and a longer pain duration (median 3.5 vs 1 years, p < 0.001). BTP occurred in 33 percent with cancer and 48 percent with noncancer pain (p = 0.042). BTP did not vary by diagnosis, but neuropathic pain was more common in those with BTP (27 vs 10 percent, p < 0.001). In patients with and without cancer, the median daily number of episodes was 1, the median time to maximum pain was 1-2 minutes, and the median duration was 45-60 minutes. There were fewer BTP precipitants in the patients with cancer (46 vs 80 percent of pains, p < 0.05), and they had less predictable pain (p < 0.05).Conclusions: The prevalence of BTP among community-dwelling patients is lower than that found in prior studies of more selected populations. BTP is more prevalent among patients with noncancer pain than patients with cancer pain, and although there are many similarities, some differences may be relevant to treatment strategies.

A grand challenge in designing polymeric materials is to tune their properties by macromolecular engineering. In this context, one of the drawbacks that often limits broader applications under high temperature conditions is their poor thermal conductivity $\kappa$. Using molecular dynamics simulations, we establish a structure-property relationship in hydrogen bonded polymer blends for possible improvement of $\kappa$. For this purpose, we investigate two experimentally relevant hydrogen bonded systems -- one system consists of short poly({N}-acryloyl piperidine) (PAP) blended with longer chains of poly(acrylic acid) (PAA) and the second system is a mixture of PAA and short poly(acrylamide) (PAM) chains. Simulation results show that PAA-PAP blends are at the onset of phase separation over the full range of PAP monomer mole fraction $\phi_{PAP}$, which intensifies even more for $\phi_{PAP} > 0.3$. While PAA and PAP interact with preferential hydrogen bonding, phase separation is triggered by the dominant van der Waals attraction between the hydrophobic side groups of PAP. However, if PAP is replaced with PAM, which has a similar chemical structure as PAP without the hydrophobic side group, PAA-PAM blends show much improved solubility. Better solubility is due to the preferential hydrogen bonding between PAA and PAM. As a result, PAM oligomers act as cross-linking bridges between PAA chains resulting in a three dimensional highly cross-linked network. While $\kappa$ for PAA-PAP blends remain almost invariant with $\phi_{PAP}$, PAA-PAM systems show improved $\kappa$ with increasing PAM concentration and also with respect to PAA-PAP blends. Consistent with the theoretical prediction for the thermal transport of amorphous polymers, we show that $\kappa$ is proportional to the materials stiffness, i.e., the bulk modulus K and sound velocity v of PAA-PAM blends.

Markenliebe ist die intensivste Form der Markenbindung. Sie geht einher mit zahlreichen okonomisch positiven Verhaltenswirkungen. Zentrale Voraussetzung fur ein effektives Management von Markenliebe ist die valide Messung der Liebe zur Marke. Der Beitrag liefert einen Uberblick uber verschiedene Zugange zur zeitpunkt- und zeitraumbezogenen Messung von Markenliebe sowie zur Erfassung der unterschiedlichen Arten der Markenliebe. Basierend auf den Erkenntnissen zur Entstehung von Markenliebe werden die wichtigsten Management-Schritte zum Aufbau von Markenliebe abgeleitet.

Disability has traditionally been defined in biomedical terms and closely associated with objective physical impairment. More recent conceptualizations though, hold that a comprehensive evaluation of disability requires not only the assessment of objective physical impairment, but also an assessment of the psychosocial context in which the disability occurs. Some psychosocial risk factors, such as socioeconomic status, are objective in nature. In contrast, other psychosocial risk factors, such as depression, are determined by the report of subjective states. To assess these subjective states, standardized psychological tests can play a valuable role. The defining characteristics of standardized psychological tests are discussed, as are their uses. Commonly used psychological tests are reviewed. Practical questions are also addressed, such as when to administer psychological tests, what psychosocial risk factors need to be assessed, what tests to use, methods of quantifying the level of psychosocial risk, and the detection of faking.

Background: Many chronic pain patients (CPPs) cannot be cured of their pain, but can learn to manage it. This has led to research on pain “acceptance” which is defined as a behavior pattern with awareness of pain but not directed at changing pain. Objective: CPPs who have accepted their pain generally acknowledge that a cure is unlikely. Time with pain may be necessary to reach such an acknowledgment. It was therefore hypothesized that fewer acute pain patients (APPs) than CPPs should affirm that a cure is unlikely and that other described aspects of acceptance such as denial of disability status should be associated with cure is unlikely in both APPs and CPPs. Study Design: APPs and CPPs were compared for frequency of endorsement of 2 items/questions with face validity for cure is unlikely: little hope of getting better from pain (LH) and physical problem (pain) can’t be cured (CBC). Demographic variables and variables reported associated with acceptance were utilized in logistic prediction models for the above items in APPs and CPPs. Setting: Rehabilitation programs/offices. Results: CPPs were statistically more likely than APPs to affirm both LH and CBC. In both APPs and CPPs, items reported associated with acceptance, e.g., denial of disability status, predicted LH and CBC. Limitations: Information gathered from CPP self-reports. Conclusions: APPs versus CPPs differ on their affirmation on acknowledgement that a cure is unlikely. Key Words: Acceptance, pain acceptance, chronic pain, acute pain, chronic pain patients, acute pain patients, Battery of Health Improvement (BHI 2), cure disability, illness uncertainty

Objectives Somatic/psychiatric symptoms are frequently found in chronic pain patients (CPPs). The objectives of this study were to determine 1) which somatic/psychiatric symptoms are more commonly found in acute pain patients (APPs) and CPPs vs community nonpatients without pain (CNPWPs) and 2) if somatic/psychiatric symptom prevalence differs between APPs and CPPs. Design The above groups were compared statistically for endorsement of 15 symptoms: fatigue, numbness/tingling, dizziness, difficulty opening/closing mouth, muscle weakness, difficulty staying asleep, depression, muscle tightness, nervousness, irritability, memory, falling, nausea, concentration, and headaches. Results After controlling for age, gender, and level of pain, APPs and CPPs had a statistically significantly greater prevalence (at a P

Pain is the most common reason why patients see a physician. Within the USA, it has been estimated that at least 116 million US adults suffer from chronic pain, with an estimated annual national economic cost of $560–635 billion. While pain is in part a sensory process, like sight, touch, or smell, pain is also in part an emotional experience, like depression, anxiety, or anger. Thus, chronic pain is arguably the quintessential biopsychosocial condition. Due to the overwhelming evidence of the biopsychosocial nature of pain and the value of psychological assessments, the majority of chronic pain guidelines recommend a psychological evaluation as an integral part of the diagnostic workup. One biopsychosocial inventory designed for the assessment of patients with chronic pain is the Battery for Health Improvement 2 (BHI 2). The BHI 2 is a standardized psychometric measure, with three validity measures, 16 clinical scales, and a multidimensional assessment of pain. This article will review how the BHI 2 was developed, BHI 2 concepts, validation research, and an overview of the description and interpretation of its scales. Like all measures, the BHI 2 has strengths and weaknesses of which the forensic psychologist should be aware, and particular purposes for which it is best suited. Guided by that knowledge, the BHI 2 can play a useful role in the forensic psychologist’s toolbox.

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level. Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain. Symptom cluster analyses were performed on 15 somatic and non-somatic symptoms for APPs and CPPs and for 2 CPP subgroups with moderate and severe pain. Setting: APPs and CPPs were from rehabilitation facilities located in 30 states in all geographical regions of the United States. Results: APPs had 4 symptom clusters and CPPs had 5. For CPPs, the clusters represented memory, neurological, behavioral, somatic, and autonomic problems. CPPs with moderate and severe pain had 3 and 4 symptom clusters, respectively, and differed in cluster symptom constitution. Limitations: Patients selected themselves for study inclusion and were paid for their participation. This could have affected random selection. Lastly, we used the current time definitions of acute pain versus chronic pain (90 days) to separate our patients into these groups. Currently, no consensus exists regarding the optimal time duration to divide acute from chronic. Conclusions: APPs and CPPs are characterized by symptom comorbidities that form clusters. In CPPs, cluster number and cluster symptom makeup are affected by pain level. This has implications for clinical practice and future research. Key words: Comorbidity, somatic symptoms, comorbid symptoms, chronic pain patients, acute pain patients, community patients without pain, clusters, symptom clusters

Objectives The belief in medical care entitlement has recently resulted in major changes in the medical system in the United States. The objectives of this study were the following: to compare endorsement of three medical entitlement beliefs (I deserve the best medical care no matter what the cost [BMC], I am entitled to all of the medical care I want at no charge [NC], I shouldn't have to wait to see my doctors [W]) in community nonpatients without pain (CNPWP), acute pain patients (APPs), and chronic pain patients (CPPs) and to develop predictor models for these beliefs in APPs and CPPs. Design CNPWP, APPs, and CPPs were compared statistically for frequency of endorsement of each belief. All available variables were utilized in logistic regression models to predict each belief in APPs and CPPs. Those affirming/nonaffirming each belief were compared by t-test for affirmation of narcissism, dependency, and antisocial practices on three scales from established inventories. Results CPPs were significantly more likely than APPs to endorse BMC. No other comparisons were significant. The logistic regression models identified variables that related to narcissism, anger, doctor dissatisfaction, depression, and anxiety, which entered the models for both APPs and CPPs for some beliefs. Those APPs and CPPs who affirmed the beliefs of NC and W were more likely than their counterparts to affirm antisocial practices, but not narcissism or dependency. Conclusions Patient medical entitlement beliefs may be related to some psychiatric/psychological issues.

OBJECTIVES: To further explore the controversy as to whether childhood molestation is associated with chronic pain in adulthood. DESIGN: Community nonpatients without pain (CNPWP), community patients with pain (CPWP), acute pain patients (APPs), and chronic pain patients (CPPs) were compared for endorsement of affirmation of childhood molestation by chi-square. Logistic regression was utilized to predict affirmation in male and female CPPs. RESULTS: A significantly higher percentage of male APPs affirmed molestation versus CNPWP and CPWP. No other comparisons were statistically significant for males. For females, no comparisons were significant. For male CPPs, the behavior health inventory-2 (BHI-2) survivor of violence scale and 1 item from this scale predicted affirmation. The following BHI-2 scales and items predicted affirmation for female CPPs: muscular bracing and survivor of violence scales; the item "I have been a victim of many sexual attacks"; and the item "My father was kind and loving to me when I was growing up" (scored opposite direction). CONCLUSIONS: In female PWCP, the prevalence of childhood molestation is not greater than in a number of unique comparison groups. Unique predictors of childhood molestation are yet to be identified. Language: en

Wie die Fallbeispiele zeigen, ist das, was Marke ausmacht, ihr Bild in den Kopfen der Menschen. Wie dieses Bild entsteht, ist ein hochst lebendiger und dynamischer Prozess. Starke Marken sind keine Leuchtturme, die ein einsames, unwirtliches Dasein fristen. Sie sind vielmehr wie Lagerfeuer, um die herum sich Menschen gesellen, um dabei ihre Geschichten und Erfahrungen auszutauschen. Marken sind Attraktionspunkt und Bestandteil einer Gemeinschaft, sie stiften Nutzen und Beziehungen. Marken sind also nicht nur eine betriebswirtschaftliche Grose, sondern auch ausdrucklich eine kulturelle Leistung. Alle, die sich heute ernsthaft mit Marken und Markenfuhrung beschaftigen, sind deshalb gleichzeitig Markenkulturschaffende. Das monokausale Markenmanagement fruherer Tage – hier die Deutungshoheit des Unternehmens als Sender, dort die glaubige Zielgruppe als Empfanger – hat ausgedient. An seine Stelle tritt die soziokulturelle Verhandlung, bei der sich Unternehmen, Marke, Konsumenten und Offentlichkeit gleichberechtigt begegnen. Der innovative Input des Markenhalters trifft dabei auf zunehmend emanzipierte, autarke Markenaneigner, die ihre eigenen Vorstellungen in die Marke einspeisen. So wird heute die Marke auf lange Sicht belebt und gestarkt. Aus ihrem Blickwinkel gewahren die Autoren der folgenden Beitrage, Einblicke in das Phanomen der Aneignung. Sie inspirieren und motivieren zu einem neuen Denken und einem neuen Umgang mit der Marke.

OBJECTIVES: There has been a significant amount of research performed on the relationship between the presence of chronic pain and all forms of suicidality. This study explored which rehabilitation acute pain patient (APP) and rehabilitation chronic pain patient (CPP) variables are predictive of six suicidality items: wanting to die because of pain; wanting to die because life is hard; history of wanting to die; history of suicide attempts; recent frequent suicide ideation; and having a suicidal plan. METHODS: The six suicide items were contained within the Battery for Health Improvement-Research Version (BHI-R) and were administered to a healthy community sample (n = 1478), community patients (n = 158), rehabilitation APPs (n = 326), rehabilitation CPPs (n = 341) and rehabilitation patients without pain (n = 110). RESULTS: Affirmation of the six items in APPs/CPPs ranged from 6.13% to 34.90%. Logistic regression predictor models for each item for APPs/CPPs were developed utilizing available variables from the BHI-R. Predictor variables differed between APPs and CPPs and between items. Most predictor variables had previously been delineated in non-pain behaviour studies (e.g., substance abuse). Some novel variables such as perseverance were also identified. Contrary to the behaviour suicide literature, no demographic variables (except employment) were predictive. Correct patient classification ranged from 87% to 95%, in most cases being better than the base rate prediction. DISCUSSION: Suicidality predictor variables were differentially distributed between APPs and CPPs and between different forms of suicidality. Some suicidality predictor variables appeared to be specific to pain patients.

Degenerately boron-doped vicinal Si(111) substrates were annealed at high temperatures to achieve complete saturation of the ‘dangling bonds’ by surface segregating boron atoms under reconstruction to the Si(111) (3×3)R30∘ phase. Different cooling procedures were applied to obtain well ordered superstructures. The surface morphology of the prepared substrates was studied by spot profile analysis of low energy electron diffraction (SPA-LEED). The splitting of the diffraction peaks into multiple satellites points to the formation of step bunches of different inclination (equivalent to different terrace widths) during the segregation process due to changes in the surface free energy. A model with step bunches consisting of steps with monoatomic or biatomic heights and large (111)-oriented terraces is developed to explain our results. Steep step bunches with short terraces and biatomic step heights are formed independently of the preparation process while flat step bunches with large terraces are dissolved with increasing annealing time.

Die Java Modeling Language (JML) wurde als Ansatz konzipiert, um das Spezifizieren von Software-Produkten einer breiteren Masse zuganglich zu machen. Die Sprache baut auf Java auf und wird in einer Vielzahl von Verifikationswerkzeugen eingesetzt. Im Gegensatz zu anderen Modellierungssprachen mangelt es JML jedoch weiterhin an einer fundierten formalen Referenzsemantik. In diesem Beitrag wird ein Schritt zu diesem Ziel unternommen, der ausschlieslich auf elementaren mathematischen Notationen beruht und unabhangig von der Semantikdefinition von Java selbst ist.

Objectives. 1) Determine and compare prevalence for homicide-suicide (H-S) affirmation in community non-patients (N = 478), community patients (N = 158), acute pain patients (APPs; N = 326), and chronic pain patients (CPPs; N = 341); and 2) Develop H-S predictor models in APPs and CPPs. Design. A large set of items containing the H-S item was administered to the above groups, who were compared statistically for H-S endorsement. APPs and CPPs affirming the H-S item were compared with those not affirming on all available variables including the Battery for Health Improvement (BHI 2) with significant variables (P ≤ 0.001) utilized in predictor models for H-S in APPs and CPPs. Setting. Community plus rehabilitation facilities. Results. The above population groups affirmed the H-S item according to the following percentages: healthy community 1.88%, community patients 3.16%, rehabilitation patients without pain 3.64%, rehabilitation AAPs 3.99%, and rehabilitation CPPs 4.40%. For both APPs and CPPs, the H-S item was significantly correlated with some suicidality items and some homicide items. The model for APPs identified "having a suicide plan" as being predictive of H-S affirmation. For CPPs, the items of having thoughts of revenge killing, being motivated to seek revenge without any verbal warning, and the Doctor Dissatisfaction Scale of the BHI 2 predicted H-S affirmation. The APPs model classified 96% of the APPs correctly, while the CPPs model classified 97% of the CPPs correctly. These predictor rates, however, were no better than the base rate. Conclusion. The prevalence of H-S affirmation within APPs and CPPs is not insignificant. The APPs predictor model points to a close association between H-S affirmation and suicidality. The CPPs model indicates that there is a close association between H-S affirmation, and anger/hostility and anger directed at physicians. These results, however, should not lead to the belief that CPPs are at greater risk for actual H-S completion for the following reasons: 1) H-S is an extremely rare event; and 2) predictive validity of the H-S item for actual H-S completion has not been determined. Language: en

There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down questions into searchable statements, and adapting statements to suit both the question being asked and the resource being searched. A number of free, evidence-based resources are listed. Knowing how and where to access this information will enable practitioners to more easily use an evidence-based approach to their practice.

Objectives: (1) Determine and compare prevalence of forms of anger (FOA; anger, hostility, aggression, anger-in, anger-out, chronic anger) in community nonpatients (n = 478), community patients (n = 158), acute pain patients (APPs; n = 326), chronic pain patients (CPPs; n = 341); and (2) develop FOA predictor models in APPs and CPPs. Design: A large set of items containing the FOA items was administered to the above groups, who were compared statistically for FOA endorsement. APPs and CPPs affirming the anger and chronic anger items were compared with those not affirming on all available variables including the Battery for Health Improvement (BHI-2) with significant variables (P ≤ 0.001) utilized in predictor models for anger and chronic anger in APPs and CPPs. Setting community plus rehabilitation facilities. Results: FOA affirmation ranged from 8.28% for chronic anger in nonpatients to 37.54% for anger in CPPs. Only CPPs were more likely to affirm anger (P ≤ 0.04) and chronic anger (P ≤ 0.01) at a significantly higher rate than community patients. In both APPs and CPPs, all FOA items except anger management-in were significantly correlated with other FOA items. For anger and chronic anger for CPPs and APPs, hostility was the strongest predictor. All models predicted anger and chronic anger significantly better than the base rate prediction. Conclusion: According to the results of this study anger and chronic anger are more frequently found in CPPs vs. community patients supporting the clinical perception that many CPPs are angry. As such,clinicians should actively screen CPPs for the presence of anger in order to engage these CPPs in anger management treatment.

The impact of scientific findings on medical, psychological, and legal concepts has led to the adoption of laws and regulations that do not easily fit into the established legal categories of medical law or mental health law. Instead, this convergence of forces has resulted in laws and regulations mandating biopsychosocial treatment guidelines, where both medical and psychological cares are integrated within the framework of a single paradigm. Laws and regulations of this type have been adopted by a number of US states and Canadian provinces, and could be considered to represent a new category, for which we offer the term “biopsychosocial law.” Biopsychosocial laws currently pertain to medical treatment guidelines for workers’ compensation, a medical treatment system noted for high costs, high levels of litigation, and psychological involvement. There are a number of examples of biopsychosocial laws, but the most noteworthy are based on guidelines developed by the Colorado Division of Workers’ Compensation, the American College of Occupational and Environmental Medicine, the Work Loss Data Institute, and The Reed Group. These guidelines differ significantly with regard to features, conditions covered, and strength of evidence basis. However, all of these guideline systems were developed with the intent of providing good care while controlling costs, are evidence based, integrate the practice of medicine and psychology, and are legally mandated in certain jurisdictions. Taken together, these guidelines represent a growing convergence of scientific evidence, professional society positions, payor policies, and legal regulations. These forces are propelling a broad societal shift away from Cartesian assumptions that the body and mind are separate, and toward a biopsychosocial paradigm for the treatment of injury and illness.

Objectives: The objectives of this article were the following: (1) determine risk for self-predicted future psychopharmacological nonadherence in rehabilitation acute pain patients (APPs) and rehabilitation chronic pain patients (CPPs) vs. pain-free community controls and community patients, and (2) determine which variables predict nonadherence. Design: The Battery for Health Improvement 2 was developed utilizing a healthy (pain-free) community sample (N = 1,478), a community patient sample (N = 158), and a rehabilitation patient sample (N = 777) of which 326 were APPs, 341 were CPPs, and 110 were patients without pain. These groups predicted their future psychopharmacological treatment adherence. Risk for nonadherence was calculated for each group utilizing the healthy community sample as the reference group. Nonadherent and adherent APPs and CPPs were compared statistically on variables of interest. Significant variables (P ≤ 0.01) were utilized in APPs' and CPPs' logistic regression models to predict nonadherence. Setting: The participants in this article were from a variety of settings. Results: Of APPs and CPPs, 10.74% and 10.85%, respectively, predicted that they would be nonadherent. Risk for nonadherence was greater in both groups vs. healthy nonpain community subjects and nonhealthy community patients. The predictors for APPs' nonadherence were general resistance to using medications and a tendency to forget physicians' suggestions. For CPPs, the predictors were general resistance to using medications, fear of dependence on prescription medications, and fighting with loved ones. The models classified 90% and 89% of APPs and CPPs (respectively) correctly. However, these were no better than the base rate. Conclusions: APPs and CPPs are at greater risk for self-predicted psychopharmacological nonadherence than healthy community subjects and community patients. We cannot as yet predict self-predicted psychopharmacological nonadherence at greater than the base rate. However, the identified variables could be clinically useful.

Objectives. Although there is limited research on patient attributes that may be related to reasons for launching a malpractice suit, no such research has been performed in acute pain patients (APPs) or chronic pain patients (CPPs). The objective of this study was then to develop some statistical models that would describe such patients’ attributes. Methods. A statement about having thoughts of suing a physician (sue medical doctor [MD]) is the focus of this study, and was contained within the Battery for Health Improvement (BHI) research version (BHI-R). The BHI-R was administered to 1,487 community subjects (1,329 healthy and 158 nonhealthy) and 777 patients in rehabilitation of whom 326 were APPs, 341 were CPPs, and 110 had no pain. In addition, descriptive data, such as whether the patient had an attorney for a worker's compensation claim, was collected. The sue MD Likert scale responses were dichotomized, and the relative risks for the sue MD wish were calculated for the aforementioned groups utilizing the healthy community group as the reference group. With APPs and CPPs, those patients responding alternatively affirmatively to the sue MD statement were compared with those patients responding negatively on all available categorical variables and BHI 2 scales via appropriate statistics. If a BHI 2 scale was statistically significant at P

Many chronic pain patients (CPPs) cannot be cured of their pain, but can learn to manage it. This has led to research on pain "acceptance" which is defined as a behavior pattern with awareness of pain but not directed at changing pain.CPPs who have accepted their pain generally acknowledge that a cure is unlikely. Time with pain may be necessary to reach such an acknowledgment. It was therefore hypothesized that fewer acute pain patients (APPs) than CPPs should affirm that a cure is unlikely and that other described aspects of acceptance such as denial of disability status should be associated with cure is unlikely in both APPs and CPPs.APPs and CPPs were compared for frequency of endorsement of 2 items/questions with face validity for cure is unlikely: little hope of getting better from pain (LH) and physical problem (pain) can't be cured (CBC). Demographic variables and variables reported associated with acceptance were utilized in logistic prediction models for the above items in APPs and CPPs.Rehabilitation programs/offices.CPPs were statistically more likely than APPs to affirm both LH and CBC. In both APPs and CPPs, items reported associated with acceptance, e.g., denial of disability status, predicted LH and CBC.Information gathered from CPP self-reports.APPs versus CPPs differ on their affirmation on acknowledgement that a cure is unlikely.

Several tools and approaches for proving noninterference properties for Java and other languages exist. Some of them have a high degree of automation or are even fully automatic, but overapproximate the actual information flow, and hence, may produce false positives. Other tools, such as those based on theorem proving, are precise, but may need interaction, and hence, analysis is time-consuming. In this paper, we propose a hybrid approach that aims at obtaining the best of both approaches: We want to use fully automatic analysis as much as possible and only at places in a program where, due to overapproximation, the automatic approaches fail, we resort to more precise, but interactive analysis, where the latter involves only the verification of specific functional properties in certain parts of the program, rather than checking more intricate noninterference properties for the whole program. To illustrate the hybrid approach, in a case study we use the hybrid approach–along with the fully automatic tool Joana for checking noninterference properties for Java programs and the theorem prover KeY for the verification of Java programs–and the CVJ framework proposed by Küsters, Truderung, and Graf to establish cryptographic privacy properties for a non-trivial Java program, namely an e-voting system. The CVJ framework allows one to establish cryptographic indistinguishability properties for Java programs by checking (standard) noninterference properties for such programs.

Research suggests that violence has entered the medical setting to a remarkable degree, causing medical professionals to be at the highest risk for becoming the victims of assaults and violent acts. This article reviews general theories of aggression and research on these theories, and uses them to assess risk factors in patients with chronic pain. There are data to suggest that pain may increase the risk of aggressiveness in some patients. However, it may decrease the risk in others paradoxically. The research available underscores the need for evaluating patients with pain for the risk of violent or aggressive behavior; specific recommendations are made in this regard.

Billing and coding is the means through which a clinical service gains economic value. Within the practice of pain medicine, knowledge of psychological billing methods is a matter of particular importance to anyone wishing to employ a psychologist or provide psychological services within a pain medicine practice, medical center, outpatient health services, or surgery center. Unfortunately, billing for psychological services is poorly understood Understanding of correct billing procedures allows psychologists to accurately code their services, as well as receive reimbursement. Health and behavior codes provide an opportunity for psychologists delivering primarily medically related services, including psychological pain treatment, to accurately code and receive reimbursement. Psychological testing is also an essential component for developing treatment plans, and appropriate coding and recording procedures of this service are also reviewed.

Psychological services are safe, effective and economical treatments for multitude of medical conditions. For a variety of contractual and procedural reasons though, when psychological services are performed within a medical setting, obtaining payer reimbursement is often problematic. Because of this, many settings make no attempt to seek reimbursement for these services. This is not a sustainable in the long run though, as it leaves the psychology profession with no economic value to the institution. However, an examination of medical business methods reveals a number of financially sustainable models for the practice of psychology.

Iron oxide monolayers are grown on Ag(0 0 1) via reactive molecular beam epitaxy (metal deposition in oxygen atmosphere). The monolayer shows FeO stoichiometry as concluded from x-ray photoemission spectra. Both low energy electron diffraction as well as scanning tunneling microscopy demonstrate that the FeO layer has a quasi-hexagonal (1 1 1) structure although deposited on a surface with square symmetry. Compared to bulk values, the FeO(1 1 1) monolayer is unidirectionally expanded by 3.4% in [Formula: see text] directions while bulk values are maintained in [Formula: see text] directions. In [Formula: see text] directions, this lattice mismatch between FeO(1 1 1) monolayer and Ag(0 0 1) causes a commensurate undulation of the FeO monolayer where 18 atomic rows of the FeO(1 1 1) monolayer match 17 atomic rows of the Ag(0 0 1) substrate. In [Formula: see text] directions, however, the FeO(1 1 1) monolayer has an incommensurate structure.

This paper contributes to the investigation of object-sensitive information flow properties for sequential Java, i.e., properties that take into account information leakage through objects, as opposed to primitive values. We present two improvements to a popular object-sensitive non-interference property. Both reduce the burden on analysis and monitoring tools. We present a formalization of this property in a program logic – JavaDL in our case – which allows using an existing tool without requiring program modification. The third contribution is a novel fine-grained specification methodology. In our approach, arbitrary JavaDL terms (read ‘side-effect-free Java expressions’) may be assigned a security level – in contrast to security labels being attached to fields and variables only.

We give an account on the authors' experience and results from the software verification competition held at the Formal Methods 2012 conference. Competitions like this are meant to provide a benchmark for verification systems. It consisted of three algorithms which the authors have implemented in Java, specified with the Java Modeling Language, and verified using the KeY system. Building on our solutions, we argue that verification systems which target implementations in real-world programming languages are required to have powerful capabilities for abstraction. Regarding the KeY tool, we explain features which, driven by the competition, have been freshly implemented to accommodate for these demands.

Objectives. To assess the relative frequency of violent ideation [VI] in physical rehabilitation and community samples, and to identify associated factors. Design. Analysis of variables from the Battery for Heath Improvement using MANOVA, ANOVA and χ2 analyses. Setting. Medical sites in 30 US states, and community sites in 16 US states, overall representing 36 US states. Participants. 527 physical rehabilitation patients suffering from both acute and chronic pain conditions, and 725 community members. Subjects from both groups were drawn from a larger pool of 2,262 subjects. Interventions. None. Outcome Measures. The Hostility scale and a VI critical item from the Battery for Heath Improvement (BHI). Results. The patient group reported significantly more violent ideation than did the community group. VI was also significantly associated with involvement in workers' compensation or personal injury insurance systems, work conditioning programs, the BHI Hostility scale, and a number of other psychosocial factors. Conclusions. Recent research supports the contention that there is a relationship between ideation, angry affect, aggressive behavior and delayed recovery. Thus the presence of VI in the patient should be a cause for concern, and has clear ramifications for those working in the clinical setting. Primary prevention should involve not only the identification of hostile patients at risk for VI and aggression, it should also involve identifying programs or systems where a higher incidence of VI is likely to be observed. As VI was found to be associated with a range of variables, including characterological disorders, mood and social conflict, a further evaluation of factors contributing to VI would be recommended prior to intervention.

Dynamic logic is an established instrument for program verification and for reasoning about the semantics of programs and programming languages. In this paper, we define an extension of dynamic logic, called Dynamic Trace Logic (DTL), which combines the expressiveness of program logics such as dynamic logic with that of temporal logic. And we present a sound and relatively complete sequent calculus for proving validity of DTL formulae. Due to its expressiveness, DTL can serve as a basis for proving functional and information-flow properties in concurrent programs, among other applications.

OBJECTIVES: The perception of being a burden or self-perceived burden (SPB) is associated with suicide ideation in chronic pain patients (CPPs). The objective of this study was to determine if SPB is associated with five types of suicidality (wish to die, active suicide ideation, presence of suicide plan, history of suicide attempts, and preference for death over being disabled) in CPPs and acute pain patients (APPs). METHODS: Affirmation of SPB was statistically compared between community nonpatients without pain (CNPWP), APPs, and CPPs. APPs and CPPs who had affirmed any of the five types of suicidality were compared statistically for affirmation of SPB. Hierarchical regression analysis was utilized to determine the significance of SPB in predicting each of the five types of suicidality in APPs and CPPs controlling for age, gender, race, education status, and two types of measures of depression (current depression and vegetative depression). RESULTS: APPs and CPPs were statistically more likely to affirm SPB than CNPWPs and CPPs were more likely than APPs to do so. There were no differences between APPs and CPPs in affirming SPB in APPs and CPPs who had affirmed any of the five types of suicidality. In CPPs, SPB predicted each type of suicidality in a significant fashion utilizing both types of depression measures. For APPs, SPB predicted each type of suicidality in a significant fashion except for history of suicide attempt controlling for vegetative depression. CONCLUSIONS: SPB is associated with the vast majority of different types of suicidality in APPs and CPPs. Language: en

There is strong evidence that the biopsychosocial model does not apply only to dysfunctional patients with chronic pain, but rather represents the inherent nature of pain. Research has determined that psychological tests are scientifically as valid and reliable as medical tests with regard to diagnostics and predicting a patient’s response to treatments for pain. As many payers and guidelines now require psychological evaluations prior to authorizing certain treatments for pain, pain clinics increasingly use some form of psychological assessment. While there are a large number of psychometric questionnaires used to assess patients with chronic pain, only a few have undergone the rigorous process required to become standardized tests, and these are reviewed. Both evidence and opinion are converging on a set of psychosocial variables that should be assessed when treating patients with chronic pain, and these can all be organized within a biopsychosocial “vortex” paradigm. A standardized method of psychological assessment can identify patients who are at low, moderate, and high risk, and this is illustrated with three case vignettes.

Purpose A noteworthy attempt at health care reform was the 1992 Colorado workers' compensation reform bill, which led to the creation of what has been called "biopsychosocial laws." These laws mandated the use of treatment guidelines for patients with injury or chronic pain, which advocated a biopsychosocial model of rehabilitation, and aspired to use a "best practice" approach to controlling costs. The purpose of this study was to examine the financial impact of this health care reform process, and to test the hypothesis that this approach can be an effective strategy to contain costs while providing good care. Research method This study utilized a dataset collected prospectively from 1992 to 2007 in 45 U.S. states for regulatory purposes. These data summarized the medical treatment and disability costs of 520,314 injured workers in Colorado, and an estimated 28.6 million injured workers nationally. As no other state passed a comparable bill, the Colorado worker compensation reform bill created a natural experiment, where a treatment group was created by legally enforceable medical treatment guidelines. Results In the 15 years following the implementation of the reform, the inflation of medical costs in Colorado workers' compensation was only one third that of the national average, saving an estimated $859 million on patients injured in 2007 alone. Conclusions Although there were confounding variables, and causality could not be determined, these data are consistent with the hypothesis that Colorado's 1992 legislative efforts to reform workers compensation law using the biopsychosocial model worked as intended to provide good care while controlling costs.

Hypothesis. Passive, active, and historical suicidality are associated with preference for death over disability. Design. Community nonpatients without pain, community patients with pain, and patients with acute and chronic pain were compared for endorsement of disability perception and preference for death over disability. Phi correlations and chi-square analyses were calculated between preference for death over disability and six suicidality items representing passive, active, and historical suicidality. Logistic regression was used to predict preference for death over disability in patients with acute and chronic pain. Results. For patients with acute and chronic pain, endorsement of preference for death over disability correlated significantly with all six suicidality items. The logistic regression models identified the following variables as predictors for preference for death over disability in patients with acute pain: the Behavior Health Inventory (BHI 2) family dysfunction scale, history of wanting to die, and disability perception. For patients with chronic pain, predictors were the BHI 2 Borderline scale, history of wanting to die, treated fairly by family item, frequent suicide ideation, people I trust turn on me item, and disability perception. Preference for death over disability was a statistically significant predictor in patients with chronic pain for disability perception, recent suicide ideation, having a suicidal plan, and a history of wanting to die but was not a significant predictor for any suicide items in patients with acute pain. Conclusion. Preference for death over disability is associated with passive and active suicide ideation and historical suicidality in patients with chronic pain.