Lower limb atherosclerotic disease causes various deteriorations of patients' health-related quality of life.

PubMed

Koivunen, Kirsi; Lukkarinen, Hannele

2006-12-01

Lower limb atherosclerotic disease (LLAD) is a worldwide health problem. Approximately 100,000 Finns have LLAD. Currently, a large number of health-related quality of life (HRQoL) studies are available, but we still have scant comprehensive information of HRQoL of patients with LLAD. The aim was to describe the HRQoL of women and men with LLAD in relation to the age- and sex-matched general population. In addition, the purpose was to study which demographic and relevant clinical and psychologic factors are connected with HRQoL of patients with LLAD. Patients with LLAD (N = 180, 62 women and 118 men) were recruited to participate in this study in the Clinic of Surgery, Oulu University Hospital, from 2001 to 2004. The control sample consisted of an age- and sex-matched general population (N = 2126; 1081 women and 1045 men). The HRQoL of the women and men with LLAD was evaluated using the Nottingham Health Profile (NHP) instrument, in relation to an age- and sex-matched general population (N = 2126) as well as demographic and relevant clinical and psychologic factors. The HRQoL of men was significantly (P < .05) poorer on all dimensions of the NHP instrument in the age groups 55 to 74 years. HRQoL was also clearly affected in the youngest age group of men on the dimensions of pain (P < .05) and mobility (P < .05) and further in the oldest age group on the dimension of energy (P < .05). The HRQoL of women with LLAD was only significantly poorer (P < .05) on the dimension of pain in the age group of 65 to 74 years than the HRQoL of age-matched Finnish women. The most emphasized relationships between poor HRQoL and the demographic, relevant clinical and psychologic factors were male sex, lack of exercise, retirement, a short painless walking distance, other atherosclerotic disease, poor subjective health status, problems with ability to cope at home, problems with the treatment of illness, and sex life. Male patients with LLAD had poorer HRQoL than the corresponding female patients on the dimensions of energy (P = .023), emotional reaction (P = .050), social isolation (P = .028), and NHP total score (P = .023). Those who did not exercise regularly had poorer HRQoL on the dimensions of energy (P = .005), pain (P = .049), emotional reaction (P = .007), social isolation (P = .001), and physical mobility (P = .028) than those who did exercise regularly. The HRQoL of middle-aged men was significantly poorer than that of controls. Male sex, retirement, asymptomatic walking distance, other atherosclerotic disease, lack of exercise, and feeling incapable of performing daily activities are important causes of impaired HRQoL. Health care professionals should pay extra attention to the development of rehabilitation programs aimed at preventing patients with LLAD from experiencing a myriad of problems.

Making the history of psychology clinically and philosophically relevant.

PubMed

Vande Kemp, Hendrika

2002-08-01

The author discusses ways to make the history of psychology course relevant for a clinical psychology doctoral program within a multidenominational Protestant theological seminary. She uses a personalist orientation to emphasize the need to integrate psychology, philosophy, and theology. She differentiates among the intrapersonal, interpersonal, impersonal, and transpersonal dimensions of experience. She illustrates the rich multidisciplinary historical roots of contemporary psychology by tracing the the history of the term psychology and examining its meanings in the existential psychology of Søren Kierkegaard and in the 19th-century novel. She includes brief histories of the "new psychology" and of the unconscious. She describes how she uses the field of psychotheological integration to illustrate principles of historiography and summarizes resources used to supplement traditional textbooks.

A review of cognitive conflicts research: a meta-analytic study of prevalence and relation to symptoms

PubMed Central

Montesano, Adrián; López-González, María Angeles; Saúl, Luis Angel; Feixas, Guillem

2015-01-01

Recent research has highlighted the role of implicative dilemmas in a variety of clinical conditions. These dilemmas are a type of cognitive conflict, in which different aspects of the self are countered in such a way that a desired change in a personal dimension (eg, symptom improvement) may be hindered by the need of personal coherence in another dimension. The aim of this study was to summarize, using a meta-analytical approach, the evidence relating to the presence and the level of this conflict, as well as its relationship with well-being, in various clinical samples. A systematic review using multiple electronic databases found that out of 37 articles assessed for eligibility, nine fulfilled the inclusion criteria for meta-analysis. Random effects model was applied when computing mean effect sizes and testing for heterogeneity level. Statistically significant associations were observed between the clinical status and the presence of dilemmas, as well as level of conflict across several clinical conditions. Likewise, the level of conflict was associated with symptom severity. Results highlighted the clinical relevance and the transdiagnostic nature of implicative dilemmas. PMID:26675503

Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations.

PubMed

Chen, Edith; Shalowitz, Madeleine U; Story, Rachel E; Ehrlich, Katherine B; Levine, Cynthia S; Hayen, Robin; Leigh, Adam K K; Miller, Gregory E

The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values < .05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (β's from |.21 to .22|, p values < .05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (β's from -.18 to -.19; p values < .05), and smaller proinflammatory cytokine responses (β = -.19; p < .05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (β's from -.18 to -.22; p values < .05). These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.

Selective attention to perceptual dimensions and switching between dimensions.

PubMed

Meiran, Nachshon; Dimov, Eduard; Ganel, Tzvi

2013-02-01

In the present experiments, the question being addressed was whether switching attention between perceptual dimensions and selective attention to dimensions are processes that compete over a common resource? Attention to perceptual dimensions is usually studied by requiring participants to ignore a never-relevant dimension. Selection failure (Garner's Interference, GI) is indicated by poorer performance in the filtering condition (when this dimension varies) as compared with baseline (when it is fixed). Switching between perceptual dimensions is usually studied with the task switching paradigm. In the present experiments, attention switching was manipulated by using single-task blocks and blocks in which participants switched between tasks or dimensions in reaction to task cues, and attention to dimensions was assessed by including a third, never-relevant dimension that was either fixed or varied randomly. In Experiments 1 (long cue-target interval, CTI) and 2 (short CTI), the tasks involved shape and color and the never-relevant dimension (texture) was chosen to be separable from them. In Experiments 3 (long CTI) and 4 (short CTI), the tasks involved shape and brightness and the never-relevant dimension, saturation, was chosen to be separable from shape and integral with brightness. Task switching did not generate GI but a short CTI did. Thus, switching and filtering generally do not compete over central limited resources unless under tight time pressure. Experiment 3 shows GI in the brightness task but not in the shape task, suggesting that participants switched their attention between brightness and shape when they switched tasks. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality

PubMed Central

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G.; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H.; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

Objective To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. Study design and setting We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Results Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Conclusion Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders’ individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research. PMID:28715491

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality.

PubMed

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders' individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research.

A framework for characterizing drug information sources.

PubMed

Sharp, Mark; Bodenreider, Olivier; Wacholder, Nina

2008-11-06

Drug information is complex, voluminous, heterogeneous, and dynamic. Multiple sources are available, each providing some elements of information about drugs (usually for a given purpose), but there exists no integrated view or directory that could be used to locate sources appropriate to a given purpose. We examined 23 sources that provide drug information in the pharmacy, chemistry, biology, and clinical medicine domains. Their drug information content could be categorized with 39 dimensions. We propose this list of dimensions as a framework for characterizing drug information sources. As an evaluation, we show that this framework is useful for comparing drug information sources and selecting sources most relevant to a given use case.

Is Fromm Relevant for Relational Approaches in Psychoanalysis?

PubMed

Cortina, Mauricio

2017-08-01

This paper provides an overview of how Erich Fromm's work influenced contemporary relational and intersubjective approaches. It stresses Fromm's humanistic and existential sensibility, his explanation of how different socioeconomic and cultural contexts mold different character types, and how his center-to-center relatedness in clinical work all contribute to psychic change. The author shows how these dimensions intersect and add to current interests in relational psychoanalysis.

Toward a Factor Analytic Definition of Academic Relevance

ERIC Educational Resources Information Center

Permut, Steven E.

1974-01-01

Underlying factor structure of 10 concepts rated by 67 students in an introductory advertising course was examined. Dimensions of relevance were found to conform to results reported by Menges and Trumpeter (1971) suggesting the potential for a university of basic dimensions of educational relevance across diverse fields of learning. (Author/RC)

Intentional attention switching in dichotic listening: exploring the efficiency of nonspatial and spatial selection.

PubMed

Lawo, Vera; Fels, Janina; Oberem, Josefa; Koch, Iring

2014-10-01

Using an auditory variant of task switching, we examined the ability to intentionally switch attention in a dichotic-listening task. In our study, participants responded selectively to one of two simultaneously presented auditory number words (spoken by a female and a male, one for each ear) by categorizing its numerical magnitude. The mapping of gender (female vs. male) and ear (left vs. right) was unpredictable. The to-be-attended feature for gender or ear, respectively, was indicated by a visual selection cue prior to auditory stimulus onset. In Experiment 1, explicitly cued switches of the relevant feature dimension (e.g., from gender to ear) and switches of the relevant feature within a dimension (e.g., from male to female) occurred in an unpredictable manner. We found large performance costs when the relevant feature switched, but switches of the relevant feature dimension incurred only small additional costs. The feature-switch costs were larger in ear-relevant than in gender-relevant trials. In Experiment 2, we replicated these findings using a simplified design (i.e., only within-dimension switches with blocked dimensions). In Experiment 3, we examined preparation effects by manipulating the cueing interval and found a preparation benefit only when ear was cued. Together, our data suggest that the large part of attentional switch costs arises from reconfiguration at the level of relevant auditory features (e.g., left vs. right) rather than feature dimensions (ear vs. gender). Additionally, our findings suggest that ear-based target selection benefits more from preparation time (i.e., time to direct attention to one ear) than gender-based target selection.

Perceptual advantage for category-relevant perceptual dimensions: the case of shape and motion.

PubMed

Folstein, Jonathan R; Palmeri, Thomas J; Gauthier, Isabel

2014-01-01

Category learning facilitates perception along relevant stimulus dimensions, even when tested in a discrimination task that does not require categorization. While this general phenomenon has been demonstrated previously, perceptual facilitation along dimensions has been documented by measuring different specific phenomena in different studies using different kinds of objects. Across several object domains, there is support for acquired distinctiveness, the stretching of a perceptual dimension relevant to learned categories. Studies using faces and studies using simple separable visual dimensions have also found evidence of acquired equivalence, the shrinking of a perceptual dimension irrelevant to learned categories, and categorical perception, the local stretching across the category boundary. These later two effects are rarely observed with complex non-face objects. Failures to find these effects with complex non-face objects may have been because the dimensions tested previously were perceptually integrated. Here we tested effects of category learning with non-face objects categorized along dimensions that have been found to be processed by different areas of the brain, shape and motion. While we replicated acquired distinctiveness, we found no evidence for acquired equivalence or categorical perception.

A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease.

PubMed

Moreira, Helena; Canavarro, Maria Cristina

2010-09-01

The research of body image among breast cancer patients is characterized by some limitations, such as the lack of longitudinal studies or the absence of a multidimensional perspective of body image. This study intends to overcome these limitations, by examining the evolution of body image dimensions (investment, emotions and evaluations) from the period of surgery (T1) to 6-months after the treatment's ending (T2). It also aims to explore the predictors of body image at T2 and, simultaneously, the predictive role of initial body image to psychosocial adjustment at T2. A total of 56 breast cancer patients participated in both assessments and completed a battery of instruments that included measures of body image dimensions (appearance investment, self-consciousness of appearance, shame and appearance satisfaction) and psychosocial adjustment (quality of life and emotional distress). Within the dimensions of body image, only shame increased over time. In general, initial levels of investment predicted subsequent body image dimensions and having a mastectomy done was associated with higher shame and lower appearance satisfaction at T2. Initial body image did not predict later adjustment, with the exception of depression, where appearance investment played a relevant role. Our findings contributed to the advance of knowledge in this area, providing relevant data about the evolution of body image dimensions, its predictors and its predictive role on psychosocial adjustment among breast cancer patients. This study also suggested some clinical implications that can assist health professionals to implement strategies focused on body image throughout the disease.

Transcultural Endocrinology: Adapting Type-2 Diabetes Guidelines on a Global Scale.

PubMed

Nieto-Martínez, Ramfis; González-Rivas, Juan P; Florez, Hermes; Mechanick, Jeffrey I

2016-12-01

Type-2 diabetes (T2D) needs to be prevented and treated effectively to reduce its burden and consequences. White papers, such as evidence-based clinical practice guidelines (CPG) and their more portable versions, clinical practice algorithms and clinical checklists, may improve clinical decision-making and diabetes outcomes. However, CPG are underused and poorly validated. Protocols that translate and implement these CPG are needed. This review presents the global dimension of T2D, details the importance of white papers in the transculturalization process, compares relevant international CPG, analyzes cultural variables, and summarizes translation strategies that can improve care. Specific protocols and algorithmic tools are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Person/Situation Selection Research: The Problem of Identifying Salient Situational Dimensions. Research Report No. 13.

ERIC Educational Resources Information Center

Schneider, Benjamin

The study was concerned with the persistent problem in conducting person/situation research--the identification of relevant dimensions or features of the situation. Since the usual strategy for discovering relevant perceptual dimension of organizational life is to ask organizational employees to respond to a set of predetermined questions, this…

Effect of Body Weight on Echocardiographic Measurements in 19,866 Pure-Bred Cats with or without Heart Disease.

PubMed

Häggström, J; Andersson, Å O; Falk, T; Nilsfors, L; OIsson, U; Kresken, J G; Höglund, K; Rishniw, M; Tidholm, A; Ljungvall, I

2016-09-01

Echocardiography is a cost-efficient method to screen cats for presence of heart disease. Current reference intervals for feline cardiac dimensions do not account for body weight (BW). To study the effect of BW on heart rate (HR), aortic (Ao), left atrial (LA) and ventricular (LV) linear dimensions in cats, and to calculate 95% prediction intervals for these variables in normal adult pure-bred cats. 19 866 pure-bred cats. Clinical data from heart screens conducted between 1999 and 2014 were included. Associations between BW, HR, and cardiac dimensions were assessed using univariate linear models and allometric scaling, including all cats, and only those considered normal, respectively. Prediction intervals were created using 95% confidence intervals obtained from regression curves. Associations between BW and echocardiographic dimensions were best described by allometric scaling, and all dimensions increased with increasing BW (all P<0.001). Strongest associations were found between BW and Ao, LV end diastolic, LA dimensions, and thickness of LV free wall. Weak linear associations were found between BW and HR and left atrial to aortic ratio (LA:Ao), for which HR decreased with increasing BW (P<0.001), and LA:Ao increased with increasing BW (P<0.001). Marginal differences were found for prediction formulas and prediction intervals when the dataset included all cats versus only those considered normal. BW had a clinically relevant effect on echocardiographic dimensions in cats, and BW based 95% prediction intervals may help in screening cats for heart disease. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Assessing physical functioning on pain management programmes: the unique contribution of directly assessed physical performance measures and their relationship to self-reports

PubMed Central

Guildford, Beth J; Jacobs, Clair M; Daly-Eichenhardt, Aisling; Scott, Whitney; McCracken, Lance M

2016-01-01

Physical functioning is a recommended outcome domain for pain management programmes. It can be assessed by self-report and by direct assessment of performance. Although physical performance measures may provide unique and useful information about patient functioning over and above self-report measures, it is not entirely clear which of the many possible performances to assess. This study investigated a battery of three directly assessed physical performance measures and their relationship to three currently used self-report measures of general health and functioning. The three performance measures were sensitive to treatment; patients performed significantly better on all three measures following completion of the pain management programme. The three performance measures were shown to represent a single underlying dimension, and there was a significant degree of overlap between them. The performance measures were shown to be relevant in explaining variation in the self-report measures, as well as to offer a clinically relevant different dimension of assessment to self-report. Future research could focus on developing performance-based measures that capture quality of movement and that are sensitive to relevant processes of therapeutic change. PMID:28386404

Developmental trends in the interaction between auditory and linguistic processing.

PubMed

Jerger, S; Pirozzolo, F; Jerger, J; Elizondo, R; Desai, S; Wright, E; Reynosa, R

1993-09-01

The developmental course of multidimensional speech processing was examined in 80 children between 3 and 6 years of age and in 60 adults between 20 and 86 years of age. Processing interactions were assessed with a speeded classification task (Garner, 1974a), which required the subjects to attend selectively to the voice dimension while ignoring the linguistic dimension, and vice versa. The children and adults exhibited both similarities and differences in the patterns of processing dependencies. For all ages, performance for each dimension was slower in the presence of variation in the irrelevant dimension; irrelevant variation in the voice dimension disrupted performance more than irrelevant variation in the linguistic dimension. Trends in the degree of interference, on the other hand, showed significant differences between dimensions as a function of age. Whereas the degree of interference for the voice-dimension-relevant did not show significant age-related change, the degree of interference for the word-dimension-relevant declined significantly with age in a linear as well as a quadratic manner. A major age-related change in the relation between dimensions was that word processing, relative to voice-gender processing, required significantly more time in the children than in the adults. Overall, the developmental course characterizing multidimensional speech processing evidenced more pronounced change when the linguistic dimension, rather than the voice dimension, was relevant.

Manual Physical Therapists' Use of Biopsychosocial History Taking in the Management of Patients with Back or Neck Pain in Clinical Practice

PubMed Central

Oostendorp, Rob A. B.; Elvers, Hans; Mikołajewska, Emilia; Laekeman, Marjan; van Trijffel, Emiel; Samwel, Han; Duquet, William

2015-01-01

Objective. To develop and evaluate process indicators relevant to biopsychosocial history taking in patients with chronic back and neck pain. Methods. The SCEBS method, covering the Somatic, Psychological (Cognition, Emotion, and Behavior), and Social dimensions of chronic pain, was used to evaluate biopsychosocial history taking by manual physical therapists (MPTs). In Phase I, process indicators were developed while in Phase II indicators were tested in practice. Results. Literature-based recommendations were transformed into 51 process indicators. Twenty MTPs contributed 108 patient audio recordings. History taking was excellent (98.3%) for the Somatic dimension, very inadequate for Cognition (43.1%) and Behavior (38.3%), weak (27.8%) for Emotion, and low (18.2%) for the Social dimension. MTPs estimated their coverage of the Somatic dimension as excellent (100%), as adequate for Cognition, Emotion, and Behavior (60.1%), and as very inadequate for the Social dimension (39.8%). Conclusion. MTPs perform screening for musculoskeletal pain mainly through the use of somatic dimension of (chronic) pain. Psychological and social dimensions of chronic pain were inadequately covered by MPTs. Furthermore, a substantial discrepancy between actual and self-estimated use of biopsychosocial history taking was noted. We strongly recommend full implementation of the SCEBS method in educational programs in manual physical therapy. PMID:25945358

The effects of variation of an irrelevant dimension on same-different visual judgments.

PubMed

Ballesteros, S; Manga, D

1996-06-01

In a series of experiments observers judged whether two visual tachistoscopically presented shapes were the same or different in a relevant dimension, and had to ignore the graded variation on an irrelevant dimension that appeared concurrently with the relevant dimension. Experimental results from judgments in orientation, size and brightness failed to support the normalization hypothesis. The hypothesis predicts a monotonous increase in RTs with the increasing degree of disparity in the irrelevant dimension in same as well as in different comparisons. The results were interpreted in terms of the type of dimensions used to construct the shapes. It was suggested that with separable stimulus dimensions normalization would not be necessary. However, interference might appear when the stimuli to be compared were generated from a combination of more integral dimensions.

New dimensions and new tools to realize the potential of RDoC: digital phenotyping via smartphones and connected devices.

PubMed

Torous, J; Onnela, J-P; Keshavan, M

2017-03-07

Mobile and connected devices like smartphones and wearable sensors can facilitate the collection of novel naturalistic and longitudinal data relevant to psychiatry at both the personal and population level. The National Institute of Mental Health's Research Domain Criteria framework offers a useful roadmap to organize, guide and lead new digital phenotyping data towards research discoveries and clinical advances.

Toward a Two-Dimensional Model of Social Cognition in Clinical Neuropsychology: A Systematic Review of Factor Structure Studies.

PubMed

Etchepare, Aurore; Prouteau, Antoinette

2018-04-01

Social cognition has received growing interest in many conditions in recent years. However, this construct still suffers from a considerable lack of consensus, especially regarding the dimensions to be studied and the resulting methodology of clinical assessment. Our review aims to clarify the distinctiveness of the dimensions of social cognition. Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements, a systematic review was conducted to explore the factor structure of social cognition in the adult general and clinical populations. The initial search provided 441 articles published between January 1982 and March 2017. Eleven studies were included, all conducted in psychiatric populations and/or healthy participants. Most studies were in favor of a two-factor solution. Four studies drew a distinction between low-level (e.g., facial emotion/prosody recognition) and high-level (e.g., theory of mind) information processing. Four others reported a distinction between affective (e.g., facial emotion/prosody recognition) and cognitive (e.g., false beliefs) information processing. Interestingly, attributional style was frequently reported as an additional separate factor of social cognition. Results of factor analyses add further support for the relevance of models differentiating level of information processing (low- vs. high-level) from nature of processed information (affective vs. cognitive). These results add to a significant body of empirical evidence from developmental, clinical research and neuroimaging studies. We argue the relevance of integrating low- versus high-level processing with affective and cognitive processing in a two-dimensional model of social cognition that would be useful for future research and clinical practice. (JINS, 2018, 24, 391-404).

Selective Attention to Perceptual Dimensions and Switching between Dimensions

ERIC Educational Resources Information Center

Meiran, Nachshon; Dimov, Eduard; Ganel, Tzvi

2013-01-01

In the present experiments, the question being addressed was whether switching attention between perceptual dimensions and selective attention to dimensions are processes that compete over a common resource? Attention to perceptual dimensions is usually studied by requiring participants to ignore a never-relevant dimension. Selection failure…

Appraisal Tools for Clinical Practice Guidelines: A Systematic Review

PubMed Central

Siering, Ulrich; Eikermann, Michaela; Hausner, Elke; Hoffmann-Eßer, Wiebke; Neugebauer, Edmund A.

2013-01-01

Introduction Clinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality. Guideline appraisal tools aim to help potential guideline users in assessing guideline quality. We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools. Methods Among others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications. We also handsearched the reference lists of relevant publications. On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions. We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items. Results We identified 40 different appraisal tools. They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items. The main focus of the appraisal tools were the quality dimensions “evaluation of evidence” (mentioned in 35 tools; 88%), “presentation of guideline content” (34 tools; 85%), “transferability” (33 tools; 83%), “independence” (32 tools; 80%), “scope” (30 tools; 75%), and “information retrieval” (29 tools; 73%). The quality dimensions “consideration of different perspectives” and “dissemination, implementation and evaluation of the guideline” were covered by only twenty (50%) and eighteen tools (45%) respectively. Conclusions Most guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine. Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered. Greater focus should be placed on these issues in the further development of guideline appraisal tools. PMID:24349397

A dissociation between attention and selection

NASA Technical Reports Server (NTRS)

Remington, R. W.; Folk, C. L.

2001-01-01

It is widely assumed that the allocatian of spatial attention results in the "selection" of attended objects or regions of space. That is, once a stimulus is attended, all its feature dimensions are processed irrespective of their relevance to behavioral goals. This assumption is based in part on experiments showing significant interference for attended stimuli when the response to an irrelevant dimension conflicts with the response to the relevant dimension (e.g., the Stroop effect). Here we show that such interference is not due to attending per se. In two spatial cuing experiments, we found that it was possible to restrict processing of attended stimuli to task-relevant dimensions. This new evidence supports two novel conclusions: (a) Selection involves more than the focusing of attention per se: and (b) task expectations play a key role in detertnining the depth of processing of the elementary feature dimensions of attended stimuli.

Dimensions of Emotion Dysregulation in Anorexia Nervosa and Bulimia Nervosa: A Conceptual Review of the Empirical Literature

PubMed Central

Lavender, Jason M.; Wonderlich, Stephen A.; Engel, Scott G.; Gordon, Kathryn H.; Kaye, Walter H.; Mitchell, James E.

2015-01-01

Several existing conceptual models and psychological interventions address or emphasize the role of emotion dysregulation in eating disorders. The current article uses Gratz and Roemer’s (2004) multidimensional model of emotion regulation and dysregulation as a clinically relevant framework to review the extant literature on emotion dysregulation in anorexia nervosa (AN) and bulimia nervosa (BN). Specifically, the dimensions reviewed include: (1) the flexible use of adaptive and situationally appropriate strategies to modulate the duration and/or intensity of emotional responses, (2) the ability to successfully inhibit impulsive behavior and maintain goal-directed behavior in the context of emotional distress, (3) awareness, clarity, and acceptance of emotional states, and (4) the willingness to experience emotional distress in the pursuit of meaningful activities. The current review suggests that both AN and BN are characterized by broad emotion regulation deficits, with difficulties in emotion regulation across the four dimensions found to characterize both AN and BN, although a small number of more specific difficulties may distinguish the two disorders. The review concludes with a discussion of the clinical implications of the findings, as well as a summary of limitations of the existing empirical literature and suggestions for future research. PMID:26112760

Cortisol in the morning and dimensions of anxiety, depression, and aggression in children from a general population and clinic-referred cohort: An integrated analysis. The TRAILS study.

PubMed

Dietrich, Andrea; Ormel, Johan; Buitelaar, Jan K; Verhulst, Frank C; Hoekstra, Pieter J; Hartman, Catharina A

2013-08-01

Anxiety and depressive problems have often been related to higher hypothalamic-pituitary-adrenal (HPA)-axis activity (basal morning cortisol levels and cortisol awakening response [CAR]) and externalizing problems to lower HPA-axis activity. However, associations appear weaker and more inconsistent than initially assumed. Previous studies from the Tracking Adolescents Individual Lives Study (TRAILS) suggested sex-differences in these relationships and differential associations with specific dimensions of depressive problems in a general population sample of children (10-12 years). Using the TRAILS population sample (n=1604), we tested hypotheses on the association between single day cortisol (basal morning levels and CAR) and specifically constructed dimensions of anxiety (cognitive versus somatic), depressive (cognitive-affective versus somatic), and externalizing problems (reactive versus proactive aggression), and explored the modifying role of sex. Moreover, we repeated analyses in an independent same-aged clinic-referred sample (n=357). Structural Equation Modeling was used to investigate the association between cortisol and higher- and lower-order (thus, broad and specific) problem dimensions based on self-reports in an integrated model. Overall, findings were consistent across the population and clinic-referred samples, as well as with the existing literature. Most support was found for higher cortisol (mainly CAR) in relation to depressive problems. However, in general, associations were weak in both samples. Therefore, the present results shed doubt on the relevance of single day cortisol measurements for problem behaviors in the milder range. Associations may be stronger in more severe or persistent psychopathology. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Marketing orientation in rehabilitation--exemplified by image analysis of a rehabilitation clinic for addictions].

PubMed

Altenhöner, T; Schönhoff, T; Wehmeier, D

2001-06-01

This article presents the findings of an image analysis carried out for a rehabilitation clinic for addictive diseases. The cross-sectional study was designed as an anonymous survey sent to relevant (regional) referral agencies (n = 90), e.g. counselling services for addictive diseases. The study covers the clinic's actual and ideal image, discriminating frequency of referrals, diagnostic categories, region, and type of institution. Results concerning the real profile indicate that on average the dimensions cooperation, communication with regard to personal contact, and reputation of the clinic were more critically judged than the issues information, communication with regard to discharge reports, standards of quality, and consideration of patients' needs. Cooperation, communication with regard to personal contact, and quality standards turned out to be the most important criteria from the referring agencies' perspective (ideal profile). A statistical comparison between those with high and low assignment rates suggested that customers rated the clinic more favourably than non-customers. Thus, it seems that the clinic's image has considerable influence on referral decisions. Particularly interesting is the additional finding that the referring institutions perceive pension insurers' directives to be of secondary relevance.

Jewish physicians' beliefs and practices regarding religion/spirituality in the clinical encounter.

PubMed

Stern, Robert M; Rasinski, Kenneth A; Curlin, Farr A

2011-12-01

We used data from a 2003 survey of US physicians to examine differences between Jewish and other religiously affiliated physicians on 4-D of physicians' beliefs and practices regarding religion and spirituality (R/S) in the clinical encounter. On each dimension, Jewish physicians ascribed less importance to the effect of R/S on health and a lesser role for physicians in addressing R/S issues. These effects were partially mediated by lower levels of religiosity among Jewish physicians and by differences in demographic and practice-level characteristics. The study provides a salient example of how religious affiliation can be an important independent predictor of physicians' clinically-relevant beliefs and practices.

Jewish Physicians' Beliefs and Practices Regarding Religion/Spirituality in the Clinical Encounter

PubMed Central

Stern, Robert M.; Rasinski, Kenneth A.; Curlin, Farr A.

2013-01-01

We used data from a 2003 survey of US physicians to examine differences between Jewish and other religiously affiliated physicians on 4-D of physicians' beliefs and practices regarding religion and spirituality (R/S) in the clinical encounter. On each dimension, Jewish physicians ascribed less importance to the effect of R/S on health and a lesser role for physicians in addressing R/S issues. These effects were partially mediated by lower levels of religiosity among Jewish physicians and by differences in demographic and practice-level characteristics. The study provides a salient example of how religious affiliation can be an important independent predictor of physicians' clinically-relevant beliefs and practices. PMID:21706257

Comparison of Wechsler Memory Scale-Fourth Edition (WMS-IV) and Third Edition (WMS-III) dimensional structures: improved ability to evaluate auditory and visual constructs.

PubMed

Hoelzle, James B; Nelson, Nathaniel W; Smith, Clifford A

2011-03-01

Dimensional structures underlying the Wechsler Memory Scale-Fourth Edition (WMS-IV) and Wechsler Memory Scale-Third Edition (WMS-III) were compared to determine whether the revised measure has a more coherent and clinically relevant factor structure. Principal component analyses were conducted in normative samples reported in the respective technical manuals. Empirically supported procedures guided retention of dimensions. An invariant two-dimensional WMS-IV structure reflecting constructs of auditory learning/memory and visual attention/memory (C1 = .97; C2 = .96) is more theoretically coherent than the replicable, heterogeneous WMS-III dimension (C1 = .97). This research suggests that the WMS-IV may have greater utility in identifying lateralized memory dysfunction.

Measuring health-related quality of life in drug clinical trials: is it given due importance?

PubMed

Miguel, Ramón San; López-González, Ana María; Sanchez-Iriso, Eduardo; Mar, Javier; Cabasés, Juan M

2008-04-01

Efficacy estimations of drug clinical trials have been based on clinical measurements and survival rates. However, advances in psychometric techniques have allowed to incorporate a new dimension based on quality of life. Questionnaires aimed at measuring patients' health status outlook, now enable us to quantify the loss of quality of life caused by disease and the improvement that can be achieved by pharmacological treatments. The Aim of this study is to make a quantitative evaluation of the use of health related quality of life (HRQL) measures in drug clinical trials. A systematic review was performed, in duplicate, of the five journals with highest contribution to the ACP Journal Club, i.e. New England Journal of Medicine, JAMA, The Lancet, Annals of Internal Medicine and the British Medical Journal. HRQL measures were evaluated in published articles referring to drug clinical trials. We identified 193 articles that reported the results of clinical trials, of which 28 included QOL measures as secondary end points and two as primary end points: in total, these comprised 16% of the articles analysed. Discussion Without considering the relevance of HRQL measures as a tool in the allocation of resources, it should be included as a health outcome dimension in drug clinical trials. The absence of this evaluation in studies about chronic diseases that affects patients' daily life activities would not be justified. HRQL measures are not used on a regular basis in drug clinical trials that are reported in the relevant literature. Systematic incorporation of QOL measures into clinical trials would make it possible to measure the benefit obtained from drug treatments taking into account the patients' perceptions. Moreover, it would encourage the development of prospective cost-effectiveness studies with patient recorded data in the context of clinical trials. Our findings have a direct impact on practice. Being conscious of the low use of HRQL in clinical trials, it could contribute to increase the demand for these measures by health care professionals. The manuscript is also a useful tool to identify where basic concepts about HRQL measures can be found.

Experts' saliency ratings of speech-language dimensions associated with cluttering.

PubMed

Myers, Florence L; Bakker, Klaas

2014-12-01

The study aimed to investigate how cluttering specialists rated degree of prominence or saliency of various communication dimensions as contributing to the overall cluttering severity. Using a 9-point Likert type scoring system 31 cluttering specialists (with an average of 19 years of experience with cluttering) rated the relative importance of eight speech and language dimensions often associated with cluttering from '1' ('not important') at the low end to a '9' ('very important') at the high saliency end. Though the salience ratings differed the values in most cases were toward the high end of the rating scale. Additionally correlational analyses revealed several patterns of inter-correlation among the dimensions indicating that contribution of each communication dimension to overall cluttering severity may not be the same for all. Rather, it suggested that these dimensions may speak to cluttering severity through differential perceptual pathways that characterized the thinking of the experts who participated. Greater understanding of the various communication behaviors contributing to cluttering, severity is needed for theoretical research and clinical purposes. To the extent that the dimensions studied are thought to be relevant for cluttering, the results strengthen the notion that these dimensions (and perhaps others) should be included if we are to capture a comprehensive picture of cluttering severity. (a) describe the multidimensionality of cluttering; (b) discuss the perceptual saliency of speech-language dimensions associated with cluttering; (c) describe the interrelatedness of various speech-language dimensions associated with cluttering; (d) discuss how experts in cluttering rate the saliency of speech and language dimensions associated with cluttering when provided a list of these dimensions. Copyright © 2013 Elsevier Inc. All rights reserved.

Shame, trauma, temperament and psychopathology: Construct validity of the Experience of Shame Scale.

PubMed

Vizin, Gabriella; Urbán, Róbert; Unoka, Zsolt

2016-12-30

Although Experience of Shame Scale (ESS) is used in clinical research and it covers psychiatrically relevant dimensions of chronic shame, characterological (CS), behavioral (BS) and bodily (BoS) respectively, its factor structures were not confirmed on clinical sample. The goals of our research were to examine the factor structure of the Hungarian version of ESS, in addition, to analyze the associations between factors of ESS and different types of predictors, such as clinical status, gender, age, school years, early abuse history, general psychopathology (GSI), and temperament dimensions by using a series of confirmatory factor analyses (CFA) with covariates in a large clinical and matched healthy sample. Psychiatric inpatients (N=148) and healthy control subjects (N=148) participated in this cross-sectional questionnaire study. In both samples, the degree of fit was adequate. The final CFA with covariates model showed significant and positive associations between CS and clinical status and education respectively, between CS, BS, BoS and frequency of verbal abuse, between CS and BoS and GSI and between CS and BS and harm avoidance and in addition we found negative associations between each of the shame factors and age. Our results support the psychiatric validity of the ESS construct. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dupilumab therapy provides clinically meaningful improvement in patient-reported outcomes (PROs): A phase IIb, randomized, placebo-controlled, clinical trial in adult patients with moderate to severe atopic dermatitis (AD).

PubMed

Simpson, Eric L; Gadkari, Abhijit; Worm, Margitta; Soong, Weily; Blauvelt, Andrew; Eckert, Laurent; Wu, Richard; Ardeleanu, Marius; Graham, Neil M H; Pirozzi, Gianluca; Sutherland, E Rand; Mastey, Vera

2016-09-01

Moderate to severe atopic dermatitis (AD) is associated with substantial patient burden despite current therapies. We sought to evaluate dupilumab treatment on patient-reported outcomes in adults with moderate to severe AD. Adults (N = 380) with moderate to severe AD inadequately controlled by topical medications were randomized to 16 weeks of double-blind, subcutaneous treatment with dupilumab 100 mg every 4 weeks, 200 mg every 2 weeks, 300 mg every 2 weeks, 300 mg once weekly, or placebo. Patient-reported outcomes included pruritus numeric rating scale; patient-reported sleep item on Scoring AD scale; Patient-Oriented Eczema Measure; Hospital Anxiety and Depression Scale; Dermatology Life Quality Index; and 5-dimension 3-level EuroQol. Dupilumab reduced peak itch at 16 weeks relative to placebo by 1.1 to 3.2 points on numeric rating scale (P < .0001 all doses, except 100 mg every 4 weeks P < .05); improved sleep and health-related quality of life on Dermatology Life Quality Index and 5-dimension 3-level EuroQol (P < .05 all doses, except 100 mg every 4 weeks); and reduced anxiety and depression symptoms (P < .05 all doses). Dupilumab's effects appeared early and achieved clinically relevant improvements without significant safety concerns. There are potential cultural differences affecting patient-reported outcome responses. Outcomes were secondary or exploratory end points. Dupilumab produced early and sustained patient-reported and clinically relevant improvements in sleep, mental health, and health-related quality of life; the two 300-mg dose regimens resulted in greatest benefits. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A Meta-analytic Review of Religious or Spiritual Involvement and Social Health among Cancer Patients

PubMed Central

Sherman, Allen C; Merluzzi, Thomas V; Pustejovsky, James E; Park, Crystal L; George, Login; Fitchett, George; Jim, Heather SL; Munoz, Alexis R; Danhauer, Suzanne C; Snyder, Mallory A; Salsman, John M

2015-01-01

Background Religion and spirituality (R/S) play an important role in the daily lives of many cancer patients. There has been great interest in determining whether R/S factors are related to clinically-relevant health outcomes. This meta-analytic review examined associations between dimensions of R/S and social health (e.g., social roles and relationships). Methods A systematic search of PubMed, PsycInfo, Cochrane Library, and CINAHL databases was conducted, and data were extracted by four pairs of investigators. Bivariate associations between specific R/S dimensions and social health outcomes were examined in a meta-analysis using a generalized estimating equation (GEE) approach. Results A total of 78 independent samples encompassing 14,277 patients were included in the meta-analysis. Social health was significantly associated with overall R/S (Fisher z effect size = .20, P< .001), and with each of the R/S dimensions (affective R/S effect size = .32, P< .001; cognitive R/S effect size = .11, P< .01; behavioral R/S effect size = .08, P < .05; and ‘other’ R/S effect size = .13, P < .001). Within these dimensions, specific variables tied to social health included spiritual well-being, spiritual struggle, images of God, R/S beliefs, and composite R/S measures (all P’s < .05). None of the demographic or clinical moderating variables examined was significant. Conclusions Several R/S dimensions are modestly associated with patients’ capacity to maintain satisfying social roles and relationships in the context of cancer. Further research is needed to examine the temporal nature of these associations and the mechanisms that underlie them. PMID:26258730

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farmer, J.D.; Ott, E.; Yorke, J.A.

Dimension is perhaps the most basic property of an attractor. In this paper we discuss a variety of different definitions of dimension, compute their values for a typical example, and review previous work on the dimension of chaotic attractors. The relevant definitions of dimension are of two general types, those that depend only on metric properties, and those that depend on probabilistic properties (that is, they depend on the frequency with which a typical trajectory visits different regions of the attractor). Both our example and the previous work that we review support the conclusion that all of the probabilistic dimensionsmore » take on the same value, which we call the dimension of the natural measure, and all of the metric dimensions take on a common value, which we call the fractal dimension. Furthermore, the dimension of the natural measure is typically equal to the Lyapunov dimension, which is defined in terms of Lyapunov numbers, and thus is usually far easier to calculate than any other definition. Because it is computable and more physically relevant, we feel that the dimension of the natural measure is more important than the fractal dimension.« less

Lexical Studies of Filipino Person Descriptors: Adding Personality-Relevant Social and Physical Attributes

PubMed Central

Imperio, Shellah Myra; Church, A. Timothy; Katigbak, Marcia S.; Reyes, Jose Alberto S.

2009-01-01

Lexical studies have focused on traits. In the Filipino language, we investigated whether additional dimensions can be identified when personality-relevant terms for social roles, statuses, and effects, plus physical attributes, are included. Filipino students (N = 496) rated themselves on 268 such terms, plus 253 markers of trait and evaluative dimensions. We identified 10 dimensions of social and physical attributes—Prominence, Uselessness, Attractiveness, Respectability, Uniqueness, Destructiveness, Presentableness, Strength, Dangerousness, and Charisma. Most of these dimensions did not correspond in a one-to-one manner to Filipino or alternative trait models (Big Five, HEXACO, ML7). However, considerable redundancy was observed between the social and physical attribute dimensions and trait and evaluative dimensions. Thus, social and physical attributes communicate information about personality traits, and vice-versa. PMID:19779603

3D structural patterns in scalable, elastomeric scaffolds guide engineered tissue architecture.

PubMed

Kolewe, Martin E; Park, Hyoungshin; Gray, Caprice; Ye, Xiaofeng; Langer, Robert; Freed, Lisa E

2013-08-27

Microfabricated elastomeric scaffolds with 3D structural patterns are created by semiautomated layer-by-layer assembly of planar polymer sheets with through-pores. The mesoscale interconnected pore architectures governed by the relative alignment of layers are shown to direct cell and muscle-like fiber orientation in both skeletal and cardiac muscle, enabling scale up of tissue constructs towards clinically relevant dimensions. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

VR-CoDES and patient-centeredness. The intersection points between a measure and a concept.

PubMed

Del Piccolo, Lidia

2017-11-01

The Verona Coding Definitions of Emotional sequences (VR-CoDES) system has been applied in a wide range of studies, in some of these, because of its attention on healthcare provider's ability to respond to patient emotions, it has been used as a proxy of patient-centeredness. The paper aims to discuss how the VR-CoDES can contribute to the broader concept of patient-centeredness and its limitations. VR-CoDES and patient-centeredness concept are briefly described, trying to detect commonalities and distinctions. The VR-CoDES dimensions of Explicit/non explicit responding and Providing or Reducing Space are analysed in relation to relevant aspects of patient-centred communication. Emotional aspects are encompassed within patient-centeredness model, but they represent only one of the numerous dimensions that contribute to define patient-centeredness as well as Explicit/non explicit responding and Providing or Reducing Space serve different functions during communication. The VR-CoDES can contribute to operationalize the description of emotional aspects emerging in a consultation, by inducing coders to adopt a factual attitude in assessing how health providers react to patient's expression of emotions. To better define empirically which measure affective aspects and dimensions of health provider responses are relevant and may contribute to patient-centeredness in different clinical settings. Copyright © 2017. Published by Elsevier B.V.

Contextual modulation of attention in human category learning.

PubMed

George, David N; Kruschke, John K

2012-12-01

In a category-learning experiment, we assessed whether participants were able to selectively attend to different components of a compound stimulus in two distinct contexts. The participants were presented with stimulus compounds for which they had to learn categorical labels. Each compound comprised one feature from each of two dimensions, and on different trials the compound was presented in two contexts, X and Y. In Context X, Dimension A was relevant to the solution of the categorization task and Dimension B was irrelevant, whereas in Context Y, Dimension A was irrelevant and Dimension B was relevant. The results of transfer tests to novel stimuli suggested that people learned to attend selectively to Dimension A in Context X and Dimension B in Context Y. These findings contribute to the growing body of evidence that people can learn to selectively attend to particular dimensions of stimuli dependent on the context in which the stimuli are presented. Furthermore, the findings demonstrate that context-dependent changes in attention transfer to other categorization tasks involving novel stimuli.

Perfectionism dimensions and dependency in relation to personality vulnerability and psychosocial adjustment in patients with coronary artery disease.

PubMed

Dunkley, David M; Schwartzman, Deborah; Looper, Karl J; Sigal, John J; Pierre, Andrena; Kotowycz, Mark A

2012-06-01

The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.

Disease Severity and Progression in Progressive Supranuclear Palsy and Multiple System Atrophy: Validation of the NNIPPS – PARKINSON PLUS SCALE

PubMed Central

Payan, Christine A. M.; Viallet, François; Landwehrmeyer, Bernhard G.; Bonnet, Anne-Marie; Borg, Michel; Durif, Franck; Lacomblez, Lucette; Bloch, Frédéric; Verny, Marc; Fermanian, Jacques; Agid, Yves; Ludolph, Albert C.

2011-01-01

Background The Natural History and Neuroprotection in Parkinson Plus Syndromes (NNIPPS) study was a large phase III randomized placebo-controlled trial of riluzole in Progressive Supranuclear Palsy (PSP, n = 362) and Multiple System Atrophy (MSA, n = 398). To assess disease severity and progression, we constructed and validated a new clinical rating scale as an ancillary study. Methods and Findings Patients were assessed at entry and 6-montly for up to 3 years. Evaluation of the scale's psychometric properties included reliability (n = 116), validity (n = 760), and responsiveness (n = 642). Among the 85 items of the initial scale, factor analysis revealed 83 items contributing to 15 clinically relevant dimensions, including Activity of daily Living/Mobility, Axial bradykinesia, Limb bradykinesia, Rigidity, Oculomotor, Cerebellar, Bulbar/Pseudo-bulbar, Mental, Orthostatic, Urinary, Limb dystonia, Axial dystonia, Pyramidal, Myoclonus and Tremor. All but the Pyramidal dimension demonstrated good internal consistency (Cronbach α≥0.70). Inter-rater reliability was high for the total score (Intra-class coefficient = 0.94) and 9 dimensions (Intra-class coefficient = 0.80–0.93), and moderate (Intra-class coefficient = 0.54–0.77) for 6. Correlations of the total score with other clinical measures of severity were good (rho≥0.70). The total score was significantly and linearly related to survival (p<0.0001). Responsiveness expressed as the Standardized Response Mean was high for the total score slope of change (SRM = 1.10), though higher in PSP (SRM = 1.25) than in MSA (SRM = 1.0), indicating a more rapid progression of PSP. The slope of change was constant with increasing disease severity demonstrating good linearity of the scale throughout disease stages. Although MSA and PSP differed quantitatively on the total score at entry and on rate of progression, the relative contribution of clinical dimensions to overall severity and progression was similar. Conclusions The NNIPPS-PPS has suitable validity, is reliable and sensitive, and therefore is appropriate for use in clinical studies with PSP or MSA. Trial Registration ClinicalTrials.gov NCT00211224 PMID:21829612

Four dimensional chaos and intermittency in a mesoscopic model of the electroencephalogram.

PubMed

Dafilis, Mathew P; Frascoli, Federico; Cadusch, Peter J; Liley, David T J

2013-06-01

The occurrence of so-called four dimensional chaos in dynamical systems represented by coupled, nonlinear, ordinary differential equations is rarely reported in the literature. In this paper, we present evidence that Liley's mesoscopic theory of the electroencephalogram (EEG), which has been used to describe brain activity in a variety of clinically relevant contexts, possesses a chaotic attractor with a Kaplan-Yorke dimension significantly larger than three. This accounts for simple, high order chaos for a physiologically admissible parameter set. Whilst the Lyapunov spectrum of the attractor has only one positive exponent, the contracting dimensions are such that the integer part of the Kaplan-Yorke dimension is three, thus giving rise to four dimensional chaos. A one-parameter bifurcation analysis with respect to the parameter corresponding to extracortical input is conducted, with results indicating that the origin of chaos is due to an inverse period doubling cascade. Hence, in the vicinity of the high order, strange attractor, the model is shown to display intermittent behavior, with random alternations between oscillatory and chaotic regimes. This phenomenon represents a possible dynamical justification of some of the typical features of clinically established EEG traces, which can arise in the case of burst suppression in anesthesia and epileptic encephalopathies in early infancy.

Physicians' perspectives of managing tensions around dimensions of effective communication in the emergency department.

PubMed

Dean, Marleah; Oetzel, John G

2014-01-01

The purpose of this study was to explore emergency department (ED) physicians' perspectives of guidelines for effective communication. More specifically, the ways in which physicians manage the tensions among effective communication dimensions framed by relational dialectics theory are examined. This study used in-depth interviews with 17 ED physicians and 70 hours of observations to identify five dimensions of effective communication: efficiency, clarity/accuracy, relevance, comprehension, and rapport. Two communication tensions resulted from these dimensions: efficiency versus rapport and efficiency versus comprehension. In almost all instances, physicians chose efficient communication at the expense of comprehension or rapport. In addition, there was a tension between patient and physician perspectives of clarity and relevance that physicians tended to resolve by emphasizing what was relevant and clear from their own perspective. Implications for managing tensions in terms of efficiency and a physician-centered approach are discussed.

Analyzing multicomponent receptive fields from neural responses to natural stimuli

PubMed Central

Rowekamp, Ryan; Sharpee, Tatyana O

2011-01-01

The challenge of building increasingly better models of neural responses to natural stimuli is to accurately estimate the multiple stimulus features that may jointly affect the neural spike probability. The selectivity for combinations of features is thought to be crucial for achieving classical properties of neural responses such as contrast invariance. The joint search for these multiple stimulus features is difficult because estimating spike probability as a multidimensional function of stimulus projections onto candidate relevant dimensions is subject to the curse of dimensionality. An attractive alternative is to search for relevant dimensions sequentially, as in projection pursuit regression. Here we demonstrate using analytic arguments and simulations of model cells that different types of sequential search strategies exhibit systematic biases when used with natural stimuli. Simulations show that joint optimization is feasible for up to three dimensions with current algorithms. When applied to the responses of V1 neurons to natural scenes, models based on three jointly optimized dimensions had better predictive power in a majority of cases compared to dimensions optimized sequentially, with different sequential methods yielding comparable results. Thus, although the curse of dimensionality remains, at least several relevant dimensions can be estimated by joint information maximization. PMID:21780916

Contingent attentional capture across multiple feature dimensions in a temporal search task.

PubMed

Ito, Motohiro; Kawahara, Jun I

2016-01-01

The present study examined whether attention can be flexibly controlled to monitor two different feature dimensions (shape and color) in a temporal search task. Specifically, we investigated the occurrence of contingent attentional capture (i.e., interference from task-relevant distractors) and resulting set reconfiguration (i.e., enhancement of single task-relevant set). If observers can restrict searches to a specific value for each relevant feature dimension independently, the capture and reconfiguration effect should only occur when the single relevant distractor in each dimension appears. Participants identified a target letter surrounded by a non-green square or a non-square green frame. The results revealed contingent attentional capture, as target identification accuracy was lower when the distractor contained a target-defining feature than when it contained a nontarget feature. Resulting set reconfiguration was also obtained in that accuracy was superior when the current target's feature (e.g., shape) corresponded to the defining feature of the present distractor (shape) than when the current target's feature did not match the distractor's feature (color). This enhancement was not due to perceptual priming. The present study demonstrated that the principles of contingent attentional capture and resulting set reconfiguration held even when multiple target feature dimensions were monitored. Copyright © 2015 Elsevier B.V. All rights reserved.

Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients.

PubMed

Attenberger, Corinna; Amsler, Felix; Gross, Thomas

2012-09-01

No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data. Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.). This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future. Copyright © 2011 Elsevier Ltd. All rights reserved.

Spike Triggered Covariance in Strongly Correlated Gaussian Stimuli

PubMed Central

Aljadeff, Johnatan; Segev, Ronen; Berry, Michael J.; Sharpee, Tatyana O.

2013-01-01

Many biological systems perform computations on inputs that have very large dimensionality. Determining the relevant input combinations for a particular computation is often key to understanding its function. A common way to find the relevant input dimensions is to examine the difference in variance between the input distribution and the distribution of inputs associated with certain outputs. In systems neuroscience, the corresponding method is known as spike-triggered covariance (STC). This method has been highly successful in characterizing relevant input dimensions for neurons in a variety of sensory systems. So far, most studies used the STC method with weakly correlated Gaussian inputs. However, it is also important to use this method with inputs that have long range correlations typical of the natural sensory environment. In such cases, the stimulus covariance matrix has one (or more) outstanding eigenvalues that cannot be easily equalized because of sampling variability. Such outstanding modes interfere with analyses of statistical significance of candidate input dimensions that modulate neuronal outputs. In many cases, these modes obscure the significant dimensions. We show that the sensitivity of the STC method in the regime of strongly correlated inputs can be improved by an order of magnitude or more. This can be done by evaluating the significance of dimensions in the subspace orthogonal to the outstanding mode(s). Analyzing the responses of retinal ganglion cells probed with Gaussian noise, we find that taking into account outstanding modes is crucial for recovering relevant input dimensions for these neurons. PMID:24039563

Clinicians' perspectives on patient satisfaction in adult congenital heart disease clinics--a dimension of health care quality whose time has come.

PubMed

Rozenblum, Ronen; Gianola, Ann; Ionescu-Ittu, Raluca; Verstappen, Amy; Landzberg, Michael; Gurvitz, Michelle; Jenkins, Kathy; Bates, David W; Marelli, Ariane J

2015-01-01

Patient-centered care and patient satisfaction represent key dimensions of health care quality. This is relevant for the growing number of patients with life-long conditions. In the present study, our goal was to examine clinicians' attitudes and behavior with respect to patient satisfaction in adult congenital heart disease outpatient clinics. A 34-question survey was developed to assess adult congenital heart disease clinicians' awareness, attitudes, and behavior relative to patient satisfaction and administered in-person or online to clinicians from the largely U.S.-based Adult Congenital Heart Association's database of adult congenital heart disease health care providers. Overall, 267 questionnaires were filled out: 108 were collected in person (79% response rate) and 159 online (17.5% response rate). Responses were received from physicians (161); nurses (73); physician assistants (20); and others (13). Although 85% of clinicians believed it was important to inquire about patient satisfaction, only 28% reported routinely inquiring about this dimension of care. Only 34% claimed they had adequate training to cope with varying levels of patient satisfaction, 44% stated that their department utilized patient satisfaction surveys, and 37% received feedback from the hospital management in the preceding 12 months. In multivariate analyses, clinicians that received feedback from the hospital management and had adequate training were more likely to inquire about patient satisfaction. Although patient satisfaction is perceived as an important dimension of quality care by adult congenital heart disease clinicians, most of them reported insufficient institutional support to achieve this. Our findings suggest that clinicians would benefit from health care organizations engaging them in the delivery of this dimension of health care quality. © 2014 Wiley Periodicals, Inc.

Cultural Relevance and Informal Reading Inventory Performance: African-American Primary and Middle School Students

ERIC Educational Resources Information Center

Christ, Tanya; Chiu, Ming Ming; Rider, Stephanie; Kitson, Deborah; Hanser, Katherine; McConnell, Elizabeth; Dipzinski, Renae; Mayernik, Heather

2018-01-01

We explore whether (a) teacher ratings of texts' cultural relevance along various dimensions differ from those of students, (b) these ratings reflect a single construct, and (c) ratings of specific dimensions are related to specific reading outcomes. Fifty African-American students were each administered two text protocols for a total of 100…

Two-dimensional adaptation in the auditory forebrain

PubMed Central

Nagel, Katherine I.; Doupe, Allison J.

2011-01-01

Sensory neurons exhibit two universal properties: sensitivity to multiple stimulus dimensions, and adaptation to stimulus statistics. How adaptation affects encoding along primary dimensions is well characterized for most sensory pathways, but if and how it affects secondary dimensions is less clear. We studied these effects for neurons in the avian equivalent of primary auditory cortex, responding to temporally modulated sounds. We showed that the firing rate of single neurons in field L was affected by at least two components of the time-varying sound log-amplitude. When overall sound amplitude was low, neural responses were based on nonlinear combinations of the mean log-amplitude and its rate of change (first time differential). At high mean sound amplitude, the two relevant stimulus features became the first and second time derivatives of the sound log-amplitude. Thus a strikingly systematic relationship between dimensions was conserved across changes in stimulus intensity, whereby one of the relevant dimensions approximated the time differential of the other dimension. In contrast to stimulus mean, increases in stimulus variance did not change relevant dimensions, but selectively increased the contribution of the second dimension to neural firing, illustrating a new adaptive behavior enabled by multidimensional encoding. Finally, we demonstrated theoretically that inclusion of time differentials as additional stimulus features, as seen so prominently in the single-neuron responses studied here, is a useful strategy for encoding naturalistic stimuli, because it can lower the necessary sampling rate while maintaining the robustness of stimulus reconstruction to correlated noise. PMID:21753019

Results of an Oncology Clinical Trial Nurse Role Delineation Study.

PubMed

Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

2017-09-01

To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics.

PubMed

Zineldin, Mosad

2006-01-01

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently. A conceptual model including behavioural dimensions of patient-physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in-patients. Hospital C has above-average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under-average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health-care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy. The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health-care quality strategies. In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting.

PubMed

Gosselin, Emilie; Bourgault, Patricia; Lavoie, Stephan; Coleman, Robin-Marie; Méziat-Burdin, Anne

2014-12-01

Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p < .001) for the whole tool, with variations from 0.619 to 0.920 (p < .01) between dimensions. The expert panel was satisfied with the content and face validity of the tool. The psychometric qualities of the NOTPaM developed in this study are satisfactory. However, the tool could be improved with slight modifications. Nevertheless, it was useful in assessing intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Concurrent and prognostic utility of subtyping anorexia nervosa along dietary and negative affect dimensions.

PubMed

Forbush, Kelsie T; Hagan, Kelsey E; Salk, Rachel H; Wildes, Jennifer E

2017-03-01

Bulimia nervosa can be reliably classified into subtypes based on dimensions of dietary restraint and negative affect. Community and clinical studies have shown that dietary-negative affect subtypes have greater test-retest reliability and concurrent and predictive validity compared to subtypes based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although dietary-negative affect subtypes have shown utility for characterizing eating disorders that involve binge eating, this framework may have broader implications for understanding restrictive eating disorders. The purpose of this study was to test the concurrent and predictive validity of dietary-negative affect subtypes among patients with anorexia nervosa (AN; N = 194). Latent profile analysis was used to identify subtypes of AN based on dimensions of dietary restraint and negative affect. Chi-square and multivariate analysis of variance were used to characterize baseline differences between identified subtypes. Structural equation modeling was used to test whether dietary-negative affect subtypes would outperform DSM categories in predicting clinically relevant outcomes. Results supported a 2-profile model that replicated dietary-negative affect subtypes: Latent Profile 1 (n = 68) had clinically elevated scores on restraint only; Latent Profile 2 (n = 126) had elevated scores on both restraint and negative affect. Validation analyses showed that membership in the dietary-negative affect profile was associated with greater lifetime psychiatric comorbidity and psychosocial impairment compared to the dietary class. Dietary-negative affect subtypes only outperformed DSM categories in predicting quality-of-life impairment at 1-year follow-up. Findings highlight the clinical utility of subtyping AN based on dietary restraint and negative affect for informing future treatment-matching or personalized medicine strategies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Perspectives on Porous Media MR in Clinical MRI

NASA Astrophysics Data System (ADS)

Sigmund, E. E.

2011-03-01

Many goals and challenges of research in natural or synthetic porous media are mirrored in quantitative medical MRI. This review will describe examples where MR techniques used in porous media (particularly diffusion-weighted imaging (DWI)) are applied to physiological pathologies. Tissue microstructure is one area with great overlap with porous media science. Diffusion-weighting (esp. in neurological tissue) has motivated models with explicit physical dimensions, statistical parameters, empirical descriptors, or hybrids thereof. Another clinically relevant microscopic process is active flow. Renal (kidney) tissue possesses significant active vascular / tubular transport that manifests as "pseudodiffusion." Cancerous lesions involve anomalies in both structure and flow. The tools of magnetic resonance and their interpretation in porous media has had great impact on clinical MRI, and continued cross-fertilization of ideas can only enhance the progress of both fields.

Influence on Simon and SNARC Effects of a Nonspatial Stimulus-Response Mapping: Between-Task Logical Recoding

ERIC Educational Resources Information Center

Treccani, Barbara; Milanese, Nadia; Umilta, Carlo

2010-01-01

In 4 experiments, we intermixed trials in which the stimulus color was relevant with trials where participants had to judge the stimulus shape or parity and found that the logical-recoding rule (Hedge & Marsh, 1975) applied to the relevant dimension in a task can generalize to the irrelevant dimension of the other task. The mapping…

Young People and the European Dimension in a Norwegian Context. Migration and National Critical Events as Challenges to Citizenship Education

ERIC Educational Resources Information Center

Skeie, Geir

2014-01-01

The article discusses the "European dimension" in a Norwegian context with focus on the relevance for young people in particular. Against a backdrop of literature discussing Norwegian majority self-understanding in relation to Europe, the article discusses some examples that are relevant for addressing the overall theme, namely recent…

Differential impact of relevant and irrelevant dimension primes on rule-based and information-integration category learning.

PubMed

Grimm, Lisa R; Maddox, W Todd

2013-11-01

Research has identified multiple category-learning systems with each being "tuned" for learning categories with different task demands and each governed by different neurobiological systems. Rule-based (RB) classification involves testing verbalizable rules for category membership while information-integration (II) classification requires the implicit learning of stimulus-response mappings. In the first study to directly test rule priming with RB and II category learning, we investigated the influence of the availability of information presented at the beginning of the task. Participants viewed lines that varied in length, orientation, and position on the screen, and were primed to focus on stimulus dimensions that were relevant or irrelevant to the correct classification rule. In Experiment 1, we used an RB category structure, and in Experiment 2, we used an II category structure. Accuracy and model-based analyses suggested that a focus on relevant dimensions improves RB task performance later in learning while a focus on an irrelevant dimension improves II task performance early in learning. © 2013.

Effects of learning content in context on knowledge acquisition and recall: a pretest-posttest control group design.

PubMed

Bergman, Esther M; de Bruin, Anique B H; Vorstenbosch, Marc A T M; Kooloos, Jan G M; Puts, Ghita C W M; Leppink, Jimmie; Scherpbier, Albert J J A; van der Vleuten, Cees P M

2015-08-15

It is generally assumed that learning in context increases performance. This study investigates the relationship between the characteristics of a paper-patient context (relevance and familiarity), the mechanisms through which the cognitive dimension of context could improve learning (activation of prior knowledge, elaboration and increasing retrieval cues), and test performance. A total of 145 medical students completed a pretest of 40 questions, of which half were with a patient vignette. One week later, they studied musculoskeletal anatomy in the dissection room without a paper-patient context (control group) or with (ir)relevant-(un)familiar context (experimental groups), and completed a cognitive load scale. Following a short delay, the students completed a posttest. Surprisingly, our results show that students who studied in context did not perform better than students who studied without context. This finding may be explained by an interaction of the participants' expertise level, the nature of anatomical knowledge and students' approaches to learning. A relevant-familiar context only reduced the negative effect of learning the content in context. Our results suggest discouraging the introduction of an uncommon disease to illustrate a basic science concept. Higher self-perceived learning scores predict higher performance. Interestingly, students performed significantly better on the questions with context in both tests, possibly due to a 'framing effect'. Since studies focusing on the physical and affective dimensions of context have also failed to find a positive influence of learning in a clinically relevant context, further research seems necessary to refine our theories around the role of context in learning.

Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder.

PubMed

Harrison, Ben J; Pujol, Jesus; Cardoner, Narcis; Deus, Joan; Alonso, Pino; López-Solà, Marina; Contreras-Rodríguez, Oren; Real, Eva; Segalàs, Cinto; Blanco-Hinojo, Laura; Menchon, José M; Soriano-Mas, Carles

2013-02-15

Functional neuroimaging studies have provided consistent support for the idea that obsessive-compulsive disorder (OCD) is associated with disturbances of brain corticostriatal systems. However, in general, these studies have not sought to account for the disorder's prominent clinical heterogeneity. To address these concerns, we investigated the influence of major OCD symptom dimensions on brain corticostriatal functional systems in a large sample of OCD patients (n = 74) and control participants (n = 74) examined with resting-state functional magnetic resonance imaging. We employed a valid method for mapping ventral and dorsal striatal functional connectivity, which supported both standard group comparisons and linear regression analyses with patients' scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Consistent with past findings, patients demonstrated a common connectivity alteration involving the ventral striatum and orbitofrontal cortex that predicted overall illness severity levels. This common alteration was independent of the effect of particular symptom dimensions. Instead, we observed distinct anatomical relationships between the severity of symptom dimensions and striatal functional connectivity. Aggression symptoms modulated connectivity between the ventral striatum, amygdala, and ventromedial frontal cortex, while sexual/religious symptoms had a specific influence on ventral striatal-insular connectivity. Hoarding modulated the strength of ventral and dorsal striatal connectivity with distributed frontal regions. Taken together, these results suggest that pathophysiological changes among orbitofrontal-striatal regions may be common to all forms of OCD. They suggest that a further examination of certain dimensional relationships will also be relevant for advancing current neurobiological models of the disorder. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Validation of the Chinese version of EORTC QLQ-BN20 for patients with brain cancer.

PubMed

Zhang, K; Tian, J; He, Z; Sun, W; Pekbay, B; Lin, Y; Wu, D; Zhang, J; Chen, P; Guo, H; Wan, Y; Wang, M; Yang, S; Zheng, J; Zhang, L

2018-03-01

This is a single centre study in mainland China aiming to evaluate the reliability, validity and responsiveness of the Chinese version of EORTC QLQ-BN20, designed by The European Organization for Research and Treatment of Cancer Quality of Life Group to evaluate the life quality of patients with brain tumour, cancer or metastases. One hundred and eighty-eight patients with primary or secondary brain cancer from Hunan Provincial Tumor Hospital during September 2013 to June 2014 completed the Chinese EORTC QLQ-C30/BN20 questionnaires developed by translation, back translation and cultural adaptation. Results were statistically analysed using SPSS17.0. The internal consistency (Cronbach's α coefficient) was between .753 and .869, the correlation coefficients among items and its own dimension were bigger than .4, and all items had a better correlation with its own dimension. The Spearman was used to analyse the correlation of each dimension between EORTC QLQ-BN20 and EORTC QLQ-C30, and the result showed that individual dimensions were moderately correlated, other dimensions were weakly correlated. In conclusion, the Chinese version of EORTC QLQ BN20 questionnaire had great relevance, reliability, convergent validity and discriminant validity. It provides a valuable tool for the assessment of health-related quality of life in clinical studies of Chinese patients with primary or secondary brain cancer. © 2018 John Wiley & Sons Ltd.

Context modulation of learned attention deployment.

PubMed

Uengoer, Metin; Pearce, John M; Lachnit, Harald; Koenig, Stephan

2018-03-01

In three experiments, we investigated the contextual control of attention in human discrimination learning. In each experiment, participants initially received discrimination training in which the cues from Dimension A were relevant in Context 1 but irrelevant in Context 2, whereas the cues from Dimension B were irrelevant in Context 1 but relevant in Context 2. In Experiment 1, the same cues from each dimension were used in Contexts 1 and 2, whereas in Experiments 2 and 3, the cues from each dimension were changed across contexts. In each experiment, participants were subsequently shifted to a transfer discrimination involving novel cues from either dimension, to assess the contextual control of attention. In Experiment 1, measures of eye gaze during the transfer discrimination revealed that Dimension A received more attention than Dimension B in Context 1, whereas the reverse occurred in Context 2. Corresponding results indicating the contextual control of attention were found in Experiments 2 and 3, in which we used the speed of learning (associability) as an indirect marker of learned attentional changes. Implications of our results for current theories of learning and attention are discussed.

Physical Inactivity from Adolescence to Young Adulthood: The Relevance of Various Dimensions of Inequality in a Swedish Longitudinal Sample

ERIC Educational Resources Information Center

Wells, Laura; Nermo, Magnus; Östberg, Viveca

2017-01-01

As physical inactivity may track from adolescence to adulthood, it is important to identify social determinants of physical inactivity in early life. However, most studies have measured socioeconomic position as one dimension. We examine whether multiple dimensions of socioeconomic position, in addition to other dimensions of inequality (i.e.,…

Two Types of Perseveration in the Dimension Change Card Sort Task

ERIC Educational Resources Information Center

Hanania, Rima

2010-01-01

In the Dimension Change Card Sort (DCCS) task, 3-year-olds can sort cards well by one dimension but have difficulty in switching to sort the same cards by another dimension when asked; that is, they perseverate on the first relevant information. What is the information that children perseverate on? Using a new version of the DCCS, the experiments…

Clinical phenotypes of perinatal depression and time of symptom onset: analysis of data from an international consortium.

PubMed

Putnam, Karen T; Wilcox, Marsha; Robertson-Blackmore, Emma; Sharkey, Katherine; Bergink, Veerle; Munk-Olsen, Trine; Deligiannidis, Kristina M; Payne, Jennifer; Altemus, Margaret; Newport, Jeffrey; Apter, Gisele; Devouche, Emmanuel; Viktorin, Alexander; Magnusson, Patrik; Penninx, Brenda; Buist, Anne; Bilszta, Justin; O'Hara, Michael; Stuart, Scott; Brock, Rebecca; Roza, Sabine; Tiemeier, Henning; Guille, Constance; Epperson, C Neill; Kim, Deborah; Schmidt, Peter; Martinez, Pedro; Di Florio, Arianna; Wisner, Katherine L; Stowe, Zachary; Jones, Ian; Sullivan, Patrick F; Rubinow, David; Wildenhaus, Kevin; Meltzer-Brody, Samantha

2017-06-01

The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19-40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe. Our findings show that there might be different types and severity of perinatal depression with varying time of onset throughout pregnancy and post partum. These findings support the need for tailored treatments that improve outcomes for women with perinatal depression. Janssen Research & Development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical phenotypes of perinatal depression and time of symptom onset: analysis of data from an international consortium

PubMed Central

Putnam, Karen T; Wilcox, Marsha; Robertson-Blackmore, Emma; Sharkey, Katherine; Bergink, Veerle; Munk-Olsen, Trine; Deligiannidis, Kristina M; Payne, Jennifer; Altemus, Margaret; Newport, Jeffrey; Apter, Gisele; Devouche, Emmanuel; Viktorin, Alexander; Magnusson, Patrik; Penninx, Brenda; Buist, Anne; Bilszta, Justin; O’Hara, Michael; Stuart, Scott; Brock, Rebecca; Roza, Sabine; Tiemeier, Henning; Guille, Constance; Epperson, C Neill; Kim, Deborah; Schmidt, Peter; Martinez, Pedro; Di Florio, Arianna; Wisner, Katherine L; Stowe, Zachary; Jones, Ian; Sullivan, Patrick F; Rubinow, David; Wildenhaus, Kevin; Meltzer-Brody, Samantha

2018-01-01

Summary Background The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Methods Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19–40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Findings Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe. Interpretation Our findings show that there might be different types and severity of perinatal depression with varying time of onset throughout pregnancy and post partum. These findings support the need for tailored treatments that improve outcomes for women with perinatal depression. Funding Janssen Research & Development. PMID:28476427

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences-Comorbidities Network Study.

PubMed

Houben-Wilke, Sarah; Jörres, Rudolf A; Bals, Robert; Franssen, Frits M E; Gläser, Sven; Holle, Rolf; Karch, Annika; Koch, Armin; Magnussen, Helgo; Obst, Anne; Schulz, Holger; Spruit, Martijn A; Wacker, Margarethe E; Welte, Tobias; Wouters, Emiel F M; Vogelmeier, Claus; Watz, Henrik

2017-01-15

Knowledge about the prevalence of objectively assessed peripheral artery disease (PAD) and its clinical relevance in patients with chronic obstructive pulmonary disease (COPD) is scarce. We aimed to: (1) assess the prevalence of PAD in COPD compared with distinct control groups; and (2) study the association between PAD and functional capacity as well as health status. The ankle-brachial index was used to diagnose PAD (ankle-brachial index ≤ 0.9). The 6-minute-walk distance, health status (St. George's Respiratory Questionnaire), COPD Assessment Test, and EuroQol-5-Dimensions were assessed in patients enrolled in the German COPD and Systemic Consequences-Comorbidities Network cohort study. Control groups were derived from the Study of Health in Pomerania. A total of 2,088 patients with COPD (61.1% male; mean [SD] age, 65.3 [8.2] years, GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I-IV: 9.4, 42.5, 37.5, and 10.5%, respectively) were included, of which 184 patients (8.8%; GOLD stage I-IV: 5.1, 7.4, 11.1, and 9.5%, respectively, vs. 5.9% in patients with GOLD stage 0 in the COPD and Systemic Consequences-Comorbidities Network) had PAD. In the Study of Health in Pomerania, PAD ranged from 1.8 to 4.2%. Patients with COPD with PAD had a significantly shorter 6-minute-walk distance (356 [108] vs. 422 [103] m, P < 0.001) and worse health status (St. George's Respiratory Questionnaire: 49.7 [20.1] vs. 42.7 [20.0] points, P < 0.001; COPD Assessment Test: 19.6 [7.4] vs. 17.9 [7.4] points, P = 0.004; EuroQol-5-Dimensions visual analog scale: 51.2 [19.0] vs. 57.2 [19.6], P < 0.001). Differences remained significant after correction for several confounders. In a large cohort of patients with COPD, 8.8% were diagnosed with PAD, which is higher than the prevalence in control subjects without COPD. PAD was associated with a clinically relevant reduction in functional capacity and health status.

Financial capacity in older adults: a growing concern for clinicians.

PubMed

Gardiner, Paul A; Byrne, Gerard J; Mitchell, Leander K; Pachana, Nancy A

2015-02-02

Older people with cognitive impairment and/or dementia may be particularly vulnerable to diminished financial decision-making capacity. Financial capacity refers to the ability to satisfactorily manage one's financial affairs in a manner consistent with personal self-interest and values. Impairment of financial capacity makes the older individual vulnerable to financial exploitation, may negatively affect their family's financial situation and places strain on relationships within the family. Clinicians are often on the front line of responding to queries regarding decision-making capacity, and clinical evaluation options are often not well understood. Assessment of financial capacity should include formal objective assessment in addition to a clinical interview and gathering contextual data. Development of a flexible, empirically supported and clinically relevant assessment approach that spans all dimensions of financial capacity yet is simple enough to be used by non-specialist clinicians is needed.

Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness.

PubMed

Azami-Aghdash, Saber; Tabrizi, Jafar Sadegh; Sadeghi-Bazargani, Homayoun; Hajebrahimi, Sakineh; Naghavi-Behzad, Mohammad

2015-04-01

This study has been designed and conducted to develop domestic indicators for evaluating the performance of clinical governance in dimensions of risk management and clinical effectiveness. This study implemented a 5-stage process including conducting a comprehensive literature review, expert panel (∼ 1000 h per person per session, 11 experts), semi-structured interviews, a 2-round Delphi study (33 experts were in attendance) and a final expert panel (8 experts were in attendance). East Azerbaijan-Iran Province. Fifty-six specialists and experts in different fields of medical sciences. Importance and applicability of indicators. Using a thorough literature review, 361 indicators (129 risk management indicators in 4 dimensions and 232 clinical effectiveness indicators in 18 dimensions) were found. After conducting expert panels and interviews, the number of indicators decreased to 168 cases (65 risk management indicators in 4 dimensions and 103 clinical effectiveness indicators in 12 dimensions). Two rounds of Delphi identified four indicators that were omitted. The members of the final expert panel agreed on 113 indicators (43 risk management indicators in 4 dimensions and 70 clinical effectiveness indicators in 11 dimensions). In this study, indicators for assessing clinical governance in domains of risk management and clinical effectiveness were designed that can be used by policy-makers and other authorities for improving the quality of services and evaluating the performance of clinical governance. Those indicators can be used with slight modifications in other countries having healthcare systems similar to that of Iran. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Extending the ‘cross-disorder’ relevance of executive functions to dimensional neuropsychiatric traits in youth

PubMed Central

McGrath, Lauren M.; Braaten, Ellen B.; Doty, Nathan D.; Willoughby, Brian L.; Wilson, H. Kent; O’Donnell, Ellen H.; Colvin, Mary K.; Ditmars, Hillary L.; Blais, Jessica E.; Hill, Erin N.; Metzger, Aaron; Perlis, Roy H.; Willcutt, Erik G.; Smoller, Jordan W.; Waldman, Irwin D.; Faraone, Stephen V.; Seidman, Larry J.; Doyle, Alysa E.

2016-01-01

Background Evidence that different neuropsychiatric conditions share genetic liability has increased interest in phenotypes with ‘cross-disorder’ relevance, as they may contribute to revised models of psychopathology. Cognition is a promising construct for study; yet, evidence that the same cognitive functions are impaired across different forms of psychopathology comes primarily from separate studies of individual categorical diagnoses versus controls. Given growing support for dimensional models that cut across traditional diagnostic boundaries, we aimed to determine, within a single cohort, whether performance on measures of executive functions (EFs) predicted dimensions of different psychopathological conditions known to share genetic liability. Methods Data are from 393 participants, ages 8 to 17, consecutively enrolled in the Longitudinal Study of Genetic Influences on Cognition (LOGIC). This project is conducting deep phenotyping and genomic analyses in youth referred for neuropsychiatric evaluation. Using structural equation modeling, we examined whether EFs predicted variation in core dimensions of autism spectrum disorder, bipolar illness and schizophrenia, including social responsiveness, mania/emotion regulation, and positive symptoms of psychosis, respectively. Results We modeled three cognitive factors (working memory, shifting, and executive processing speed) that loaded on a second-order EF factor. The EF factor predicted variation in our three target traits but not in a negative control (somatization). Moreover, this EF factor was primarily associated with the overlapping (rather than unique) variance across the three outcome measures, suggesting it related to a general increase in psychopathology symptoms across those dimensions. Conclusions Findings extend support for the relevance of cognition to neuropsychiatric conditions that share underlying genetic risk. They suggest that higher-order cognition, including EFs, relate to the dimensional spectrum of each of these disorders and not just the clinical diagnoses. Moreover, results have implications for bottom-up models linking genes, cognition, and a general psychopathology liability. PMID:26411927

Sequential Analysis of the Numerical Stroop Effect Reveals Response Suppression

ERIC Educational Resources Information Center

Kadosh, Roi Cohen; Gevers, Wim; Notebaert, Wim

2011-01-01

Automatic processing of irrelevant stimulus dimensions has been demonstrated in a variety of tasks. Previous studies have shown that conflict between relevant and irrelevant dimensions can be reduced when a feature of the irrelevant dimension is repeated. The specific level at which the automatic process is suppressed (e.g., perceptual repetition,…

Clusters of Occupations Based on Systematically Derived Work Dimensions: An Exploratory Study.

ERIC Educational Resources Information Center

Cunningham, J. W.; And Others

The study explored the feasibility of deriving an educationally relevant occupational cluster structure based on Occupational Analysis Inventory (OAI) work dimensions. A hierarchical cluster analysis was applied to the factor score profiles of 814 occupations on 22 higher-order OAI work dimensions. From that analysis, 73 occupational clusters were…

Therapist Adherence in Brief Strategic Family Therapy for Adolescent Drug Abusers

PubMed Central

Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Puccinelli, Marc J.; Henderson, Craig; Szapocznik, José

2012-01-01

Objective Therapist adherence has been shown to predict clinical outcomes in family therapy. In prior studies, adherence has been represented broadly by core principles and a consistent family (vs. individual) focus. To date, these studies have not captured the range of clinical skills that are represented in complex family-based approaches or examined how variations in these skills predict different clinically relevant outcomes over the course of treatment. In this study, the authors examined the reliability and validity of an observational adherence measure and the relationship between adherence and outcome in a sample of drug-using adolescents who received brief strategic family therapy within a multisite effectiveness study. Method Participants were 480 adolescents (age 12–17) and their family members, who were randomized to the Brief Strategic Family Therapist treatment condition (J. Szapocznik, U. Hervis, & S. Schwartz, 2003) or treatment as usual. The adolescents were mostly male (377 vs. 103 female) and Hispanic (213), whereas 148 were White, and 110 were Black. Therapists were also randomly assigned to treatment condition within agencies. Results Results supported the proposed factor structure of the adherence measure, providing evidence that it is possible to capture and discriminate between distinct dimensions of family therapy. Analyses demonstrated that the mean levels of the factors varied over time in theoretically and clinically relevant ways and that therapist adherence was associated with engagement and retention in treatment, improvements in family functioning, and reductions in adolescent drug use. Conclusions Clinical implications and future research directions are discussed, including the relevance of these findings on training therapists and studies focusing on mechanisms of action in family therapy. PMID:21261433

Aortic root dilatation in athletic population.

PubMed

Pelliccia, Antonio; Di Paolo, Fernando M; Quattrini, Filippo M

2012-01-01

Remodeling of the aortic root may be expected to occur in athletes as a consequence of hemodynamic overload associated with exercise training; however, there are few data reporting its presence or extent. This review reports the current knowledge regarding the prevalence, upper limits, and clinical significance of aortic remodeling induced by athletic training. Several determinants impact aortic dimension in healthy, nonathletic individuals, including height, body size, age, sex, and blood pressure. Of these factors, anthropometric variables have the greatest impact. In athletes, the effect of exercise training appears to have only a modest additional influence on aortic dimension, although previous studies have produced some conflicting results. Specifically, data derived from the largest available athletic cohort suggest that the most hemodynamically intense endurance disciplines (eg, cycling and swimming) are associated with a significant but mild increase in aortic dimensions. Power disciplines, instead, (eg, weight lifting, throwing events) have only trivial, if any, impact. In contrast, selected data from a different athlete population suggest a more significant dimensional aortic remodeling in strength-trained individuals. In our experience, the 99th percentile value of aortic root diameter corresponds to 40 mm in males and 34 mm in females, which can reasonably be considered the upper limits of physiologic aortic root remodeling. However, a small proportion of apparently healthy male athletes (approximately 1%) show aortic enlargement above the upper limits, in the absence of systemic disease (ie, Marfan syndrome). Athletes presenting with aortic enlargement may demonstrate a further dimensional increase in midlife leading to clinically relevant aortic dilatation. Occasionally, dilation may be severe enough to warrant consideration for surgical treatment. Therefore, serial clinical and echocardiographic evaluations are recommended in athletes when aortic root exceeds the sex-specific thresholds. Copyright © 2012 Elsevier Inc. All rights reserved.

Morphometric analysis and clinical application of the working dimensions of cricothyroid membrane in south Indian adults: with special relevance to surgical cricothyroidotomy.

PubMed

Prithishkumar, Ivan J; David, Suresh S

2010-02-01

To measure the working dimensions of the cricothyroid membrane in the adult south Indian population and to establish the association between the working dimensions and the appropriate endotracheal tube size for the purpose of cricothyroidotomy. Cross-sectional evaluation of 50 fresh adult autopsy cases (35 men, 15 women) in a medical university teaching hospital in South India. Age ranged from 17.0 to 83.0 years. Working dimensions of the membrane in neutral position of neck, in men: width = 8.41 +/- 2.11 mm, height = 6.57 +/- 1.87 mm; in women: width = 6.30 +/- 1.29 mm, height = 5.80 +/- 1.56 mm. Depth of the subglottic larynx at the level of cricoid cartilage: men = 20.73 +/- 1.97 mm, women = 15.62 +/- 1.71 mm. Distance of the lower border of cricothyroid membrane from suprasternal notch in neutral position of neck, in men = 5.18 +/- 1.76 cm, women = 4.72 +/- 1.55 cm; in passively extended neck, men = 7.86 +/- 1.25 cm, women = 8.05 +/- 1.28 cm. Regression equations have been derived to determine endotracheal tube size for cricothyroidotomy, based on distance between sternal notch and chin, and height of the individual (P < 0.05). Working dimensions are smaller in the Indian group compared with western publications. Endotracheal tubes ranging from size 3.0 to 6.0 might be used for cricothyroidotomy in the adult south Indian population.

Insight in schizophrenia: a review.

PubMed

Dam, Jesper

2006-01-01

The issue of insight in schizophrenia must be assumed to be one of the most important aspects of the clinical examination. Comprehensive studies have shown that between 50% and 80% of all patients suffering from schizophrenia do not believe that they have a disorder. In recent years, poor insight in schizophrenia has been the subject of increasing interest, as manifested in a number of studies discussed in the present review. Some of these studies focus on insight correlated to various parameters such as psychopathology, neuropsychology, clinical relevance and compliance. Other studies refer to more theoretical implications, among these the issue of defining the concept of insight: whether insight can be seen as a "primary" phenomenon in schizophrenia, and whether insight may be graduated, dimensioned or increased. Several authors have developed rating scales in an attempt to obtain a measure for the degree or dimension of insight. Here, the range of parameters employed gives an excellent impression of the complexity of the concept of insight. In the concluding discussion, a phenomenological aspect is brought in, in an attempt to place the concept of insight in relation to disturbances of the self in schizophrenia and to primary symptoms in schizophrenia, amongst these autism.

Love and compassion meditation: a nondual perspective.

PubMed

Josipovic, Zoran

2016-06-01

This paper discusses meditation from the unique perspective of the nondual approach and explores the possible relevance of this approach to applications of love and compassion meditation in clinical settings. It contrasts the nondual approach with the better known gradual or goal-oriented, dualistic view of meditation. This paper also introduces one of the central ideas of the nondual approach-that love and compassion, like other positive qualities that are ordinarily considered as goals of meditation practice, can be found to be already present within oneself as innate dimensions of one's authentic being. © 2016 New York Academy of Sciences.

Exploring the Dimensions of Brand Reputation in Higher Education--A Case Study of a Finnish Master's Degree Programme

ERIC Educational Resources Information Center

Suomi, Kati

2014-01-01

This exploratory study examines the dimensions that are relevant to brand reputation, particularly in the context of master's degree programmes. The data analysis is based on Vidaver-Cohen's "Business school quality dimensions and reputational attributes". The qualitative data for the case study comprise a student questionnaire and…

[Evaluating the maturity of IT-supported clinical imaging and diagnosis using the Digital Imaging Adoption Model : Are your clinical imaging processes ready for the digital era?

PubMed

Studzinski, J

2017-06-01

The Digital Imaging Adoption Model (DIAM) has been jointly developed by HIMSS Analytics and the European Society of Radiology (ESR). It helps evaluate the maturity of IT-supported processes in medical imaging, particularly in radiology. This eight-stage maturity model drives your organisational, strategic and tactical alignment towards imaging-IT planning. The key audience for the model comprises hospitals with imaging centers, as well as external imaging centers that collaborate with hospitals. The assessment focuses on different dimensions relevant to digital imaging, such as software infrastructure and usage, workflow security, clinical documentation and decision support, data exchange and analytical capabilities. With its standardised approach, it enables regional, national and international benchmarking. All DIAM participants receive a structured report that can be used as a basis for presenting, e.g. budget planning and investment decisions at management level.

Hoarding in obsessive-compulsive disorder: clinical and genetic correlates.

PubMed

Lochner, Christine; Kinnear, Craig J; Hemmings, Sian M J; Seller, Cathlene; Niehaus, Dana J H; Knowles, James A; Daniels, Willie; Moolman-Smook, Johanna C; Seedat, Soraya; Stein, Dan J

2005-09-01

Hoarding may be an important symptom dimension in obsessive-compulsive disorder (OCD). Hoarding in OCD has been associated with poor insight, poorer response to selective serotonin reuptake inhibitors than other OCD symptom dimensions, and a distinctive psychobiological profile. The clinical and genetic correlates of hoarding in OCD therefore deserve additional investigation. Adult OCD patients (N = 315) underwent a comprehensive clinical assessment that included the Structured Clinical Interview for DSM-IV Axis I Disorders (Patient Edition) and for Diagnosis of Obsessive-Compulsive Spectrum Disorders. DNA extracted from venous blood (10-30 mL) in a Caucasian subset of the interviewed OCD patients (N = 204) and Caucasian controls (N = 169), including patients (N = 94) and controls (N = 138) of Afrikaner descent, was genotyped to investigate polymorphisms in genes involved in monoamine function and previously hypothesized to be relevant to OCD. Data were collected from 1998 through 2004. OCD patients with hoarding made up 18.1% of the total sample. Compared with nonhoarding OCD, OCD with hoarding was associated with a number of comorbid Axis I disorders, obsessive-compulsive personality disorder, significantly higher OCD severity scores, and more functional impairment. In subjects of Afrikaner descent, the L/L genotype of the COMT Val158Met polymorphism was significantly more common in the OCD hoarding group, with a preponderance of low activity alleles, compared with nonhoarding patients and controls. These data are consistent with the hypothesis that hoarding represents a unique symptom subtype in OCD with a distinctive clinical and psychobiological profile. Further work is needed to determine the psychobiological mechanisms responsible for hoarding and to replicate the genetic findings noted here.

Exterior dimension of fat fractals

NASA Technical Reports Server (NTRS)

Grebogi, C.; Mcdonald, S. W.; Ott, E.; Yorke, J. A.

1985-01-01

Geometric scaling properties of fat fractal sets (fractals with finite volume) are discussed and characterized via the introduction of a new dimension-like quantity which is called the exterior dimension. In addition, it is shown that the exterior dimension is related to the 'uncertainty exponent' previously used in studies of fractal basin boundaries, and it is shown how this connection can be exploited to determine the exterior dimension. Three illustrative applications are described, two in nonlinear dynamics and one dealing with blood flow in the body. Possible relevance to porous materials and ballistic driven aggregation is also noted.

Which Dimensions of Patient-Centeredness Matter? - Results of a Web-Based Expert Delphi Survey.

PubMed

Zill, Jördis M; Scholl, Isabelle; Härter, Martin; Dirmaier, Jörg

2015-01-01

Present models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions. A two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria. 105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment. 11 out of the 15 dimensions have been validated through experts' ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy.

Which Dimensions of Patient-Centeredness Matter? - Results of a Web-Based Expert Delphi Survey

PubMed Central

Zill, Jördis M.; Scholl, Isabelle; Härter, Martin; Dirmaier, Jörg

2015-01-01

Background Present models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions. Method A two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria. Results 105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment. Discussion 11 out of the 15 dimensions have been validated through experts’ ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy. PMID:26539990

Identification of symptom and functional domains that fibromyalgia patients would like to see improved: a cluster analysis.

PubMed

Bennett, Robert M; Russell, Jon; Cappelleri, Joseph C; Bushmakin, Andrew G; Zlateva, Gergana; Sadosky, Alesia

2010-06-28

The purpose of this study was to determine whether some of the clinical features of fibromyalgia (FM) that patients would like to see improved aggregate into definable clusters. Seven hundred and eighty-eight patients with clinically confirmed FM and baseline pain > or =40 mm on a 100 mm visual analogue scale ranked 5 FM clinical features that the subjects would most like to see improved after treatment (one for each priority quintile) from a list of 20 developed during focus groups. For each subject, clinical features were transformed into vectors with rankings assigned values 1-5 (lowest to highest ranking). Logistic analysis was used to create a distance matrix and hierarchical cluster analysis was applied to identify cluster structure. The frequency of cluster selection was determined, and cluster importance was ranked using cluster scores derived from rankings of the clinical features. Multidimensional scaling was used to visualize and conceptualize cluster relationships. Six clinical features clusters were identified and named based on their key characteristics. In order of selection frequency, the clusters were Pain (90%; 4 clinical features), Fatigue (89%; 4 clinical features), Domestic (42%; 4 clinical features), Impairment (29%; 3 functions), Affective (21%; 3 clinical features), and Social (9%; 2 functional). The "Pain Cluster" was ranked of greatest importance by 54% of subjects, followed by Fatigue, which was given the highest ranking by 28% of subjects. Multidimensional scaling mapped these clusters to two dimensions: Status (bounded by Physical and Emotional domains), and Setting (bounded by Individual and Group interactions). Common clinical features of FM could be grouped into 6 clusters (Pain, Fatigue, Domestic, Impairment, Affective, and Social) based on patient perception of relevance to treatment. Furthermore, these 6 clusters could be charted in the 2 dimensions of Status and Setting, thus providing a unique perspective for interpretation of FM symptomatology.

An investigation on the quality of midwifery services from the viewpoint of the clients in Isfahan through SERVQUAL model.

PubMed

Oliaee, Zohreh; Jabbari, Alireza; Ehsanpour, Soheila

2016-01-01

Quality of care is of great importance in health services as these services have the important mission to preserve health, and to give care to the society. The present study aimed to investigate the quality of midwifery services from the viewpoint of the clients, under coverage of health care centers in Isfahan, through SERVQUAL model. This descriptive and analytical study was conducted on 218 subjects in 2014. Study population comprised the women referring to midwifery services clinics in health care centers in Isfahan. Data of the subjects (n = 218) were collected by SERVQUAL model containing the dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Data were analyzed by paired t-test, Spearman and Pearson correlation coefficients, and independent t-test through SPSS 20. There was a negative gap in all five relevant dimensions of giving services. The widest gap was in the mean of dimension of tangibles (-1.5), and the narrowest gap was in the dimension of assurance (-0.9). There was no significant association between the scores of expectations and perceptions, and age, education level, occupation, and marital status. The obtained negative gap showed that the level of service receivers' perception from existing condition was far from their expectation, and there was a wide gap between attaining their satisfaction with midwifery services and their expectation and reaching their appropriate level of services.

Bootstrapping rapidity anomalous dimensions for transverse-momentum resummation

DOE PAGES

Li, Ye; Zhu, Hua Xing

2017-01-11

Soft function relevant for transverse-momentum resummation for Drell-Yan or Higgs production at hadron colliders are computed through to three loops in the expansion of strong coupling, with the help of bootstrap technique and supersymmetric decomposition. The corresponding rapidity anomalous dimension is extracted. Furthermore, an intriguing relation between anomalous dimensions for transverse-momentum resummation and threshold resummation is found.

Structural and Process Factors That Influence Clinical Nurse Specialist Role Implementation.

PubMed

Kilpatrick, Kelley; Tchouaket, Eric; Carter, Nancy; Bryant-Lukosius, Denise; DiCenso, Alba

2016-01-01

The aim of this study was to examine the influence of structure and process on clinical nurse specialist (CNS) role implementation. We conducted a secondary analysis of cross-sectional survey data. The study was performed in Canada. The authors included 445 of 471 questionnaires (94.5%) of graduate-prepared CNSs. Based on Donabedian's framework, we conducted a secondary analysis of CNS responses using hierarchical regression. The internal consistency of the 6 CNS role dimensions and team dynamics subscales was excellent. The use of a framework to guide CNS role implementation influences all the role dimensions. Employer understanding of the CNS role, working in an urban catchment area, specialty certification, and more years in a CNS role had a direct positive influence on team dynamics. Full-time employment exerted a direct negative influence on this dimension. Furthermore, team dynamics (as a mediator variable), seeing patients in practice, and having an office in the clinical unit exerted a direct positive influence on the clinical dimension. Having an annual performance appraisal and a job description exerted a direct negative influence on the clinical dimension. Employer understanding, working in an urban area, full-time employment, and specialty certification had an indirect effect on the clinical dimension. Accountability to a nonnurse manager exerted a direct negative influence on the education dimension. The research and scholarly/professional development dimensions were influenced by more years in a CNS role. Accountability to a nurse manager exerted a direct positive influence on the organizational leadership dimension; unionization and seeing patients in practice had a direct negative influence on this dimension. Seeing patients in practice and full-time employment exerted a direct positive influence on the consultation dimension. The identification of structures and processes that influence CNS role implementation may inform strategies used by providers and decision makers to optimize these roles across healthcare settings and support the delivery of high-quality care.

An integrated programme after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: effect on emotional and functional dimensions of quality of life.

PubMed

Moullec, G; Ninot, G

2010-02-01

To assess whether a maintenance integrated health care programme is effective in improving functional and emotional dimensions of quality of life in patients with chronic obstructive pulmonary disease (COPD) after a first pulmonary rehabilitation. Prospective controlled trial. Three rehabilitation centres and three patient self-help associations within a health care network in France. Forty patients with moderate to severe COPD. After a first four-week inpatient pulmonary rehabilitation programme, patients took part in a maintenance integrated health care programme or usual care for 12 months. The primary outcomes were the change in functional and emotional dimensions of quality of life measured by the St George's Respiratory Questionnaire (SGRQ), the brief World Health Organization Quality of Life questionnaire (Brief-WHOQOL) and six specific questions using a 10-cm visual analogue scale. Secondary outcomes were change in exercise tolerance measured by six-minute walking test and cycle exercise. At one year, the maintenance intervention (n = 11) produced improvements in functional and emotional dimensions scores of quality of life and exercise tolerance. Patients in the usual aftercare group (n = 16) exhibited maintenance of functional dimension scores of quality of life, but a clinically relevant decline in emotional scores of quality of life and in six-minute walking distance one year after the pulmonary rehabilitation. Patient self-help association seems to be an innovative and efficient organizational structure to support patients with COPD after pulmonary rehabilitation in real-life settings. A distinction between emotional and functional dimensions of quality of life may improve the design and evaluation of integrated health care programmes in patients with COPD.

Robotically Assisted Sonic Therapy as a Noninvasive Nonthermal Ablation Modality: Proof of Concept in a Porcine Liver Model.

PubMed

Smolock, Amanda R; Cristescu, Mircea M; Vlaisavljevich, Eli; Gendron-Fitzpatrick, Annette; Green, Chelsey; Cannata, Jonathan; Ziemlewicz, Timothy J; Lee, Fred T

2018-05-01

Purpose To determine the feasibility of creating a clinically relevant hepatic ablation (ie, an ablation zone capable of treating a 2-cm liver tumor) by using robotically assisted sonic therapy (RAST), a noninvasive and nonthermal focused ultrasound therapy based on histotripsy. Materials and Methods This study was approved by the institutional animal use and care committee. Ten female pigs were treated with RAST in a single session with a prescribed 3-cm spherical treatment region and immediately underwent abdominal magnetic resonance (MR) imaging. Three pigs (acute group) were sacrificed immediately following MR imaging. Seven pigs (chronic group) were survived for approximately 4 weeks and were reimaged with MR imaging immediately before sacrifice. Animals underwent necropsy and harvesting of the liver for histologic evaluation of the ablation zone. RAST ablations were performed with a 700-kHz therapy transducer. Student t tests were performed to compare prescribed versus achieved ablation diameter, difference of sphericity from 1, and change in ablation zone volume from acute to chronic imaging. Results Ablation zones had a sphericity index of 0.99 ± 0.01 (standard deviation) (P < .001 vs sphericity index of 1). Anteroposterior and transverse dimensions were not significantly different from prescribed (3.4 ± 0.7; P = .08 and 3.2 ± 0.8; P = .29, respectively). The craniocaudal dimension was significantly larger than prescribed (3.8 ± 1.1; P = .04), likely because of respiratory motion. The central ablation zone demonstrated complete cell destruction and a zone of partial necrosis. A fibrous capsule surrounded the ablation zone by 4 weeks. On 4-week follow-up images, ablation zone volumes decreased by 64% (P < .001). Conclusion RAST is capable of producing clinically relevant ablation zones in a noninvasive manner in a porcine model. © RSNA, 2018.

Postapproval Development Options in COPD: A Case Study in Value-Based Healthcare Systems.

PubMed

Murphy, Michael F; Antonini, Paola; Lai, Zhihong Vicki

2011-01-01

Research and development activities in an era of globalization encounter a mosaic of providers, products, services, and intermediaries; regulatory and other government institutions; and consumers. The introduction of novel therapeutics into this environment mandates research programs that are relevant to the registration process, payers and purchasers, transparent pricing, and rule-driven business practices, while providing data relevant to marketing initiatives internationally. To outline an example for clinical development programs that incorporate the perspective of multiple stakeholders into a portfolio of study designs to provide optimal data platforms that can resonate with diverse recipients. A contract research organization directly involved in the design, execution, and analysis of clinical trials for new drugs and devices across pharmaceutical and biotechnology companies provides a unique perspective regarding opportunities and challenges within the international clinical research environment. Drs Murphy, Antonini, and Lai, representing Worldwide Clinical Trials, utilize chronic obstructive pulmonary disease as a demonstration project exploiting its prevalence, direct and indirect costs, and the rapid infusion/diffusion of innovative therapy into practice as a rationale for focus, and illustrate methods of informing registration and technology assessments during a prototypical development process. By virtue of its chronicity, prevalence, and pattern of healthcare utilization, chronic obstructive pulmonary disease provides an ideal case for illustrating the application of clinical trial methodology that can facilitate data evaluation through the prism of multiple stakeholders. Adding an international dimension exacerbates system complexity and serves to illustrate the breadth of issues that can be addressed within this therapeutic area.

Attention to Local Health Burden and the Global Disparity of Health Research

PubMed Central

Evans, James A.; Shim, Jae-Mahn; Ioannidis, John P. A.

2014-01-01

Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge—including clinical trials—in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality. PMID:24691431

Attention to local health burden and the global disparity of health research.

PubMed

Evans, James A; Shim, Jae-Mahn; Ioannidis, John P A

2014-01-01

Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge--including clinical trials--in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality.

Can Psychological, Social and Demographical Factors Predict Clinical Characteristics Symptomatology of Bipolar Affective Disorder and Schizophrenia?

PubMed

Maciukiewicz, Malgorzata; Pawlak, Joanna; Kapelski, Pawel; Łabędzka, Magdalena; Skibinska, Maria; Zaremba, Dorota; Leszczynska-Rodziewicz, Anna; Dmitrzak-Weglarz, Monika; Hauser, Joanna

2016-09-01

Schizophrenia (SCH) is a complex, psychiatric disorder affecting 1 % of population. Its clinical phenotype is heterogeneous with delusions, hallucinations, depression, disorganized behaviour and negative symptoms. Bipolar affective disorder (BD) refers to periodic changes in mood and activity from depression to mania. It affects 0.5-1.5 % of population. Two types of disorder (type I and type II) are distinguished by severity of mania episodes. In our analysis, we aimed to check if clinical and demographical characteristics of the sample are predictors of symptom dimensions occurrence in BD and SCH cases. We included total sample of 443 bipolar and 439 schizophrenia patients. Diagnosis was based on DSM-IV criteria using Structured Clinical Interview for DSM-IV. We applied regression models to analyse associations between clinical and demographical traits from OPCRIT and symptom dimensions. We used previously computed dimensions of schizophrenia and bipolar affective disorder as quantitative traits for regression models. Male gender seemed protective factor for depression dimension in schizophrenia and bipolar disorder sample. Presence of definite psychosocial stressor prior disease seemed risk factor for depressive and suicidal domain in BD and SCH. OPCRIT items describing premorbid functioning seemed related with depression, positive and disorganised dimensions in schizophrenia and psychotic in BD. We proved clinical and demographical characteristics of the sample are predictors of symptom dimensions of schizophrenia and bipolar disorder. We also saw relation between clinical dimensions and course of disorder and impairment during disorder.

Cross-Cultural Studies of Personality Traits and their Relevance to Psychiatry

PubMed Central

Terracciano, Antonio; McCrae, Robert R.

2009-01-01

Aims This article provides a brief review of recent cross-cultural research on personality traits at both individual and culture levels, highlighting the relevance of recent findings for psychiatry. Method In most cultures around the world, personality traits can be clearly summarized by the five broad dimensions of the Five-Factor Model (FFM), which makes it feasible to compare cultures on personality and psychopathology. Results Maturational patterns and sex differences in personality traits generally show cultural invariance, which generates the hypothesis that age of onset, clinical evolution, and sex differences in the prevalence of psychiatric disorders might follow similar universal patterns. The average personality profiles from 51 cultures show meaningful geographical distributions and associations with culture-level variables, but are clearly unrelated to national character stereotypes. Conclusions Aggregate personality scores can potentially be related to epidemiological data on psychiatric disorders, and dimensional personality models have implications for psychiatric diagnosis and treatment around the world. PMID:17128620

PET Timing Performance Measurement Method Using NEMA NEC Phantom

NASA Astrophysics Data System (ADS)

Wang, Gin-Chung; Li, Xiaoli; Niu, Xiaofeng; Du, Huini; Balakrishnan, Karthik; Ye, Hongwei; Burr, Kent

2016-06-01

When comparing the performance of time-of-flight whole-body PET scanners, timing resolution is one important benchmark. Timing performance is heavily influenced by detector and electronics design. Even for the same scanner design, measured timing resolution is a function of many factors including the activity concentration, geometry and positioning of the radioactive source. Due to lack of measurement standards, the timing resolutions reported in the literature may not be directly comparable and may not describe the timing performance under clinically relevant conditions. In this work we introduce a method which makes use of the data acquired during the standard NEMA Noise-Equivalent-Count-Rate (NECR) measurements, and compare it to several other timing resolution measurement methods. The use of the NEMA NEC phantom, with well-defined dimensions and radioactivity distribution, is attractive because it has been widely accepted in the industry and allows for the characterization of timing resolution across a more relevant range of conditions.

Relevance in the science classroom: A multidimensional analysis

NASA Astrophysics Data System (ADS)

Hartwell, Matthew F.

While perceived relevance is considered a fundamental component of adaptive learning, the experience of relevance and its conceptual definition have not been well described. The mixed-methods research presented in this dissertation aimed to clarify the conceptual meaning of relevance by focusing on its phenomenological experience from the students' perspective. Following a critical literature review, I propose an identity-based model of perceived relevance that includes three components: a contextual target, an identity target, and a connection type, or lens. An empirical investigation of this model that consisted of two general phases was implemented in four 9th grade-biology classrooms. Participants in Phase 1 (N = 118) completed a series of four open-ended writing activities focused on eliciting perceived personal connections to academic content. Exploratory qualitative content analysis of a 25% random sample of the student responses was used to identify the main meaning-units of the proposed model as well as different dimensions of student relevance perceptions. These meaning-units and dimensions provided the basis for the construction of a conceptual mapping sentence capturing students' perceived relevance, which was then applied in a confirmatory analysis to all other student responses. Participants in Phase 2 (N = 139) completed a closed survey designed based on the mapping sentence to assess their perceived relevance of a biology unit. The survey also included scales assessing other domain-level motivational processes. Exploratory factor analysis and non-metric multidimensional scaling indicated a coherent conceptual structure, which included a primary interpretive relevance dimension. Comparison of the conceptual structure across various groups (randomly-split sample, gender, academic level, domain-general motivational profiles) provided support for its ubiquity and insight into variation in the experience of perceived relevance among students of different groups. The findings combine to support a multidimensional perspective of relevance in the 9th grade biology classroom; offering researchers a useful model for future investigation and educators with insights into the students' classroom experience.

Two Types of Perseveration in the Dimension Change Card Sort Task

PubMed Central

Hanania, Rima

2010-01-01

Three-year-old children in the Dimension Change Card Sort (DCCS) task can sort cards well by one dimension, but have difficulty switching to sort the same cards by another dimension when asked, i.e., they perseverate on the first relevant information. What is the information that children perseverate on? Using a new version of the DCCS, the experiments in this article reveal that there are two types of perseverators-- those who perseverate at the level of dimensions, and those who perseverate at the level of values (stimulus features). This novel finding has implications for theories of perseveration. PMID:20566206

Incomplete Kochen-Specker coloring

NASA Astrophysics Data System (ADS)

Granström, Helena

2007-09-01

A particular incomplete Kochen-Specker coloring, suggested by Appleby [Stud. Hist. Philos. Mod. Phys. 36, 1 (2005)] in dimension three, is generalized to arbitrary dimension. We investigate its effectivity as a function of dimension, using two different measures. A limit is derived for the fraction of the sphere that can be colored using the generalized Appleby construction as the number of dimensions approaches infinity. The second, and physically more relevant measure of effectivity, is to look at the fraction of properly colored ON bases. Using this measure, we derive a "lower bound for the upper bound" in three and four real dimensions.

Hardy's test as a device-independent dimension witness

NASA Astrophysics Data System (ADS)

Mukherjee, Amit; Roy, Arup; Bhattacharya, Some Sankar; Das, Subhadipa; Gazi, Md. Rajjak; Banik, Manik

2015-08-01

Knowing the dimension of an unknown physical system has practical relevance, as dimensionality plays an important role in various information theoretic tasks. In this work we show that a modified version of Hardy's argument, which reveals the contradiction of quantum theory with local realism, turns out to be useful for inspecting the minimal subsystem dimension of an unknown correlated quantum system. The use of Hardy's test in this task has a novel advantage: the subsystem dimension can be determined without knowing the detailed functioning of the experimental devices; i.e., Hardy's test suffices to be a device-independent dimension witness.

Behavioral resilience in the post-genomic era: emerging models linking genes with environment

PubMed Central

Rende, Richard

2012-01-01

One of the most important deliverables of the post-genomic era has been a new and nuanced appreciation of how the environment shapes—and holds potential to alter—the expression of susceptibility genes for behavioral dimensions and disorders. This paper will consider three themes that have emerged from cutting-edge research studies that utilize newer molecular genetic approaches as well as tried-and-true genetic epidemiological methodologies, with particular reference to evolving perspectives on resilience and plasticity. These themes are: (1) evidence for replicable and robust shared environmental effects on a number of clinically relevant behaviors in childhood and adolescence; (2) evolving research on gene-environment interaction; and (3) a newer focus on differential susceptibility and plasticity. The net sum of these themes is that consideration of genetic effects on behavioral dimensions and disorders needs to be connected to thinking about the role of environment as a potent source for promoting resilience and change. PMID:22461772

Associations between self-harm and distinct types of impulsivity

PubMed Central

Chamberlain, Samuel R; Leppink, Eric W.; Redden, Sarah A.; Grant, Jon E.

2017-01-01

Objective Self-harm is common and is of considerable public health concern. There is an ongoing debate regarding how self-harm should be classified. The aim of this study was to characterize associations between self-harm and impulsivity, including from the perspective of formal mental disorders and neuropsychological functioning. Method Total 333 adults (mean [SD] age 22.6 (3.6) years, 61% male) were recruited from the general community, and undertook detailed clinical and cognitive assessments. History of self-harm was quantified using the Self-Harm Inventory (SHI), which asks about 22 self-harm behaviors (classic self-harm behaviors as well as broader types of behavior that may be relevant, such as engaging in emotionally abusive relationships). Principal components analysis was used to identify latent dimensions of self-harming behaviors. Relationships between self-harm dimensions and other measures were characterized using ordinary least squares regression. Results Principal Components Analysis yielded a three factor solution, corresponding to self-injurious self-harm (e.g. cutting, overdoses, burning), interpersonal related self-harm (e.g. engaging in emotionally or sexually abusive relationships), and reckless self-harm (e.g. losing one’s job deliberately, driving recklessly, abusing alcohol). Regression modelling showed that all three dimensions of self-harm were associated with lower quality of life. Classic and interpersonal self-harm dimensions were associated with impulse control disorders (ICDs) whereas reckless self-harm was associated with other mainstream mental disorders besides ICDs. Only interpersonal self-harm was significantly associated with other impulsive measures ( less risk adjustment on the Cambridge Gambling Task). Conclusions This study suggests the existence of three distinct subtypes or ‘latent factors’ of self-harm: all three appear clinically important in that they are linked with worse quality of life. Clinicians should screen for impulse control disorders in people presenting with self-harm, especially when it is self-injurious or involves interpersonal harm. Our findings militate against self-harm being broadly associated with impulsive personality and cognitive measures, at least in people recruited from a non-clinical / non-treatment setting. If future nosological revisions and treatment trials focus on self-injurious self-harm alone, they may overlook other aspects of self-harm that are also functionally impairing. PMID:28135642

Selective weighting of action-related feature dimensions in visual working memory.

PubMed

Heuer, Anna; Schubö, Anna

2017-08-01

Planning an action primes feature dimensions that are relevant for that particular action, increasing the impact of these dimensions on perceptual processing. Here, we investigated whether action planning also affects the short-term maintenance of visual information. In a combined memory and movement task, participants were to memorize items defined by size or color while preparing either a grasping or a pointing movement. Whereas size is a relevant feature dimension for grasping, color can be used to localize the goal object and guide a pointing movement. The results showed that memory for items defined by size was better during the preparation of a grasping movement than during the preparation of a pointing movement. Conversely, memory for color tended to be better when a pointing movement rather than a grasping movement was being planned. This pattern was not only observed when the memory task was embedded within the preparation period of the movement, but also when the movement to be performed was only indicated during the retention interval of the memory task. These findings reveal that a weighting of information in visual working memory according to action relevance can even be implemented at the representational level during maintenance, demonstrating that our actions continue to influence visual processing beyond the perceptual stage.

Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria

PubMed Central

Karalunas, Sarah L.; Fair, Damien; Musser, Erica D.; Aykes, Kamari; Iyer, Swathi P.; Nigg, Joel T.

2014-01-01

Importance Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosological distinctions limits both mechanistic understanding and clinical prediction. Here, we demonstrate an approach consistent with the NIMH Research Domain Criteria (RDoC) initiative to identifying superior, neurobiologically-valid subgroups with better predictive capacity than existing psychiatric categories for childhood Attention-Deficit Hyperactivity Disorder (ADHD). Objective Refine subtyping of childhood ADHD by using biologically-based behavioral dimensions (i.e. temperament), novel classification algorithms, and multiple external validators. In doing so, we demonstrate how refined nosology is capable of improving on current predictive capacity of long-term outcomes relative to current DSM-based nosology. Design, Setting, Participants 437 clinically well-characterized, community-recruited children with and without ADHD participated in an on-going longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and to examine external validators including physiological and MRI measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. Main Outcome Measures Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using three widely-accepted external validators: peripheral physiology (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity MRI), and clinical outcomes (at one-year longitudinal follow-up). Results The community detection algorithm suggested three novel types of ADHD, labeled as “Mild” (normative emotion regulation); “Surgent” (extreme levels of positive approach-motivation); and “Irritable” (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations, including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcome one year later. Conclusions and Relevance Results suggest that a biologically-informed temperament-based typology, developed with a discovery-based community detection algorithm, provided a superior description of heterogeneity in the ADHD population than any current clinical nosology. This demonstration sets the stage for more aggressive attempts at a tractable, biologically-based nosology. PMID:25006969

Dental students' motivation and the context of learning.

PubMed

Kristensen, Bettina Tjagvad; Netterstrom, Ingeborg; Kayser, Lars

2009-02-01

This qualitative study shows dental students' motives for choosing the dental education and how the motives influence their motivation at the first semester of study. Further the study demonstrates the relevance of the context of learning. This issue is of importance when planning a curriculum for the dental education. The material consists of interviews with eight dental students. The results show that dental students were focused on their future professional role, its practical dimensions and their future working conditions. Their motivation for choosing the dental education was found to influence their motivation for studying and their experience of the relevance of the first semester. The dental students who had co-education with the medical students at the first year of study missed a dental context and courses with clinically relevant contents. In conclusion, our data signify the importance of the context of learning. It is recommended that a future curriculum for the dental school should be designed in a way where basic science subjects are taught with both theoretically as well as practically oriented subjects and in a context which is meaningful for the students.

[Sibling relations from the family therapy perspective--support, attachment, rivalry and envy].

PubMed

Cierpka, M

2001-01-01

In family therapy, during the last years more and more importance is attached to the dynamics of the sibling subsystem. In the present paper differences between them as well as similarities are discussed from the point of view of family theory. Relevant dimensions like support, attachment, rivalry and envy between brothers and sisters contribute essentially to the family dynamics. In this clinically orientated paper, we describe by means of a case example how the couple's conflicts after their separation is unconsciously repeated in the sibling subsystem. It is shown how the intergenerational dynamics can be interrupted by the initiative of the children and the initiated family therapy.

Being a Clinical Educator

ERIC Educational Resources Information Center

Higgs, Joy; Mcallister, Lindy

2007-01-01

What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the…

Academic espionage: dysfunctional aspects of the publish or perish ethic.

PubMed

Mensah, L L

1982-11-01

There are many dysfunctional manifestations relative to the tenure and promotion process. These are disruptive to academic life. Much of this is encouraged by the university because of their publish or perish ethic. Excellence in classroom teaching and success in the field of clinical and human endeavours are not highly valued in deliberations to grant tenure and advancement in academic rank. Research and publications are the major yardsticks upon which a faculty member is judged. This prevailing perspective poses a dilemma for many nursing faculty who have high clinical workloads and have not been socialized for academic survival. The pressures to publish and research can be achieved in a realistic and non-stressful way. Three aspects seem to be particularly relevant to facilitate this achievement; these are: anticipatory planning, balancing the workload, and understanding the interpersonal dimensions of collegiality.

Exploration of the Medicinal Peptide Space.

PubMed

Gevaert, Bert; Stalmans, Sofie; Wynendaele, Evelien; Taevernier, Lien; Bracke, Nathalie; D'Hondt, Matthias; De Spiegeleer, Bart

2016-01-01

The chemical properties of peptide medicines, known as the 'medicinal peptide space' is considered a multi-dimensional subset of the global peptide space, where each dimension represents a chemical descriptor. These descriptors can be linked to biofunctional, medicinal properties to varying degrees. Knowledge of this space can increase the efficiency of the peptide-drug discovery and development process, as well as advance our understanding and classification of peptide medicines. For 245 peptide drugs, already available on the market or in clinical development, multivariate dataexploration was performed using peptide relevant physicochemical descriptors, their specific peptidedrug target and their clinical use. Our retrospective analysis indicates that clusters in the medicinal peptide space are located in a relatively narrow range of the physicochemical space: dense and empty regions were found, which can be explored for the discovery of novel peptide drugs.

Psychopathological correlates of eating behavior among Portuguese undergraduate students.

PubMed

Poínhos, Rui; Oliveira, Bruno M P M; Correia, Flora

2018-04-01

The aim of this study was to explore the relationships between eating behavior dimensions and psychopathological symptoms among Portuguese undergraduate students. We studied 258 participants (62.4% women) regarding eating behavior dimensions (emotional, external and binge eating, flexible and rigid control of eating behavior, and eating self-efficacy), psychopathological distress (as assessed by the Brief Symptom Inventory), and body mass index. In addition to studying bivariate associations between eating behavior dimensions and psychopathological subscales and indexes, what we believe to be a novel analytical approach, considering simultaneously the effects of the overall level of psychopathological distress and the relevance of specific symptoms on the eating behavior dimensions. Emotional, external, and binge eating had positive correlations with psychopathological symptomatology, whereas eating self-efficacy was negatively associated. Multivariate analysis showed that the overall level of psychopathological distress (combined with body mass index, among women) had a larger effect on eating behavior than the relevance of specific symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotional distractors can enhance attention

PubMed Central

Sussman, Tamara J.; Heller, Wendy; Miller, Gregory A.; Mohanty, Aprajita

2015-01-01

The deleterious effects of emotional distractors on attention are well demonstrated. However, it is unclear if emotional distractors inevitably disrupt task-relevant attention. Using multilevel modeling (MLM), the present study examined the impact of valence and arousal dimensions of distracting emotional stimuli and individual differences in anxiety on task-relevant processing. Consistent with prior literature, high-arousal negative distractors were associated with poor task-relevant attention compared to positive and neutral distractors. However, low-arousal negative distractors were associated with better task-relevant performance than were positive and neutral distractors. Furthermore, these effects were accentuated by individual differences in worry. These findings challenge assumptions that distraction and worry must be minimized for augmented attentional performance. Overall, these results emphasize the importance of taking into account emotional dimensions of arousal and valence as well as individual differences in anxiety when examining attention in the presence of emotional distractors. PMID:24058065

Expanding the Dimensions of Epistemic Cognition: Arguments from Philosophy and Psychology

ERIC Educational Resources Information Center

Chinn, Clark A.; Buckland, Luke A.; Samarapungavan, Ala

2011-01-01

Psychological and educational researchers have developed a flourishing research program on epistemological dimensions of cognition (epistemic cognition). Contemporary philosophers investigate many epistemological topics that are highly relevant to this program but that have not featured in research on epistemic cognition. We argue that integrating…

Understanding the fluid nature of personhood - the ring theory of personhood.

PubMed

Radha Krishna, Lalit Kumar; Alsuwaigh, Rayan

2015-03-01

Familial determination, replete with its frequent usurping of patient autonomy, propagation of collusion, and circumnavigation of direct patient involvement in their own care deliberations, continues to impact clinical practice in many Asian nations. Suggestions that underpinning this practice, in Confucian-inspired societies, is the adherence of the populace to the familial centric ideas of personhood espoused by Confucian ethics, provide a novel means of understanding and improving patient-centred care at the end of life. Clinical experience in Confucian-inspired Singapore, however, suggests that personhood is conceived in broader terms. This diverging view inspired a study of local conceptions of personhood and scrutiny of the influence of the family upon it. From the data gathered, a culturally appropriate, clinically relevant and ethically sensitive concept of personhood was proposed: the Ring Theory of Personhood (Ring Theory) that better captures the nuances of local conceptions of personhood. The Ring Theory highlights the fact that, far from being solely dependent upon familial centric ideals, local conceptions of personhood are dynamic, context dependent, evolving ideas delineated by four dimensions. Using the Ring Theory, the nature of familial influences upon the four dimensions of personhood - the Innate, Individual, Relational and Societal - are examined to reveal that, contrary to perceived knowledge, conceptions of personhood within Confucian societies are not the prime reason for the continued presence of this decision-making model but remain present within local thinking and practices as a sociocultural residue and primarily because of inertia in updating ideas. © 2014 John Wiley & Sons Ltd.

An investigation on the quality of midwifery services from the viewpoint of the clients in Isfahan through SERVQUAL model

PubMed Central

Oliaee, Zohreh; Jabbari, Alireza; Ehsanpour, Soheila

2016-01-01

Background: Quality of care is of great importance in health services as these services have the important mission to preserve health, and to give care to the society. The present study aimed to investigate the quality of midwifery services from the viewpoint of the clients, under coverage of health care centers in Isfahan, through SERVQUAL model. Materials and Methods: This descriptive and analytical study was conducted on 218 subjects in 2014. Study population comprised the women referring to midwifery services clinics in health care centers in Isfahan. Data of the subjects (n = 218) were collected by SERVQUAL model containing the dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Data were analyzed by paired t-test, Spearman and Pearson correlation coefficients, and independent t-test through SPSS 20. Results: There was a negative gap in all five relevant dimensions of giving services. The widest gap was in the mean of dimension of tangibles (−1.5), and the narrowest gap was in the dimension of assurance (−0.9). There was no significant association between the scores of expectations and perceptions, and age, education level, occupation, and marital status. Conclusions: The obtained negative gap showed that the level of service receivers' perception from existing condition was far from their expectation, and there was a wide gap between attaining their satisfaction with midwifery services and their expectation and reaching their appropriate level of services. PMID:27186207

The Relationship between Childhood Maltreatment and Emotional Dysregulation in Self Mutilation: An Investigation among Substance Dependent Patients

PubMed Central

KARAGÖZ, Başak; DAĞ, İhsan

2015-01-01

Introduction The present study aims to examine the role of emotion dysregulation and childhood maltreatment in self mutilation (SM) of substance dependent patients. Specifically, the present study examined whether emotion dysregulation and its dimensions, and childhood maltreatment and its dimensions were associated with SM. The relationship between emotion dysregulation and childhood maltreatment was also investigated. Methods The sample of study consisted of 55 alcohol dependent and 24 opiate dependent patients (n=79). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV-TR (SCID-I), Turkish version. Childhood Trauma Questionnaire (CTQ) and Difficulties in Emotion Regulation Scale (DERS) were used. Results Findings indicated that substance dependents with SM and without SM were differentiated in terms of overall emotion dysregulation. Results also suggest the relevance of three specific dimensions of emotion dysregulation to SM: Difficulties engaging in goal-directed behaviors when experiencing negative emotions, difficulties controlling impulsive behaviors when experiencing negative emotions, and limited access to effective emotion regulation strategies. These dimensions were predicted from childhood emotional maltreatment and neglect. It is also revealed that substance dependents with SM had higher points than those without SM on emotional childhood maltreatment and neglect, physical childhood maltreatment. Conclusion Results were supported by the literature suggested that self-mutilation functions as a emotional regulation strategy. Findings also suggested that self- mutilation is related to early relationships take place in family environment in which individuals grow up. PMID:28360668

The Careful Nursing philosophy and professional practice model.

PubMed

Meehan, Therese C

2012-10-01

To present the Careful Nursing philosophy and professional practice model which has its source in the skilled practice of 19th century Irish nurses and to propose that its implementation could provide a relevant foundation for contemporary nursing practice. Nursing models are widely considered not relevant to nursing practice. Alarming instances of incompetent and insensitive nursing practice and experiences of powerlessness amongst nurses are being reported. Professional practice models that will inspire and strengthen nurses in practice and help them to address these challenges are needed. Nursing history has been suggested as a source of such models. Discursive. Content analysis of historical documents describing the thinking and practice of 19th century Irish nurses. Identification of emergent categories and subcategories as philosophical assumptions, concepts and dimensions of professional nursing practice. A philosophical approach to practise encompassing the nature and innate dignity of the person, the experience of an infinite transcendent reality in life processes and health as human flourishing. A professional practice model constructed from four concepts; therapeutic milieu, practice competence and excellence, management of practice and influence in health systems and professional authority; and their eighteen dimensions. As a philosophy and professional practice model, Careful Nursing can engage nurses and provide meaningful direction for practice. It could help decrease incidents of incompetent and insensitive practice and sustain already exemplary practice. As a basis for theory development, it could help close the relevance gap between nursing practice and nursing science. Careful Nursing highlights respect for the innate dignity of all persons and what this means for nurses in their relationships with patients. It balances attentive tenderness in nurse-patient relationships with clinical skill and judgement. It helps nurses to establish their professional practice boundaries and take authoritative responsibility for their practice. © 2012 Blackwell Publishing Ltd.

Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being.

PubMed

Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F

2018-01-01

The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions - ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality - interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality - formed by bottom-up primary emotions and cortical top-down regulation - might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups.

Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being

PubMed Central

Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F.

2018-01-01

The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions – ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality – interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality – formed by bottom-up primary emotions and cortical top-down regulation – might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups. PMID:29615950

Cue-type manipulation dissociates two types of task set inhibition: backward inhibition and competitor rule suppression.

PubMed

Regev, Shirley; Meiran, Nachshon

2016-07-01

Backward inhibition (BI) reflects the suppression of a recently abandoned task set to allow for smooth transition to a new task even when the rules do not generate a response conflict. Competitor rule suppression (CRS) reflects the inhibition/suppression of irrelevant task rules when these rules generate a response conflict even if they have not recently been abandoned. We assessed whether BI and CRS are differentially affected by the difficulty in retrieving category-response mappings from memory. Retrieval demands were manipulated via the information provided by the task cues, which either indicated the relevant dimension (dimension cues; "color") or the relevant dimension with its category-to-key mapping (mapping cues; "red green", indicating that "red" and "green" go with the left/right responses, respectively). CRS was larger with dimension compared to mapping cues when cue-type varied between groups and was larger after trials involving dimension cues when cue-type varied on a trial-by-trial basis. In contrast, BI was not influenced by cue-type. These results suggest that task switching involve at least two distinct inhibitory processes, with CRS being related to the ease of retrieval of category-response mappings from memory.

Factors associated with student learning processes in primary health care units: a questionnaire study.

PubMed

Bos, Elisabeth; Alinaghizadeh, Hassan; Saarikoski, Mikko; Kaila, Päivi

2015-01-01

Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

[In search of politics in knowledge production. A plea for a historical-political epistemology].

PubMed

Roelcke, Volker

2010-06-01

Knowledge production has an intrinsic political dimension. Starting from this presupposition, it is argued that the systematic integration of and reflection on the political dimension is necessary for an adequate understanding of historical processes of knowledge production in the sciences. The consecutive plea for a historical-political epistemology proceeds in two steps: First, it is illustrated that in a number of recent historical science study cases, the political dimension is frequently marginal, or even absent. After a short discussion of previous theoretical concepts to describe the impact of politics for the production of scientific knowledge, an approach is sketched which builds on Hans-Jörg Rheinberger's historical epistemology and Bruno Latour's symmetrical anthropology. It is argued that in addition to Rheinberger's program to describe epistemic systems, the political dimension is intrinsic to three stages of the process of data production: First to an initial phase which consists in the arrangement socio-technical configurations to produce new evidence. Here, factors such as the culturally shaped perception and evaluation of "relevant" problems, as well as the perception of career resources have to be taken into account. Second, the political dimension is relevant in view of the continuous re-adjustments of the configuration of epistemic systems, e.g., towards newly available financial, technical, or intellectual resources and "relevant" challenges from outside the system. Thirdly, the data produced and represented by epistemic systems--"evidence"--are yet in need of interpretation. This process is in itself imbued with continuously shifting mechanisms of selecting and creating hierarchies amongst the pool of available data.

Attentional Factors in Conceptual Congruency

ERIC Educational Resources Information Center

Santiago, Julio; Ouellet, Marc; Roman, Antonio; Valenzuela, Javier

2012-01-01

Conceptual congruency effects are biases induced by an irrelevant conceptual dimension of a task (e.g., location in vertical space) on the processing of another, relevant dimension (e.g., judging words' emotional evaluation). Such effects are a central empirical pillar for recent views about how the mind/brain represents concepts. In the present…

The Learning Organization: Variations at Different Organizational Levels

ERIC Educational Resources Information Center

Weldy, Teresa G.; Gillis, William E.

2010-01-01

Purpose: The purpose of this paper is to examine the perceptions of managers, supervisors, and employees from different organizations relevant to the seven dimensions of a learning organization (LO), and the two dimensions of knowledge and financial performance. Design/methodology/approach: The perceptions of 143 organizational members from…

Valuing Teacher Perceptions Related to the Principalship

ERIC Educational Resources Information Center

Williams, Jermaine

2016-01-01

This dissertation served to answer the over-arching research question: How do stakeholders describe effective leadership? In addition, two sub-questions were answered: 1) what dimensions do teachers use to describe effective principal leadership, and 2) why do teachers identify those dimensions as relevant? This study was conducted in a Northern…

Teasing Out Cognitive Development from Cognitive Style: A Training Study.

ERIC Educational Resources Information Center

Globerson, Tamar; And Others

1985-01-01

Tested whether or not cognitive development (as measured by mental capacity) and cognitive style (as measured by field-dependence/independence) are different dimensions. Results are discussed with regard to Pascual-Leone's model of cognitive development, relevance to stylistic dimension of reflection/impulsivity, and educational implications.…

From clinical uncertainties to precision medicine: the emerging role of the gut barrier and microbiome in small bowel functional diseases.

PubMed

Marlicz, Wojciech; Yung, Diana E; Skonieczna-Żydecka, Karolina; Loniewski, Igor; van Hemert, Saskia; Loniewska, Beata; Koulaouzidis, Anastasios

2017-10-01

Over the last decade, remarkable progress has been made in the understanding of disease pathophysiology. Many new theories expound on the importance of emerging factors such as microbiome influences, genomics/omics, stem cells, innate intestinal immunity or mucosal barrier complexities. This has introduced a further dimension of uncertainty into clinical decision-making, but equally, may shed some light on less well-understood and difficult to manage conditions. Areas covered: Comprehensive review of the literature on gut barrier and microbiome relevant to small bowel pathology. A PubMed/Medline search from 1990 to April 2017 was undertaken and papers from this range were included. Expert commentary: The scenario of clinical uncertainty is well-illustrated by functional gastrointestinal disorders (FGIDs). The movement towards achieving a better understanding of FGIDs is expressed in the Rome IV guidelines. Novel diagnostic and therapeutic protocols focused on the GB and SB microbiome can facilitate diagnosis, management and improve our understanding of the underlying pathological mechanisms in FGIDs.

Multi-stakeholder perspectives in defining health-services quality in cataract care.

PubMed

Stolk-Vos, Aline C; van de Klundert, Joris J; Maijers, Niels; Zijlmans, Bart L M; Busschbach, Jan J V

2017-08-01

To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. Mixed-method study between 2014 and 2015. Cataract care in the Netherlands. Stakeholder representatives. We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. Stakeholders and multi-stakeholder perspective on health-service quality. Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods helped to unify different quality definitions and facilitated operationalisation of quality measurement in a way that was accepted by relevant stakeholders. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Discrimination learning and attentional set formation in a mouse model of Fragile X.

PubMed

Casten, Kimberly S; Gray, Annette C; Burwell, Rebecca D

2011-06-01

Fragile X Syndrome is the most prevalent genetic cause of mental retardation. Selective deficits in executive function, including inhibitory control and attention, are core features of the disorder. In humans, Fragile X results from a trinucleotide repeat in the Fmr1 gene that renders it functionally silent and has been modeled in mice by targeted deletion of the Fmr1 gene. Fmr1 knockout (KO) mice recapitulate many features of Fragile X syndrome, but evidence for deficits in executive function is inconsistent. To address this issue, we trained wild-type and Fmr1 KO mice on an experimental paradigm that assesses attentional set-shifting. Mice learned to discriminate between stimuli differing in two of three perceptual dimensions. Successful discrimination required attending only to the relevant dimension, while ignoring irrelevant dimensions. Mice were trained on three discriminations in the same perceptual dimension, each followed by a reversal. This procedure normally results in the formation of an attentional set to the relevant dimension. Mice were then required to shift attention and discriminate based on a previously irrelevant perceptual dimension. Wild-type mice exhibited the increase in trials to criterion expected when shifting attention from one perceptual dimension to another. In contrast, the Fmr1 KO group failed to show the expected increase, suggesting impairment in forming an attentional set. Fmr1 KO mice also exhibited a general impairment in learning discriminations and reversals. This is the first demonstration that Fmr1 KO mice show a deficit in attentional set formation.

Associations between belief inflexibility and dimensions of delusions: A meta-analytic review of two approaches to assessing belief flexibility.

PubMed

Zhu, Chen; Sun, Xiaoqi; So, Suzanne Ho-Wai

2018-03-01

Belief inflexibility has been suggested to maintain delusions. Different measures of assessing belief inflexibility have been developed, and it remains unclear whether patients with delusions display belief inflexibility similarly across measures. As delusions consist of multiple dimensions, the aim of this meta-analytic review was to examine how belief inflexibility is related to different aspects of delusions (conviction, distress, and preoccupation) and to compare these associations between interview-based and task-based measures of belief inflexibility. We conducted a systematic database search (PsycINFO, PsycARTICLES, PubMed, and MEDLINE) and identified relevant articles using the following search items: belief*, delusion*, or overvalued idea*; psychosis or schizo*; flexib*, inflexib*, change, revision, or update. Meta-analyses were conducted for each dimension of delusions and were reported according to the PRISMA guidelines. A total of 16 studies, with a total sample of 1,065, were included in the analysis. Belief inflexibility was associated with global severity of delusions (Hedges' g = 0.452, p < .001). Specifically, all dimensions of delusions were significantly associated with belief inflexibility (conviction: Hedges' g = 0.678, p < .001; preoccupation: Hedges' g = 0.274, p = .002; distress: Hedges' g = 0.200, p = .025). There was no significant heterogeneity across studies for each dimension. Preliminary subgroup analysis did not find any significant between-measure differences in the relationship between belief inflexibility and overall severity of delusions. Belief inflexibility, across measures, was robustly associated with delusions, with a particularly strong association for delusional conviction. Our results carried implications for process-based interventions for delusions. Positive clinical implications Belief inflexibility is consistently associated with the maintenance of delusions. Assessing belief inflexibility in routine clinical practice will inform psychological interventions for patients with persistent delusions. Interview- and task-based measures of belief inflexibility may be used complementarily to facilitate our understanding of this reasoning bias. Aetiological factors may be more closely associated with some aspects of delusions than the others. In line with a multidimensional view of delusions, interventions targeting different dimensions of delusions may have different therapeutic emphases. Limitations The current review focused on three core dimensions of delusions only (conviction, preoccupation, distress). Other ways of dissecting delusions are possible. Comparisons between the two measures of belief inflexibility may benefit from further research. © 2017 The British Psychological Society.

Students' Personal Connection with Science: Investigating the Multidimensional Phenomenological Structure of Self-Relevance

ERIC Educational Resources Information Center

Hartwell, Matthew; Kaplan, Avi

2018-01-01

This paper presents findings from a two-phase mixed methods study investigating the phenomenological structure of self-relevance among ninth-grade junior high school biology students (Phase 1: N = 118; Phase 2: N = 139). We begin with a phenomenological multidimensional definition of self-relevance as comprising three dimensions: the academic…

Cyberbullying Definition Among Adolescents: A Comparison Across Six European Countries

PubMed Central

Nocentini, Annalaura; Palladino, Benedetta Emanuela; Frisén, Ann; Berne, Sofia; Ortega-Ruiz, Rosario; Calmaestra, Juan; Scheithauer, Herbert; Schultze-Krumbholz, Anja; Luik, Piret; Naruskov, Karin; Blaya, Catherine; Berthaud, Julien; Smith, Peter K.

2012-01-01

Abstract Several criteria have been proposed for defining cyberbullying to young people, but no studies have proved their relevance. There are also variations across different countries in the meaning and the definition of this behavior. We systematically investigated the role of five definitional criteria for cyberbullying, in six European countries. These criteria (intentionality, imbalance of power, repetition, anonymity, and public vs. private) were combined through a set of 32 scenarios, covering a range of four types of behaviors (written-verbal, visual, exclusion, and impersonation). For each scenario, participants were asked whether it was cyberbullying or not. A randomized version of the questionnaire was shown to 295 Italian, 610 Spanish, 365 German, 320 Sweden, 336 Estonian, and 331 French adolescents aged 11–17 years. Results from multidimensional scaling across country and type of behavior suggested a clear first dimension characterized by imbalance of power and a clear second dimension characterized by intentionality and, at a lower level, by anonymity. In terms of differences across types of behaviors, descriptive frequencies showed a more ambiguous role for exclusion as a form of cyberbullying, but general support was given to the relevance of the two dimensions across all the types of behavior. In terms of country differences, French participants more often perceived the scenarios as cyberbullying as compared with those in other countries, but general support was found for the relevance of the two dimensions across countries. PMID:22817693

How category learning affects object representations: Not all morphspaces stretch alike

PubMed Central

Folstein, Jonathan R.; Gauthier, Isabel; Palmeri, Thomas J.

2012-01-01

How does learning to categorize objects affect how we visually perceive them? Behavioral, neurophysiological, and neuroimaging studies have tested the degree to which category learning influences object representations, with conflicting results. Some studies find that objects become more visually discriminable along dimensions relevant to previously learned categories, while others find no such effect. One critical factor we explore here lies in the structure of the morphspaces used in different studies. Studies finding no increase in discriminability often use “blended” morphspaces, with morphparents lying at corners of the space. By contrast, studies finding increases in discriminability use “factorial” morphspaces, defined by separate morphlines forming axes of the space. Using the same four morphparents, we created both factorial and blended morphspaces matched in pairwise discriminability. Category learning caused a selective increase in discriminability along the relevant dimension of the factorial space, but not in the blended space, and led to the creation of functional dimensions in the factorial space, but not in the blended space. These findings demonstrate that not all morphspaces stretch alike: Only some morphspaces support enhanced discriminability to relevant object dimensions following category learning. Our results have important implications for interpreting neuroimaging studies reporting little or no effect of category learning on object representations in the visual system: Those studies may have been limited by their use of blended morphspaces. PMID:22746950

Critical Domains of Culturally Relevant Leadership Learning: A Call to Transform Leadership Programs.

PubMed

Jones, Tamara Bertrand; Guthrie, Kathy L; Osteen, Laura

2016-12-01

This chapter introduces the critical domains of culturally relevant leadership learning. The model explores how capacity, identity, and efficacy of student leaders interact with dimensions of campus climate. © 2016 Wiley Periodicals, Inc., A Wiley Company.

Escaping the recent past: Which stimulus dimensions influence proactive interference?

PubMed Central

Craig, Kimberly S.; Berman, Marc G.; Jonides, John; Lustig, Cindy

2013-01-01

Proactive interference occurs when information from the past disrupts current processing and is a major source of confusion and errors in short-term memory (Wickens, Born & Allen, 1963). The present investigation examines potential boundary conditions for interference, testing the hypothesis that potential competitors must be similar along task-relevant dimensions to influence proactive interference effects. We manipulated both the type of task being completed (Experiments 1, 2 and 3) and dimensions of similarity irrelevant to the current task (Experiments 4 and 5) to determine how the recent presentation of a probe item would affect the speed with which participants could reject that item. Experiments 1, 2 and 3 contrasted short-term memory judgments, which require temporal information, with semantic and perceptual judgments, for which temporal information is irrelevant. In Experiments 4 and 5, task-irrelevant information (perceptual similarity) was manipulated within the recent probes task. We found that interference from past items affected short-term memory (STM) task performance but did not affect performance in semantic or perceptual judgment tasks. Conversely, similarity along a nominally-irrelevant perceptual dimension did not affect the magnitude of interference in STM tasks. Results are consistent with the view that items in STM are represented by noisy codes consisting of multiple dimensions, and that interference occurs when items are similar to each other and thus compete along the dimensions relevant to target selection. PMID:23297049

Escaping the recent past: which stimulus dimensions influence proactive interference?

PubMed

Craig, Kimberly S; Berman, Marc G; Jonides, John; Lustig, Cindy

2013-07-01

Proactive interference occurs when information from the past disrupts current processing and is a major source of confusion and errors in short-term memory (STM; Wickens, Born, & Allen, Journal of Verbal Learning and Verbal Behavior, 2:440-445, 1963). The present investigation examines potential boundary conditions for interference, testing the hypothesis that potential competitors must be similar along task-relevant dimensions to influence proactive interference effects. We manipulated both the type of task being completed (Experiments 1, 2, and 3) and dimensions of similarity irrelevant to the current task (Experiments 4 and 5) to determine how the recent presentation of a probe item would affect the speed with which participants could reject that item. Experiments 1, 2, and 3 contrasted STM judgments, which require temporal information, with semantic and perceptual judgments, for which temporal information is irrelevant. In Experiments 4 and 5, task-irrelevant information (perceptual similarity) was manipulated within the recent probes task. We found that interference from past items affected STM task performance but did not affect performance in semantic or perceptual judgment tasks. Conversely, similarity along a nominally irrelevant perceptual dimension did not affect the magnitude of interference in STM tasks. Results are consistent with the view that items in STM are represented by noisy codes consisting of multiple dimensions and that interference occurs when items are similar to each other and, thus, compete along the dimensions relevant to target selection.

Health-relevant personality is associated with sensitivity to sound (hyperacusis).

PubMed

Villaume, Karin; Hasson, Dan

2017-04-01

Hyperacusis, over-sensitivity to sounds, causes distress and disability and the etiology is not fully understood. The study aims to explore possible associations between health-relevant personality traits and hyperacusis. Hyperacusis was assessed using the Hyperacusis Questionnaire (HQ), and clinical uncomfortable loudness levels (ULL). Personality was measured with the Health-relevant Personality (HP5i) Inventory. The study sample was 348 (140 men and 208 women; age 23-71 years). Moderate correlations were found between the personality trait negative affectivity (NA; a facet of neuroticism) and dimensions of the HQ and weak correlations were found with the ULLs. Hedonic capacity (a facet of extraversion) was significantly correlated with the HQ but not with the ULLs. Impulsivity (a facet of conscientiousness) was correlated with the HQ and the ULLs. A significant difference in mean values was found in all hyperacusis measures and different levels of NA - those with higher levels displayed more severe signs of hyperacusis. A multiple logistic regression analysis showed that higher levels of NA increases the odds of having hyperacusis on average 4.6 times for men and 2.4 times for women. These findings imply that health-relevant personality traits should be considered in the diagnosis and treatment of hyperacusis. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Interpersonal subtypes in social phobia: diagnostic and treatment implications.

PubMed

Cain, Nicole M; Pincus, Aaron L; Grosse Holtforth, Martin

2010-11-01

Interpersonal assessment may provide a clinically useful way to identify subtypes of social phobia. In this study, we examined evidence for interpersonal subtypes in a sample of 77 socially phobic outpatients. A cluster analysis based on the dimensions of dominance and love on the Inventory of Interpersonal Problems-Circumplex Scales (Alden, Wiggins, & Pincus, 1990) found 2 interpersonal subtypes of socially phobic patients. These subtypes did not differ on pretreatment global symptom severity as measured by the Brief Symptom Inventory (Derogatis, 1993) or diagnostic comorbidity but did exhibit differential responses to outpatient psychotherapy. Overall, friendly-submissive social phobia patients had significantly lower scores on measures of social anxiety and significantly higher scores on measures of well-being and satisfaction at posttreatment than cold-submissive social phobia patients. We discuss the results in terms of interpersonal theory and the clinical relevance of assessment of interpersonal functioning prior to beginning psychotherapy with socially phobic patients.

SemanticFind: Locating What You Want in a Patient Record, Not Just What You Ask For

PubMed Central

Prager, John M.; Liang, Jennifer J.; Devarakonda, Murthy V.

2017-01-01

We present a new model of patient record search, called SemanticFind, which goes beyond traditional textual and medical synonym matches by locating patient data that a clinician would want to see rather than just what they ask for. The new model is implemented by making extensive use of the UMLS semantic network, distributional semantics, and NLP, to match query terms along several dimensions in a patient record with the returned matches organized accordingly. The new approach finds all clinically related concepts without the user having to ask for them. An evaluation of the accuracy of SemanticFind shows that it found twice as many relevant matches compared to those found by literal (traditional) search alone, along with very high precision and recall. These results suggest potential uses for SemanticFind in clinical practice, retrospective chart reviews, and in automated extraction of quality metrics. PMID:28815139

Fractal measures of video-recorded trajectories can classify motor subtypes in Parkinson's Disease

NASA Astrophysics Data System (ADS)

Figueiredo, Thiago C.; Vivas, Jamile; Peña, Norberto; Miranda, José G. V.

2016-11-01

Parkinson's Disease is one of the most prevalent neurodegenerative diseases in the world and affects millions of individuals worldwide. The clinical criteria for classification of motor subtypes in Parkinson's Disease are subjective and may be misleading when symptoms are not clearly identifiable. A video recording protocol was used to measure hand tremor of 14 individuals with Parkinson's Disease and 7 healthy subjects. A method for motor subtype classification was proposed based on the spectral distribution of the movement and compared with the existing clinical criteria. Box-counting dimension and Hurst Exponent calculated from the trajectories were used as the relevant measures for the statistical tests. The classification based on the power-spectrum is shown to be well suited to separate patients with and without tremor from healthy subjects and could provide clinicians with a tool to aid in the diagnosis of patients in an early stage of the disease.

Brain Dynamics: Methodological Issues and Applications in Psychiatric and Neurologic Diseases

NASA Astrophysics Data System (ADS)

Pezard, Laurent

The human brain is a complex dynamical system generating the EEG signal. Numerical methods developed to study complex physical dynamics have been used to characterize EEG since the mid-eighties. This endeavor raised several issues related to the specificity of EEG. Firstly, theoretical and methodological studies should address the major differences between the dynamics of the human brain and physical systems. Secondly, this approach of EEG signal should prove to be relevant for dealing with physiological or clinical problems. A set of studies performed in our group is presented here within the context of these two problematic aspects. After the discussion of methodological drawbacks, we review numerical simulations related to the high dimension and spatial extension of brain dynamics. Experimental studies in neurologic and psychiatric disease are then presented. We conclude that if it is now clear that brain dynamics changes in relation with clinical situations, methodological problems remain largely unsolved.

Methodology Of PACS Effectiveness Evaluation As Part Of A Technology Assessment. The Dutch PACS Project Extrapolated.

NASA Astrophysics Data System (ADS)

Andriessen, J. H. T. H.; van der Horst-Bruinsma, I. E.; ter Haar Romeny, B. M.

1989-05-01

The present phase of the clinical evaluation within the Dutch PACS project mainly focuses on the development and evaluation of a PACSystem for a few departments in the Utrecht University hospital (UUH). A report on the first clinical experiences and a detailed cost/savings analysis of the PACSystem in the UUH are presented elsewhere. However, an assessment of the wider fmancial and organizational implications for hospitals and for the health sector is also needed. To this end a model for (financial) cost assessment of PACSystems is being developed by BAZIS. Learning from the actual pilot implementation in UUH we realized that general Technology Assessment (TA) also calls for an extra-polation of the medical and organizational effects. After a short excursion into the various approaches towards TA, this paper discusses the (inter) organizational dimensions relevant to the development of the necessary exttapolationmodels.

Magnetic resonance imaging measurements of organs within the coelomic cavity of red-eared sliders (Trachemys scripta elegans), yellow-bellied sliders (Trachemys scripta scripta), Coastal plain cooters (Pseudemys concinna floridana), and hieroglyphic river cooters (Pseudemys concinna hieroglyphica).

PubMed

Mathes, Karina A; Schnack, Marcus; Rohn, Karl; Fehr, Michael

2017-12-01

OBJECTIVE To determine anatomic reference points for 4 turtle species and to evaluate data on relative anatomic dimensions, signal intensities (SIs), and position of selected organs within the coelomic cavity by use of MRI. ANIMALS 3 turtle cadavers (1 red-eared slider [Trachemys scripta elegans], 1 yellow-bellied slider [Trachemys scripta scripta], and 1 Coastal plain cooter [Pseudemys concinna floridana]) and 63 live adult turtles (30 red-eared sliders, 20 yellow-bellied sliders, 5 Coastal plain cooters, and 8 hieroglyphic river cooters [Pseudemys concinna hieroglyphica]). PROCEDURES MRI and necropsy were performed on the 3 turtle cadavers. Physical examination, hematologic evaluation, and whole-body radiography were performed on the 63 live turtles. Turtles were sedated, and MRI in transverse, sagittal, and dorsal planes was used to measure organ dimensions, position within the coelomic cavity, and SIs. Body positioning after sedation was standardized with the head, neck, limbs, and tail positioned in maximum extension. RESULTS Measurements of the heart, liver, gallbladder, and kidneys in sagittal, transverse, and dorsal planes; relative position of those organs within the coelom; and SIs of the kidneys and liver were obtained with MRI and provided anatomic data for these 4 turtle species. CONCLUSIONS AND CLINICAL RELEVANCE MRI was a valuable tool for determining the position, dimensions, and SIs of selected organs. Measurement of organs in freshwater chelonians was achievable with MRI. Further studies are needed to establish reference values for anatomic structures in turtles. Results reported here may serve as guidelines and aid in clinical interpretation of MRI images for these 4 species.

Investigating psoriasis awareness among patients in Italy: validation of a questionnaire.

PubMed

Bardazzi, F; Amerio, P; Amoruso, G; Campanati, A; Conti, A; De Simone, C; Gisondi, P; Gualdi, G; Guarneri, C; Loconsole, F; Mazzotta, A; Musumeci, M L; Odorici, G; Piaserico, S; Potenza, C; Scudeller, L

2014-11-01

Psoriasis can have a profound impact on quality of life (QoL) and an awareness of the processes of the disease and its treatment is important in coping with symptoms. Patients do not always understand the potential consequences of their disease and the wide range of effective treatment strategies now available. We designed and validated a questionnaire to investigate patient awareness and understanding of psoriasis including pathogenesis, diagnosis, prognosis and treatment. This was a multicentre, cross-sectional investigation involving 14 psoriasis referral centres in Italy. The focus group technique was used by a panel of experts in psoriasis, to draw-up a list of questions exploring pathogenesis, diagnosis, prognosis, factors influencing clinical course of psoriasis as well as QoL issues and sources of information on their condition. Psychometric properties of the questionnaire were tested on a sample of 240 adult patients with psoriasis (including treatment-naïve and -experienced patients). The mean age of patients was 50.3±14.9 years and 34.2% were female. The median time from diagnosis was 13.7 years (IQR 7.3-23.2). The Cronbach alpha was 0.77 and all items showed higher correlations within their own dimensions than to other dimensions. Each domain of awareness was well represented by a single dimension. Mean overall awareness was 59.7±13.1 on a 100-point scale. Our questionnaire was valid in assessing patient awareness in five relevant areas of psoriasis, and can be useful in both the clinical setting and research studies to evaluate patients' knowledge of psoriasis better, with the final aim of reducing the burden of this chronic condition.

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

PubMed Central

Baune, Bernhard T.; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological “genomic” correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological “genomic” correlates. The CoFaMS team welcomes collaborations with both national and international researchers. PMID:27616997

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder - Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study).

PubMed

Baune, Bernhard T; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological "genomic" correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological "genomic" correlates. The CoFaMS team welcomes collaborations with both national and international researchers.

The Size Congruity Effect: Is Bigger Always More?

ERIC Educational Resources Information Center

Santens, Seppe; Verguts, Tom

2011-01-01

When comparing digits of different physical sizes, numerical and physical size interact. For example, in a numerical comparison task, people are faster to compare two digits when their numerical size (the relevant dimension) and physical size (the irrelevant dimension) are congruent than when they are incongruent. Two main accounts have been put…

Coping With Pain: Studies in Stress Inoculation.

ERIC Educational Resources Information Center

Horan, John J.; And Others

The stress-inoculation paradigm for helping clients deal with pain consists of education about the psychological dimensions of pain, training in a number of coping skills relevant to each dimension, and practice in applying these skills to the noxious stimulus. Presented are two studies, the first of which represents a component analysis of stress…

Perceived Parenting Dimensions and Identity Styles: Exploring the Socialization of Adolescents' Processing of Identity-Relevant Information

ERIC Educational Resources Information Center

Smits, Ilse; Soenens, Bart; Luyckx, Koen; Duriez, Bart; Berzonsky, Michael; Goossens, Luc

2008-01-01

This study examined the relationships between crucial dimensions of perceived parenting (support, behavioral control, and psychological control) and the three identity styles defined by Berzonsky [Berzonsky, M. D. (1990). "Self-construction over the life span: A process perspective on identity formation." "Advances in Personal Construct…

A Description of Restructuring in Nationally Nominated Schools: Legacy of the Iron Cage?

ERIC Educational Resources Information Center

Berends, Mark; King, M. Bruce

1994-01-01

Presents a strategy for identifying schools that are restructured across several dimensions. Analyzes data from a nominated sample of restructured schools to discover relevant dimensions and criteria and degree of restructuring. Schools tended to meet more criteria in the areas of student experiences and teachers' professional life; significantly…

The normative dimensions of extending the human lifespan by age-related biomedical innovations.

PubMed

Ehni, Hans-Joerg; Marckmann, Georg

2008-10-01

The current normative debate on age-related biomedical innovations and the extension of the human lifespan has important shortcomings. Mainly, the complexity of the different normative dimensions relevant for ethical and/or juridicial norms is not fully developed and the normative quality of teleological and deontological arguments is not properly distinguished. This article addresses some of these shortcomings and develops the outline of a more comprehensive normative framework covering all relevant dimensions. Such a frame necessarily has to include conceptions of a good life on the individual and societal levels. Furthermore, as a third dimension, a model for the access to and the just distribution of age-related biomedical innovations and technologies extending the human lifespan will be developed. It is argued that such a model has to include the different levels of the general philosophical theories of distributive justice, including social rights and theories of just health care. Furthermore, it has to show how these theories can be applied to the problem area of aging and extending the human lifespan.

[In-hospital stroke care in Catalonia [Spain]. Results of the "First Clinical Audit of Stroke. Catalonia, 2005/2006"].

PubMed

Abilleira, Sònia; Ribera, Aida; Sánchez, Emília; Roquer, Jaume; Duarte, Esther; Tresserras, Ricard; Gallofré, Miquel

2008-01-01

To determine the quality of in-hospital stroke care in public acute care hospitals in Catalonia before the implementation of a clinical practice guideline (CPG) on stroke by determining adherence to specific recommendations of the CPG. We retrospectively reviewed the case notes of consecutive patients with stroke (defined with ICD-9 codes: 431, 433.x1, 434.x1, and 436) admitted to 48 Catalan hospitals within the first half of 2005. Data were collected on indicators of the healthcare process selected on the basis of their scientific evidence and/or clinical relevance. The participating hospitals included 20, 40 or 60 stroke cases according to their annual stroke caseload. After random selection, up to 9.3% of all cases recruited at each study center were externally monitored to assess the quality of the data gathered. Indicators were grouped into six different dimensions related to distinct aspects of clinical practice. We analyzed data from 1,791 stroke cases (53.9% men, mean age: 75.6 [12.4] years). Overall inter-observer agreement was 0.7. Compliance with the six dimensions was as follows (mean percentage [95%CI]): quality of medical records, 78.5% (77.5-79.4); initial interventions, 92.4% (91.5-93.2); neurological assessment, 38.3% (37.3-39.3); assessment of rehabilitation needs, 44.9% (43.2-46.7); prevention and management of medical complications, 68.4% (66.9-70), and initial preventive measures, 78.9% (77.3-80.4). In the first half of 2005, in-hospital stroke care in Catalonia showed room for improvement particularly in aspects related to the neurological assessment and follow-up of patients and their rehabilitation process.

Shifting Attention Between Visual Dimensions as a Source of Switch Costs.

PubMed

Elchlepp, Heike; Best, Maisy; Lavric, Aureliu; Monsell, Stephen

2017-04-01

Task-switching experiments have documented a puzzling phenomenon: Advance warning of the switch reduces but does not eliminate the switch cost. Theoretical accounts have posited that the residual switch cost arises when one selects the relevant stimulus-response mapping, leaving earlier perceptual processes unaffected. We put this assumption to the test by seeking electrophysiological markers of encoding a perceptual dimension. Participants categorized a colored letter as a vowel or consonant or its color as "warm" or "cold." Orthogonally to the color manipulation, some colors were eight times more frequent than others, and the letters were in upper- or lowercase. Color frequency modulated the electroencephalogram amplitude at around 150 ms when participants repeated the color-classification task. When participants switched from the letter task to the color task, this effect was significantly delayed. Thus, even when prepared for, a task switch delays or prolongs encoding of the relevant perceptual dimension.

Nonperturbative renormalization group study of the stochastic Navier-Stokes equation.

PubMed

Mejía-Monasterio, Carlos; Muratore-Ginanneschi, Paolo

2012-07-01

We study the renormalization group flow of the average action of the stochastic Navier-Stokes equation with power-law forcing. Using Galilean invariance, we introduce a nonperturbative approximation adapted to the zero-frequency sector of the theory in the parametric range of the Hölder exponent 4-2ε of the forcing where real-space local interactions are relevant. In any spatial dimension d, we observe the convergence of the resulting renormalization group flow to a unique fixed point which yields a kinetic energy spectrum scaling in agreement with canonical dimension analysis. Kolmogorov's -5/3 law is, thus, recovered for ε = 2 as also predicted by perturbative renormalization. At variance with the perturbative prediction, the -5/3 law emerges in the presence of a saturation in the ε dependence of the scaling dimension of the eddy diffusivity at ε = 3/2 when, according to perturbative renormalization, the velocity field becomes infrared relevant.

Development of a Research Participants’ Perception Survey to Improve Clinical Research

PubMed Central

Yessis, Jennifer L.; Kost, Rhonda G.; Lee, Laura M.; Coller, Barry S.; Henderson, David K.

2012-01-01

Abstract Introduction: Clinical research participants’ perceptions regarding their experiences during research protocols provide outcome‐based insights into the effectiveness of efforts to protect rights and safety, and opportunities to enhance participants’ clinical research experiences. Use of validated surveys measuring patient‐centered outcomes is standard in hospitals, yet no instruments exist to assess outcomes of clinical research processes. Methods: We derived survey questions from data obtained from focus groups comprised of research participants and professionals. We assessed the survey for face/content validity, and privacy/confidentiality protections and fielded it to research participants at 15 centers. We conducted analyses of response rates, sample characteristics, and psychometrics, including survey and item completion and analysis, internal consistency, item internal consistency, criterion‐related validity, and item usefulness. Responses were tested for fit into existing patient‐centered dimensions of care and new clinical research dimensions using Cronbach's alpha coefficient. Results: Surveys were mailed to 18,890 individuals; 4,961 were returned (29%). Survey completion was 89% overall; completion rates exceeded 90% for 88 of 93 evaluable items. Questions fit into three dimensions of patient‐centered care and two novel clinical research dimensions (Cronbach's alpha for dimensions: 0.69–0.85). Conclusions: The validated survey offers a new method for assessing and improving outcomes of clinical research processes. Clin Trans Sci 2012; Volume 5: 452–460 PMID:23253666

DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups.

PubMed

James, Lisa M; Anders, Samantha L; Peterson, Carly K; Engdahl, Brian E; Krueger, Robert F; Georgopoulos, Apostolos P

2015-07-01

The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions-negative affect, detachment, antagonism, disinhibition, and psychoticism-is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited. In the present study, we utilized the PID-5 to evaluate the personality profile elevation and composition of 150 control veterans and 35 veterans diagnosed with posttraumatic stress disorder (PTSD). Results indicated that veterans with PTSD endorsed significantly more personality pathology than control veterans, with scores on detachment and psychoticism domains most clearly discriminating between the two groups. When personality domain scores were considered as parts of each subject's personality profile, a slightly different picture emerged. Specifically, the PTSD composition was primarily characterized by detachment and negative affect, followed by disinhibition, psychoticism, and antagonism in that order of relative importance. The profile of the control group was significantly different, mostly accounted for differences in antagonism and psychoticism. Using these complementary analytic strategies, the findings demonstrate the relevance of personality pathology to PTSD, highlight internalizing features of PTSD, and pave the way for future research aimed at evaluating the role of shared maladaptive personality traits in underlying the comorbidity of PTSD and related disorders.

Determining criminal responsibility: How relevant are insight and personal attitudes to mock jurors?

PubMed

Jung, Sandy

2015-01-01

High levels of insight are interpreted as indications of a treatment compliance and good outcome by clinical professionals. However, it is unclear whether a defendant's insight plays a role in the decision-making of jurors when determining criminal responsibility. It may be the case that personal biases and attitudes toward the mentally ill and the insanity defense are more relevant in such decisions. This study examines the influence of two core dimensions of insight and personal attitudes on juror decision-making. Participants read trial scenarios describing a defendant who is accused of a violent crime and is diagnosed with schizophrenia. Assigning a verdict of not criminally responsible to the defendant was not influenced by insight, but instead, by supportive attitudes of the insanity defense and higher attributions of blame to external factors and to psychological factors. These findings highlight the need for continued investigation in the area of extra-legal factors that guide legal decision-making when defendants have a mental disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

Operant conditioning of a multiple degree-of-freedom brain-machine interface in a primate model of amputation.

PubMed

Balasubramanian, Karthikeyan; Southerland, Joshua; Vaidya, Mukta; Qian, Kai; Eleryan, Ahmed; Fagg, Andrew H; Sluzky, Marc; Oweiss, Karim; Hatsopoulos, Nicholas

2013-01-01

Operant conditioning with biofeedback has been shown to be an effective method to modify neural activity to generate goal-directed actions in a brain-machine interface. It is particularly useful when neural activity cannot be mathematically mapped to motor actions of the actual body such as in the case of amputation. Here, we implement an operant conditioning approach with visual feedback in which an amputated monkey is trained to control a multiple degree-of-freedom robot to perform a reach-to-grasp behavior. A key innovation is that each controlled dimension represents a behaviorally relevant synergy among a set of joint degrees-of-freedom. We present a number of behavioral metrics by which to assess improvements in BMI control with exposure to the system. The use of non-human primates with chronic amputation is arguably the most clinically-relevant model of human amputation that could have direct implications for developing a neural prosthesis to treat humans with missing upper limbs.

Anxiety Sensitivity and Its Factors in Relation to Generalized Anxiety Disorder among Adolescents.

PubMed

Knapp, Ashley A; Blumenthal, Heidemarie; Mischel, Emily R; Badour, Christal L; Leen-Feldner, Ellen W

2016-02-01

Anxiety psychopathology, one of the most prevalent classes of disorder among youth, is linked to detrimental outcomes. Accordingly, identifying factors that influence vulnerability to anxiety disorders is important. One promising factor, given emerging evidence for its transdiagnostic nature, is anxiety sensitivity (AS); however, relatively little is known about the linkage between AS and indicators of generalized anxiety disorder (GAD), particularly among youth. The aim of the current investigation was to address this gap in the literature using a community-based sample of adolescents aged 10-17 years (n = 165; M age  = 14.49 years, SD = 2.26). Results indicated global AS and the AS-physical concerns dimension were significantly associated with worry, generalized anxiety symptoms, and GAD diagnosis assessed via a structured clinical interview, above and beyond key theoretically-relevant covariates. These findings add to a growing body of work underscoring the relevance of AS for multiple types of anxiety-related disorders among youth.

Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

PubMed

Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

2018-01-16

Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.

PubMed

Kroenke, Kurt; Monahan, Patrick O; Kean, Jacob

2015-09-01

Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. Published by Elsevier Inc.

A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogeneous clinical data

PubMed Central

Sittig, Dean F.; Hazlehurst, Brian L.; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B.

2012-01-01

Comparative Effectiveness Research (CER) has the potential to transform the current healthcare delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for inter-institutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast six, large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, socio-technical model of health information technology use to help guide our work. We identified six generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions. PMID:22692259

Personality factors moderate the associations between Apolipoprotein genotype and cognitive function as well as late onset Alzheimer’s Disease

PubMed Central

Dar-Nimrod, Ilan; Chapman, Benjamin P.; Franks, Peter; Robbins, John; Porsteinsson, Anton; Mapstone, Mark; Duberstein, Paul R.

2014-01-01

Objectives We tested the hypothesis that neuroticism moderates the association between APOE (apolipoprotein E) genotype and two major outcomes, cognitive function and Alzheimer’s disease (AD). We also explored whether other personality dimensions (extraversion, openness to experience, agreeableness, and conscientiousness) moderate the associations of APOE with these outcomes. Design Primary analyses of existing randomized clinical trial data. Sample Six-hundred and two older adults (mean age of 78 at baseline). Measurements APOE genotype, the NEO-Five Factor Inventory, the Alzheimer’s Disease Assessment Scale- cognitive (ADAS-COG: measured every 6 months for 6.5 years) and relevant covariates. Results Fully adjusted multivariate analyses showed that the association between the presence of APOE ε-4 allele(s) and both outcomes was evident among individuals with high levels of neuroticism and extraversion but not among persons with low levels of these traits. Conclusions Phenotypic personality dimensions, primarily neuroticism and extraversion, moderate the relationship between APOE ε-4 genotype and cognitive outcomes among older adults. Future research is needed to elucidate the physiological processes involved in these particular phenotype-genotype interactions. PMID:23079898

Benefits of fading in perceptual learning are driven by more than dimensional attention.

PubMed

Wisniewski, Matthew G; Radell, Milen L; Church, Barbara A; Mercado, Eduardo

2017-01-01

Individuals learn to classify percepts effectively when the task is initially easy and then gradually increases in difficulty. Some suggest that this is because easy-to-discriminate events help learners focus attention on discrimination-relevant dimensions. Here, we tested whether such attentional-spotlighting accounts are sufficient to explain easy-to-hard effects in auditory perceptual learning. In two experiments, participants were trained to discriminate periodic, frequency-modulated (FM) tones in two separate frequency ranges (300-600 Hz or 3000-6000 Hz). In one frequency range, sounds gradually increased in similarity as training progressed. In the other, stimulus similarity was constant throughout training. After training, participants showed better performance in their progressively trained frequency range, even though the discrimination-relevant dimension across ranges was the same. Learning theories that posit experience-dependent changes in stimulus representations and/or the strengthening of associations with differential responses, predict the observed specificity of easy-to-hard effects, whereas attentional-spotlighting theories do not. Calibrating the difficulty and temporal sequencing of training experiences to support more incremental representation-based learning can enhance the effectiveness of practice beyond any benefits gained from explicitly highlighting relevant dimensions.

[Self-judgment of personality traits and cognitive dimensions of the self].

PubMed

Horiuchi, T

1996-12-01

When people make a judgment as to whether a trait describes themselves or not, cognitive structure about the self must play an important role. Cognitive dimensions are a characteristic of such cognitive structure. The present study examined whether a self-referent information processing was mediated by cognitive dimensions of the self. For the purpose, Klein, Loftus, and Burton's task facilitation paradigm (1989) was adapted, which consisted of performing in succession two tasks, initial and target, for each trait adjective used. Experiment 1, which examined the evaluative dimension, showed that an evaluative processing in the target task was facilitated when the initial task was self-referent. Experiment 2, which examined six dimensions, showed that processing of the relevant dimension in the target task was facilitated when the initial task was self-referent. These results suggest that a self-referent information processing is mediated by cognitive dimensions of the self.

Preparation for horizontal or vertical dimensions affects the right-left prevalence effect.

PubMed

Nishimura, Akio; Yokosawa, Kazuhiko

2007-10-01

When stimulus and response simultaneously vary in both horizontal and vertical dimensions, the stimulus-response compatibility effect is often larger for the horizontal dimension. We investigated the role of preparation for each dimension in this right-left prevalence. In Experiment 1, tasks based on horizontal and vertical dimensions were mixed in random order, and the relevant dimension in each trial was cued with a variable cue-target stimulus onset asynchrony (SOA). A right-left prevalence effect was observed only when participants prepared for the upcoming task. Experiment 2 replicated the absence of the prevalence effect for the simultaneous presentation of cue and target using a fixed SOA of 0 msec. In Experiment 3, the right-left prevalence emerged with a 0-msec SOA when participants prepared for e achdimension basedon its frequency. These resultssuggest that participants' internal set can be greater for the horizontal dimension, leading to the right-left prevalence effect.

Attributional style and depressive symptoms in a male prison sample.

PubMed

O'Sullivan, Danny J; O'Sullivan, Maura E; O'Connell, Brendan D; O'Reilly, Ken; Sarma, Kiran M

2018-01-01

The reformulated learned helplessness model proposes that people who tend to make internal, stable, and global attributions in response to uncontrollable aversive events are more likely to develop depression. The present study sought to investigate the nature of the relationship between attributional style and depression in a male prison sample. One hundred and one adult male prisoners from four medium security prisons in Ireland completed the Attributional Style Questionnaire and measures of depression (BDI-II) and anxiety (BAI). Severity of self-reported depressive symptoms in the present sample was comparable to other prison and clinical samples, but higher than community samples. Participants were more severely affected by depressive symptoms than anxiety. The original attributional dimensions (i.e. internal, stable, and global) predicted a significant amount of variance in depression, but the model was not significant after controlling for anxiety. A subsequent regression model, comprising attributional dimensions for both negative events and positive events including a measure of 'uncontrollability', accounted for 35% of the variance in depression and the model retained significance while controlling for anxiety. An attributional model of depression may be relevant to the prison population and could provide a valid insight into the development and treatment of depressive symptoms in prisoners. The findings are interpreted in relation to previous research and implications for theory, clinical practice, and rehabilitation are discussed.

Attributional style and depressive symptoms in a male prison sample

PubMed Central

O’Sullivan, Danny J.; O’Sullivan, Maura E.; O’Connell, Brendan D.; O’Reilly, Ken; Sarma, Kiran M.

2018-01-01

The reformulated learned helplessness model proposes that people who tend to make internal, stable, and global attributions in response to uncontrollable aversive events are more likely to develop depression. The present study sought to investigate the nature of the relationship between attributional style and depression in a male prison sample. One hundred and one adult male prisoners from four medium security prisons in Ireland completed the Attributional Style Questionnaire and measures of depression (BDI-II) and anxiety (BAI). Severity of self-reported depressive symptoms in the present sample was comparable to other prison and clinical samples, but higher than community samples. Participants were more severely affected by depressive symptoms than anxiety. The original attributional dimensions (i.e. internal, stable, and global) predicted a significant amount of variance in depression, but the model was not significant after controlling for anxiety. A subsequent regression model, comprising attributional dimensions for both negative events and positive events including a measure of ‘uncontrollability’, accounted for 35% of the variance in depression and the model retained significance while controlling for anxiety. An attributional model of depression may be relevant to the prison population and could provide a valid insight into the development and treatment of depressive symptoms in prisoners. The findings are interpreted in relation to previous research and implications for theory, clinical practice, and rehabilitation are discussed. PMID:29444084

Relations of the Big-Five personality dimensions to autodestructive behavior in clinical and non-clinical adolescent populations.

PubMed

Kotrla Topic, Marina; Perkovic Kovacevic, Marina; Mlacic, Boris

2012-10-01

To examine the relationship between the Big-Five personality model and autodestructive behavior symptoms, namely Autodestructiveness and Suicidal Depression in two groups of participants: clinical and non-clinical adolescents. Two groups of participants, clinical (adolescents with diagnosis of psychiatric disorder based on clinical impression and according to valid diagnostic criteria, N=92) and non-clinical (high-school students, N=87), completed two sets of questionnaires: the Autodestructiveness Scale which provided data on Autodestructiveness and Suicidal Depression, and the International Personality Item Pool (IPIP), which provided data on the Big -Five personality dimensions. Clinical group showed significantly higher values on the Autodestructiveness scale in general, as well as on Suicidal Depression, Aggressiveness, and Borderline subscales than the non-clinical group. Some of the dimensions of the Big-Five personality model, ie, Emotional Stability, Conscientiousness, and Agreeableness showed significant relationship (hierarchical regression analyses, P values for β coefficients from 0.000 to 0.021) with Autodestructiveness and Suicidal Depression, even after controlling for the sex and group effects or, when analyzing Suicidal Depression, after controlling the effect of other subscales. The results indicate that dimensions of the Big-Five model are important when evaluating adolescent psychiatric patients and adolescents from general population at risk of self-destructive behavior.

Relations of the Big-Five personality dimensions to autodestructive behavior in clinical and non-clinical adolescent populations

PubMed Central

Kotrla Topić, Marina; Perković Kovačević, Marina; Mlačić, Boris

2012-01-01

Aim To examine the relationship between the Big-Five personality model and autodestructive behavior symptoms, namely Autodestructiveness and Suicidal Depression in two groups of participants: clinical and non-clinical adolescents. Methods Two groups of participants, clinical (adolescents with diagnosis of psychiatric disorder based on clinical impression and according to valid diagnostic criteria, N = 92) and non-clinical (high-school students, N = 87), completed two sets of questionnaires: the Autodestructiveness Scale which provided data on Autodestructiveness and Suicidal Depression, and the International Personality Item Pool (IPIP), which provided data on the Big -Five personality dimensions. Results Clinical group showed significantly higher values on the Autodestructiveness scale in general, as well as on Suicidal Depression, Aggressiveness, and Borderline subscales than the non-clinical group. Some of the dimensions of the Big-Five personality model, ie, Emotional Stability, Conscientiousness, and Agreeableness showed significant relationship (hierarchical regression analyses, P values for β coefficients from <0.001 to 0.021) with Autodestructivness and Suicidal Depression, even after controlling for the sex and group effects or, when analyzing Suicidal Depression, after controlling the effect of other subscales. Conclusion The results indicate that dimensions of the Big-Five model are important when evaluating adolescent psychiatric patients and adolescents from general population at risk of self-destructive behavior. PMID:23100207

Metamemory and aging: Psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire for elderly

PubMed Central

Simon, Sharon Sanz; Ávila, Renata Thomas; Vieira, Gilson; Bottino, Cássio Machado de Campos

2016-01-01

ABSTRACT Metamemory measures provide subjective memory information and are relevant to investigate memory ability in aging. However, there is a lack of metamemory instruments available in Brazil. Objective: The aim of this study was to examine the psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire (MMQ), which evaluates different dimensions of subjective memory functioning, such as Feelings, Abilities and Strategies used in everyday life. Methods: The MMQ was translated into Portuguese and administered to 30 Brazilian elderly subjects. The participants underwent cognitive tests, mood scales and metamemory instruments. Results: Analyses revealed good internal consistency (Cronbach's a coefficient ranged from 0.75 to 0.89) and test-retest validity for each MMQ dimensions (positive correlations between two applications ranged from 0.75 to 0.8). Convergent validity evidence for the MMQ was confirmed by significant positive correlations (0.47 to 0.68) with dimensions of the Metamemory in Adulthood scale (MIA) (i.e., the Ability, Control, Self-efficacy and Strategy dimensions). Discriminant validity revealed no associations between the MMQ and cognitive performance, suggesting a weak metamemory-objective memory correspondence. Moreover, there was a negative correlation between MMQ-Ability subscale scores and mood symptoms (-0.63 for anxious symptoms, and -0.54 for depressive symptoms); and the Brazilian MMQ was comparable with MMQ translations to other languages. Conclusion: The Brazilian MMQ exhibits good psychometric properties and appears promising for clinical and research purposes. Additional studies are needed to further examine the psychometric properties of the Brazilian MMQ in a larger sample. PMID:29213442

Defeat and entrapment: more than meets the eye? Applying network analysis to estimate dimensions of highly correlated constructs.

PubMed

Forkmann, Thomas; Teismann, Tobias; Stenzel, Jana-Sophie; Glaesmer, Heide; de Beurs, Derek

2018-01-25

Defeat and entrapment have been shown to be of central relevance to the development of different disorders. However, it remains unclear whether they represent two distinct constructs or one overall latent variable. One reason for the unclarity is that traditional factor analytic techniques have trouble estimating the right number of clusters in highly correlated data. In this study, we applied a novel approach based on network analysis that can deal with correlated data to establish whether defeat and entrapment are best thought of as one or multiple constructs. Explanatory graph analysis was used to estimate the number of dimensions within the 32 items that make up the defeat and entrapment scales in two samples: an online community sample of 480 participants, and a clinical sample of 147 inpatients admitted to a psychiatric hospital after a suicidal attempt or severe suicidal crisis. Confirmatory Factor analysis (CFA) was used to test whether the proposed structure fits the data. In both samples, bootstrapped exploratory graph analysis suggested that the defeat and entrapment items belonged to different dimensions. Within the entrapment items, two separate dimensions were detected, labelled internal and external entrapment. Defeat appeared to be multifaceted only in the online sample. When comparing the CFA outcomes of the one, two, three and four factor models, the one factor model was preferred. Defeat and entrapment can be viewed as distinct, yet, highly associated constructs. Thus, although replication is needed, results are in line with theories differentiating between these two constructs.

Anthropometric data of elderly people in Australia.

PubMed

Kothiyal, K; Tettey, S

2000-06-01

An anthropometric data set on 171 elderly people in Australia has been presented. The data set consists of 22 body dimensions relevant to design of living facilities, equipment and workplaces for the elderly people. The study was carried out in metropolitan Sydney, New South Wales, Australia. A comparative analysis with other populations indicates significant differences in the body dimensions.

Learning Organizations: Diagnosis and Measurement in a Developing Country Context--The Case of Lebanon

ERIC Educational Resources Information Center

Jamali, Dima; Sidani, Yusuf

2008-01-01

Purpose: The purpose of this paper is to assess the performance of a sample of Lebanese organizations vis-a-vis some of the core learning organization dimensions identified in the literature, focusing specifically on those dimensions that are considered most salient and relevant in the Lebanese context. Design/methodology/approach: The paper…

Considering Culture in the Selection of Teaching Approaches for Adults. ERIC Digest.

ERIC Educational Resources Information Center

Ziegahn, Linda

Cultural differences, including the personal cultures of learners and educators and the culture of the larger social-political environment, are relevant to adult learning. Culture includes those values, beliefs, and practices shared by a group of people. Cultures tend to vary along a number of dimensions, and the following dimensions are among…

U.S. Adult Literacy Program Practice: A Typology across Dimensions of Life-Contextualized/Decontextualized and Dialogic/Monologic. NCSALL Report #2.

ERIC Educational Resources Information Center

Purcell-Gates, Victoria; Degener, Sophie; Jacobson, Erik

A study created a typology of 271 adult literacy programs nationwide describing their distribution along two dimensions: (1) relevance of materials to learner needs and sociocultural context (life-contextual/decontextual), and (2) extent of learner control of decisions about program activities (dialogic/monologic). A questionnaire elicited…

Intervention Fidelity: Aspects of Complementary and Alternative Medicine (CAM) Research

PubMed Central

Wyatt, Gwen; Sikorskii, Alla; Rahbar, Mohammad Hossein; Victorson, David; Adams, Lora

2010-01-01

Background The Treatment Fidelity Workgroup (TFW) established by the National Institutes of Health (NIH) provides a 5-point structure for intervention fidelity: dosing, interventionists’ consistency, intervention delivery, receipt and enactment of the intervention. Using our reflexology trial, we apply the first three points. Objectives Study objectives are to: 1) evaluate key dosage dimensions associated with CAM research; 2) evaluate approaches to interventionists’ consistency of delivery of CAM protocols; and 3) evaluate and discuss data that reflect CAM intervention fidelity. Intervention Women with late stage breast cancer (N=318) were randomly assigned to either 4 weeks of reflexology, placebo, or standard care. Results Dosing consists of three dimensions: frequency (4-sessions), duration (30 minutes), and interval between sessions (5–9 days). Interventionist consistency revealed over a 90% accuracy rate in following the protocol; 84% and 89% completion rate of the 4 session in the reflexology and placebo groups respectively; and no differences in attrition after randomization between reflexology and placebo groups (17% and 15%, respectively). Intervention delivery, examined through debriefing data, indicated a significantly higher rate of correct guesses on group assignment in the reflexology group as compared to the placebo (82% versus 46%, p-value=.0002). Conclusions This study points out the relevance of dosing, interventionists’ consistency, and delivery data within a CAM clinical trial, as well as the challenges of blinding. Implications Monitoring intervention fidelity by using the key areas identified by the BCC ensures that findings from a clinical trial are meaningful and have the potential to be translated to clinical practice. PMID:20467309

Triarchic dimensions of psychopathy in young adulthood: Associations with clinical and physiological measures after accounting for adolescent psychopathic traits.

PubMed

Kyranides, Melina Nicole; Fanti, Kostas A; Sikki, Maria; Patrick, Christopher J

2017-04-01

This study examined associations of psychopathy facets of boldness, meanness, and disinhibition with clinically relevant variables and physiological reactivity to affective stimuli. These associations were examined after accounting for developmental associations with adolescent psychopathic traits, namely callous-unemotional traits, narcissism, and impulsivity. Psychopathic traits were assessed during adolescence using the Antisocial Process Screening Device and the Inventory of Callous Unemotional traits and during young adulthood via the Triarchic Psychopathy Measure. Clinical variables (N = 99, Mage = 15.91, 53% female), as well as affective and physiological responses (heart rate, skin conductance, startle modulation) to violent and erotic videos (N = 88, Mage = 19.92, 50% female) were also assessed during adulthood. After accounting for adolescent psychopathic traits, boldness was associated with high cognitive reappraisal and low anxiety, fear, and hostility, and meanness was related to callous-unemotional traits, hostility, less sympathy to victims, and less use of cognitive reappraisal. Disinhibition, by contrast, was associated with impulsivity, increased anxiety, and hostile and aggressive tendencies, as well as conduct disorder, antisocial personality disorder symptoms, and cognitive suppression. In addition, evidence was found for different physiological measures operating as biological indicators of these distinctive dimensions, with reduced resting heart rate and cardiac reactivity to violent stimuli indicative of boldness, above and beyond adolescent psychopathic traits, and low startle potentiation for violent stimuli indicative of callous-unemotional traits and meanness. These findings provide evidence for the value of a multidomain approach for clarifying neurobiological mechanisms of psychopathic tendencies that can inform prevention and treatment efforts. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Sub-dimensions of trait emotional intelligence and health: A critical and systematic review of the literature.

PubMed

Baudry, Anne-Sophie; Grynberg, Delphine; Dassonneville, Charlotte; Lelorain, Sophie; Christophe, Véronique

2018-04-01

Despite a growing number of studies on the role of the multidimensional construct of trait emotional intelligence (EI) in health, most have focused on global EI, without examining the role of the sub-dimensions. The present systematic review aimed to highlight the current knowledge about self-reported health associated with trait-EI sub-dimensions in general and clinical populations. We searched for the articles including valid self-report scales of trait-EI and health (mental or physical or general) in general and clinical samples. Based on 42 studies, the majority of studies was based on mental health with cross-sectional designs and the TMMS scale, in the general population. Few studies have been focused on physical health and clinical population. The description of studies results revealed that trait-EI sub-dimensions are associated to a greater extent with better mental health, rather than with physical and general health. Furthermore, intrapersonal dimensions, and especially emotion regulation, have stronger effects on health than interpersonal dimensions. Finally, patients with a clinical disorder present lower trait-EI sub-dimensions than the general population. This review supports the importance of focusing on the sub-dimensions of trait-EI to understand better the role of EI in health. The use of scales exclusively based on emotional competences in health contexts is recommended. Developing interventions targeting emotional competences according to the emotional profiles and contexts of individuals could be beneficial to improve health and disease adjustment. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Infrapatellar fat pad-derived stem cells maintain their chondrogenic capacity in disease and can be used to engineer cartilaginous grafts of clinically relevant dimensions.

PubMed

Liu, Yurong; Buckley, Conor Timothy; Almeida, Henrique V; Mulhall, Kevin J; Kelly, Daniel John

2014-11-01

A therapy for regenerating large cartilaginous lesions within the articular surface of osteoarthritic joints remains elusive. While tissue engineering strategies such as matrix-assisted autologous chondrocyte implantation can be used in the repair of focal cartilage defects, extending such approaches to the treatment of osteoarthritis will require a number of scientific and technical challenges to be overcome. These include the identification of an abundant source of chondroprogenitor cells that maintain their chondrogenic capacity in disease, as well as the development of novel approaches to engineer scalable cartilaginous grafts that could be used to resurface large areas of damaged joints. In this study, it is first demonstrated that infrapatellar fat pad-derived stem cells (FPSCs) isolated from osteoarthritic (OA) donors possess a comparable chondrogenic capacity to FPSCs isolated from patients undergoing ligament reconstruction. In a further validation of their functionality, we also demonstrate that FPSCs from OA donors respond to the application of physiological levels of cyclic hydrostatic pressure by increasing aggrecan gene expression and the production of sulfated glycosaminoglycans. We next explored whether cartilaginous grafts could be engineered with diseased human FPSCs using a self-assembly or scaffold-free approach. After examining a range of culture conditions, it was found that continuous supplementation with both transforming growth factor-β3 (TGF-β3) and bone morphogenic protein-6 (BMP-6) promoted the development of tissues rich in proteoglycans and type II collagen. The final phase of the study sought to scale-up this approach to engineer cartilaginous grafts of clinically relevant dimensions (≥2 cm in diameter) by assembling FPSCs onto electrospun PLLA fiber membranes. Over 6 weeks in culture, it was possible to generate robust, flexible cartilage-like grafts of scale, opening up the possibility that tissues engineered using FPSCs derived from OA patients could potentially be used to resurface large areas of joint surfaces damaged by trauma or disease.

Infrapatellar Fat Pad-Derived Stem Cells Maintain Their Chondrogenic Capacity in Disease and Can be Used to Engineer Cartilaginous Grafts of Clinically Relevant Dimensions

PubMed Central

Liu, Yurong; Buckley, Conor Timothy; Almeida, Henrique V.; Mulhall, Kevin J.

2014-01-01

A therapy for regenerating large cartilaginous lesions within the articular surface of osteoarthritic joints remains elusive. While tissue engineering strategies such as matrix-assisted autologous chondrocyte implantation can be used in the repair of focal cartilage defects, extending such approaches to the treatment of osteoarthritis will require a number of scientific and technical challenges to be overcome. These include the identification of an abundant source of chondroprogenitor cells that maintain their chondrogenic capacity in disease, as well as the development of novel approaches to engineer scalable cartilaginous grafts that could be used to resurface large areas of damaged joints. In this study, it is first demonstrated that infrapatellar fat pad-derived stem cells (FPSCs) isolated from osteoarthritic (OA) donors possess a comparable chondrogenic capacity to FPSCs isolated from patients undergoing ligament reconstruction. In a further validation of their functionality, we also demonstrate that FPSCs from OA donors respond to the application of physiological levels of cyclic hydrostatic pressure by increasing aggrecan gene expression and the production of sulfated glycosaminoglycans. We next explored whether cartilaginous grafts could be engineered with diseased human FPSCs using a self-assembly or scaffold-free approach. After examining a range of culture conditions, it was found that continuous supplementation with both transforming growth factor-β3 (TGF-β3) and bone morphogenic protein-6 (BMP-6) promoted the development of tissues rich in proteoglycans and type II collagen. The final phase of the study sought to scale-up this approach to engineer cartilaginous grafts of clinically relevant dimensions (≥2 cm in diameter) by assembling FPSCs onto electrospun PLLA fiber membranes. Over 6 weeks in culture, it was possible to generate robust, flexible cartilage-like grafts of scale, opening up the possibility that tissues engineered using FPSCs derived from OA patients could potentially be used to resurface large areas of joint surfaces damaged by trauma or disease. PMID:24785365

Emotional reactivity, functioning, and C-reactive protein alterations in remitted bipolar patients: Clinical relevance of a dimensional approach.

PubMed

Dargél, Aroldo A; Godin, Ophelia; Etain, Bruno; Hirakata, Vânia; Azorin, Jean-Michel; M'Bailara, Katia; Bellivier, Frank; Bougerol, Thierry; Kahn, Jean-Pierre; Passerieux, Christine; Aubin, Valerie; Courtet, Philippe; Leboyer, Marion; Henry, Chantal

2017-08-01

Inter-episode mood instability has increasingly been considered in bipolar disorder. This study aimed to investigate emotional reactivity as a major dimension for better characterizing remitted bipolar patients with subthreshold mood symptoms and functional status. This study also aimed to investigate whether high-sensitivity C-reactive protein, a marker of low-grade inflammation, could be a biological marker of emotional dysregulation in bipolar disorder (BD). Cross-sectional study of 613 subjects who met Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria for BD recruited from the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort from 2009 to 2014. All patients had been in remission for at least 3 months before assessment. Patients were classified into three groups according to levels of emotional reactivity. Emotional reactivity was assessed by using the Multidimensional Assessment of Thymic States, and functional status was assessed by the Functioning Assessment Short Test. Clinical characteristics and blood sample were collected from all patients. In total, 415 (68%) patients had abnormal emotional reactivity. Independent of potential confounders, including age, gender and subthreshold mood symptoms, serum levels of high-sensitivity C-reactive protein were significantly higher in patients with emotional hyper-reactivity (median = 4.0 mg/L, interquartile range = 2.7-5.6), and with emotional hypo-reactivity (median = 3.0 mg/L, interquartile range = 1-4) compared with patients with normal emotional reactivity (median = 0.95 mg/L, interquartile range = 0.4-1.9, p < 0.001). Patients with emotional hyper-reactivity showed significant cognitive functioning impairment ( p < 0.001). Emotional reactivity appears to be a relevant dimension for better characterizing remitted bipolar patients with subthreshold mood symptoms. Levels of high-sensitivity C-reactive protein may be an objective marker of emotional dysregulation in BD. Further studies are needed to confirm our findings.

Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain.

PubMed

Brooks, Jessica M; Iwanaga, Kanako; Chiu, Chung-Yi; Cotton, Brandi Parker; Deiches, Jon; Morrison, Blaise; Moser, Erin; Chan, Fong

2017-08-01

This study examined the relationships between self-determination theory (SDT) and theory of planned behavior (TpB) applied to physical activity and exercise behavior (PA&E) in people with chronic pain. Two hundred and eleven adults with chronic musculoskeletal pain (28 males and 183 females, age range 18 to 82 years, mean age 43 years) were recruited from online support groups and clinic networks in the United States. Participants completed SDT measures relevant to PA&E on perceived autonomy support, autonomy, competence, and relatedness, as well as TpB measures relevant to PA&E on intention, attitudes, subjective norms, and perceived behavioral control. Correlational techniques and canonical correlation analysis were performed to examine the relationships and variance within and between theoretical dimensions. Overall, the SDT set accounted for 37% of the TpB variance and the TpB set accounted for 32% of the SDT set variance. The results indicate there are statistical similarities and differences between concepts in SDT and TpB models for PA&E. Using both empirical guidance and clinical expertise, researchers and practitioners should attempt to select and integrate non-redundant and complementary components from SDT, TpB, and other related health behavior theories.

Psychometric properties of the Beck Depression Inventory-II: a comprehensive review.

PubMed

Wang, Yuan-Pang; Gorenstein, Clarice

2013-01-01

To review the psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-report measure of depression in a variety of settings and populations. Relevant studies of the BDI-II were retrieved through a search of electronic databases, a hand search, and contact with authors. Retained studies (k = 118) were allocated into three groups: non-clinical, psychiatric/institutionalized, and medical samples. The internal consistency was described as around 0.9 and the retest reliability ranged from 0.73 to 0.96. The correlation between BDI-II and the Beck Depression Inventory (BDI-I) was high and substantial overlap with measures of depression and anxiety was reported. The criterion-based validity showed good sensitivity and specificity for detecting depression in comparison to the adopted gold standard. However, the cutoff score to screen for depression varied according to the type of sample. Factor analysis showed a robust dimension of general depression composed by two constructs: cognitive-affective and somatic-vegetative. The BDI-II is a relevant psychometric instrument, showing high reliability, capacity to discriminate between depressed and non-depressed subjects, and improved concurrent, content, and structural validity. Based on available psychometric evidence, the BDI-II can be viewed as a cost-effective questionnaire for measuring the severity of depression, with broad applicability for research and clinical practice worldwide.

Extending the search for folk personality constructs: the dimensionality of the personality-relevant proverb domain.

PubMed

Haas, Heather A

2002-04-01

College students (95 men and 264 women) rated how well 211 familiar proverbs described their behavior and beliefs. A factor analysis of these data yielded 7 major dimensions; many of the factors were similar to recognized lexical personality factors. Big Five Conscientiousness and Neuroticism were each strongly associated with a single proverb dimension (interpreted as Restraint and Enjoys Life, respectively). Big Five Agreeableness, Extraversion, and Intellect/Imagination were all associated with several proverb dimensions. Agreeableness was most strongly associated with proverb dimensions representing Machiavellian behavior and strong Group Ties, and both Extraversion and Intellect showed particularly notable associations with an Achievement Striving dimension. The 2 remaining proverb dimensions, which represented a belief that Life is Fair and an attitude of Cynicism, could not be accounted for by the Big Five.

Correlation dimension of financial market

NASA Astrophysics Data System (ADS)

Nie, Chun-Xiao

2017-05-01

In this paper, correlation dimension is applied to financial data analysis. We calculate the correlation dimensions of some real market data and find that the dimensions are significantly smaller than those of the simulation data based on geometric Brownian motion. Based on the analysis of the Chinese and US stock market data, the main results are as follows. First, by calculating three data sets for the Chinese and US market, we find that large market volatility leads to a significant decrease in the dimensions. Second, based on 5-min stock price data, we find that the Chinese market dimension is significantly larger than the US market; this shows a significant difference between the two markets for high frequency data. Third, we randomly extract stocks from a stock set and calculate the correlation dimensions, and find that the average value of these dimensions is close to the dimension of the original set. In addition, we analyse the intuitional meaning of the relevant dimensions used in this paper, which are directly related to the average degree of the financial threshold network. The dimension measures the speed of the average degree that varies with the threshold value. A smaller dimension means that the rate of change is slower.

Use of a severity indicator as a predictor of the use of hepatic transplantation resources.

PubMed

Eiras, Flavia Regina Cocuzza das; Barbosa, Antonio Pires; Leão, Eliseth Ribeiro; Biancolino, César Augusto

2016-01-01

To evaluate the use of a severity indicator for end-stage liver disease as a predictor of resource use in a teaching hospital in São Paulo. Descriptive, retrospective study, classifying independent variables in seven key dimensions: identification/risk rating; length of stay/use of advanced life support; imaging; clinical analysis; special procedures; blood products in the intensive care unit; and in the operating room. The frequencies were analyzed by linear regression analysis of variance to detect relevance due to the dependent variable (severity indicator) in 76 cases seen in 2013. Among the variables studied, those that presented relevance due to the functional risk score were laboratory measurements of bilirubin, amylase, transaminase, blood count, creatine phosphokinase (p<0.05), hemotherapy procedures fresh frozen plasma (FFP) and platelet concentrate (p<0.05), and Doppler echocardiography image (p<0.07). Given the results/objective of this study, it is concluded that the indicator presents a potential predictive capability in the use of postoperative resources of liver receptors in the size, clinical analysis, images and hemotherapy dimensions. Avaliar o uso do indicador de gravidade para doenças hepáticas terminais como fator preditivo do uso de recursos em um hospital-escola de São Paulo. Estudo descritivo, retrospectivo, classificando variáveis independentes em sete dimensões principais: identificação/classificação de risco; tempo de permanência/uso de suporte avançado à vida; exames de imagem; análises clínicas; procedimentos especiais; hemoderivados em unidade de terapia intensiva; e em centro cirúrgico. As frequências foram analisadas por regressão linear com análise de variância para detecção de relevâncias face à variável dependente (indicador de gravidade) em 76 casos atendidos em 2013. Dentre as variáveis estudadas, apresentaram relevância em função do escore de risco funcional as dosagens laboratoriais de bilirrubina, amilase, transaminase, hemograma, creatinofosfoquinase (p<0,05), procedimentos hemoterápicos plasma fresco congelado (PFC) e concentrado de plaquetas (p<0,05), e imagem Ecodoppler (p<0,07). Face aos resultados/propósito do estudo conclui-se que o indicador apresenta potencial capacidade preditiva no uso de recursos pós-operatórios de receptores de fígado nas dimensões, análises clínicas, imagens e hemoterapia.

Problem behaviours and symptom dimensions of psychiatric disorders in adults with intellectual disabilities: An exploratory and confirmatory factor analysis.

PubMed

Melville, Craig A; Johnson, Paul C D; Smiley, Elita; Simpson, Neill; Purves, David; McConnachie, Alex; Cooper, Sally-Ann

2016-08-01

The limited evidence on the relationship between problem behaviours and symptoms of psychiatric disorders experienced by adults with intellectual disabilities leads to conflict about diagnostic criteria and confused treatment. This study examined the relationship between problem behaviours and other psychopathology, and compared the predictive validity of dimensional and categorical models experienced by adults with intellectual disabilities. Exploratory and confirmatory factor analyses appropriate for non-continuous data were used to derive, and validate, symptom dimensions using two clinical datasets (n=457; n=274). Categorical diagnoses were derived using DC-LD. Severity and 5-year longitudinal outcome was measured using a battery of instruments. Five factors/dimensions were identified and confirmed. Problem behaviours were included in an emotion dysregulation-problem behaviour dimension that was distinct from the depressive, anxiety, organic and psychosis dimensions. The dimensional model had better predictive validity than categorical diagnosis. International classification systems should not include problem behaviours as behavioural equivalents in diagnostic criteria for depression or other psychiatric disorders. Investigating the relevance of emotional regulation to psychopathology may provide an important pathway for development of improved interventions. There is uncertainty whether new onset problem behaviours or a change in longstanding problem behaviours should be considered as symptoms of depression or other types of psychiatric disorders in adults with intellectual disabilities. The validity of previous studies was limited by the use of pre-defined, categorical diagnoses or unreliable statistical methods. This study used robust statistical modelling to examine problem behaviours within a dimensional model of symptoms. We found that problem behaviours were included in an emotional dysregulation dimension and not in the dimension that included symptoms that are typical of depression. The dimensional model of symptoms had greater predictive validity than categorical diagnoses of psychiatric disorders. Our findings suggest that problem behaviours are a final common pathway for emotional distress in adults with intellectual disabilities so clinicians should not use a change in problem behaviours as a diagnostic criterion for depression, or other psychiatric disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Unpacking the Clinical and Participatory Dimensions of the Trump Math-Teacher-Residency-Program

ERIC Educational Resources Information Center

Imanuel-Noy, Dalia; Wagner, Tili

2016-01-01

The research presents a Residency Math teacher education program that has been developed in Israel in search of transforming initial teacher preparation on the Clinical-Participatory continuum. It is a "multi-phase" mixed-method research aiming to present the clinical and participatory dimensions of the TMR: the way in which they are…

The Relevance Aura of Bibliographic Records.

ERIC Educational Resources Information Center

Brooks, Terrence A.

1997-01-01

Analyzes relevance assessments of topical descriptors for bibliographic records for two dimensions: (1) a vertical conceptual hierarchy of broad to narrow descriptors, and (2) a horizontal linkage of related terms. The data were analyzed for a semantic distance and semantic direction effect as postulated by the Semantic Distance Model. (Author/LRW)

Extracting Social Information from Chemosensory Cues: Consideration of Several Scenarios and Their Functional Implications

PubMed Central

Ben-Shaul, Yoram

2015-01-01

Across all sensory modalities, stimuli can vary along multiple dimensions. Efficient extraction of information requires sensitivity to those stimulus dimensions that provide behaviorally relevant information. To derive social information from chemosensory cues, sensory systems must embed information about the relationships between behaviorally relevant traits of individuals and the distributions of the chemical cues that are informative about these traits. In simple cases, the mere presence of one particular compound is sufficient to guide appropriate behavior. However, more generally, chemosensory information is conveyed via relative levels of multiple chemical cues, in non-trivial ways. The computations and networks needed to derive information from multi-molecule stimuli are distinct from those required by single molecule cues. Our current knowledge about how socially relevant information is encoded by chemical blends, and how it is extracted by chemosensory systems is very limited. This manuscript explores several scenarios and the neuronal computations required to identify them. PMID:26635515

Category learning increases discriminability of relevant object dimensions in visual cortex.

PubMed

Folstein, Jonathan R; Palmeri, Thomas J; Gauthier, Isabel

2013-04-01

Learning to categorize objects can transform how they are perceived, causing relevant perceptual dimensions predictive of object category to become enhanced. For example, an expert mycologist might become attuned to species-specific patterns of spacing between mushroom gills but learn to ignore cap textures attributable to varying environmental conditions. These selective changes in perception can persist beyond the act of categorizing objects and influence our ability to discriminate between them. Using functional magnetic resonance imaging adaptation, we demonstrate that such category-specific perceptual enhancements are associated with changes in the neural discriminability of object representations in visual cortex. Regions within the anterior fusiform gyrus became more sensitive to small variations in shape that were relevant during prior category learning. In addition, extrastriate occipital areas showed heightened sensitivity to small variations in shape that spanned the category boundary. Visual representations in cortex, just like our perception, are sensitive to an object's history of categorization.

Generalizing attentional control across dimensions and tasks: evidence from transfer of proportion-congruent effects.

PubMed

Wühr, Peter; Duthoo, Wout; Notebaert, Wim

2015-01-01

Three experiments investigated transfer of list-wide proportion congruent (LWPC) effects from a set of congruent and incongruent items with different frequency (inducer task) to a set of congruent and incongruent items with equal frequency (diagnostic task). Experiments 1 and 2 mixed items from horizontal and vertical Simon tasks. Tasks always involved different stimuli that varied on the same dimension (colour) in Experiment 1 and on different dimensions (colour, shape) in Experiment 2. Experiment 3 mixed trials from a manual Simon task with trials from a vocal Stroop task, with colour being the relevant stimulus in both tasks. There were two major results. First, we observed transfer of LWPC effects in Experiments 1 and 3, when tasks shared the relevant dimension, but not in Experiment 2. Second, sequential modulations of congruency effects transferred in Experiment 1 only. Hence, the different transfer patterns suggest that LWPC effects and sequential modulations arise from different mechanisms. Moreover, the observation of transfer supports an account of LWPC effects in terms of list-wide cognitive control, while being at odds with accounts in terms of stimulus-response (contingency) learning and item-specific control.

Topological electronic liquids: Electronic physics of one dimension beyond the one spatial dimension

NASA Astrophysics Data System (ADS)

Wiegmann, P. B.

1999-06-01

There is a class of electronic liquids in dimensions greater than 1 that shows all essential properties of one-dimensional electronic physics. These are topological liquids-correlated electronic systems with a spectral flow. Compressible topological electronic liquids are superfluids. In this paper we present a study of a conventional model of a topological superfluid in two spatial dimensions. This model is thought to be relevant to a doped Mott insulator. We show how the spectral flow leads to the superfluid hydrodynamics and how the orthogonality catastrophe affects off-diagonal matrix elements. We also compute the major electronic correlation functions. Among them are the spectral function, the pair wave function, and various tunneling amplitudes. To compute correlation functions we develop a method of current algebra-an extension of the bosonization technique of one spatial dimension. In order to emphasize a similarity between electronic liquids in one dimension and topological liquids in dimensions greater than 1, we first review the Fröhlich-Peierls mechanism of ideal conductivity in one dimension and then extend the physics and the methods into two spatial dimensions.

The Role of Work-Related Factors in the Development of Psychological Distress and Associated Mental Disorders: Differential Views of Human Resource Managers, Occupational Physicians, Primary Care Physicians and Psychotherapists in Germany.

PubMed

Junne, Florian; Michaelis, Martina; Rothermund, Eva; Stuber, Felicitas; Gündel, Harald; Zipfel, Stephan; Rieger, Monika A

2018-03-20

Objectives : This study analyses the perceived relevance of stress-dimensions in work-settings from the differential views of Human Resource Managers (HRM), Occupational Physicians (OP), Primary Care Physicians (PCP) and Psychotherapists (PT) in Germany. Methods : Cross-sectional study design, using a self-report questionnaire. Descriptive measures and explorative bivariate methods were applied for group-comparisons. Results are presented as rankings of perceived importance and as polarity profiles of contrasting views. Results: N = 627 participants completed the questionnaires (HRM: n = 172; OP: n = 133; PCP: n = 136; PT: n = 186). The stress dimensions with the highest mean ratings across all four professions were: 'social relationships in the work place' ( M = 3.55, SD = 0.62) and 'superiors´ leadership style' ( M = 3.54, SD = 0.64). Mean ratings of perceived relevance of stress dimensions differed most between HRM and the three medical professions. Conclusions : The perceived importance of work-related stress-dimensions seems to be higher in the medical disciplines (OP, PCP, PT) than in the group from the management sector (HRM). However, no fundamental disagreement on the role of work-related stress-dimensions seems to hinder e.g., intensified efforts of cooperation across sectors in tackling the "stress-pandemic" and improving the (mental) health of employees.

The Role of Work-Related Factors in the Development of Psychological Distress and Associated Mental Disorders: Differential Views of Human Resource Managers, Occupational Physicians, Primary Care Physicians and Psychotherapists in Germany

PubMed Central

Junne, Florian; Michaelis, Martina; Stuber, Felicitas; Gündel, Harald; Zipfel, Stephan

2018-01-01

Objectives: This study analyses the perceived relevance of stress-dimensions in work-settings from the differential views of Human Resource Managers (HRM), Occupational Physicians (OP), Primary Care Physicians (PCP) and Psychotherapists (PT) in Germany. Methods: Cross-sectional study design, using a self-report questionnaire. Descriptive measures and explorative bivariate methods were applied for group-comparisons. Results are presented as rankings of perceived importance and as polarity profiles of contrasting views. Results: N = 627 participants completed the questionnaires (HRM: n = 172; OP: n = 133; PCP: n = 136; PT: n = 186). The stress dimensions with the highest mean ratings across all four professions were: ‘social relationships in the work place’ (M = 3.55, SD = 0.62) and ‘superiors´ leadership style’ (M = 3.54, SD = 0.64). Mean ratings of perceived relevance of stress dimensions differed most between HRM and the three medical professions. Conclusions: The perceived importance of work-related stress-dimensions seems to be higher in the medical disciplines (OP, PCP, PT) than in the group from the management sector (HRM). However, no fundamental disagreement on the role of work-related stress-dimensions seems to hinder e.g., intensified efforts of cooperation across sectors in tackling the “stress-pandemic” and improving the (mental) health of employees. PMID:29558427

Re-thinking the classification of autism spectrum disorders

PubMed Central

Lord, Catherine; Jones, Rebecca M.

2012-01-01

Background The nosology of autism spectrum disorders (ASD) is at a critical point in history as the field seeks to better define dimensions of social-communication deficits and restricted/repetitive behaviors on an individual level for both clinical and neurobiological purposes. These different dimensions also suggest an increasing need for quantitative measures that accurately map their differences, independent of developmental factors such as age, language level and IQ. Method Psychometric measures, clinical observation as well as genetic, neurobiological and physiological research from toddlers, children and adults with ASD are reviewed. Results The question of how to conceptualize ASDs along dimensions versus categories is discussed within the nosology of autism and the proposed changes to the DSM-5 and ICD-11. Differences across development are incorporated into the new classification frameworks. Conclusions It is crucial to balance the needs of clinical practice in ASD diagnostic systems, with neurobiologically based theories that address the associations between social-communication and restricted/repetitive dimensions in individuals. Clarifying terminology, improving description of the core features of ASD and other dimensions that interact with them and providing more valid and reliable ways to quantify them, both for research and clinical purposes, will move forward both practice and science. PMID:22486486

Integrative dimensions of psychotherapy training.

PubMed

Greben, Daniel H

2004-04-01

This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

How families cope with diabetes in adolescence. An approach and case analyses.

PubMed

Hauser, S T; Paul, E L; Jacobson, A M; Weiss-Perry, B; Vieyra, M A; Rufo, P; Spetter, L D; DiPlacido, J; Wertlieb, D; Wolfsdorf, J

1988-01-01

In this paper we describe our newly constructed Family Coping Coding System. This scheme was constructed to identify family coping strategies that involve appraisal, problem solving, and emotion management dimensions. We discuss the theoretical rationale, meanings and reliability of the coping codes, and illustrate them through excerpts drawn from family discussions of a recent stressful situation (the onset of a chronic or acute illness in an adolescent member). Finally, we consider the clinical research relevance of this new assessment technique, exemplifying this potential with respect to medical compliance. We present analyses of two families with diabetic adolescents who strikingly differ with respect to compliance, and explore which family coping strategies may be predictive of an adolescent's favorable or problematic compliance to diabetes management.

Low-energy Lorentz violation from high-energy modified dispersion in inertial and circular motion

NASA Astrophysics Data System (ADS)

Louko, Jorma; Upton, Samuel D.

2018-01-01

We consider an Unruh-DeWitt detector in inertial and circular motion in Minkowski spacetime of arbitrary dimension, coupled to a quantized scalar field with the Lorentz-violating dispersion relation ω =|k |f (|k |/M⋆) , where M⋆ is the Lorentz-breaking scale. Assuming that f dips below unity somewhere, we show that an inertial detector experiences large low-energy Lorentz violations in all spacetime dimensions greater than two, generalizing previous results in four dimensions. For a detector in circular motion, we show that a similar low-energy Lorentz violation occurs in three spacetime dimensions, and we lay the analytic groundwork for examining circular motion in all dimensions greater than three, generalizing previous work by Stargen, Kajuri and Sriramkumar in four dimensions. The circular motion results may be relevant for the prospects of observing the circular motion Unruh effect in analogue laboratory systems.

Validation of the Portuguese version of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS-P) in clinical and non-clinical samples.

PubMed

Curcio, Cristiane Schumann Silva; Lucchetti, Giancarlo; Moreira-Almeida, Alexander

2015-04-01

Despite Brazil's high levels of religious involvement, there is a scarcity of validated religiousness/spirituality (R/S) measures in Portuguese, particularly multidimensional ones. This study presents the validation of the Portuguese version of the "Brief Multidimensional Measure in Religiousness and Spirituality" (BMMRS) within the Brazilian context. Inpatients (262) and caregivers (389) at two hospitals of Brazil answered the BMMRS, the DUREL-p, and a sociodemographic questionnaire. The internal and convergent validity and test-retest reliability for major dimensions were good. Discriminant validity was high (except for the Forgiveness dimension). The Portuguese version of the BMMRS is a reliable and valid instrument to assess multiple R/S dimensions in clinical and non-clinical samples.

Recommendations for Self-Report Outcome Measures in Vulvodynia Clinical Trials.

PubMed

Pukall, Caroline F; Bergeron, Sophie; Brown, Candace; Bachmann, Gloria; Wesselmann, Ursula

2017-08-01

Vulvodynia (idiopathic chronic vulvar pain) is a prevalent condition associated with significant and negative impacts in many areas of function. Despite the increased research interest in vulvodynia in recent years, recommendations for outcome measures for use in clinical trials are missing. The purpose of this paper, therefore, was to provide recommendations for outcome measures for vulvodynia clinical trials so that consistent measures are used across trials to facilitate between-study comparisons and the conduct of large multicenter trials, and to improve measurement of the multiple dimensions of vulvodynia. Given that provoked vestibulodynia (PVD)-characterized by provoked pain localized to the vaginal opening-is the most common subtype of vulvodynia and the current main focus of clinical trials, this paper focused on recommended outcome measures in PVD clinical trials. The framework used to guide the selection of outcome measures was based on the one proposed by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). The IMMPACT framework provided a well-suited guideline for outcome measure recommendations in PVD clinical trials. However, given the provoked presentation of PVD and the significant impact it has on sexuality, modifications to some of the IMMPACT recommendations were made and specific additional measures were suggested. Measures that are specific to vulvovaginal pain are ideal for adoption in PVD clinical trials, and many such measures currently exist that allow the relevant IMMPACT domains to be captured.

The relationship between strategic control and conscious structural knowledge in artificial grammar learning.

PubMed

Norman, Elisabeth; Scott, Ryan B; Price, Mark C; Dienes, Zoltan

2016-05-01

We address Jacoby's (1991) proposal that strategic control over knowledge requires conscious awareness of that knowledge. In a two-grammar artificial grammar learning experiment all participants were trained on two grammars, consisting of a regularity in letter sequences, while two other dimensions (colours and fonts) varied randomly. Strategic control was measured as the ability to selectively apply the grammars during classification. For each classification, participants also made a combined judgement of (a) decision strategy and (b) relevant stimulus dimension. Strategic control was found for all types of decision strategy, including trials where participants claimed to lack conscious structural knowledge. However, strong evidence of strategic control only occurred when participants knew or guessed that the letter dimension was relevant, suggesting that strategic control might be associated with - or even causally requires - global awareness of the nature of the rules even though it does not require detailed knowledge of their content. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Dynamic Interaction between Reinforcement Learning and Attention in Multidimensional Environments.

PubMed

Leong, Yuan Chang; Radulescu, Angela; Daniel, Reka; DeWoskin, Vivian; Niv, Yael

2017-01-18

Little is known about the relationship between attention and learning during decision making. Using eye tracking and multivariate pattern analysis of fMRI data, we measured participants' dimensional attention as they performed a trial-and-error learning task in which only one of three stimulus dimensions was relevant for reward at any given time. Analysis of participants' choices revealed that attention biased both value computation during choice and value update during learning. Value signals in the ventromedial prefrontal cortex and prediction errors in the striatum were similarly biased by attention. In turn, participants' focus of attention was dynamically modulated by ongoing learning. Attentional switches across dimensions correlated with activity in a frontoparietal attention network, which showed enhanced connectivity with the ventromedial prefrontal cortex between switches. Our results suggest a bidirectional interaction between attention and learning: attention constrains learning to relevant dimensions of the environment, while we learn what to attend to via trial and error. Copyright © 2017 Elsevier Inc. All rights reserved.

SOCIAL, HISTORICAL AND CULTURAL DIMENSIONS OF TUBERCULOSIS.

PubMed

Mason, Paul H; Roy, Anupom; Spillane, Jayden; Singh, Puneet

2016-03-01

Tuberculosis (TB) researchers and clinicians, by virtue of the social disease they study, are drawn into an engagement with ways of understanding illness that extend beyond the strictly biomedical model. Primers on social science concepts directly relevant to TB, however, are lacking. The particularities of TB disease mean that certain social science concepts are more relevant than others. Concepts such as structural violence can seem complicated and off-putting. Other concepts, such as gender, can seem so familiar that they are left relatively unexplored. An intimate familiarity with the social dimensions of disease is valuable, particularly for infectious diseases, because the social model is an important complement to the biomedical model. This review article offers an important introduction to a selection of concepts directly relevant to TB from health sociology, medical anthropology and social cognitive theory. The article has pedagogical utility and also serves as a useful refresher for those researchers already engaged in this genre of work. The conceptual tools of health sociology, medical anthropology and social cognitive theory offer insightful ways to examine the social, historical and cultural dimensions of public health. By recognizing cultural experience as a central force shaping human interactions with the world, TB researchers and clinicians develop a more nuanced consideration of how health, illness and medical treatment are understood, interpreted and confronted.

The missing dimension: the relevance of people's conception of time.

PubMed

Norgate, Sarah H; Davies, Nigel; Speed, Chris; Cherrett, Tom; Dickinson, Janet

2014-02-01

While a timely conceptual innovation for the digital age, the "map" proposed by Bentley et al. would benefit from strengthening through the inclusion of a non-clock-time perspective. In this way, there could be new hypotheses developed which could be applied and tested relevant to more diverse societies, cultures, and individuals.

Task relevance modulates the cortical representation of feature conjunctions in the target template.

PubMed

Reeder, Reshanne R; Hanke, Michael; Pollmann, Stefan

2017-07-03

Little is known about the cortical regions involved in representing task-related content in preparation for visual task performance. Here we used representational similarity analysis (RSA) to investigate the BOLD response pattern similarity between task relevant and task irrelevant feature dimensions during conjunction viewing and target template maintenance prior to visual search. Subjects were cued to search for a spatial frequency (SF) or orientation of a Gabor grating and we measured BOLD signal during cue and delay periods before the onset of a search display. RSA of delay period activity revealed that widespread regions in frontal, posterior parietal, and occipitotemporal cortices showed general representational differences between task relevant and task irrelevant dimensions (e.g., orientation vs. SF). In contrast, RSA of cue period activity revealed sensory-related representational differences between cue images (regardless of task) at the occipital pole and additionally in the frontal pole. Our data show that task and sensory information are represented differently during viewing and during target template maintenance, and that task relevance modulates the representation of visual information across the cortex.

An Instrument to Measure Maturity of Integrated Care: A First Validation Study

PubMed Central

2018-01-01

Introduction: Lessons captured from interviews with 12 European regions are represented in a new instrument, the B3-Maturity Model (B3-MM). B3-MM aims to assess maturity along 12 dimensions reflecting the various aspects that need to be managed in order to deliver integrated care. The objective of the study was to test the content validity of B3-MM as part of SCIROCCO (Scaling Integrated Care into Context), a European Union funded project. Methods: A literature review was conducted to compare B3-MM’s 12 dimensions and their measurement scales with existing measures and instruments that focus on assessing the development of integrated care. Subsequently, a three-round survey conducted through a Delphi study with international experts in the field of integrated care was performed to test the relevance of: 1) the dimensions, 2) the maturity indicators and 3) the assessment scale used in B3-MM. Results: The 11 articles included in the literature review confirmed all the dimensions described in the original version of B3-MM. The Delphi study rounds resulted in various phrasing amendments of indicators and assessment scale. Full agreement among the experts on the relevance of the 12 B3-MM dimensions, their indicators, and assessment scale was reached after the third Delphi round. Conclusion and discussion: The B3-MM dimensions, maturity indicators and assessment scale showed satisfactory content validity. While the B3-MM is a unique instrument based on existing knowledge and experiences of regions in integrated care, further testing is needed to explore other measurement properties of B3-MM. PMID:29588644

Internalizing and Externalizing Personality Dimensions and Clinical Problems in Adolescents

ERIC Educational Resources Information Center

Hopwood, Christopher J.; Grilo, Carlos M.

2010-01-01

Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study,…

The Logical and Psychological Structure of Physical Chemistry and Its Relevance to the Organization/Sequencing of the Major Areas Covered in Physical Chemistry Textbooks

ERIC Educational Resources Information Center

Tsaparlis, Georgios

2014-01-01

Jensen's scheme for the logical structure of chemistry is taken as reference to study the logical structure of physical chemistry. The scheme distinguishes three dimensions (composition and structure, energy, and time), with each dimension treated at one of the three levels (molar, molecular, and electrical). Such a structure places the outer…

On the Use of Adaptive Instructional Images Based on the Sequential-Global Dimension of the Felder-Silverman Learning Style Theory

ERIC Educational Resources Information Center

Filippidis, Stavros K.; Tsoukalas, Ioannis A.

2009-01-01

An adaptive educational system that uses adaptive presentation is presented. In this system fragments of different images present the same content and the system can choose the one most relevant to the user based on the sequential-global dimension of Felder-Silverman's learning style theory. In order to retrieve the learning style of each student…

Goal-driven selective attention in patients with right hemisphere lesions: how intact is the ipsilesional field?

PubMed

Snow, Jacqueline C; Mattingley, Jason B

2006-01-01

Patients with right hemisphere (RH) lesions often display a spatial bias in attention towards the ipsilesional hemifield. The behavioural manifestations of this spatial bias are typically interpreted as reflecting increased or enhanced attention for stimuli within the 'intact' ipsilesional field, and impaired attentional functioning within the contralesional field. In the healthy brain, goal-driven and stimulus-driven attentional processes interact to determine which stimuli should be prioritized for selection. Although unilateral brain damage increases the relative attentional salience of stimuli within the ipsilesional field, it might also cause problems in filtering or attenuating task-irrelevant information. We examined whether goal-driven attention modulates the processing of ipsilesional and contralesional information in 6 patients with unilateral brain damage following RH stroke (5 male, 1 female; mean age 60.8 years) and a group of age and sex-matched controls. We used a flanker task in which participants made speeded judgements on a central target item (a coloured letter). On each trial the target was flanked by a coloured letter in the left and right hemifields. In separate blocks, participants were instructed to judge either the identity or the colour of the central target and to ignore the flankers. The flanker on one side could be congruent, incongruent or neutral with respect to the target, on either the letter or the colour dimension, whereas the flanker on the other side was always neutral on both dimensions. Healthy controls showed significant interference from incongruent flankers on either side. Crucially, however, this effect only occurred for the task-relevant dimension [F(2,10) = 24.60; P < 0.001]. For patients, however, both the task-relevant and task-irrelevant dimensions of ipsilesional flankers interfered with response times [task-relevant: F(2,10) = 7.50, P < 0.05; task-irrelevant: F(1,5) = 6.20, P < 0.05]. Conversely, contralesional flankers influenced response times only when the target and distractor were incongruent on the task-relevant dimension [F(2,10) = 4.85; P < 0.05]. Our findings demonstrate that following RH damage, goal-driven biases cannot constrain the processing of task-irrelevant features of ipsilesional stimuli. We speculate that a lateralized bias in spatial attention leads to unselective prioritization of all feature-based attributes of stimuli appearing within the ipsilesional hemifield, whether or not they are relevant to performance. Attentional selection for ipsilesional stimuli in disorders such as spatial neglect and extinction may not therefore be entirely normal, as previously assumed.

The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care.

PubMed

Dancet, E A F; Apers, S; Kluivers, K B; Kremer, J A M; Sermeus, W; Devriendt, C; Nelen, W L D M; D'Hooghe, T M

2012-11-01

How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness did not differ between the clinics, that each clinic was significantly more patient-centered for 2 out of 10 dimensions of patient-centered endometriosis care and that clinics 1 and 2 had to improve 8 and 13 specific care aspects, respectively. Patient-centered endometriosis care is essential to high-quality care and is defined by 10 dimensions. The ECQ was developed, validated and proved to be reliable in a European setting of self-reported endometriosis patients but had not yet been used at a clinic level for quality management. A cross-sectional survey was disseminated in 2011 to all 514 women diagnosed with endometriosis during a laparoscopy indicated for pain and/or infertility during a retrospective 2-year period (2009-2010) in two university clinics from two different European countries. In total 337 patients completed the ECQ (216 and 121 per clinic). Respondents had a mean age of 34.3 years. Three in four reported a surgical diagnosis of moderate or severe endometriosis and the majority reported surgical treatment by a multidisciplinary team. The ECQ assessed the 10 dimensions of patient-centeredness, more specifically whether the health-care performance, as perceived by patients, measured up to what is important to patients in general. The ECQ was completed by 337 respondents (response rate = 65.6%). Reliability and validity of the ECQ for use on clinic level were confirmed. Clinics did not differ in overall mean importance scores; importance rankings of the ECQ dimensions were almost identical. The overall patient-centeredness scores (PCS), adjusted for education level, did not discriminate between the clinics. However, the adjusted PCS for the dimensions 'clinic staff' and 'technical skills' were significantly better in clinic 1, whereas the dimensions 'physical comfort' and 'access to care' were significantly better in clinic 2. There were 8 (clinic 1) and 13 (clinic 2) targets identified for joint and cross-clinic improvement. Response rates were relatively high. Recall bias was the most important limitation and research in more clinics is needed to define the statistical discriminative value of the ECQ. European endometriosis clinics can use the validated ECQ for reliable assessment of their 'patient-centeredness', for comparison with others and for setting specific targets to improve the patient-centeredness of their endometriosis care, to plan interventions, and to evaluate their effectiveness. This work was funded by KU Leuven and European Network of Endometriosis (ENE), supported by the European Commission (Public Health Executive Agency). No competing interests are declared.

Establishing a clinically relevant cutoff to the Dependency Scale from the dimensional clinical personality inventory.

PubMed

Carvalho, Lucas de F; Pianowski, Giselle; Filho, Nelson H

2017-05-01

The Clinical Dimensional Personality Inventory (IDCP) is a 163-item self-report tool developed for the assessment of 12 dimensions of personality pathology. One of the scales comprising the instrument-the Dependency scale-is intended to provide psychometric information on traits closely related to the Dependent Personality Disorder (DPD). In the present study, we used both Item Response Theory modeling and Receiver Operating Characteristic curve analysis to establishing a clinically meaningful cutoff for the IDCP Dependency Scale. Participants were 2.481 adults, comprised by outpatients diagnosed with DPD, outpatients diagnosed with other PDs, and adults from the general population. The Wright's item map graphing technique revealed that outpatients were located at the very high levels in the latent scale continuum of the Dependency Scale, with a very large effect size for the mean difference between patients and non-patients. The ROC curve analysis supported a cutoff at 2.3 points in the Dependency Scale, which yielded 0.86 of sensitivity and 0.79 of specificity. Findings from the present investigation suggest the IDCP Dependency Scale is useful as a screening tool of the core features of the DPD. We address potential clinical applications for the instrument, and discuss limitations from the present study. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

[Inclusion criteria and rating scales for RCTs in Psychiatry. The future of qualitative studies].

PubMed

Pringuey, D; Pommier, R; Pringuey-Criou, F; Boyer, S; Massoubre, C; Fakra, E; Adida, M; Belzeaux, R; Bottai, T; Azorin, J-M

2016-12-01

An inventory on the two critical dimensions that structure the Randomized Controlled Trial in Psychiatry, namely the definition of inclusion criteria for eligible patients for testing and the choice of psychometric methods of pathology assessment and its evolution during the experiment, considers the importance of increasingly numerous and precise international recommendations. Taking into account the formal constraints of industrial, questioning the cultural differences of the methodological approach of the tests, meeting the requirements of feasibility and ever increasing security, frequent cumbersome procedure often contrasts with the modest nature of the results. A better definition to include patients in randomized trials is desirable and it asks to return to the clinic studying the expectations of patients and their response to the therapeutic situation. Excessive standardization otherwise required for ensuring the objective nature of the assessment hampers the collection of original and varied clinical features of importance in the further definitions of indications. On the way to a resumption of the single case study, we can expect from qualitative methods applied to small groups of subjects, optimization principles of patient selection for the upcoming randomized trial and greater chance to address the relevant details of clinical response to the therapeutic situation. This is what has led to the discovery of psychotropic drugs and which is involved in the various modalities of the qualitative approach. For example, and beyond the exploration of clinical drug effects, the study of the experience of psychiatric inpatient care in the Healing Garden, conducted on a small group and on the basis of the narrative analysis of their experience, notes several operating thematic dimensions: a reduction in the perception of symptoms of the disease, the impression of regaining a foothold into reality, the interest of a differently perceived doctor-patient relationship, the advantage of renewed power to act and the recognition of the importance of support from others, patients recovering somehow « vitality » of touch with reality. This suggests the possibility to establish an appropriate rating scale for such a specific therapeutic situation and to provide a more accurate and efficient recruitment for a comparative objective demonstration. Moreover, this construction of meaning reinforces the therapeutic benefit of treatment in Healing Garden and offers new dimensions for research. © L’Encéphale, Paris, 2016.

The Personality Psychopathology-Five (PSY-5): recent constructive replication and assessment literature review.

PubMed

Harkness, Allan R; Finn, Jacob A; McNulty, John L; Shields, Susan M

2012-06-01

The Personality Psychopathology-Five (PSY-5; Harkness & McNulty, 1994) is a model of individual differences relevant to adaptive functioning in both clinical and non-clinical populations. In this article, we review the development of the PSY-5 model (Harkness, 1992; Harkness & McNulty, 1994) and discuss the ways in which the PSY-5 model is related to and distinct from other 5-factor models. Using different methods and measures, the dimensions of the PSY-5 model have been constructively replicated (Lykken, 1968) by Tackett, Silberschmidt, Krueger, and Sponheim (2008) and by Watson, Clark, and Chmielewski (2008), and dimensions congruent with the PSY-5 have even been suggested for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; Krueger et al., 2011). PSY-5 Scales can be scored from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001), the MMPI-Adolescent version (MMPI-A; Butcher et al., 1992), and the Restructured Form of the MMPI-2 (MMPI-2-RF; Ben-Porath & Tellegen, 2008). Because the largest body of research exists for the MMPI-2-based scales, we focus our review of the literature on the MMPI-2-based PSY-5 scales (Harkness, McNulty, & Ben-Porath, 1995), but we briefly cover the small, but growing, body of MMPI-A and MMPI-2-RF PSY-5 scales research. We show that the PSY-5 research literature includes a wide variety of psychometric methodologies as well as diverse samples and clinical problems. An integrative summary reprises the theory behind each PSY-5 construct and links it to the reviewed literature. Advantages and limitations of MMPI-2-based PSY-5 scales are discussed. (c) 2012 APA, all rights reserved

Fractal Dimension of EEG Activity Senses Neuronal Impairment in Acute Stroke

PubMed Central

Zappasodi, Filippo; Olejarczyk, Elzbieta; Marzetti, Laura; Assenza, Giovanni; Pizzella, Vittorio; Tecchio, Franca

2014-01-01

The brain is a self-organizing system which displays self-similarities at different spatial and temporal scales. Thus, the complexity of its dynamics, associated to efficient processing and functional advantages, is expected to be captured by a measure of its scale-free (fractal) properties. Under the hypothesis that the fractal dimension (FD) of the electroencephalographic signal (EEG) is optimally sensitive to the neuronal dysfunction secondary to a brain lesion, we tested the FD’s ability in assessing two key processes in acute stroke: the clinical impairment and the recovery prognosis. Resting EEG was collected in 36 patients 4–10 days after a unilateral ischemic stroke in the middle cerebral artery territory and 19 healthy controls. National Health Institute Stroke Scale (NIHss) was collected at T0 and 6 months later. Highuchi FD, its inter-hemispheric asymmetry (FDasy) and spectral band powers were calculated for EEG signals. FD was smaller in patients than in controls (1.447±0.092 vs 1.525±0.105) and its reduction was paired to a worse acute clinical status. FD decrease was associated to alpha increase and beta decrease of oscillatory activity power. Larger FDasy in acute phase was paired to a worse clinical recovery at six months. FD in our patients captured the loss of complexity reflecting the global system dysfunction resulting from the structural damage. This decrease seems to reveal the intimate nature of structure-function unity, where the regional neural multi-scale self-similar activity is impaired by the anatomical lesion. This picture is coherent with neuronal activity complexity decrease paired to a reduced repertoire of functional abilities. FDasy result highlights the functional relevance of the balance between homologous brain structures’ activities in stroke recovery. PMID:24967904

Fractal dimension of EEG activity senses neuronal impairment in acute stroke.

PubMed

Zappasodi, Filippo; Olejarczyk, Elzbieta; Marzetti, Laura; Assenza, Giovanni; Pizzella, Vittorio; Tecchio, Franca

2014-01-01

The brain is a self-organizing system which displays self-similarities at different spatial and temporal scales. Thus, the complexity of its dynamics, associated to efficient processing and functional advantages, is expected to be captured by a measure of its scale-free (fractal) properties. Under the hypothesis that the fractal dimension (FD) of the electroencephalographic signal (EEG) is optimally sensitive to the neuronal dysfunction secondary to a brain lesion, we tested the FD's ability in assessing two key processes in acute stroke: the clinical impairment and the recovery prognosis. Resting EEG was collected in 36 patients 4-10 days after a unilateral ischemic stroke in the middle cerebral artery territory and 19 healthy controls. National Health Institute Stroke Scale (NIHss) was collected at T0 and 6 months later. Highuchi FD, its inter-hemispheric asymmetry (FDasy) and spectral band powers were calculated for EEG signals. FD was smaller in patients than in controls (1.447±0.092 vs 1.525±0.105) and its reduction was paired to a worse acute clinical status. FD decrease was associated to alpha increase and beta decrease of oscillatory activity power. Larger FDasy in acute phase was paired to a worse clinical recovery at six months. FD in our patients captured the loss of complexity reflecting the global system dysfunction resulting from the structural damage. This decrease seems to reveal the intimate nature of structure-function unity, where the regional neural multi-scale self-similar activity is impaired by the anatomical lesion. This picture is coherent with neuronal activity complexity decrease paired to a reduced repertoire of functional abilities. FDasy result highlights the functional relevance of the balance between homologous brain structures' activities in stroke recovery.

Combining neural and behavioral indicators in the assessment of internalizing psychopathology in children and adolescents.

PubMed

Moser, Jason S; Durbin, C Emily; Patrick, Christopher J; Schmidt, Norman B

2015-01-01

Anxiety and mood disorders are among the most prevalent mental health problems affecting our youth. We propose that assessment and treatment efforts in this area can benefit from a focus on developmentally sensitive neurobehavioral trait constructs, that is, individual difference constructs with direct referents in both neurobiology and behavior across the lifespan. This approach dovetails with the National Institute of Mental Health's Research Domain Criteria initiative, which aims to improve classification and treatment of psychopathology by delineating dimensions of functioning that transcend measurement domains and traditional diagnostic categories. We highlight two neurobehavioral dimensions with clear relevance for understanding internalizing problems at differing ages: (a) defensive reactivity and (b) cognitive control. Individual differences in defensive reactivity are posited to reflect variations in sensitivity of the brain's negative valence systems, whereas differences in cognitive control are theorized to reflect variations in neural systems dedicated to regulating behavior and affect. Focusing on these target constructs, we illustrate a psychoneurometric approach to assessment of internalizing psychopathology entailing use of neural, self-report, and behavioral indicators. We address the feasibility of the psychoneurometric approach for clinical application and present results from a pilot study demonstrating expected associations for neural, parent-report, and behavioral measures of defensive reactivity and cognitive control with internalizing symptoms in preschoolers. Together, our conceptual and empirical analyses highlight the promise of multimethod, dimensional assessment of internalizing psychopathology in the lab and in the clinic.

Clinical Holistic Medicine: Chronic Pain in the Locomotor System

PubMed Central

Ventegodt, Søren; Merrick, Joav

2005-01-01

Most pains from the locomotor system arise due to involuntary, chronic tensions in the muscles or other tissues. When the patient is motivated, the pain is easily cured in most of the cases by using the tools of consciousness-based medicine, primarily therapeutic touch, conversation, and coaching the patient in a positive philosophy of life. The pains are often caused by “blockages” that may cause problems other than just pain. Often it turns out that the blocked areas develop actual physical damage over time: a slipped disk in the back, articular degeneration, or osteoarthritis when the cartilage is affected, can often be explained in this way. Apparently, the exact areas where the blockage is situated cause cellular problems, disrupting cellular order. The holistic process theory of healing and the related quality of life theories state that return to the natural state of being is possible, whenever the person gets the resources needed for existential healing. The resources needed are “holding” in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for holistic healing are trust and the intention for the healing to take place. Case stories of holistic treatment of patients with chronic back pain, low back pain, muscle problems, knee pain, and symptoms of rheumatoid arthritis are discussed with exercises relevant for patients with these conditions in the holistic clinic. PMID:15759082

Clarifying Interpersonal Heterogeneity in Borderline Personality Disorder Using Latent Mixture Modeling

PubMed Central

Wright, Aidan G.C.; Hallquist, Michael N.; Morse, Jennifer Q.; Scott, Lori N.; Stepp, Stephanie D.; Nolf, Kimberly A.; Pilkonis, Paul A.

2013-01-01

Significant interpersonal impairment is a cardinal feature of borderline personality disorder (BPD). However, past research has demonstrated that the interpersonal profile associated with BPD varies across samples, evidence for considerable interpersonal heterogeneity. The current study used Inventory of Interpersonal Problems – Circumplex (IIP-C; Alden, Wiggins, & Pincus, 1990) scale scores to investigate interpersonal inhibitions and excesses in a large sample (N = 255) selected for significant borderline pathology. Results indicated that BPD symptom counts were unrelated to the primary dimensions of the IIP-C, but were related to generalized interpersonal distress. A latent class analysis clarified this finding by revealing six homogeneous interpersonal classes with prototypical profiles associated with Intrusive, Vindictive, Avoidant, Nonassertive, and moderate and severe Exploitable interpersonal problems. These classes differed in clinically relevant features (e.g., antisocial behaviors, self-injury, past suicide attempts). Findings are discussed in terms of the incremental clinical utility of the interpersonal circumplex model and the implications for developmental and nosological models of BPD. PMID:23514179

Predicting dimensions of personality disorder from domains and facets of the Five-Factor Model.

PubMed

Reynolds, S K; Clark, L A

2001-04-01

We compared the utility of several trait models for describing personality disorder in a heterogeneous clinical sample (N = 94). Participants completed the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993b), a self-report measure that assesses traits relevant to personality disorder, and two measures of the Five-Factor Model: the Revised NEO Personality Inventory (NEO-PI-R; Costa and McCrae, 1992) and the Big Five Inventory (BFI; John, Donahue, & Kentle, 1991). Regression analyses indicated substantial overlap between the SNAP scales and the NEO-PI-R facets. In addition, use of the NEO-PI-R facets afforded substantial improvement over the Five-Factor Model domains in predicting interview-based ratings of DSM-IV personality disorder (American Psychiatric Association, 1994), such that the NEO facets and the SNAP scales demonstrated roughly equivalent levels of predictive power. Results support assessment of the full range of NEO-PI-R facets over the Five-Factor Model domains for both research and clinical use.

Phlebotomy, a bridge between laboratory and patient.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to "bridge" patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient's compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper.

Globalization, migration health, and educational preparation for transnational medical encounters

PubMed Central

Koehn, Peter H

2006-01-01

Unprecedented migration, a core dimension of contemporary globalization, challenges population health. In a world of increasing human mobility, many health outcomes are shaped by transnational interactions among care providers and care recipients who meet in settings where nationality/ethnic match is not an option. This review article explores the value of transnational competence (TC) education as preparation for ethnically and socially discordant clinical encounters. The relevance of TC's five core skill domains (analytic, emotional, creative, communicative, and functional) for migration health and the medical-school curriculum is elaborated. A pedagogical approach that prepares for the transnational health-care consultation is presented, with a focus on clinical-clerkship learning experiences. Educational preparation for contemporary medical encounters needs to include a comprehensive set of patient-focused interpersonal skills, be adaptable to a wide variety of service users and global practice sites, and possess utility in addressing both the quality of patient care and socio-political constraints on migration health. PMID:16441899

Phlebotomy, a bridge between laboratory and patient

PubMed Central

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to “bridge” patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient’s compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper. PMID:26981016

Monitoring sinew contraction during formation of tissue-engineered fibrin-based ligament constructs.

PubMed

Paxton, Jennifer Z; Wudebwe, Uchena N G; Wang, Anqi; Woods, Daniel; Grover, Liam M

2012-08-01

The ability to study the gross morphological changes occurring during tissue formation is vital to producing tissue-engineered structures of clinically relevant dimensions in vitro. Here, we have used nondestructive methods of digital imaging and optical coherence tomography to monitor the early-stage formation and subsequent maturation of fibrin-based tissue-engineered ligament constructs. In addition, the effect of supplementation with essential promoters of collagen synthesis, ascorbic acid (AA) and proline (P), has been assessed. Contraction of the cell-seeded fibrin gel occurs unevenly within the first 5 days of culture around two fixed anchor points before forming a longitudinal ligament-like construct. AA+P supplementation accelerates gel contraction in the maturation phase of development, producing ligament-like constructs with a higher collagen content and distinct morphology to that of unsupplemented constructs. These studies highlight the importance of being able to control the methods of tissue formation and maturation in vitro to enable the production of tissue-engineered constructs with suitable replacement tissue characteristics for repair of clinical soft-tissue injuries.

The tacit dimension of clinical judgment.

PubMed Central

Goldman, G. M.

1990-01-01

Two distinct views of the nature of clinical judgment are identified and contrasted. The dominant view that clinical judgment is a fully explicit process is compared to the relatively neglected view that tacit knowledge plays a substantial role in the clinician's mental operations. The tacit dimension of medical thinking is explored at length. The discussion suggests severe limits when applying decision analysis, expert systems, and computer-aided cost-benefit review to medicine. The goals and practices of postgraduate medical education are also examined from this perspective, as are various other implications for the clinician. The paper concludes that it is valuable to explore the nature of medical thinking in order to improve clinical practice and education. Such explorations should, however, take cognizance of the often overlooked tacit dimension of clinical judgment. Possible constraints on the medical applicability of both formal expert systems and heavily didactic instructional programs are considered. PMID:2356625

The governance dimensions of water security: a review.

PubMed

Bakker, Karen; Morinville, Cynthia

2013-11-13

Water governance is critical to water security, and to the long-term sustainability of the Earth's freshwater systems. This review examines recent debates regarding the governance dimensions of water security, including adaptive governance, polycentric governance, social learning and multi-level governance. The analysis emphasizes the political and institutional dimensions of water governance, and explores the relevance of social power-an overlooked yet important aspect of the water security debate. In addition, the review explores the intersection and potential synergies between water governance perspectives and risk-based approaches to water security, and offers critiques and suggestions for further research questions and agendas.

The Benefits of Bimodal Aiding on Extended Dimensions of Speech Perception: Intelligibility, Listening Effort, and Sound Quality

PubMed Central

Chalupper, Josef

2017-01-01

The benefits of combining a cochlear implant (CI) and a hearing aid (HA) in opposite ears on speech perception were examined in 15 adult unilateral CI recipients who regularly use a contralateral HA. A within-subjects design was carried out to assess speech intelligibility testing, listening effort ratings, and a sound quality questionnaire for the conditions CI alone, CIHA together, and HA alone when applicable. The primary outcome of bimodal benefit, defined as the difference between CIHA and CI, was statistically significant for speech intelligibility in quiet as well as for intelligibility in noise across tested spatial conditions. A reduction in effort on top of intelligibility at the highest tested signal-to-noise ratio was found. Moreover, the bimodal listening situation was rated to sound more voluminous, less tinny, and less unpleasant than CI alone. Listening effort and sound quality emerged as feasible and relevant measures to demonstrate bimodal benefit across a clinically representative range of bimodal users. These extended dimensions of speech perception can shed more light on the array of benefits provided by complementing a CI with a contralateral HA. PMID:28874096

Resting-State fMRI Functional Connectivity Is Associated with Sleepiness, Imagery, and Discontinuity of Mind

PubMed Central

Chen, Gang; den Braber, Anouk; van ‘t Ent, Dennis; Boomsma, Dorret I.; Mansvelder, Huibert D.; de Geus, Eco; Van Someren, Eus J. W.; Linkenkaer-Hansen, Klaus

2015-01-01

Resting-state functional magnetic resonance imaging (rs-fMRI) is widely used to investigate the functional architecture of the healthy human brain and how it is affected by learning, lifelong development, brain disorders or pharmacological intervention. Non-sensory experiences are prevalent during rest and must arise from ongoing brain activity, yet little is known about this relationship. Here, we used two runs of rs-fMRI both immediately followed by the Amsterdam Resting-State Questionnaire (ARSQ) to investigate the relationship between functional connectivity within ten large-scale functional brain networks and ten dimensions of thoughts and feelings experienced during the scan in 106 healthy participants. We identified 11 positive associations between brain-network functional connectivity and ARSQ dimensions. ‘Sleepiness’ exhibited significant associations with functional connectivity within Visual, Sensorimotor and Default Mode networks. Similar associations were observed for ‘Visual Thought’ and ‘Discontinuity of Mind’, which may relate to variation in imagery and thought control mediated by arousal fluctuations. Our findings show that self-reports of thoughts and feelings experienced during a rs-fMRI scan help understand the functional significance of variations in functional connectivity, which should be of special relevance to clinical studies. PMID:26540239

Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review).

PubMed

Salama, Mahmoud; Isachenko, Vladimir; Isachenko, Evgenia; Rahimi, Gohar; Mallmann, Peter; Westphal, Lynn M; Inhorn, Marcia C; Patrizio, Pasquale

2018-05-28

Many people travel abroad to access fertility treatments. This growing phenomenon is known as cross border reproductive care (CBRC) or fertility tourism. Due to its complex nature and implications worldwide, CBRC has become an emerging dilemma deserving more attention on the global healthcare agenda. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English during the past 18 years to explore CBRC phenomenon in the new millennium. Little is known about the accurate magnitude and scope of CBRC around the globe. In this systematic and critical review, we identify three major dimensions of CBRC: legal, economic, and ethical. We analyze each of these dimensions from clinical and practical perspectives. CBRC is a growing reality worldwide with potential benefits and risks. Therefore, it is very crucial to regulate the global market of CBRC on legal, economic, and ethical bases in order to increase harmonization and reduce any forms of exploitation. Establishment of accurate international statistics and a global registry will help diminish the current information gap surrounding the CBRC phenomenon.

What does the amygdala contribute to social cognition?

PubMed Central

Adolphs, Ralph

2010-01-01

The amygdala has received intense recent attention from neuroscientists investigating its function at the molecular, cellular, systems, cognitive, and clinical level. It clearly contributes to processing emotionally and socially relevant information, yet a unifying description and computational account have been lacking. The difficulty of tying together the various studies stems in part from the sheer diversity of approaches and species studied, in part from the amygdala’s inherent heterogeneity in terms of its component nuclei, and in part because different investigators have simply been interested in different topics. Yet, a synthesis now seems close at hand in combining new results from social neuroscience with data from neuroeconomics and reward learning. The amygdala processes a psychological stimulus dimension related to saliency or relevance; mechanisms have been identified to link it to processing unpredictability; and insights from reward learning have situated it within a network of structures that include the prefrontal cortex and the ventral striatum in processing the current value of stimuli. These aspects help to clarify the amygdala’s contributions to recognizing emotion from faces, to social behavior toward conspecifics, and to reward learning and instrumental behavior. PMID:20392275

Three-dimensional bioprinting using self-assembling scalable scaffold-free “tissue strands” as a new bioink

PubMed Central

Yu, Yin; Moncal, Kazim K.; Li, Jianqiang; Peng, Weijie; Rivero, Iris; Martin, James A.; Ozbolat, Ibrahim T.

2016-01-01

Recent advances in bioprinting have granted tissue engineers the ability to assemble biomaterials, cells, and signaling molecules into anatomically relevant functional tissues or organ parts. Scaffold-free fabrication has recently attracted a great deal of interest due to the ability to recapitulate tissue biology by using self-assembly, which mimics the embryonic development process. Despite several attempts, bioprinting of scale-up tissues at clinically-relevant dimensions with closely recapitulated tissue biology and functionality is still a major roadblock. Here, we fabricate and engineer scaffold-free scalable tissue strands as a novel bioink material for robotic-assisted bioprinting technologies. Compare to 400 μm-thick tissue spheroids bioprinted in a liquid delivery medium into confining molds, near 8 cm-long tissue strands with rapid fusion and self-assemble capabilities are bioprinted in solid form for the first time without any need for a scaffold or a mold support or a liquid delivery medium, and facilitated native-like scale-up tissues. The prominent approach has been verified using cartilage strands as building units to bioprint articular cartilage tissue. PMID:27346373

Clinical relevance vs. statistical significance: Using neck outcomes in patients with temporomandibular disorders as an example.

PubMed

Armijo-Olivo, Susan; Warren, Sharon; Fuentes, Jorge; Magee, David J

2011-12-01

Statistical significance has been used extensively to evaluate the results of research studies. Nevertheless, it offers only limited information to clinicians. The assessment of clinical relevance can facilitate the interpretation of the research results into clinical practice. The objective of this study was to explore different methods to evaluate the clinical relevance of the results using a cross-sectional study as an example comparing different neck outcomes between subjects with temporomandibular disorders and healthy controls. Subjects were compared for head and cervical posture, maximal cervical muscle strength, endurance of the cervical flexor and extensor muscles, and electromyographic activity of the cervical flexor muscles during the CranioCervical Flexion Test (CCFT). The evaluation of clinical relevance of the results was performed based on the effect size (ES), minimal important difference (MID), and clinical judgement. The results of this study show that it is possible to have statistical significance without having clinical relevance, to have both statistical significance and clinical relevance, to have clinical relevance without having statistical significance, or to have neither statistical significance nor clinical relevance. The evaluation of clinical relevance in clinical research is crucial to simplify the transfer of knowledge from research into practice. Clinical researchers should present the clinical relevance of their results. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reliable critical sized defect rodent model for cleft palate research.

PubMed

Mostafa, Nesrine Z; Doschak, Michael R; Major, Paul W; Talwar, Reena

2014-12-01

Suitable animal models are necessary to test the efficacy of new bone grafting therapies in cleft palate surgery. Rodent models of cleft palate are available but have limitations. This study compared and modified mid-palate cleft (MPC) and alveolar cleft (AC) models to determine the most reliable and reproducible model for bone grafting studies. Published MPC model (9 × 5 × 3 mm(3)) lacked sufficient information for tested rats. Our initial studies utilizing AC model (7 × 4 × 3 mm(3)) in 8 and 16 weeks old Sprague Dawley (SD) rats revealed injury to adjacent structures. After comparing anteroposterior and transverse maxillary dimensions in 16 weeks old SD and Wistar rats, virtual planning was performed to modify MPC and AC defects dimensions, taking the adjacent structures into consideration. Modified MPC (7 × 2.5 × 1 mm(3)) and AC (5 × 2.5 × 1 mm(3)) defects were employed in 16 weeks old Wistar rats and healing was monitored by micro-computed tomography and histology. Maxillary dimensions in SD and Wistar rats were not significantly different. Preoperative virtual planning enhanced postoperative surgical outcomes. Bone healing occurred at defect margin leaving central bone void confirming the critical size nature of the modified MPC and AC defects. Presented modifications for MPC and AC models created clinically relevant and reproducible defects. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

On inducing finite dimensional physical field representations for massless particles in even dimensions

NASA Technical Reports Server (NTRS)

Bhansali, Vineer

1993-01-01

Assuming trivial action of Euclidean translations, the method of induced representations is used to derive a correspondence between massless field representations transforming under the full generalized even dimensional Lorentz group, and highest weight states of the relevant little group. This gives a connection between 'helicity' and 'chirality' in all dimensions. Restrictions on 'gauge independent' representations for physical particles that this induction imposes are also stated.

Developing an integrative level-dimensional taxonomy model for rehabilitation psychology research and practice.

PubMed

Mermis, Bernie J

2018-02-01

The present article concerns the development of a taxonomy model for organizing and classifying all aspects of rehabilitation psychology from an integrative level-dimensional conceptualization. This conceptualization is presented as an alternative to a primarily categorical approach to classification. It also assumes a continuity perspective for all aspects of behavior and experience. Development of this taxonomy model involves organizing information relevant to levels/domains of all aspects of behavior and experience, and to constructs describing their underlying components conceptually as well as dimensions which constitute the measurable basis of constructs. A taxonomy model with levels/domains, representative examples of constructs and dimensions is presented as a foundation for development of the present taxonomy model, with specific relevance to rehabilitation psychology. This integrative level-dimensional taxonomy model provides a structure for organizing all aspects of rehabilitation psychology relevant to understanding, assessing, and influencing the rehabilitation process. Suggestions for development and research are provided for the taxonomy model. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention

PubMed Central

Williams, Monnica T.; Mugno, Beth; Franklin, Martin; Faber, Sonya

2014-01-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The cognitive-behavioral treatment with the most empirical support is currently exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e., symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. PMID:23615340

Personality traits and psychotic symptoms in recent onset of psychosis patients.

PubMed

Sevilla-Llewellyn-Jones, Julia; Cano-Domínguez, Pablo; de-Luis-Matilla, Antonia; Peñuelas-Calvo, Inmaculada; Espina-Eizaguirre, Alberto; Moreno-Kustner, Berta; Ochoa, Susana

2017-04-01

Personality in patients with psychosis, and particularly its relation to psychotic symptoms in recent onset of psychosis (ROP) patients, is understudied. The aims of this research were to study the relation between dimensional and categorical clinical personality traits and symptoms, as well as the effects that symptoms, sex and age have on clinically significant personality traits. Data for these analyses were obtained from 94 ROP patients. The Millon Clinical Multiaxial Inventory and the Positive and Negative Syndrome Scale were used to assess personality and symptoms. Correlational Analysis, Mann-Whitney test, and, finally, logistic regression were carried out. The negative dimension was higher in patients with schizoid traits. The excited dimension was lower for those with avoidant and depressive traits. The anxiety and depression dimension was higher for patients with dependent traits. The positive dimension was lower for patients with histrionic and higher for patients with compulsive traits. Logistic regression demonstrated that gender and the positive and negative dimensions explained 35.9% of the variance of the schizoid trait. The excited dimension explained 9.1% of the variance of avoidant trait. The anxiety and depression dimension and age explained 31.3% of the dependent trait. Gender explained 11.6% of the histrionic trait, 14.5% of the narcissistic trait and 11.6% of the paranoid trait. Finally gender and positive dimension explained 16.1% of the compulsive trait. The study highlights the importance of studying personality in patients with psychosis as it broadens understating of the patients themselves and the symptoms suffered. Copyright © 2017 Elsevier Inc. All rights reserved.

Validation of Proposed DSM-5 Criteria for Autism Spectrum Disorder

PubMed Central

Frazier, Thomas W.; Youngstrom, Eric A.; Speer, Leslie; Embacher, Rebecca; Law, Paul; Constantino, John; Findling, Robert L.; Hardan, Antonio Y.; Eng, Charis

2011-01-01

Objective The primary aim of the present study was to evaluate the validity of proposed DSM-5 criteria for Autism Spectrum Disorder (ASD). Method We analyzed symptoms from 14,744 siblings (8,911 ASD; 5,863 non-ASD) included in a national registry, the Interactive Autism Network. Youth aged 2–18 were included if at least one child in the family was diagnosed with ASD. Caregivers reported symptoms using the Social Responsiveness Scale and the Social Communication Questionnaire. The structure of autism symptoms was examined using latent variable models that included categories, dimensions, or hybrid models specifying categories and sub-dimensions. Diagnostic efficiency statistics evaluated the proposed DSM-5 algorithm in identifying ASD. Results A hybrid model that included both a category (ASD vs. non-ASD) and two symptom dimensions (social communication/interaction and restricted/repetitive behaviors) was more parsimonious than all other models and replicated across measures and sub-samples. Empirical classifications from this hybrid model closely mirrored clinical ASD diagnoses (90% overlap), implying a broad ASD category distinct from non-ASD. DSM-5 criteria had superior specificity relative to DSM-IV-TR criteria (.97 vs. .86), however sensitivity was lower (.81 vs. .95). Relaxing DSM-5 criteria by requiring one less symptom criterion increased sensitivity (.93 vs. .81), with minimal reduction in specificity (.95 vs. .97). Conclusions Results supported the validity of proposed DSM-5 criteria for ASD as provided in Phase I field trials criteria. Increased specificity of DSM-5 relative to DSM-IV-TR may reduce false positive diagnoses, a particularly relevant consideration for low base rate clinical settings. Phase II testing of DSM-5 should consider a relaxed algorithm, without which as many as 12% of ASD-affected individuals, particularly females, will be missed. Relaxed DSM-5 criteria may improve identification of ASD, decreasing societal costs through appropriate early diagnosis and maximizing intervention resources. PMID:22176937

Integrating the dimensions of sex and gender into basic life sciences research: methodologic and ethical issues.

PubMed

Holdcroft, Anita

2007-01-01

The research process -- from study design and selecting a species and its husbandry, through the experiment, analysis, peer review, and publication -- is rarely subject to questions about sex or gender differences in mainstream life sciences research. However, the impact of sex and gender on these processes is important in explaining biological variations and presentation of symptoms and diseases. This review aims to challenge assumptions and to develop opportunities to mainstream sex and gender in basic scientific research. Questions about the mechanisms of sex and gender effects were reviewed in relation to biological, environmental, social, and psychological interactions. Gender variations, in respect to aging, socializing, and reproduction, that are present in human populations but are rarely featured in laboratory research were considered to more effectively translate animal research into clinical health care. Methodologic approaches to address the present lack of a gender dimension in research include actively reducing variations through attention to physical factors, biological rhythms, and experimental design. In addition, through genomic and acute nongenomic activity, hormones may compound effects through multiple small sex differences that occur during the course of an acute pathologic event. Furthermore, the many exogenous sex steroid hormones and their congeners used in medicine (eg, in contraception and cancer therapies) may add to these effects. The studies reviewed provide evidence that sex and gender are determinants of many outcomes in life science research. To embed the gender dimension into basic scientific research, a broad approach -- gender mainstreaming -- is warranted. One example is the use of review boards (eg, animal ethical review boards and journal peer-review boards) in which gender-related standardized questions can be asked about study design and analysis. A more fundamental approach is to question the relevance of present-day laboratory models to design methods to best represent the age-related changes, comorbidity, and variations experienced by each sex in clinical medicine.

Modeling Cryotherapy Ice Ball Dimensions and Isotherms in a Novel Gel-based Model to Determine Optimal Cryo-needle Configurations and Settings for Potential Use in Clinical Practice

PubMed Central

Shah, Taimur T.; Arbel, Uri; Foss, Sonja; Zachman, Andrew; Rodney, Simon; Ahmed, Hashim U.; Arya, Manit

2016-01-01

Objective To gain a better understanding of ice ball dimensions and temperature isotherms relevant for cell kill when using combinations of cryo-needles we set out to answer 4 questions: (1) what type of cryo-needle? (2) how many needles? (3) best spatial configuration? and (4) correct duty cycle percentage? Methods We conducted laboratory experiments to monitor ice ball dimensions and create multi-needle planar isotherm maps for 17G and 10G cryo-needles using a novel multi-needle thermocouple fixture within gel at body temperature. We tested configurations of 1-4 cryo-needles at duty cycles of 20%-100% with 1-2.5 cm spacing. Results Analysis of various combinations shows that a central core of ≤−40°C develops at a distance of ~1 cm around the cryo-needles. Temperature increases linearly from this point to the ice ball leading edge (0°C), which is a further ≈1 cm away. Thus, the −40°C isotherm is approximately 1 cm inside the leading edge of the ice ball. The optimum distance between cryo-needles was 1.5-2 cm, at duty cycle settings of 70%-100%. At distances further apart or with lower duty cycle settings, ice balls either had a central core >−40°C or had an hourglass shape. Conclusion In answer to questions 1-3, tumor length, diameter, and shape will ultimately determine the number of needles and their configuration. However, we propose a conservative distance for cryo-needle placement between 1 and 1.5 cm should be adopted for clinical practice. In answer to question 4, using low duty cycle settings runs the risk of incomplete −40°C isotherm coverage of the tumor, and thus in routine practice we suggest that settings of 70%-100% are most appropriate. PMID:26902833

The ABC of stereotypes about groups: Agency/socioeconomic success, conservative-progressive beliefs, and communion.

PubMed

Koch, Alex; Imhoff, Roland; Dotsch, Ron; Unkelbach, Christian; Alves, Hans

2016-05-01

Previous research argued that stereotypes differ primarily on the 2 dimensions of warmth/communion and competence/agency. We identify an empirical gap in support for this notion. The theoretical model constrains stereotypes a priori to these 2 dimensions; without this constraint, participants might spontaneously employ other relevant dimensions. We fill this gap by complementing the existing theory-driven approaches with a data-driven approach that allows an estimation of the spontaneously employed dimensions of stereotyping. Seven studies (total N = 4,451) show that people organize social groups primarily based on their agency/socioeconomic success (A), and as a second dimension, based on their conservative-progressive beliefs (B). Communion (C) is not found as a dimension by its own, but rather as an emergent quality in the two-dimensional space of A and B, resulting in a 2D ABC model of stereotype content about social groups. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Etiology of Triarchic Psychopathy Dimensions in Chimpanzees (Pan troglodytes)

PubMed Central

Latzman, Robert D.; Patrick, Christopher J.; Freeman, Hani J.; Schapiro, Steven J.; Hopkins, William D.

2016-01-01

The current study undertook analyses of genealogical data from a sample of 178 socially-housed chimpanzees (Pan troglodytes) with well-documented pedigrees, to clarify the etiologic bases of triarchic psychopathy dimensions and the influence of early social rearing experiences. Whereas biometric analyses for the full sample indicated significant heritability for the boldness dimension of psychopathy only, heritability estimates varied by early rearing, with all three triarchic dimensions showing significant heritabilities among mother-reared but not nursery-reared apes. For mother-reared apes, both genes and environment contributed to covariance between meanness and disinhibition, whereas environment contributed mainly to covariation between these dimensions and boldness. Results indicate contributions of both genes and environment to psychopathic tendencies, with an important role for early-rearing in their relative contributions to distinct phenotypic subdimensions. In conjunction with findings from human studies, results provide valuable insights into core biobehavioral processes relevant to psychological illness and health. PMID:28503367

Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses.

PubMed

Herpers, Pierre C M; Klip, Helen; Rommelse, Nanda N J; Taylor, Mark J; Greven, Corina U; Buitelaar, Jan K

2017-07-01

Callous-unemotional (CU) traits have mainly been studied in relation to conduct disorder (CD), but can also occur in other disorder groups. However, it is unclear whether there is a clinically relevant cut-off value of levels of CU traits in predicting reduced quality of life (QoL) and clinical symptoms, and whether CU traits better fit a categorical (taxonic) or dimensional model. Parents of 979 youths referred to a child and adolescent psychiatric clinic rated their child's CU traits on the Inventory of Callous-Unemotional traits (ICU), QoL on the Kidscreen-27, and clinical symptoms on the Child Behavior Checklist. Experienced clinicians conferred DSM-IV-TR diagnoses of ADHD, ASD, anxiety/mood disorders and DBD-NOS/ODD. The ICU was also used to score the DSM-5 specifier 'with limited prosocial emotions' (LPE) of Conduct Disorder. Receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the ICU and LPE regarding QoL and clinical symptoms was poor to fair, and similar across diagnoses. A clinical cut-off point could not be defined. Taxometric analyses suggested that callous-unemotional traits on the ICU best reflect a dimension rather than taxon. More research is needed on the impact of CU traits on the functional adaptation, course, and response to treatment of non-CD conditions. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams.

PubMed

Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian

2017-01-01

Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.

The role of religiosity, coping strategies, self-efficacy and personality dimensions in the prediction of Iranian undergraduate rehabilitation interns' satisfaction with their clinical experience.

PubMed

Mirsaleh, Y R; Rezai, H; Kivi, S R; Ghorbani, R

2010-12-01

to investigate the relationship between religiosity, coping styles, self-efficacy and personality dimensions as predictors of satisfaction with clinical experience in rehabilitation interns during transition from academic study to clinical internship. a cross-sectional survey design. five rehabilitation faculties. three hundred and eighteen undergraduate rehabilitation interns, including physical therapy, occupational therapy and speech and language pathology students. Islamic Religiosity Scale, Ways of Coping Questionnaire, General Self-efficacy Scale, NEO Five Factor Inventory, and Satisfaction with Clinical Experiences Questionnaire. religiosity, problem-focused coping and general self-efficacy had significant positive correlation with satisfaction with clinical internship in rehabilitation students. Among personality dimensions, openness, agreement and consciousness had significant positive correlation with satisfaction with clinical experience and neuroticism had significant negative correlation with satisfaction with clinical experience. The results of regression analysis demonstrated that religiosity and self-efficacy had important roles in the prediction of satisfaction with clinical experience in all the rehabilitation intern students of three disciplines (physical therapy, occupational therapy, and speech and language pathology). religiosity, problem-focused coping and general self-efficacy seem to be good predictors of satisfaction with clinical internship in rehabilitation students.

Changes in the Neuropsychological Correlates of Clinical Dimensions between the Acute and Stable Phase of Schizophrenia

ERIC Educational Resources Information Center

Guillem, F.; Ganeva, E.; Pampoulova, T.; Stip, E.; Lalonde, P.; Sasseville, M.

2005-01-01

This study was designed to investigate whether the neuropsychological correlates of the symptom dimensions of schizophrenia vary with the clinical state in patients followed from the acute to stable the phase of the illness. Fifteen patients were assessed for symptoms (SAPS-SANS) and undergone a complete neuropsychological assessment at two…

Facial anthropometric measurements in Iranian male workers using Digimizer version 4.1.1.0 image analysis software: a pilot study.

PubMed

Salvarzi, Elham; Choobineh, Alireza; Jahangiri, Mehdi; Keshavarzi, Sareh

2018-02-26

Craniometry is a subset of anthropometry, which measures the anatomical sizes of the head and face (craniofacial indicators). These dimensions are used in designing devices applied in the facial area, including respirators. This study was conducted to measure craniofacial dimensions of Iranian male workers required for face protective equipment design. In this study, facial anthropometric dimensions of 50 randomly selected Iranian male workers were measured by photographic method and Digimizer version 4.1.1.0. Ten facial dimensions were extracted from photographs and measured by Digimizer version 4.1.1.0. Mean, standard deviation and 5th, 50th and 95th percentiles for each dimension were determined and the relevant data bank was established. The anthropometric data bank for the 10 dimensions required for respirator design was provided for the target group with photo-anthropometric methods. The results showed that Iranian face dimensions were different from those of other nations and ethnicities. In this pilot study, anthropometric dimensions required for half-mask respirator design for Iranian male workers were measured by Digimizer version 4.1.1.0. The obtained anthropometric tables could be useful for the design of personal face protective equipment.

Nepalese undergraduate nursing students' perceptions of the clinical learning environment, supervision and nurse teachers: A questionnaire survey.

PubMed

Nepal, Bijeta; Taketomi, Kikuko; Ito, Yoichi M; Kohanawa, Masashi; Kawabata, Hidenobu; Tanaka, Michiko; Otaki, Junji

2016-04-01

Clinical practice enables nursing students to acquire essential professional skills, but little is known about nursing students' perceptions of the clinical learning environment (CLE) in Nepal. To examine Nepalese nursing students' perceptions regarding the CLE and supervision. A cross-sectional questionnaire design was used. Government and private hospitals in Nepal where the undergraduate nursing college students undertook their clinical practice. Students with clinical practice experience were recruited from years 2-4 of the B.Sc. nursing program in Nepal (n=350). The final sample comprised 263 students. A self-administered questionnaire including demographic characteristics, latest clinical practice site, and general satisfaction was administered February-March 2014. The previously validated Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was used in the questionnaire. The analytical approach used exploratory factor analysis, assessments of the scale and sub-dimension reliability, correlations of factors between scale sub-dimensions, and multiple regression analysis. Students' practicum satisfaction level at government hospitals was significantly higher than those at private hospitals (p<0.0001). Five factors explained 85.7% of the variance, with minor factorial structure differences compared with the original scale. Reliability was confirmed (Cronbach's alpha=0.93 for total scale, 0.76-0.92 for sub-dimensions). Inter-correlations between the five original sub-dimensions were 0.27-0.68 (p<0.0001). Students undertaking their practicum in private hospitals evaluated their clinical placements significantly more negatively on most sub-dimensions than those in government hospitals. Multiple regression analysis revealed a significant positive relationship between satisfaction and pedagogical atmosphere (p<0.0001). This is the first study to investigate nursing students' perceptions of the CLE in undergraduate nursing programs in Nepal. Students were satisfied with the CLE overall, but satisfaction varied by practicum hospital sector. The most influential factor explaining satisfaction was pedagogical atmosphere. Copyright © 2016 Elsevier Ltd. All rights reserved.

Analysis of the fractal dimension of volcano geomorphology through Synthetic Aperture Radar (SAR) amplitude images acquired in C and X band.

NASA Astrophysics Data System (ADS)

Pepe, S.; Di Martino, G.; Iodice, A.; Manzo, M.; Pepe, A.; Riccio, D.; Ruello, G.; Sansosti, E.; Tizzani, P.; Zinno, I.

2012-04-01

In the last two decades several aspects relevant to volcanic activity have been analyzed in terms of fractal parameters that effectively describe natural objects geometry. More specifically, these researches have been aimed at the identification of (1) the power laws that governed the magma fragmentation processes, (2) the energy of explosive eruptions, and (3) the distribution of the associated earthquakes. In this paper, the study of volcano morphology via satellite images is dealt with; in particular, we use the complete forward model developed by some of the authors (Di Martino et al., 2012) that links the stochastic characterization of amplitude Synthetic Aperture Radar (SAR) images to the fractal dimension of the imaged surfaces, modelled via fractional Brownian motion (fBm) processes. Based on the inversion of such a model, a SAR image post-processing has been implemented (Di Martino et al., 2010), that allows retrieving the fractal dimension of the observed surfaces, dictating the distribution of the roughness over different spatial scales. The fractal dimension of volcanic structures has been related to the specific nature of materials and to the effects of active geodynamic processes. Hence, the possibility to estimate the fractal dimension from a single amplitude-only SAR image is of fundamental importance for the characterization of volcano structures and, moreover, can be very helpful for monitoring and crisis management activities in case of eruptions and other similar natural hazards. The implemented SAR image processing performs the extraction of the point-by-point fractal dimension of the scene observed by the sensor, providing - as an output product - the map of the fractal dimension of the area of interest. In this work, such an analysis is performed on Cosmo-SkyMed, ERS-1/2 and ENVISAT images relevant to active stratovolcanoes in different geodynamic contexts, such as Mt. Somma-Vesuvio, Mt. Etna, Vulcano and Stromboli in Southern Italy, Shinmoe in Japan, Merapi in Indonesia. Preliminary results reveal that the fractal dimension of natural areas, being related only to the roughness of the observed surface, is very stable as the radar illumination geometry, the resolution and the wavelength change, thus holding a very unique property in SAR data inversion. Such a behavior is not verified in case of non-natural objects. As a matter of fact, when the fractal estimation is performed in the presence of either man-made objects or SAR image features depending on geometrical distortions due to the SAR system acquisition (i.e. layover, shadowing), fractal dimension (D) values outside the range of fractality of natural surfaces (2 < D < 3) are retrieved. These non-fractal characteristics show to be heavily dependent on sensor acquisition parameters (e.g. view angle, resolution). In this work, the behaviour of the maps generated starting from the C- and X- band SAR data, relevant to all the considered volcanoes, is analyzed: the distribution of the obtained fractal dimension values is investigated on different zones of the maps. In particular, it is verified that the fore-slope and back-slope areas of the image share a very similar fractal dimension distribution that is placed around the mean value of D=2.3. We conclude that, in this context, the fractal dimension could be considered as a signature of the identification of the volcano growth as a natural process. The COSMO-SkyMed data used in this study have been processed at IREA-CNR within the SAR4Volcanoes project under Italian Space Agency agreement n. I/034/11/0.

Brainstem response and state-trait variables

NASA Technical Reports Server (NTRS)

Gilliland, Kirby

1988-01-01

A series of investigations are summarized from a personality research program that have relevance for mental state estimation. Of particular concern are those personality variables that are believed to have either a biological or perceptual basis and their relationship to human task performance and psychophysiology. These variables are among the most robust personality measures and include such dimensions as extraversion-introversion, sensation seeking, and impulsiveness. These dimensions also have the most distinct link to performance and psychophysiology. Through the course of many of these investigations two issues have emerged repeatedly: these personality dimensions appear to mediate mental state, and mental state appears to influence measures of performance or psychophysiology.

Patient safety culture perceptions in the college of dentistry

PubMed Central

Al Sweleh, Fahad Saleh; Al Saedan, Abdullah Mohammed; Al Dayel, Omar Abdullah

2018-01-01

Abstract A positive safety culture is essential to patient safety because it improves quality of care. The aim of this study was to assess staff and student perceptions of the patient safety culture in the clinics of the College of Dentistry at King Saud University in Saudi Arabia. A cross-sectional study was conducted in the College of Dentistry at King Saud University in Saudi Arabia. It included 4th and 5th year students, interns, general practitioners, and dental assistants. The data were collected by using paper-based questionnaire of modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. Data were entered into SPSS Version 20. Score on a particular safety culture dimension was calculated. The overall response rate was 72.8% (390/536). Team work dimension had the highest average percent positive dimension score (72.3%) while staffing had the lowest score (10%). Dental assistant had high agreement in Teamwork dimension (87.8%); Supervisor/Manager Expectations and Actions Promoting Patient Safety dimension (66.9%); Organizational Learning—Continuous Improvement dimension (79.1%); Management Support for Patient Safety dimension (84.5%); Feedback and Communication About Error dimension (58.3%); Frequency of Events Reported dimension (54.0%); Teamwork Across Units dimension (73.2%). Most of areas perceived that there is no event reported (76.1-85.3%) in the past 12 months. Overall patient safety grade is more than moderate in the clinic. Teamwork within Units and Organizational Learning—Continuous Improvement dimension had the highest score while staffing had the lowest score. Dental assistants perceived positive score in most dimensions while students perceived slight negative score in most dimensions. PMID:29480849

Training medical students in health promotion: twenty years of experience at the Faculty of Medicine of the University of Geneva.

PubMed

Mattig, Thomas; Chastonay, Philippe; Kabengele, Emmanuel; Bernheim, Laurent

2017-01-01

Background: In most cases, the work of medical doctors, be they general practitioners or specialists, involves some dimension of health promotion (HP). There is thus ample justification for increasing the awareness of medical students vis-à-vis HP and its relevance for their future practice. Methods: In the context of a major curriculum reform (problem-based learning [PBL]) at the Faculty of Medicine of the University of Geneva in the mid-1990s, several steps were taken to strengthen HP throughout the curriculum and include HP in its key domains as defined by the Ottawa Charter (OC). Results: First, the political dimension of HP was developed in a series of first- and fifth-year lectures and third-year workshops; second, community action was strengthened through a third-year one-month community immersion program; third, the development of personal skills was integrated into second- and third-year PBL cases and into fourth-and fifth-year learning activities in clinical settings as well as second- and third-year HP electives; in terms of reorienting health services, the chosen approach included the development of a HP-specific track in the context of a Certificate of Advanced Studies (CAS) in Community Health and a Master of Advanced Studies(MAS) in Public Health. Furthermore, a supportive intra-university environment was created through a collaborative convention with Health Promotion Switzerland, which is in charge of coordinating HP in Switzerland. Conclusion: In our view, HP teaching for medical students seems all the more relevant given that future medical doctors will have to take care of an increasing number of patients likely to develop chronic non-communicable diseases.

Development and Psychometric Properties of a Tuberculosis-Specific Multidimensional Health-Related Quality-of-Life Measure for Patients with Pulmonary Tuberculosis.

PubMed

Abdulelah, Juman; Sulaiman, Syed Azhar Syed; Hassali, Mohamed A; Blebil, Ali Q; Awaisu, Ahmed; Bredle, Jason M

2015-05-01

Various generic instruments exist to assess health-related quality of life (HRQOL) in patients with tuberculosis (TB), but a psychometrically sound disease-specific instrument is lacking. The present study aimed to develop and psychometrically validate a multidimensional TB-specific HRQOL instrument relevant to the value of patients with pulmonary TB in Iraq with an eye toward cross-cultural application. The core general HRQOL questionnaire is composed of the Functional Assessment of Cancer Therapy-General items. A modular approach was followed for the development of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) questionnaire in which a set of items assessing quality-of-life (QOL) issues not sufficiently covered by the core Functional Assessment of Cancer Therapy-General items, but considered to be relevant to the target population, was added. Moreover, principal-component analysis was used to determine the new subscale structure of the questionnaire. In addition to the 27 items of the core questionnaire, a set of 20 items referring to disease symptoms related to the site of infection, adverse effects, and additional QOL dimensions such as fatigue, social stigma, and economic burden of the illness was included. Factor analysis demonstrated that the FACIT-TB construct comprised five domains. A rigorous method was applied in the development of the FACIT-TB measure to fully understand the impact of TB on patients' QOL. The instrument is psychometrically sound and portrays multiple important dimensions of HRQOL. FACIT-TB is relatively brief, is easy to administer and score, and is appropriate for use in clinical trials and practice. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A Proposal of the European Association for the Study of Obesity to Improve the ICD-11 Diagnostic Criteria for Obesity Based on the Three Dimensions Etiology, Degree of Adiposity and Health Risk

PubMed Central

Hebebrand, Johannes; Holm, Jens-Christian; Woodward, Euan; Baker, Jennifer Lyn; Blaak, Ellen; Schutz, Dominique Durrer; Farpour-Lambert, Nathalie J.; Frühbeck, Gema; Halford, Jason G.C.; Lissner, Lauren; Micic, Dragan; Mullerova, Dana; Roman, Gabriela; Schindler, Karin; Toplak, Hermann; Visscher, Tommy L.S.; Yumuk, Volkan

2017-01-01

Diagnostic criteria for complex medical conditions caused by a multitude of both genetic and environmental factors should be descriptive and avoid any attribution of causality. Furthermore, the wording used to describe a disorder should be evidence-based and avoid stigmatization of the affected individuals. Both terminology and categorizations should be readily comprehensible for healthcare professionals and guide clinical decision making. Uncertainties with respect to diagnostic issues and their implications may be addressed to direct future clinical research. In this context, the European Association of the Study of Obesity (EASO) considers it an important endeavor to review the current ICD-11 Beta Draft for the definition of overweight and obesity and to propose a substantial revision. We aim to provide an overview of the key issues that we deem relevant for the discussion of the diagnostic criteria. We first discuss the current ICD-10 criteria and those proposed in the ICD 11 Beta Draft. We conclude with our own proposal for diagnostic criteria, which we believe will improve the assessment of patients with obesity in a clinically meaningful way. PMID:28738325

Patient selection for transcatheter aortic valve replacement: A combined clinical and multimodality imaging approach

PubMed Central

Cocchia, Rosangela; D’Andrea, Antonello; Conte, Marianna; Cavallaro, Massimo; Riegler, Lucia; Citro, Rodolfo; Sirignano, Cesare; Imbriaco, Massimo; Cappelli, Maurizio; Gregorio, Giovanni; Calabrò, Raffaele; Bossone, Eduardo

2017-01-01

Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview on TAVR clinical and technical aspects essential for adequate selection. PMID:28400918

Job satisfaction of registered dental practitioners.

PubMed

Luzzi, L; Spencer, A J; Jones, K; Teusner, D

2005-09-01

This study was designed to measure job satisfaction among registered clinical dentists so as to identify issues which may influence recruitment and retention of dentists in active clinical practice. A questionnaire measuring dimensions of job satisfaction was mailed to a stratified random sample of 80 private and 80 public sector dentists selected from the 1999 Victorian Dental Register. An adjusted response rate of 60 per cent was achieved (n = 87). Analyses showed significant differences (ANOVA; p < 0.05) in levels of satisfaction for various dimensions of job satisfaction by gender, age group and practice type. Differences in job satisfaction between male and female dentists related to the personal time dimension. Differences in satisfaction between dentists of different age groups were attributable to six dimensions: relationships with colleagues, relationships with patients, relationships with staff, personal time, community and administrative responsibilities. Differences between levels of satisfaction among private and public dentists related to the autonomy, relationships with patients, pay and resources dimensions. There are various dimensions of job satisfaction that may be pertinent to issues influencing recruitment and retention of dentists. Differences that exist between levels of job satisfaction among private and public sector dentists, between male and female dentists and dentists of different age groups need to be addressed in order to improve recruitment and retention rates of dentists in active clinical practice in different sectors of the dental care system.

Representation of Time-Relevant Common Data Elements in the Cancer Data Standards Repository: Statistical Evaluation of an Ontological Approach

PubMed Central

Chen, Henry W; Du, Jingcheng; Song, Hsing-Yi; Liu, Xiangyu; Jiang, Guoqian

2018-01-01

Background Today, there is an increasing need to centralize and standardize electronic health data within clinical research as the volume of data continues to balloon. Domain-specific common data elements (CDEs) are emerging as a standard approach to clinical research data capturing and reporting. Recent efforts to standardize clinical study CDEs have been of great benefit in facilitating data integration and data sharing. The importance of the temporal dimension of clinical research studies has been well recognized; however, very few studies have focused on the formal representation of temporal constraints and temporal relationships within clinical research data in the biomedical research community. In particular, temporal information can be extremely powerful to enable high-quality cancer research. Objective The objective of the study was to develop and evaluate an ontological approach to represent the temporal aspects of cancer study CDEs. Methods We used CDEs recorded in the National Cancer Institute (NCI) Cancer Data Standards Repository (caDSR) and created a CDE parser to extract time-relevant CDEs from the caDSR. Using the Web Ontology Language (OWL)–based Time Event Ontology (TEO), we manually derived representative patterns to semantically model the temporal components of the CDEs using an observing set of randomly selected time-related CDEs (n=600) to create a set of TEO ontological representation patterns. In evaluating TEO’s ability to represent the temporal components of the CDEs, this set of representation patterns was tested against two test sets of randomly selected time-related CDEs (n=425). Results It was found that 94.2% (801/850) of the CDEs in the test sets could be represented by the TEO representation patterns. Conclusions In conclusion, TEO is a good ontological model for representing the temporal components of the CDEs recorded in caDSR. Our representative model can harness the Semantic Web reasoning and inferencing functionalities and present a means for temporal CDEs to be machine-readable, streamlining meaningful searches. PMID:29472179

[Association of Schizophrenia and its Clinical Implications with the NOS1AP Gene in the Colombian Population].

PubMed

Valencia, Jenny García; Duarte, Ana Victoria Valencia; Vila, Ana Lucía Páez; Kremeyer, Bárbara; Montoya, María Patricia Arbeláez; Linares, Andrés Ruiz; Acosta, Carlos Alberto Palacio; Duque, Jorge Ospina; Berrío, Gabriel Bedoya

2012-06-01

The nitric oxide synthase 1 adaptor protein (NOS1AP) gene is possibly implicated in schizophrenia etiopathogenesis. To determine the association of NOS1AP gene variants with schizophrenia and the relationship of variants with the clinical dimensions of the disorder in the Colombian population. It is a case-control study with 255 subjects per group. Markers within the NOS1AP gene were typified as well as other informative material of genetic origin so as to adjust by population stratification. A factorial analysis of the main components for each item in the Scales for Evaluating Negative Symptoms (SENS) together with the Scales for Evaluating Positive Symptoms (SEPS) to determine clinical dimensions. Association between the C/C genotype of the rs945713 marker with schizophrenia (OR = 1.79, 95% CI: 1.13 - 2.84) was found. The C/C genotype of the rs945713 was related to higher scores in the "affective flattening and alogia" dimension; and the A/A genotype of the rs4657181 marker was associated to lower scores in the same dimension. Significant associations of markers inside the NOS1AP gene with schizophrenia and the "affective flattening and alogia" clinical dimension were found. These results are consistent with previous studies and support the possibility that NOS1AP influences schizophrenia susceptibility. Furthermore, NOS1AP might be a modifier of schizophrenia clinical characteristics. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Feature-selective Attention in Frontoparietal Cortex: Multivoxel Codes Adjust to Prioritize Task-relevant Information.

PubMed

Jackson, Jade; Rich, Anina N; Williams, Mark A; Woolgar, Alexandra

2017-02-01

Human cognition is characterized by astounding flexibility, enabling us to select appropriate information according to the objectives of our current task. A circuit of frontal and parietal brain regions, often referred to as the frontoparietal attention network or multiple-demand (MD) regions, are believed to play a fundamental role in this flexibility. There is evidence that these regions dynamically adjust their responses to selectively process information that is currently relevant for behavior, as proposed by the "adaptive coding hypothesis" [Duncan, J. An adaptive coding model of neural function in prefrontal cortex. Nature Reviews Neuroscience, 2, 820-829, 2001]. Could this provide a neural mechanism for feature-selective attention, the process by which we preferentially process one feature of a stimulus over another? We used multivariate pattern analysis of fMRI data during a perceptually challenging categorization task to investigate whether the representation of visual object features in the MD regions flexibly adjusts according to task relevance. Participants were trained to categorize visually similar novel objects along two orthogonal stimulus dimensions (length/orientation) and performed short alternating blocks in which only one of these dimensions was relevant. We found that multivoxel patterns of activation in the MD regions encoded the task-relevant distinctions more strongly than the task-irrelevant distinctions: The MD regions discriminated between stimuli of different lengths when length was relevant and between the same objects according to orientation when orientation was relevant. The data suggest a flexible neural system that adjusts its representation of visual objects to preferentially encode stimulus features that are currently relevant for behavior, providing a neural mechanism for feature-selective attention.

Relationship between symptom dimensions and brain morphology in obsessive-compulsive disorder.

PubMed

Hirose, Motohisa; Hirano, Yoshiyuki; Nemoto, Kiyotaka; Sutoh, Chihiro; Asano, Kenichi; Miyata, Haruko; Matsumoto, Junko; Nakazato, Michiko; Matsumoto, Koji; Masuda, Yoshitada; Iyo, Masaomi; Shimizu, Eiji; Nakagawa, Akiko

2017-10-01

Obsessive-compulsive disorder (OCD) is known as a clinically heterogeneous disorder characterized by symptom dimensions. Although substantial numbers of neuroimaging studies have demonstrated the presence of brain abnormalities in OCD, their results are controversial. The clinical heterogeneity of OCD could be one of the reasons for this. It has been hypothesized that certain brain regions contributed to the respective obsessive-compulsive dimensions. In this study, we investigated the relationship between symptom dimensions of OCD and brain morphology using voxel-based morphometry to discover the specific regions showing alterations in the respective dimensions of obsessive-compulsive symptoms. The severities of symptom dimensions in thirty-three patients with OCD were assessed using Obsessive-Compulsive Inventory-Revised (OCI-R). Along with numerous MRI studies pointing out brain abnormalities in autistic spectrum disorder (ASD) patients, a previous study reported a positive correlation between ASD traits and regional gray matter volume in the left dorsolateral prefrontal cortex and amygdala in OCD patients. We investigated the correlation between gray and white matter volumes at the whole brain level and each symptom dimension score, treating all remaining dimension scores, age, gender, and ASD traits as confounding covariates. Our results revealed a significant negative correlation between washing symptom dimension score and gray matter volume in the right thalamus and a significant negative correlation between hoarding symptom dimension score and white matter volume in the left angular gyrus. Although our result was preliminary, our findings indicated that there were specific brain regions in gray and white matter that contributed to symptom dimensions in OCD patients.

Psychological Profile of Sasang Typology: A Systematic Review

PubMed Central

Park, Soo Hyun; Lee, Soo Jin; Kim, Myoung-geun; Wedding, Danny; Kwon, Young-Kyu

2009-01-01

A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition. PMID:19745008

Psychological profile of sasang typology: a systematic review.

PubMed

Chae, Han; Park, Soo Hyun; Lee, Soo Jin; Kim, Myoung-Geun; Wedding, Danny; Kwon, Young-Kyu

2009-09-01

A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition.

Symptom dimensions in obsessive-compulsive disorder: phenomenology and treatment outcomes with exposure and ritual prevention.

PubMed

Williams, Monnica T; Mugno, Beth; Franklin, Martin; Faber, Sonya

2013-01-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. Copyright © 2013 S. Karger AG, Basel.

Constructing core competency indicators for clinical teachers in Taiwan: a qualitative analysis and an analytic hierarchy process

PubMed Central

2014-01-01

Background The objective of this study was to construct a framework of core competency indicators of medical doctors who teach in the clinical setting in Taiwan and to evaluate the relative importance of the indicators among these clinical teachers. Methods The preliminary framework of the indicators was developed from an in-depth interview conducted with 12 clinical teachers who had previously been recognized and awarded for their teaching excellence in university hospitals. The framework was categorized into 4 dimensions: 1) Expertise (i.e., professional knowledge and skill); 2) Teaching Ability; 3) Attitudes and Traits; and 4) Beliefs and Values. These areas were further divided into 11 sub-dimensions and 40 indicators. Subsequently, a questionnaire built upon this qualitative analysis was distributed to another group of 17 clinical teachers. Saaty’s eigenvector approach, or the so-called analytic hierarchy process (AHP), was applied to perform the pairwise comparisons between indicators and to determine the ranking and relative importance of the indicators. Results Fourteen questionnaires were deemed valid for AHP assessment due to completeness of data input. The relative contribution of the four main dimensions was 31% for Attitudes and Traits, 30% for Beliefs and Values, 22% for Expertise, and 17% for Teaching Ability. Specifically, 9 out of the 10 top-ranked indicators belonged to the “Attitudes and Traits” or “Beliefs and Values” dimensions, indicating that inner characteristics (i.e., attitudes, traits, beliefs, and values) were perceived as more important than surface ones (i.e., professional knowledge, skills, and teaching competency). Conclusion We performed a qualitative analysis and developed a questionnaire based upon an interview with experienced clinical teachers in Taiwan, and used this tool to construct the key features for the role model. The application has also demonstrated the relative importance in the dimensions of the core competencies for clinical teachers in Taiwan. PMID:24726054

Constructing core competency indicators for clinical teachers in Taiwan: a qualitative analysis and an analytic hierarchy process.

PubMed

Li, Ai-Tzu; Lin, Jou-Wei

2014-04-11

The objective of this study was to construct a framework of core competency indicators of medical doctors who teach in the clinical setting in Taiwan and to evaluate the relative importance of the indicators among these clinical teachers. The preliminary framework of the indicators was developed from an in-depth interview conducted with 12 clinical teachers who had previously been recognized and awarded for their teaching excellence in university hospitals. The framework was categorized into 4 dimensions: 1) Expertise (i.e., professional knowledge and skill); 2) Teaching Ability; 3) Attitudes and Traits; and 4) Beliefs and Values. These areas were further divided into 11 sub-dimensions and 40 indicators. Subsequently, a questionnaire built upon this qualitative analysis was distributed to another group of 17 clinical teachers. Saaty's eigenvector approach, or the so-called analytic hierarchy process (AHP), was applied to perform the pairwise comparisons between indicators and to determine the ranking and relative importance of the indicators. Fourteen questionnaires were deemed valid for AHP assessment due to completeness of data input. The relative contribution of the four main dimensions was 31% for Attitudes and Traits, 30% for Beliefs and Values, 22% for Expertise, and 17% for Teaching Ability. Specifically, 9 out of the 10 top-ranked indicators belonged to the "Attitudes and Traits" or "Beliefs and Values" dimensions, indicating that inner characteristics (i.e., attitudes, traits, beliefs, and values) were perceived as more important than surface ones (i.e., professional knowledge, skills, and teaching competency). We performed a qualitative analysis and developed a questionnaire based upon an interview with experienced clinical teachers in Taiwan, and used this tool to construct the key features for the role model. The application has also demonstrated the relative importance in the dimensions of the core competencies for clinical teachers in Taiwan.

Ultrasonographic appearance of the major duodenal papilla in dogs without evidence of hepatobiliary, pancreatic, or gastrointestinal tract disease.

PubMed

Mortier, Jeremy R; Maddox, Thomas W; White, Gillian M; Blundell, Richard J; Monné, Josep M; Lillis, Susannah M

2016-06-01

OBJECTIVE To determine the ultrasonographic appearance of the major duodenal papilla (MDP) in dogs without evidence of hepatobiliary, pancreatic, or gastrointestinal tract disease. ANIMALS 40 adult client-owned dogs examined because of conditions that did not include hepatobiliary, pancreatic, or gastrointestinal tract disease. PROCEDURES Ultrasonographic examination of the MDP was performed. Each MDP was measured in 3 planes. Intraobserver reliability of measurements was determined, and associations between MDP dimensions and characteristics of the dogs were investigated. Histologic examination of longitudinal sections of the MDP was performed for 1 dog to compare the ultrasonographic and histologic appearance. RESULTS The MDP appeared as a layered structure with a hyperechoic outer layer, hypoechoic middle layer, and hyperechoic inner layer that corresponded to the duodenal serosa, duodenal muscularis, and duodenal submucosa, respectively. Layers visible during ultrasonographic examinations were consistent with layers identified histologically. Intraobserver reliability was substantial for each plane of measurement. Mean ± SD length, width, and height of the MDP were 15.2 ± 3.5 mm, 6.3 ± 1.6 mm, and 4.3 ± 1.0 mm, respectively. An increase in body weight of dogs was significantly associated with increased values for all measurements. CONCLUSIONS AND CLINICAL RELEVANCE The ultrasonographic appearance and approximate dimensions of the MDP of dogs without evidence of hepatobiliary, pancreatic, or gastrointestinal tract disease were determined. Additional studies are needed to evaluate possible ultrasonographic lesions of the MDP in dogs with hepatobiliary, pancreatic, or intestinal diseases and to investigate clinical implications of these lesions with regard to diagnosis and prognosis.

Ventricular Geometry From Non-contrast Non-ECG-gated CT Scans: An Imaging Marker of Cardiopulmonary Disease in Smokers.

PubMed

Rahaghi, Farbod N; Vegas-Sanchez-Ferrero, Gonzalo; Minhas, Jasleen K; Come, Carolyn E; De La Bruere, Isaac; Wells, James M; González, Germán; Bhatt, Surya P; Fenster, Brett E; Diaz, Alejandro A; Kohli, Puja; Ross, James C; Lynch, David A; Dransfield, Mark T; Bowler, Russel P; Ledesma-Carbayo, Maria J; San José Estépar, Raúl; Washko, George R

2017-05-01

Imaging-based assessment of cardiovascular structure and function provides clinically relevant information in smokers. Non-cardiac-gated thoracic computed tomographic (CT) scanning is increasingly leveraged for clinical care and lung cancer screening. We sought to determine if more comprehensive measures of ventricular geometry could be obtained from CT using an atlas-based surface model of the heart. Subcohorts of 24 subjects with cardiac magnetic resonance imaging (MRI) and 262 subjects with echocardiography were identified from COPDGene, a longitudinal observational study of smokers. A surface model of the heart was manually initialized, and then automatically optimized to fit the epicardium for each CT. Estimates of right and left ventricular (RV and LV) volume and free-wall curvature were then calculated and compared to structural and functional metrics obtained from MRI and echocardiograms. CT measures of RV dimension and curvature correlated with similar measures obtained using MRI. RV and LV volume obtained from CT inversely correlated with echocardiogram-based estimates of RV systolic pressure using tricuspid regurgitation jet velocity and LV ejection fraction respectively. Patients with evidence of RV or LV dysfunction on echocardiogram had larger RV and LV dimensions on CT. Logistic regression models based on demographics and ventricular measures from CT had an area under the curve of >0.7 for the prediction of elevated right ventricular systolic pressure and ventricular failure. These data suggest that non-cardiac-gated, non-contrast-enhanced thoracic CT scanning may provide insight into cardiac structure and function in smokers. Copyright © 2017. Published by Elsevier Inc.

Torsional and axial compressive properties of tibiotarsal bones of red-tailed hawks (Buteo jamaicensis).

PubMed

Kerrigan, Shannon M; Kapatkin, Amy S; Garcia, Tanya C; Robinson, Duane A; Guzman, David Sanchez-Migallon; Stover, Susan M

2018-04-01

OBJECTIVE To describe the torsional and axial compressive properties of tibiotarsal bones of red-tailed hawks (Buteo jamaicensis). SAMPLE 16 cadaveric tibiotarsal bones from 8 red-tailed hawks. PROCEDURES 1 tibiotarsal bone from each bird was randomly assigned to be tested in torsion, and the contralateral bone was tested in axial compression. Intact bones were monotonically loaded in either torsion (n = 8) or axial compression (8) to failure. Mechanical variables were derived from load-deformation curves. Fracture configurations were described. Effects of sex, limb side, and bone dimensions on mechanical properties were assessed with a mixed-model ANOVA. Correlations between equivalent torsional and compressive properties were determined. RESULTS Limb side and bone dimensions were not associated with any mechanical property. During compression tests, mean ultimate cumulative energy and postyield energy for female bones were significantly greater than those for male bones. All 8 bones developed a spiral diaphyseal fracture and a metaphyseal fissure or fracture during torsional tests. During compression tests, all bones developed a crushed metaphysis and a fissure or comminuted fracture of the diaphysis. Positive correlations were apparent between most yield and ultimate torsional and compressive properties. CONCLUSIONS AND CLINICAL RELEVANCE The torsional and axial compressive properties of tibiotarsal bones described in this study can be used as a reference for investigations into fixation methods for tibiotarsal fractures in red-tailed hawks. Although the comminuted and spiral diaphyseal fractures induced in this study were consistent with those observed in clinical practice, the metaphyseal disruption observed was not and warrants further research.

Reciprocal Effects of Social Support in Major Depression Epidemiology

PubMed Central

Patten, Scott B; Williams, Jeanne V.A; Lavorato, Dina H; Bulloch, Andrew G.M

2010-01-01

Background: The clinical course and epidemiology of major depressive episodes (MDEs) may be influenced by reciprocal interactions between an individual and the social environment. Epidemiological data concerning these interactions may assist with anticipating the clinical needs of depressed patients. Methods: The data source for this study was a Canadian longitudinal study, the National Population Health Survey (NPHS), which provided 8 years of follow-up data. The NPHS interview included a brief diagnostic indicator for MDE, the Composite International Diagnostic Interview Short Form for Major Depression (CIDI-SFMD). The NPHS interview also incorporated the Medical Outcomes Study Social Support Scale (MOSSS) and a set of relevant demographic and health-related measures. The MOSSS assesses total social support and four specific dimensions of social support. Hazard ratios (HR) were used to quantify associations in the longitudinal data. Results: Lower quartile total social support ratings predicted MDE incidence: the HR adjusted for age and sex was 1.9 (95% CI 1.6 – 2.2). Lower quartile ratings in specific social support dimensions yielded similar HRs. MDE was associated with emergence of lower-quartile affection social support (age and sex adjusted HR 1.3, 95% CI 1.1 – 1.7), but other aspects of social support were not consistently associated with MDE. Conclusions: Low social support appears to be a robust risk factor for MDE and can be used to identify persons at higher risk of MDE. Evidence that MDE has a negative effect on social support was weaker and was restricted to affection social support. PMID:21253020

Evaluation of Spiritual Needs of Patients with Advanced Cancer in a Palliative Care Unit

PubMed Central

Valls, Joan; Porta, Josep; Viñas, Juan

2014-01-01

Abstract Introduction: Spiritual needs play an important role in palliative care as both a clinical dimension and a therapeutic strategy. However, recent studies have shown that the management of this dimension still remains a challenge at the clinical level of palliative care. Goals: Our goal was to evaluate the spiritual needs of patients diagnosed with advanced and terminal cancer by the palliative care unit of a hospital in Barcelona, Spain. Methods: An observational study was conducted that involved 50 patients who were recruited between May 2007 and January 2008. A questionnaire was used which included 28 items selected from a review of the literature; the responses were analyzed using a five-point Lickert scale. The results were grouped in 11 categories corresponding to different spiritual needs. Results: Two spiritual needs emerged as the most relevant for the patients: their need to be recognized as a person until the end of their life and their need to know the truth about their illness. The least important spiritual needs were identified as those: for continuity and an afterlife; to get rid of obsessions; to achieve freedom from blame and to be able to forgive others; and the need for reconciliation and to feel forgiven by others. Conclusions: When patients knew the truth about their illnesses and they were treated with dignity, their most important needs were likely to be covered. These results suggest that patients receiving palliative care wish to live for the present with as much normality as possible and show only minor concern for their past and future. PMID:24745870

Transversal changes, space closure, and efficiency of conventional and self-ligating appliances : A quantitative systematic review.

PubMed

Yang, Xianrui; Xue, Chaoran; He, Yiruo; Zhao, Mengyuan; Luo, Mengqi; Wang, Peiqi; Bai, Ding

2018-01-01

Self-ligating brackets (SLBs) were compared to conventional brackets (CBs) regarding their effectiveness on transversal changes and space closure, as well as the efficiency of alignment and treatment time. All previously published randomized controlled clinical trials (RCTs) dealing with SLBs and CBs were searched via electronic databases, e.g., MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Registry Platform, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, relevant journals were searched manually. Data extraction was performed independently by two reviewers and assessment of the risk of bias was executed using Cochrane Collaboration's tool. Discrepancies were resolved by discussion with a third reviewer. Meta-analyses were conducted using Review Manager (version 5.3). A total of 976 patients in 17 RCTs were included in the study, of which 11 could be produced quantitatively and 2 showed a low risk of bias. Meta-analyses were found to favor CB for mandibular intercanine width expansion, while passive SLBs were more effective in posterior expansion. Moreover, CBs had an apparent advantage during short treatment periods. However, SLBs and CBs did not differ in closing spaces. Based on current clinical evidence obtained from RCTs, SLBs do not show clinical superiority compared to CBs in expanding transversal dimensions, space closure, or orthodontic efficiency. Further high-level studies involving randomized, controlled, clinical trials are warranted to confirm these results.

Assessing the Importance of Treatment Goals in Patients with Psoriasis: Analytic Hierarchy Process vs. Likert Scales.

PubMed

Gutknecht, Mandy; Danner, Marion; Schaarschmidt, Marthe-Lisa; Gross, Christian; Augustin, Matthias

2018-02-15

To define treatment benefit, the Patient Benefit Index contains a weighting of patient-relevant treatment goals using the Patient Needs Questionnaire, which includes a 5-point Likert scale ranging from 0 ("not important at all") to 4 ("very important"). These treatment goals have been assigned to five health dimensions. The importance of each dimension can be derived by averaging the importance ratings on the Likert scales of associated treatment goals. As the use of a Likert scale does not allow for a relative assessment of importance, the objective of this study was to estimate relative importance weights for health dimensions and associated treatment goals in patients with psoriasis by using the analytic hierarchy process and to compare these weights with the weights resulting from the Patient Needs Questionnaire. Furthermore, patients' judgments on the difficulty of the methods were investigated. Dimensions of the Patient Benefit Index and their treatment goals were mapped into a hierarchy of criteria and sub-criteria to develop the analytic hierarchy process questionnaire. Adult patients with psoriasis starting a new anti-psoriatic therapy in the outpatient clinic of the Institute for Health Services Research in Dermatology and Nursing at the University Medical Center Hamburg (Germany) were recruited and completed both methods (analytic hierarchy process, Patient Needs Questionnaire). Ratings of treatment goals on the Likert scales (Patient Needs Questionnaire) were summarized within each dimension to assess the importance of the respective health dimension/criterion. Following the analytic hierarchy process approach, consistency in judgments was assessed using a standardized measurement (consistency ratio). At the analytic hierarchy process level of criteria, 78 of 140 patients achieved the accepted consistency. Using the analytic hierarchy process, the dimension "improvement of physical functioning" was most important, followed by "improvement of social functioning". Concerning the Patient Needs Questionnaire results, these dimensions were ranked in second and fifth position, whereas "strengthening of confidence in the therapy and in a possible healing" was ranked most important, which was least important in the analytic hierarchy process ranking. In both methods, "improvement of psychological well-being" and "reduction of impairments due to therapy" were equally ranked in positions three and four. In contrast to this, on the level of sub-criteria, predominantly a similar ranking of treatment goals could be observed between the analytic hierarchy process and the Patient Needs Questionnaire. From the patients' point of view, the Likert scales (Patient Needs Questionnaire) were easier to complete than the analytic hierarchy process pairwise comparisons. Patients with psoriasis assign different importance to health dimensions and associated treatment goals. In choosing a method to assess the importance of health dimensions and/or treatment goals, it needs to be considered that resulting importance weights may differ in dependence on the used method. However, in this study, observed discrepancies in importance weights of the health dimensions were most likely caused by the different methodological approaches focusing on treatment goals to assess the importance of health dimensions on the one hand (Patient Needs Questionnaire) or directly assessing health dimensions on the other hand (analytic hierarchy process).

[Study of correlation dimension on EEG].

PubMed

Yang, Hao; Fang, Liang; He, Wei

2004-02-01

The study of non-linear EEG is of great significance in clinical practice and research work. This paper has gone into the feasibility of calculating the correlation dimension and has developed some subjects with the characters of correlation dimension and the difference under four conditions: (1) passive eyes closed(PEC); (2) mental arithmetic with eyes closed(MAEC); (3) passive eyes open(PEO); (4) mental reasoning with eyes open (MRED). The results show it is feasible and meaningful to calculate correlation dimension and the correlation dimension can reflect the regular patterns of mental activity.

Exploring extra dimensions through inflationary tensor modes

NASA Astrophysics Data System (ADS)

Im, Sang Hui; Nilles, Hans Peter; Trautner, Andreas

2018-03-01

Predictions of inflationary schemes can be influenced by the presence of extra dimensions. This could be of particular relevance for the spectrum of gravitational waves in models where the extra dimensions provide a brane-world solution to the hierarchy problem. Apart from models of large as well as exponentially warped extra dimensions, we analyze the size of tensor modes in the Linear Dilaton scheme recently revived in the discussion of the "clockwork mechanism". The results are model dependent, significantly enhanced tensor modes on one side and a suppression on the other. In some cases we are led to a scheme of "remote inflation", where the expansion is driven by energies at a hidden brane. In all cases where tensor modes are enhanced, the requirement of perturbativity of gravity leads to a stringent upper limit on the allowed Hubble rate during inflation.

Clinical relevance in anesthesia journals.

PubMed

Lauritsen, Jakob; Møller, Ann M

2006-04-01

The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles. In the last few years, more attention has been paid to evidence-based medicine in anesthesia. Several articles on the subject have focused on the need to base clinical decisions on sound research employing both methodological rigor and clinically relevant outcomes. The number of systematic reviews in anesthesia literature is increasing as well as the focus on diminishing the number of surrogate outcomes. It has been shown that the impact factor is not a valid measure of establishing the level of clinical relevance to a journal. This review presents definitions of clinically relevant anesthesia articles. A clinically relevant article employs both methodological rigor and a clinically relevant outcome. The terms methodological rigor and clinical outcomes are fully discussed in the review as well as problems with journal impact factors.

Towards quality criteria for regional public health reporting: concept mapping with Dutch experts.

PubMed

van Bon-Martens, Marja J H; Achterberg, Peter W; van de Goor, Ien A M; van Oers, Hans A M

2012-06-01

In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined 'good public health reporting'. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a 'product' dimension, ranging from 'production' to 'content', and a 'context' dimension, ranging from 'science' to 'policy'. The three most important clusters were: (i) 'solution orientation', (ii) 'policy relevance' and (iii) 'policy impact'. This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports.

Patient Safety Competence of Nursing Students in Saudi Arabia: A Self-Reported Survey

PubMed Central

Colet, Paolo C.; Cruz, Jonas P.; Cruz, Charlie P.; Al-otaibi, Jazi; Qubeilat, Hikmet; Alquwez, Nahed

2015-01-01

Objective With the growing recognition of the significance of patient safety (PS) in educational institutions and health organizations, it is essential to understand the perspective of nursing students on their own PS competence. This study analyzed the self-reported PS competence of nursing students at a government university in Saudi Arabia. Methodology A cross-sectional self-reported survey of 191 respondents, using the Health Professional Education in Patient Safety Survey (H-PEPSS) was conducted. The survey tool reflected 6 key socio-cultural dimensions assessing competence in classroom and clinical setting. Results Female nursing students reported higher PS competence in both the classroom and clinical settings along the dimensions ‘working in teams’ and ‘communicating effectively’ while males reported higher competence in both settings as to the ‘managing safety risks’ and ‘understanding human and environmental factors’ dimensions. The respondents’ academic level and self–reported PS competence have weak negative correlation in the classroom while a strong negative correlation between the 2 variables existed in the clinical setting. Self-reported PS competence for the dimensions ‘working in teams’, ‘recognize and respond to remove immediate risks of harm’, and ‘culture of safety’ is significantly higher in classroom than in the clinical setting. Conclusion Generally, the Saudi nursing students reported varying levels of competence in the six dimensions of patient safety. Significant gap between the perceived PS competence was observed between learning settings. Educational and training interventions are suggested for implementation to bridge this gap. PMID:26715921

Qualitative approaches to use of the RE-AIM framework: rationale and methods.

PubMed

Holtrop, Jodi Summers; Rabin, Borsika A; Glasgow, Russell E

2018-03-13

There have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs. Full use of the model includes use of qualitative methods to understand why and how results were obtained on different RE-AIM dimensions, however, recent reviews have revealed that qualitative methods have been used infrequently. Having quantitative and qualitative methods and results iteratively inform each other should enhance understanding and lessons learned. Because there have been few published examples of qualitative approaches and methods using RE-AIM for planning or assessment and no guidance on how qualitative approaches can inform these processes, we provide guidance on qualitative methods to address the RE-AIM model and its various dimensions. The intended audience is researchers interested in applying RE-AIM or similar implementation models, but the methods discussed should also be relevant to those in community or clinical settings. We present directions for, examples of, and guidance on how qualitative methods can be used to address each of the five RE-AIM dimensions. Formative qualitative methods can be helpful in planning interventions and designing for dissemination. Summative qualitative methods are useful when used in an iterative, mixed methods approach for understanding how and why different patterns of results occur. In summary, qualitative and mixed methods approaches to RE-AIM help understand complex situations and results, why and how outcomes were obtained, and contextual factors not easily assessed using quantitative measures.

Predictors of illness anxiety symptoms in patients with obsessive compulsive disorder.

PubMed

Reuman, Lillian; Jacoby, Ryan J; Blakey, Shannon M; Riemann, Bradley C; Leonard, Rachel C; Abramowitz, Jonathan S

2017-10-01

Illness anxiety and OCD symptoms appear to overlap in their presentation as well as in other conceptually important ways (e.g., dysfunctional cognitions). Little research, however, has directly examined these putative relationships. The present study examined the extent to which illness anxiety symptoms were associated with OCD symptom dimensions and relevant cognitive factors in a large treatment-seeking sample of patients with OCD. Patients completed a battery of self-report measures of OCD and health anxiety symptoms and related cognitive biases. Results from regression analyses indicated that illness anxiety symptoms were associated with harm obsessions and checking rituals, as well as with the tendency to overestimate threat and responsibility for harm. Illness anxiety was not associated with perfectionism. Conceptual and clinical implications of these findings are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Microfluidics to Mimic Blood Flow in Health and Disease

NASA Astrophysics Data System (ADS)

Sebastian, Bernhard; Dittrich, Petra S.

2018-01-01

Throughout history, capillary systems have aided the establishment of the fundamental laws of blood flow and its non-Newtonian properties. The advent of microfluidics technology in the 1990s propelled the development of highly integrated lab-on-a-chip platforms that allow highly accurate replication of vascular systems' dimensions, mechanical properties, and biological complexity. Applications include the detection of pathological changes to red blood cells, white blood cells, and platelets at unparalleled sensitivity and the efficacy assessment of drug treatment. Recent efforts have aimed at the development of microfluidics-based tests usable in a clinial environment or the replication of more complex diseases such as thrombosis. These microfluidic disease models enable the study of onset and progression of disease as well as the identification of key players and risk factors, which have led to a spectrum of clinically relevant findings.

A cross-sectional examination of non-suicidal self-injury, disordered eating, impulsivity, and compulsivity in a sample of adult women.

PubMed

Black, Emma B; Mildred, Helen

2014-12-01

Non-suicidal self-injury has been classed as having both impulsive and compulsive characteristics (Simeon & Favazza, 2001). These constructs have been related to disordered eating behaviors such as vomiting (Favaro & Santonastaso, 1998). Utilizing an international sample of adult females, this paper further explored this model, aiming to identify whether all types of disordered eating could be classified as impulsive or compulsive, and whether the impulsive and compulsive groupings reflect underlying trait impulsivity and compulsivity. The hypothesized impulsive and compulsive dimensions did not emerge from the data. Notably however, all self-injurious and disordered eating behaviors were linked to Urgency (an impulsivity facet) to varying degrees; no relationship with trait compulsivity was found. These findings are discussed, study limitations are noted, and relevance for clinical practice is outlined.

Bootstrapping the O(N) archipelago

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kos, Filip; Poland, David; Simmons-Duffin, David

2015-11-17

We study 3d CFTs with an O(N) global symmetry using the conformal bootstrap for a system of mixed correlators. Specifically, we consider all nonvanishing scalar four-point functions containing the lowest dimension O(N) vector Φ i and the lowest dimension O(N) singlet s, assumed to be the only relevant operators in their symmetry representations. The constraints of crossing symmetry and unitarity for these four-point functions force the scaling dimensions (Δ Φ , Δ s ) to lie inside small islands. Here, we also make rigorous determinations of current two-point functions in the O(2) and O(3) models, with applications to transport inmore » condensed matter systems.« less

Time to get healthy: associations of time perspective with perceived health status and health behaviors.

PubMed

Griva, Fay; Tseferidi, Sofia-Ioanna; Anagnostopoulos, Fotios

2015-01-01

The present study examined the associations of time perspective (TP) with health behaviors including smoking, exercise, and body mass index (BMI), and perceptions of health status after controlling for sociodemographic factors. Participants (N = 413) completed a web-based questionnaire that included a short version of the Zimbardo Time Perspective Inventory, and reported their weight, height, smoking, and exercise frequency. Future TP was associated with more physical exercise, whereas past-negative and present-fatalistic dimensions were associated with higher BMI. Smoking was not associated with any of the TP dimensions. Additionally, all of the dimensions of TP were found to be associated with conceptually relevant perceptions of health status. Research on TP predominantly focuses on the future and the present orientation, but the findings of the present study suggest that all dimensions of TP should be used in health-related research. Also, issues regarding the role of the present-hedonistic dimension are discussed and directions for future research are proposed.

Measuring Contextual Characteristics for Community Health

PubMed Central

Hillemeier, Marianne M; Lynch, John; Harper, Sam; Casper, Michele

2003-01-01

Objective To conceptualize and measure community contextual influences on population health and health disparities. Data Sources We use traditional and nontraditional secondary sources of data comprising a comprehensive array of community characteristics. Study Design Using a consultative process, we identify 12 overarching dimensions of contextual characteristics that may affect community health, as well as specific subcomponents relating to each dimension. Data Collection An extensive geocoded library of data indicators relating to each dimension and subcomponent for metropolitan areas in the United States is assembled. Principal Findings We describe the development of community contextual health profiles, present the rationale supporting each of the profile dimensions, and provide examples of relevant data sources. Conclusions Our conceptual framework for community contextual characteristics, including a specified set of dimensions and components, can provide practical ways to monitor health-related aspects of the economic, social, and physical environments in which people live. We suggest several guiding principles useful for understanding how aspects of contextual characteristics can affect health and health disparities. PMID:14727793

Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV.

PubMed

Wolraich, M L; Feurer, I D; Hannah, J N; Baumgaertel, A; Pinnock, T Y

1998-04-01

This study examines the psychometric properties of the Vanderbilt AD/HD Diagnostic Teacher Rating Scale (VADTRS) and provides preliminary normative data from a large, geographically defined population. The VADTRS consists of the complete list of DSM-IV AD/HD symptoms, a screen for other disruptive behavior disorders, anxiety and depression, and ratings of academic and classroom behavior performance. Teachers in one suburban county completed the scale for their students during 2 consecutive years. Statistical methods included (a) exploratory and confirmatory latent variable analyses of item data, (b) evaluation of the internal consistency of the latent dimensions, (c) evaluation of latent structure concordance between school year samples, and (d) preliminary evaluation of criterion-related validity. The instrument comprises four behavioral dimensions and two performance dimensions. The behavioral dimensions were concordant between school years and were consistent with a priori DSM-IV diagnostic criteria. Correlations between latent dimensions and relevant, known disorders or problems varied from .25 to .66.

Dimensions Underlying Measures of Disability, Personal Factors, and Health Status in Cervical Radiculopathy

PubMed Central

Halvorsen, Marie; Kierkegaard, Marie; Harms-Ringdahl, Karin; Peolsson, Anneli; Dedering, Åsa

2015-01-01

Abstract This cross-sectional study sought to identify dimensions underlying measures of impairment, disability, personal factors, and health status in patients with cervical radiculopathy. One hundred twenty-four patients with magnetic resonance imaging-verified cervical radiculopathy, attending a neurosurgery clinic in Sweden, participated. Data from clinical tests and questionnaires on disability, personal factors, and health status were used in a principal-component analysis (PCA) with oblique rotation. The PCA supported a 3-component model including 14 variables from clinical tests and questionnaires, accounting for 73% of the cumulative percentage. The first component, pain and disability, explained 56%. The second component, health, fear-avoidance beliefs, kinesiophobia, and self-efficacy, explained 9.2%. The third component including anxiety, depression, and catastrophizing explained 7.6%. The strongest-loading variables of each dimension were “present neck pain intensity,” “fear avoidance,” and “anxiety.” The three underlying dimensions identified and labeled Pain and functioning, Health, beliefs, and kinesiophobia, and Mood state and catastrophizing captured aspects of importance for cervical radiculopathy. Since the variables “present neck pain intensity,” “fear avoidance,” and “anxiety” had the strongest loading in each of the three dimensions; it may be important to include them in a reduced multidimensional measurement set in cervical radiculopathy. PMID:26091482

Dimensions Underlying Measures of Disability, Personal Factors, and Health Status in Cervical Radiculopathy: A Cross-Sectional Study.

PubMed

Halvorsen, Marie; Kierkegaard, Marie; Harms-Ringdahl, Karin; Peolsson, Anneli; Dedering, Åsa

2015-06-01

This cross-sectional study sought to identify dimensions underlying measures of impairment, disability, personal factors, and health status in patients with cervical radiculopathy. One hundred twenty-four patients with magnetic resonance imaging-verified cervical radiculopathy, attending a neurosurgery clinic in Sweden, participated. Data from clinical tests and questionnaires on disability, personal factors, and health status were used in a principal-component analysis (PCA) with oblique rotation. The PCA supported a 3-component model including 14 variables from clinical tests and questionnaires, accounting for 73% of the cumulative percentage. The first component, pain and disability, explained 56%. The second component, health, fear-avoidance beliefs, kinesiophobia, and self-efficacy, explained 9.2%. The third component including anxiety, depression, and catastrophizing explained 7.6%. The strongest-loading variables of each dimension were "present neck pain intensity," "fear avoidance," and "anxiety." The three underlying dimensions identified and labeled Pain and functioning, Health, beliefs, and kinesiophobia, and Mood state and catastrophizing captured aspects of importance for cervical radiculopathy. Since the variables "present neck pain intensity," "fear avoidance," and "anxiety" had the strongest loading in each of the three dimensions; it may be important to include them in a reduced multidimensional measurement set in cervical radiculopathy.

A Successful Strategy to Integrate Sex and Gender Medicine into a Newly Developed Medical Curriculum.

PubMed

Ludwig, Sabine; Oertelt-Prigione, Sabine; Kurmeyer, Christine; Gross, Manfred; Grüters-Kieslich, Annette; Regitz-Zagrosek, Vera; Peters, Harm

2015-12-01

A new modular, outcome-based, interdisciplinary curriculum was introduced for undergraduate medical education at one of the largest European medical faculties. A key stated institutional goal was to systematically integrate sex and gender medicine and gender perspectives into the curriculum in order to foster adequate gender-related knowledge and skills for future doctors concerning the etiology, pathogenesis, clinical presentation, diagnosis, treatment, and research of diseases. A change agent was integrated directly into the curriculum development team to facilitate interactions with all key players of the curricular development process. The gender change agent established a supporting organizational framework of all stakeholders, and developed a 10-step approach including identification, selection, placing relevant sex and gender medicine-related issues in the curricular planning sessions, counseling of faculty members, and monitoring of the integration achieved. With this approach, quantitatively sex and gender medicine-related content was widely integrated throughout all teaching and learning formats and from early basic science to later clinical modules (94 lectures, 33 seminars, and 16 practical courses). Gender perspectives involve 5% of the learning objectives and represent an integral part of the assessment program. Qualitatively, the relevance of gender (sociocultural) differences was combined with sex (biological) differences in disease manifestation throughout the curriculum. The appointment of a change agent facilitates the development of systematic approaches that can be a key and serve as practice models to successfully integrate new overarching curricular perspectives and dimensions--in this case sex and gender medicine--into a new medical curriculum.

Solitons and SeaSat,

DTIC Science & Technology

1984-08-01

the Kadomtsev - • . Petviashvili (1) equations . A derivation of Eq. (1) in the case of . " * internal waves is given in reference (2). An important...second statement is demonstrated to be false. The% Kadomtsev -.1etviashvile equation relevant to Internal Waves is shown not to have SOliL -solutions. This...more than one space dimension. The second statement is demonstrated to be false. The Kadomtsev -Petviashvile equation relevant to Internal Waves Is

Nasal Septal Deviations: A Systematic Review of Classification Systems.

PubMed

Teixeira, Jeffrey; Certal, Victor; Chang, Edward T; Camacho, Macario

2016-01-01

Objective. To systematically review the international literature for internal nasal septal deviation classification systems and summarize them for clinical and research purposes. Data Sources. Four databases (including PubMed/MEDLINE) were systematically searched through December 16, 2015. Methods. Systematic review, adhering to PRISMA. Results. After removal of duplicates, this study screened 952 articles for relevance. A final comprehensive review of 50 articles identified that 15 of these articles met the eligibility criteria. The classification systems defined in these articles included C-shaped, S-shaped, reverse C-shaped, and reverse S-shaped descriptions of the septal deviation in both the cephalocaudal and anteroposterior dimensions. Additional studies reported use of computed tomography and categorized deviation based on predefined locations. Three studies graded the severity of septal deviations based on the amount of deflection. The systems defined in the literature also included an evaluation of nasal septal spurs and perforations. Conclusion. This systematic review ascertained that the majority of the currently published classification systems for internal nasal septal deviations can be summarized by C-shaped or reverse C-shaped, as well as S-shaped or reverse S-shaped deviations in the anteroposterior and cephalocaudal dimensions. For imaging studies, predefined points have been defined along the septum. Common terminology can facilitate future research.

A robust nanofluidic membrane with tunable zero-order release for implantable dose specific drug delivery.

PubMed

Fine, Daniel; Grattoni, Alessandro; Hosali, Sharath; Ziemys, Arturas; De Rosa, Enrica; Gill, Jaskaran; Medema, Ryan; Hudson, Lee; Kojic, Milos; Milosevic, Miljan; Brousseau Iii, Louis; Goodall, Randy; Ferrari, Mauro; Liu, Xuewu

2010-11-21

This manuscript demonstrates a mechanically robust implantable nanofluidic membrane capable of tunable long-term zero-order release of therapeutic agents in ranges relevant for clinical applications. The membrane, with nanochannels as small as 5 nm, allows for the independent control of both dosage and mechanical strength through the integration of high-density short nanochannels parallel to the membrane surface with perpendicular micro- and macrochannels for interfacing with the ambient solutions. These nanofluidic membranes are created using precision silicon fabrication techniques on silicon-on-insulator substrates enabling exquisite control over the monodispersed nanochannel dimensions and surface roughness. Zero-order release of analytes is achieved by exploiting molecule to surface interactions which dominate diffusive transport when fluids are confined to the nanoscale. In this study we investigate the nanofluidic membrane performance using custom diffusion and gas testing apparatuses to quantify molecular release rate and process uniformity as well as mechanical strength using a gas based burst test. The kinetics of the constrained zero-order release is probed with molecules presenting a range of sizes, charge states, and structural conformations. Finally, an optimal ratio of the molecular hydrodynamic diameter to the nanochannel dimension is determined to assure zero-order release for each tested molecule.

[Development of a questionnaire for measuring effort-reward imbalance in household and family work].

PubMed

Sperlich, Stefanie; Arnhold-Kerri, Sonja; Engelke, Sonja; Noeres, Dorothee; Collatz, Jürgen; Geyer, Siegfried

2009-05-01

Siegrists concept of effort-reward imbalance (ERI) had been shown to be associated with a broad range of health impairments, in particular cardiovascular diseases and depression. The original questionnaire was designed to assess ERI in the field of occupational work. This paper reports on a newly developed questionnaire for the assessment of ERI in household and family work. Analogous to the original version, it is divided into two components: (i) dysbalance of effort and reward (extrinsic component), and (ii) over-commitment (intrinsic components). The questionnaire was tested with data drawn from a clinical sample of mothers (n = 567) in rehabilitation clinics. Factor analyses have reproduced the two main dimensions "effort" and "reward". Relevant aspects of reward at home were (i) meaningfulness, (ii) social gratification, (iii) appreciation from the spouse, and (iv) affection for the child. Finally a 19-item questionnaire for assessing ERI in household and family work (ERI-M) and a four-item measure for measuring parental over-commitment (Over-M) are available. The psychometric properties of both instruments are good to satisfactory.

Publications in anesthesia journals: quality and clinical relevance.

PubMed

Lauritsen, Jakob; Moller, Ann M

2004-11-01

Clinicians performing evidence-based anesthesia rely on anesthesia journals for clinically relevant information. The objective of this study was to analyze the proportion of clinically relevant articles in five high impact anesthesia journals. We evaluated all articles published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anesthesia, Anesthesia, and Acta Anaesthesiologica Scandinavica from January to June, 2000. Articles were assessed and classified according to type, outcome, and design; 1379 articles consisting of 5468 pages were evaluated and categorized. The most common types of article were animal and laboratory research (31.2%) and randomized clinical trial (20.4%). A clinically relevant article was defined as an article that used a statistically valid method and had a clinically relevant end-point. Altogether 18.6% of the pages had as their subject matter clinically relevant trials. We compared the Journal Impact Factor (a measure of the number of citations per article in a journal) and the proportion of clinically relevant pages and found that they were inversely proportional to each other.

Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP Regeneration Workshop.

PubMed

Kim, David M; Neiva, Rodrigo

2015-02-01

Gingival augmentation procedures around natural teeth and dental implants are performed to facilitate plaque control, to improve patient comfort, to prevent future recession, and in conjunction with restorative, orthodontic, or prosthetic dentistry. The aim of this study is to answer the most common questions related to this treatment modality based on the most relevant and current knowledge in the field. Two reviewers worked to answer the five most common and clinically relevant questions with supporting literature to understand the role of gingiva around teeth. 1) What circumstances require an increased zone of keratinized tissue (KT), or is KT important? 2) What is the ideal thickness of an autogenous gingival graft? Is a thick autogenous gingival graft more effective than a thin autogenous gingival graft? 3) What are the alternatives to autogenous gingival grafting to increase the zone of attached gingiva? 4) Does orthodontic intervention affect soft tissue health and dimensions? 5) What is the patient-reported patient outcome for minimal KT compared with that for an enhanced zone of KT? An extensive literature search was performed using PubMed, the Cochrane Oral Health Group Specialized Trials Registry (the Cochrane Library), and the most respected journals in the field. Although gingival augmentation procedures were first introduced in 1960s, there have not been in-depth comparative studies examining the five questions that have been proposed by the authors. Lack of relevant systematic reviews and randomized clinical trials (RCTs) on this topic do not allow authors to answer those questions with a strong level of evidence. However, the following can be recommended after reviewing case reports and case series on these topics. 1) There is enough clinical evidence to support maintaining an adequate band of gingiva for intracrevicular margin restoration. 2) Thick grafts do not appear to result in better clinical outcomes than thin grafts. Thick grafts are likely to result in more primary contraction, whereas thin grafts tend to be prone to secondary contraction. 3) Viable alternative treatment modalities are currently available that are capable of providing KT augmentation without the need for palatal donor tissue. 4) Appropriately applied orthodontic forces do not cause permanent damage to a healthy periodontium. The probability of recession during tooth movement in thin biotype is high to justify gingival augmentation when the dimension of gingiva is inadequate. In addition, cases in which there will be a facial tooth movement outside of the alveolar process need to be considered for a gingival augmentation procedure. 5) Although the articles that have been published on this topic did not consider patient-reported outcomes and esthetics as part of the overall treatment success assessment, patients who have received alternative treatment modalities that did not depend on palatal tissue harvesting appear to have reported more satisfaction and less discomfort after treatment. Autogenous gingival grafts are still considered to be the "gold standard" procedure with unmatched success rates and clinical success when gingival augmentation procedures are required. However, tissue-engineered materials may offer viable options to palatal tissue harvesting for gingival augmentation. KT augmentation may prevent the development and progression of gingival recession, especially when restorative margins may interact with the periodontium and/or orthodontic treatment is indicated. Patient-reported outcomes should be considered for future studies on this topic. Additional RCTs and systematic reviews are needed to support these conclusions.

Stakeholder-based evaluation categories for regional climate services - a case study at the German Baltic Sea coast

NASA Astrophysics Data System (ADS)

Meinke, Insa

2017-08-01

In this study, categories, dimensions, and criteria for evaluating regional climate services are derived by a participatory approach with potential service users at the German Baltic Sea coast. The development is carried out within nine face-to-face interviews conducted with decision makers, working in climate sensitive sectors at the German Baltic Sea coast. Three main groups of categories were localized which seem to matter most to the considered stakeholders and which seem to be crucial evaluation categories for regional climate services: (1) credibility, (2) relevance, and (3) appropriateness. For each of these evaluation categories several dimensions emerged, indicating certain perspectives of stakeholder demands. When summarizing these evaluation categories and their dimensions, 13 evaluation criteria for regional climate services can be derived (see Table 1). The results show that stakeholders do mainly address components other than those found in the literature (e.g. inputs, process, outputs, outcomes, and impacts). This might indicate that an evaluation, following solely literature-based (non-participative) components, is not sufficient to localize deficiencies or efficiencies within a regional climate service, since it might lead to results which are not relevant for potential users.

Face Adaptation Effects: Reviewing the Impact of Adapting Information, Time, and Transfer

PubMed Central

Strobach, Tilo; Carbon, Claus-Christian

2013-01-01

The ability to adapt is essential to live and survive in an ever-changing environment such as the human ecosystem. Here we review the literature on adaptation effects of face stimuli to give an overview of existing findings in this area, highlight gaps in its research literature, initiate new directions in face adaptation research, and help to design future adaptation studies. Furthermore, this review should lead to better understanding of the processing characteristics as well as the mental representations of face-relevant information. The review systematizes studies at a behavioral level in respect of a framework which includes three dimensions representing the major characteristics of studies in this field of research. These dimensions comprise (1) the specificity of adapting face information, e.g., identity, gender, or age aspects of the material to be adapted to (2) aspects of timing (e.g., the sustainability of adaptation effects) and (3) transfer relations between face images presented during adaptation and adaptation tests (e.g., images of the same or different identities). The review concludes with options for how to combine findings across different dimensions to demonstrate the relevance of our framework for future studies. PMID:23760550

Hand anthropometry survey of rural farm workers in south-eastern Nigeria.

PubMed

Obi, Okey Francis

2016-04-01

The importance of hand anthropometry as it relates to design of hand tools particularly for farm workers have been established; however, anthropometric data for this group of agricultural workers have continued to remain scarce. A survey of hand anthropometry relevant in design of agricultural hand tools was carried out on 200 male and 100 female adult farm workers in south-eastern Nigeria. Comparison of the male and female data obtained showed that male dimensions were higher than that recorded for the females. The hand anthropometric data of the male and female farm workers were compared with that of other populations but no clear distinction was observed. It was however clear that the following hand dimensions, 2nd Joint to root digit 3 and width at tip digit 3 recorded for Nigerian farm workers were highest and lowest, respectively, compared to other populations. Practitioner Summary: Hand anthropometric data relevant in design of hand tools have continued to remain scarce particularly for farm workers. Hand anthropometry survey of farm workers carried out in south-eastern Nigeria revealed higher dimensions for males than females; however, no clear distinction was observed in comparison with other populations.

From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic's Service Perspective.

PubMed

Kim, Minseong; Koo, Dong-Woo; Shin, Dong-Jin; Lee, Sae-Mi

2017-01-01

Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics' servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics' servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists' loyalty to a medical clinic.

From psychiatric disorders to animal models: a bidirectional and dimensional approach

PubMed Central

Donaldson, Zoe. R.; Hen, René

2014-01-01

Psychiatric genetics research is bidirectional in nature, with human and animal studies becoming more closely integrated as techniques for genetic manipulations allow for more subtle exploration of disease phenotypes. This synergy, however, highlights the importance of considering the way in which we approach the genotype-phenotype relationship. In particular, the nosological divide of psychiatric illness, while clinically relevant, is not directly translatable in animal models. For instance, mice will never fully re-capitulate the broad criteria for many psychiatric disorders; nor will they have guilty ruminations, suicidal thoughts, or rapid speech. Instead, animal models have been and continue to provide a means to explore dimensions of psychiatric disorders in order to identify neural circuits and mechanisms underlying disease-relevant phenotypes. Thus, the genetic investigation of psychiatric illness will yield the greatest insights if efforts continue to identify and utilize biologically valid phenotypes across species. In this review we discuss the progress to date and the future efforts that will enhance translation between human and animal studies, including the identification of intermediate phenotypes that can be studied across species, as well as the importance of refined modeling of human disease-associated genetic variation in mice and other animal models. PMID:24650688

A targeted metabolomics approach for clinical diagnosis of inborn errors of metabolism.

PubMed

Jacob, Minnie; Malkawi, Abeer; Albast, Nour; Al Bougha, Salam; Lopata, Andreas; Dasouki, Majed; Abdel Rahman, Anas M

2018-09-26

Metabolome, the ultimate functional product of the genome, can be studied through identification and quantification of small molecules. The global metabolome influences the individual phenotype through clinical and environmental interventions. Metabolomics has become an integral part of clinical research and allowed for another dimension of better understanding of disease pathophysiology and mechanism. More than 95% of the clinical biochemistry laboratory routine workload is based on small molecular identification, which can potentially be analyzed through metabolomics. However, multiple challenges in clinical metabolomics impact the entire workflow and data quality, thus the biological interpretation needs to be standardized for a reproducible outcome. Herein, we introduce the establishment of a comprehensive targeted metabolomics method for a panel of 220 clinically relevant metabolites using Liquid chromatography-tandem mass spectrometry (LC-MS/MS) standardized for clinical research. The sensitivity, reproducibility and molecular stability of each targeted metabolite (amino acids, organic acids, acylcarnitines, sugars, bile acids, neurotransmitters, polyamines, and hormones) were assessed under multiple experimental conditions. The metabolic tissue distribution was determined in various rat organs. Furthermore, the method was validated in dry blood spot (DBS) samples collected from patients known to have various inborn errors of metabolism (IEMs). Using this approach, our panel appears to be sensitive and robust as it demonstrated differential and unique metabolic profiles in various rat tissues. Also, as a prospective screening method, this panel of diverse metabolites has the ability to identify patients with a wide range of IEMs who otherwise may need multiple, time-consuming and expensive biochemical assays causing a delay in clinical management. Copyright © 2018 Elsevier B.V. All rights reserved.

Oxidative stress biomarkers and clinical dimensions in first 10 years of schizophrenia.

PubMed

González-Blanco, Leticia; García-Portilla, María Paz; García-Álvarez, Leticia; de la Fuente-Tomás, Lorena; Iglesias García, Celso; Sáiz, Pilar A; Rodríguez-González, Susana; Coto-Montes, Ana; Bobes, Julio

2018-04-21

Several studies have described increased oxidative stress parameters in patients with schizophrenia. The objectives of the current study were to identify potential oxidative stress biomarkers in stable patients during first 10 years of schizophrenia and determine if they are associated with specific clinical dimensions. Seventy-three clinically stable outpatients with schizophrenia and 73 sex and age-matched healthy controls were recruited. Sociodemographic, clinical and biological data were collected at enrollment. Blood biomarkers included homocysteine, the percentage of hemolysis, lipid peroxidation subproducts, and as an antioxidant biomarker, catalase activity in erythrocytes. Comparative analyses after controlling for smoking and metabolic syndrome evidenced a significant increase in catalase activity in patients. Also, lower lipid peroxidation levels showed an association with negative symptoms. In conclusion, compensatory antioxidant mechanisms might be increased in stable patients with schizophrenia at early stages. Furthermore, there may be an inverse relationship between oxidative stress and negative dimension. Copyright © 2018 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Explaining low rates of sustained use of siphon water filter: evidence from follow-up of a randomised controlled trial in Bangladesh.

PubMed

Najnin, Nusrat; Arman, Shaila; Abedin, Jaynal; Unicomb, Leanne; Levine, David I; Mahmud, Minhaj; Leder, Karin; Yeasmin, Farzana; Luoto, Jill E; Albert, Jeff; Luby, Stephen P

2015-04-01

To assess sustained siphon filter usage among a low-income population in Bangladesh and study relevant motivators and barriers. After a randomised control trial in Bangladesh during 2009, 191 households received a siphon water filter along with educational messages. Researchers revisited households after 3 and 6 months to assess filter usage and determine relevant motivators and barriers. Regular users were defined as those who reported using the filter most of the time and were observed to be using the filter at follow-up visits. Integrated behavioural model for water, sanitation and hygiene (IBM-WASH) was used to explain factors associated with regular filter use. Regular filter usage was 28% at the 3-month follow-up and 21% at the 6-month follow-up. Regular filter users had better quality water at the 6-month, but not at the 3-month visit. Positive predictors of regular filter usage explained through IBM-WASH at both times were willingness to pay >US$1 for filters, and positive attitude towards filter use (technology dimension at individual level); reporting boiling drinking water at baseline (psychosocial dimension at habitual level); and Bengali ethnicity (contextual dimension at individual level). Frequently reported barriers to regular filter use were as follows: considering filter use an additional task, filter breakage and time required for water filtering (technology dimension at individual level). The technological, psychosocial and contextual dimensions of IBM-WASH contributed to understanding the factors related to sustained use of siphon filter. Given the low regular usage rate and the hardware-related problems reported, the contribution of siphon filters to improving water quality in low-income urban communities in Bangladesh is likely to be minimal. © 2014 John Wiley & Sons Ltd.

Anatomy of the Adductor Magnus Origin

PubMed Central

Obey, Mitchel R.; Broski, Stephen M.; Spinner, Robert J.; Collins, Mark S.; Krych, Aaron J.

2016-01-01

Background: The adductor magnus (AM) has historically been a potential source of confusion in patients with suspected proximal hamstring avulsion injuries. Purpose: To investigate the anatomic characteristics of the AM, including its osseous origin, anatomic dimensions, and relationship to the proximal hamstring tendons. Study Design: Descriptive laboratory study. Methods: Dissection of the AM origin was performed in 11 (8 cadavers) fresh-frozen hip-to-foot cadaveric hemipelvis specimens. The gross anatomy and architecture of the proximal hamstring and AM tendons were studied. After dissecting the hamstring tendons away from their origin, the dimension, shape, and orientation of the tendon footprints on the ischial tuberosity were determined. Results: The AM was identified in all cadaveric specimens. The mean tendon thickness (anterior to posterior [AP]) was 5.7 ± 2.9 mm. The mean tendon width (medial to lateral [ML]) was 7.1 ± 2.2 mm. The mean tendon length was 13.1 ± 8.7 cm. The mean footprint height (AP dimension) was 12.1 ± 2.9 mm, and mean footprint width (ML dimension) was 17.3 ± 7.1 mm. The mean distance between the AM footprint and the most medial aspect of the conjoint tendon footprint was 8.5 ± 4.2 mm. Tendon measurements demonstrated a considerable degree of both intra- and interspecimen variability. Conclusion: The AM tendon is consistently present just medial to the conjoint tendon at the ischial tuberosity, representing the lateral-most portion of the AM muscle. This study found wide variation in the dimensional characteristics of the AM tendon between specimens. Its shape and location can mimic the appearance of an intact hamstring (conjoint or semimembranosus) tendon intraoperatively or on diagnostic imaging, potentially misleading surgeons and radiologists. Therefore, detailed knowledge of the AM tendon anatomy, footprint anatomy, and its relationship to the hamstring muscle complex is paramount when planning surgical approach and technique. Clinical Relevance: The reported data may aid surgeons in more accurate recognition, diagnosis, and repair of proximal hamstring avulsion injuries. PMID:26798764

Dimensions of the scala tympani in the human and cat with reference to cochlear implants.

PubMed

Hatsushika, S; Shepherd, R K; Tong, Y C; Clark, G M; Funasaka, S

1990-11-01

The width, height, and cross-sectional area of the scala tympani in both the human and cat were measured to provide dimensional information relevant to the design of scala tympani electrode arrays. Both the height and width of the human scala tympani decreased rapidly within the first 1.5 mm from the round window. Thereafter, they exhibit a gradual reduction in their dimension with increasing distance from the round window. The cross-sectional area of the human scala tympani reflects the changes observed in both the height and width. In contrast, the cat scala tympani exhibits a rapid decrease in its dimensions over the first 6 to 8 mm from the round window. However, beyond this point the cat scala tympani also exhibits a more gradual decrease in its dimensions. Finally, the width of the scala tympani, in both human and cat, is consistently greater than the height.

Perturbative search for dead-end CFTs

DOE PAGES

Nakayama, Yu

2015-05-08

To explore the possibility of self-organized criticality, we look for CFTs without any relevant scalar deformations (a.k.a. dead-end CFTs) within power-counting renormalizable quantum field theories with a weakly coupled Lagrangian description. In three dimensions, the only candidates are pure (Abelian) gauge theories, which may be further deformed by Chern-Simons terms. In four dimensions, we show that there are infinitely many non-trivial candidates based on chiral gauge theories. Using the three-loop beta functions, we compute the gap of scaling dimensions above the marginal value, and it can be as small as O(10 –5) and robust against the perturbative corrections. These classesmore » of candidates are very weakly coupled and our perturbative conclusion seems difficult to refute. Furthermore, the hypothesis that non-trivial dead-end CFTs do not exist is likely to be false in four dimensions.« less

Perturbative search for dead-end CFTs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakayama, Yu

To explore the possibility of self-organized criticality, we look for CFTs without any relevant scalar deformations (a.k.a. dead-end CFTs) within power-counting renormalizable quantum field theories with a weakly coupled Lagrangian description. In three dimensions, the only candidates are pure (Abelian) gauge theories, which may be further deformed by Chern-Simons terms. In four dimensions, we show that there are infinitely many non-trivial candidates based on chiral gauge theories. Using the three-loop beta functions, we compute the gap of scaling dimensions above the marginal value, and it can be as small as O(10 –5) and robust against the perturbative corrections. These classesmore » of candidates are very weakly coupled and our perturbative conclusion seems difficult to refute. Furthermore, the hypothesis that non-trivial dead-end CFTs do not exist is likely to be false in four dimensions.« less

Dual Character Concepts in Social Cognition: Commitments and the Normative Dimension of Conceptual Representation.

PubMed

Del Pinal, Guillermo; Reuter, Kevin

2017-04-01

The concepts expressed by social role terms such as artist and scientist are unique in that they seem to allow two independent criteria for categorization, one of which is inherently normative (Knobe, Prasada, & Newman, 2013). This study presents and tests an account of the content and structure of the normative dimension of these "dual character concepts." Experiment 1 suggests that the normative dimension of a social role concept represents the commitment to fulfill the idealized basic function associated with the role. Background information can affect which basic function is associated with each social role. However, Experiment 2 indicates that the normative dimension always represents the relevant commitment as an end in itself. We argue that social role concepts represent the commitments to basic functions because that information is crucial to predict the future social roles and role-dependent behavior of others. Copyright © 2016 Cognitive Science Society, Inc.

Multiple identities in Northern Ireland: hierarchical ordering in the representation of group membership.

PubMed

Crisp, R J; Hewstone, M; Cairns, E

2001-12-01

A study was conducted to explore whether participants in Northern Ireland attend to, and process information about, different group members as a function of a single dimension of category membership (religion) or as a function of additional and/or alternative bases for group membership. Utilizing a bogus 'newspaper story' paradigm, we explored whether participants would differentially recall target attributes as a function of two dimensions of category membership. Findings from this recall measure suggested that information concerning ingroup and outgroup members was processed as an interactive function of both religion and gender intergroup dimensions. Religion was only used to guide processing of more specific information if the story character was also an outgroup member on the gender dimension. These findings suggest a complex pattern of intergroup representation in the processing of group-relevant information in the Northern Irish context.

A Relational Encoding of a Conceptual Model with Multiple Temporal Dimensions

NASA Astrophysics Data System (ADS)

Gubiani, Donatella; Montanari, Angelo

The theoretical interest and the practical relevance of a systematic treatment of multiple temporal dimensions is widely recognized in the database and information system communities. Nevertheless, most relational databases have no temporal support at all. A few of them provide a limited support, in terms of temporal data types and predicates, constructors, and functions for the management of time values (borrowed from the SQL standard). One (resp., two) temporal dimensions are supported by historical and transaction-time (resp., bitemporal) databases only. In this paper, we provide a relational encoding of a conceptual model featuring four temporal dimensions, namely, the classical valid and transaction times, plus the event and availability times. We focus our attention on the distinctive technical features of the proposed temporal extension of the relation model. In the last part of the paper, we briefly show how to implement it in a standard DBMS.

Quality Perception of the 2012 World Indoor Athletics Championships

PubMed Central

2016-01-01

Abstract The objective of this study was to compare the views of spectators concerning the quality perception of the World Indoor Athletics Championships. The study group consisted of 568 spectators who watched the events. A measurement scale of event quality in spectator sports (SEQSS) developed by Ko et al. (2011) was used as a data collection tool in the study. In order to determine the views of the spectators concerning the quality of the Indoor Athletics Championships, the dimensions constituting the scale were compared according to the demographic features of the sample group. As a consequence, important differences in most of the dimensions of the scale were revealed with respect to the demographic data of the subjects. The most relevant finding of the study is that the dimension of “physical environment quality”, which is one of the dimensions constituting the event quality, differed significantly in all comparisons that were made according to demographic features. PMID:28031769

Dimensions of motor vehicle crash risk

DOT National Transportation Integrated Search

1999-05-01

A valid assessment of motor vehicle crash risks and the potential impact of safety interventions requires a precise understanding of the types of vehicles likely to be equipped and otherwise affected, the most relevant referent to the intervention (e...

Attentional Selection Can Be Predicted by Reinforcement Learning of Task-relevant Stimulus Features Weighted by Value-independent Stickiness.

PubMed

Balcarras, Matthew; Ardid, Salva; Kaping, Daniel; Everling, Stefan; Womelsdorf, Thilo

2016-02-01

Attention includes processes that evaluate stimuli relevance, select the most relevant stimulus against less relevant stimuli, and bias choice behavior toward the selected information. It is not clear how these processes interact. Here, we captured these processes in a reinforcement learning framework applied to a feature-based attention task that required macaques to learn and update the value of stimulus features while ignoring nonrelevant sensory features, locations, and action plans. We found that value-based reinforcement learning mechanisms could account for feature-based attentional selection and choice behavior but required a value-independent stickiness selection process to explain selection errors while at asymptotic behavior. By comparing different reinforcement learning schemes, we found that trial-by-trial selections were best predicted by a model that only represents expected values for the task-relevant feature dimension, with nonrelevant stimulus features and action plans having only a marginal influence on covert selections. These findings show that attentional control subprocesses can be described by (1) the reinforcement learning of feature values within a restricted feature space that excludes irrelevant feature dimensions, (2) a stochastic selection process on feature-specific value representations, and (3) value-independent stickiness toward previous feature selections akin to perseveration in the motor domain. We speculate that these three mechanisms are implemented by distinct but interacting brain circuits and that the proposed formal account of feature-based stimulus selection will be important to understand how attentional subprocesses are implemented in primate brain networks.

Generalized Knudsen Number for Unsteady Fluid Flow.

PubMed

Kara, V; Yakhot, V; Ekinci, K L

2017-02-17

We explore the scaling behavior of an unsteady flow that is generated by an oscillating body of finite size in a gas. If the gas is gradually rarefied, the Navier-Stokes equations begin to fail and a kinetic description of the flow becomes more appropriate. The failure of the Navier-Stokes equations can be thought to take place via two different physical mechanisms: either the continuum hypothesis breaks down as a result of a finite size effect or local equilibrium is violated due to the high rate of strain. By independently tuning the relevant linear dimension and the frequency of the oscillating body, we can experimentally observe these two different physical mechanisms. All the experimental data, however, can be collapsed using a single dimensionless scaling parameter that combines the relevant linear dimension and the frequency of the body. This proposed Knudsen number for an unsteady flow is rooted in a fundamental symmetry principle, namely, Galilean invariance.

Generalized Knudsen Number for Unsteady Fluid Flow

NASA Astrophysics Data System (ADS)

Kara, V.; Yakhot, V.; Ekinci, K. L.

2017-02-01

We explore the scaling behavior of an unsteady flow that is generated by an oscillating body of finite size in a gas. If the gas is gradually rarefied, the Navier-Stokes equations begin to fail and a kinetic description of the flow becomes more appropriate. The failure of the Navier-Stokes equations can be thought to take place via two different physical mechanisms: either the continuum hypothesis breaks down as a result of a finite size effect or local equilibrium is violated due to the high rate of strain. By independently tuning the relevant linear dimension and the frequency of the oscillating body, we can experimentally observe these two different physical mechanisms. All the experimental data, however, can be collapsed using a single dimensionless scaling parameter that combines the relevant linear dimension and the frequency of the body. This proposed Knudsen number for an unsteady flow is rooted in a fundamental symmetry principle, namely, Galilean invariance.

Deformations of superconformal theories

DOE PAGES

Córdova, Clay; Dumitrescu, Thomas T.; Intriligator, Kenneth

2016-11-22

Here, we classify possible supersymmetry-preserving relevant, marginal, and irrelevant deformations of unitary superconformal theories in d ≥ 3 dimensions. Our method only relies on symmetries and unitarity. Hence, the results are model independent and do not require a Lagrangian description. Two unifying themes emerge: first, many theories admit deformations that reside in multiplets together with conserved currents. Such deformations can lead to modifications of the supersymmetry algebra by central and noncentral charges. Second, many theories with a sufficient amount of supersymmetry do not admit relevant or marginal deformations, and some admit neither. The classification is complicated by the fact thatmore » short superconformal multiplets display a rich variety of sporadic phenomena, including supersymmetric deformations that reside in the middle of a multiplet. We illustrate our results with examples in diverse dimensions. In particular, we explain how the classification of irrelevant supersymmetric deformations can be used to derive known and new constraints on moduli-space effective actions.« less

Topological dimension tunes activity patterns in hierarchical modular networks

NASA Astrophysics Data System (ADS)

Safari, Ali; Moretti, Paolo; Muñoz, Miguel A.

2017-11-01

Connectivity patterns of relevance in neuroscience and systems biology can be encoded in hierarchical modular networks (HMNs). Recent studies highlight the role of hierarchical modular organization in shaping brain activity patterns, providing an excellent substrate to promote both segregation and integration of neural information. Here, we propose an extensive analysis of the critical spreading rate (or ‘epidemic’ threshold)—separating a phase with endemic persistent activity from one in which activity ceases—on diverse HMNs. By employing analytical and computational techniques we determine the nature of such a threshold and scrutinize how it depends on general structural features of the underlying HMN. We critically discuss the extent to which current graph-spectral methods can be applied to predict the onset of spreading in HMNs and, most importantly, we elucidate the role played by the network topological dimension as a relevant and unifying structural parameter, controlling the epidemic threshold.

Spanish validation of the adult Attention Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS): relevance of clinical subtypes.

PubMed

Richarte, Vanesa; Corrales, Montserrat; Pozuelo, Marian; Serra-Pla, Juanfran; Ibáñez, Pol; Calvo, Eva; Corominas, Margarida; Bosch, Rosa; Casas, Miquel; Ramos-Quiroga, Josep Antoni

Adult attention deficit hyperactivity disorder (ADHD) has a prevalence between 2.5% and 4% of the general adult population. Over the past few decades, self-report measures have been developed for the current evaluation of adult ADHD. The ADHD-RS is a 18-items scale self-report version for assessing symptoms for ADHD DSM-IV. A validation of Spanish version of the ADHD-RS was performed. The sample consisted of 304 adult with ADHD and 94 controls. A case control study was carried out (adult ADHD vs. non ADHD). The diagnosis of ADHD was evaluated with the Structured Clinical Interview for DSM-IV (SCID-I) and the Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID-II). To determinate the internal validity of the two dimensions structure of ADHD-RS an exploratory factor analysis was performed. The α-coefficients were taken as a measure of the internal consistency of the dimensions considered. A logistic regression study was carried out to evaluate the model in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV). Average age was 33.29 (SD=10.50) and 66% of subjects were men (there were no significant differences between the two groups). Factor analysis was done with a principal component analysis followed by a normalized varimax rotation. The Kaiser-Meyer-Olkin measure of sampling adequacy tests was .868 (remarkable) and the Bartlett's test of sphericity was 2 (153)=1,835.76, P<.0005, indicating the appropriateness of the factor analysis. This two-factor model accounted for 37.81% of the explained variance. The α-coefficient of the two factors was .84 and .82. The original strategy proposed 24 point for cut-off: sensitivity (81.9%), specificity (74.7%), PPV (50.0%), NPV (93.0%), kappa coefficient .78 and area under the curve (AUC) .89. The new score strategy proposed by our group suggests different cut-off for different clinical presentations. The 24 point is the best cut-off for ADHD combined presentation: sensitivity (81.9%), specificity (87.3%), PPV (78.6%), NPV (89.4%), kappa coefficient .88 and AUC .94, and 21 point is the best cut-off for ADHD predominantly inattentive presentation: sensitivity (70.2%), specificity (76.1%), PPV (71.7%), NPV (74.8%), kappa coefficient .88 and AUC .94. In this study, the Spanish version of the ADHD-RS is a valid scale to discriminate between ADHD adults and controls. The new proposed score strategy suggests the relevance of clinical presentations in the different cut-offs selected. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

An optimised protocol for isolation of RNA from small sections of laser-capture microdissected FFPE tissue amenable for next-generation sequencing.

PubMed

Amini, Parisa; Ettlin, Julia; Opitz, Lennart; Clementi, Elena; Malbon, Alexandra; Markkanen, Enni

2017-08-23

Formalin-fixed paraffin embedded (FFPE) tissue constitutes a vast treasury of samples for biomedical research. Thus far however, extraction of RNA from FFPE tissue has proved challenging due to chemical RNA-protein crosslinking and RNA fragmentation, both of which heavily impact on RNA quantity and quality for downstream analysis. With very small sample sizes, e.g. when performing Laser-capture microdissection (LCM) to isolate specific subpopulations of cells, recovery of sufficient RNA for analysis with reverse-transcription quantitative PCR (RT-qPCR) or next-generation sequencing (NGS) becomes very cumbersome and difficult. We excised matched cancer-associated stroma (CAS) and normal stroma from clinical specimen of FFPE canine mammary tumours using LCM, and compared the commonly used protease-based RNA isolation procedure with an adapted novel technique that additionally incorporates a focused ultrasonication step. We successfully adapted a protocol that uses focused ultrasonication to isolate RNA from small amounts of deparaffinised, stained, clinical LCM samples. Using this approach, we found that total RNA yields could be increased by 8- to 12-fold compared to a commonly used protease-based extraction technique. Surprisingly, RNA extracted using this new approach was qualitatively at least equal if not superior compared to the old approach, as Cq values in RT-qPCR were on average 2.3-fold lower using the new method. Finally, we demonstrate that RNA extracted using the new method performs comparably in NGS as well. We present a successful isolation protocol for extraction of RNA from difficult and limiting FFPE tissue samples that enables successful analysis of small sections of clinically relevant specimen. The possibility to study gene expression signatures in specific small sections of archival FFPE tissue, which often entail large amounts of highly relevant clinical follow-up data, unlocks a new dimension of hitherto difficult-to-analyse samples which now become amenable for investigation.

Evaluation of perceived and actual competency in a family medicine objective structured clinical examination

PubMed Central

Graves, Lisa; Lalla, Leonora; Young, Meredith

2017-01-01

Abstract Objective To examine the relationship between objective assessment of performance and self-rated competence immediately before and after participation in a required summative family medicine clerkship objective structured clinical examination (OSCE). Design Learners rated their competence (on a 7-point Likert scale) before and after an OSCE along 3 dimensions: general, specific, and professional competencies relevant to family medicine. Setting McGill University in Montreal, Que. Participants All 168 third-year clinical clerks completing their mandatory family medicine rotation in 2010 to 2011 were invited to participate. Main outcome measures Self-ratings of competence and objective performance scores were compared, and were examined to determine if OSCEs could be a “corrective” tool for self-rating perceived competence (ie, if the experience of undergoing an assessment might assist learners in recalibrating their understanding of their own performance). Results A total of 140 (83%) of the third-year clinical clerks participated. Participating in an OSCE decreased learners’ ratings of perceived competence (pre-OSCE score = 4.9, post-OSCE score = 4.7; F1,3192 = 4.2; P < .05). Learners’ mean self-rated competence for all categories of behaviour (before and after) showed no relationship to OSCE performance (r < 0.12 and P > .08 for all), nor did ratings of station-relevant competence (before and after) (r < 0.19 and P > .09 for all). Ratings of competence before and after the OSCE were correlated for individual students (r > 0.40 and P < .001 for all). Conclusion After the OSCE, students’ self-ratings of perceived competence had decreased, and these ratings had little relationship to actual performance, regardless of the specificity of the rated competency. Discordance between perceived and actual competence is neither novel nor unique to family medicine. However, this discordance is an important consideration for the development of competency-based curricula. PMID:28404722

Evaluation of perceived and actual competency in a family medicine objective structured clinical examination.

PubMed

Graves, Lisa; Lalla, Leonora; Young, Meredith

2017-04-01

To examine the relationship between objective assessment of performance and self-rated competence immediately before and after participation in a required summative family medicine clerkship objective structured clinical examination (OSCE). Learners rated their competence (on a 7-point Likert scale) before and after an OSCE along 3 dimensions: general, specific, and professional competencies relevant to family medicine. McGill University in Montreal, Que. All 168 third-year clinical clerks completing their mandatory family medicine rotation in 2010 to 2011 were invited to participate. Self-ratings of competence and objective performance scores were compared, and were examined to determine if OSCEs could be a "corrective" tool for self-rating perceived competence (ie, if the experience of undergoing an assessment might assist learners in recalibrating their understanding of their own performance). A total of 140 (83%) of the third-year clinical clerks participated. Participating in an OSCE decreased learners' ratings of perceived competence (pre-OSCE score = 4.9, post-OSCE score = 4.7; F 1,3192 = 4.2; P  < .05). Learners' mean self-rated competence for all categories of behaviour (before and after) showed no relationship to OSCE performance ( r < 0.12 and P > .08 for all), nor did ratings of station-relevant competence (before and after) ( r < 0.19 and P > .09 for all). Ratings of competence before and after the OSCE were correlated for individual students ( r > 0.40 and P < .001 for all). After the OSCE, students' self-ratings of perceived competence had decreased, and these ratings had little relationship to actual performance, regardless of the specificity of the rated competency. Discordance between perceived and actual competence is neither novel nor unique to family medicine. However, this discordance is an important consideration for the development of competency-based curricula. Copyright© the College of Family Physicians of Canada.

Disentangling Heterogeneity of Childhood Disruptive Behavior Problems Into Dimensions and Subgroups.

PubMed

Bolhuis, Koen; Lubke, Gitta H; van der Ende, Jan; Bartels, Meike; van Beijsterveldt, Catharina E M; Lichtenstein, Paul; Larsson, Henrik; Jaddoe, Vincent W V; Kushner, Steven A; Verhulst, Frank C; Boomsma, Dorret I; Tiemeier, Henning

2017-08-01

Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions. Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n = 6,209) and 10 (n = 4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n = 4,402, and Swedish Twin Study of Child and Adolescent Development, n = 1,089) and a clinical sample (n = 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist. Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16). This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuroimaging and genetic measures. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Penile Dimensions of Diabetic and Nondiabetic Men With Erectile Dysfunction: A Case-Control Study.

PubMed

Salama, Nader

2018-05-01

This study aimed to report penile dimensions in diabetic and nondiabetic men with erectile dysfunction (ED) and correlate their dimensions with other study variables. A case-control study was designed through retrospective data analysis of diabetic and nondiabetic patients consulting for ED and a control group ( n = 105, each group). Study data retrieved included history, clinical evaluation, and penile dimensions (pendulous length [PL], total length [TL], and circumference [CF]) at flaccid and erect states. Results identified that patients had lower values (mean, cm) for almost all penile dimensions. The diabetic patients identified significant differences in most dimensions, whether in flaccid (PL: 7.46 vs. 7.51 and 7.81, p = .11; TL: 11.8 vs. 12.77 and 12.88, p = .000; CF: 8.84 vs. 9.1 and 9.14, p = .016) or erect state (PL: 9.66 vs. 9.61 and 10, p = .092; TL: 13.96 vs. 14.88 and 15.04, p = .000; CF: 11.56 vs. 12.06 and 11.92, p = .018) as compared with the nondiabetic patients and controls, respectively. No significant correlation was detected between the dimensions and age, durations of diabetes and ED, or erectile function scores. In conclusion, diabetic and nondiabetic patients with ED presented, in varying degrees, significant decline in their penile dimensions, and this was more prevalent in diabetic patients. As changes in penile size could be a silent corollary of comorbidities, monitoring the changes in penile dimensions should be an important component of the clinical checkup of any patient with ED, especially a diabetic patient.

Penile Dimensions of Diabetic and Nondiabetic Men With Erectile Dysfunction: A Case–Control Study

PubMed Central

Salama, Nader

2015-01-01

This study aimed to report penile dimensions in diabetic and nondiabetic men with erectile dysfunction (ED) and correlate their dimensions with other study variables. A case–control study was designed through retrospective data analysis of diabetic and nondiabetic patients consulting for ED and a control group (n = 105, each group). Study data retrieved included history, clinical evaluation, and penile dimensions (pendulous length [PL], total length [TL], and circumference [CF]) at flaccid and erect states. Results identified that patients had lower values (mean, cm) for almost all penile dimensions. The diabetic patients identified significant differences in most dimensions, whether in flaccid (PL: 7.46 vs. 7.51 and 7.81, p = .11; TL: 11.8 vs. 12.77 and 12.88, p = .000; CF: 8.84 vs. 9.1 and 9.14, p = .016) or erect state (PL: 9.66 vs. 9.61 and 10, p = .092; TL: 13.96 vs. 14.88 and 15.04, p = .000; CF: 11.56 vs. 12.06 and 11.92, p = .018) as compared with the nondiabetic patients and controls, respectively. No significant correlation was detected between the dimensions and age, durations of diabetes and ED, or erectile function scores. In conclusion, diabetic and nondiabetic patients with ED presented, in varying degrees, significant decline in their penile dimensions, and this was more prevalent in diabetic patients. As changes in penile size could be a silent corollary of comorbidities, monitoring the changes in penile dimensions should be an important component of the clinical checkup of any patient with ED, especially a diabetic patient. PMID:26130730

Healthcare professionals' agreement on clinical relevance of drug-related problems among elderly patients.

PubMed

Bech, Christine Flagstad; Frederiksen, Tine; Villesen, Christine Tilsted; Højsted, Jette; Nielsen, Per Rotbøll; Kjeldsen, Lene Juel; Nørgaard, Lotte Stig; Christrup, Lona Louring

2018-02-01

Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems' clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss' κ. Main outcome measure Healthcare professionals' agreement on clinical relevance of drug related problems, using Fleiss' κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0-2) and 46% of higher clinical relevance (level 3-4). Only slight agreement (κ = 0.12) was found between the panellists' classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.

The factor structure and clinical utility of formal thought disorder in first episode psychosis.

PubMed

Roche, Eric; Lyne, John Paul; O'Donoghue, Brian; Segurado, Ricardo; Kinsella, Anthony; Hannigan, Ailish; Kelly, Brendan D; Malone, Kevin; Clarke, Mary

2015-10-01

Formal thought disorder (FTD) is a core feature of psychosis, however there are gaps in our knowledge about its prevalence and factor structure. We had two aims: first, to establish the factor structure of FTD; second, to explore the clinical utility of dimensions of FTD in order to further the understanding of its nosology. A cross-validation study was undertaken to establish the factor structure of FTD in first episode psychosis (FEP). The relative utility of FTD categories vs. dimensions across diagnostic categories was investigated. The prevalence of clinically significant FTD in this FEP sample was 21%, although 41% showed evidence of disorganised speech, 20% displayed verbosity and 24% displayed impoverished speech. A 3-factor model was identified as the best fit for FTD, with disorganisation, poverty and verbosity dimensions (GFI=0.99, RMR=0.07). These dimensions of FTD accurately distinguished affective from non-affective diagnostic categories. A categorical approach to FTD assessment was useful in identifying markers of clinical acuteness, as identified by short duration of untreated psychosis (OR=2.94, P<0.01) and inpatient treatment status (OR=3.98, P<0.01). FTD is moderately prevalent and multi-dimensional in FEP. Employing both a dimensional and categorical assessment of FTD gives valuable clinical information, however there may be a need to revise our conceptualisation of the nosology of FTD. The prognostic value of FTD, as well as its neural basis, requires elucidation. Copyright © 2015 Elsevier B.V. All rights reserved.

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

PubMed Central

Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian

2017-01-01

Purpose Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. Method A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. Results In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. Conclusion The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention. PMID:28704377

Understanding critical barriers to implementing a clinical information system in a nursing home through the lens of a socio-technical perspective.

PubMed

Or, Calvin; Dohan, Michael; Tan, Joseph

2014-09-01

This paper addresses key barriers to implementing a clinical information system (CIS) in a Hong Kong nursing home setting, from a healthcare specific socio-technical perspective. Data was collected through field observations (n = 12) and semi-structured individual interviews (n = 18) of CIS stakeholders in a Hong Kong nursing home, and analyzed using the immersion/crystallization approach. Complex interactions relevant to our case were contextualized and interpreted within the perspective of the Sittig-Singh Healthcare Socio-Technical Framework (HSTF). Three broad clusters of implementation barriers from the eight HSTF dimensions were identified: (a) Infrastructure-based barriers, which relate to conflict between government regulations and system functional needs of users; lack of financial support; inconsistency between workflow, work policy, and procedures; and inadequacy of hardware-software infrastructural and technical support; (b) Process-based barriers, which relate to mismatch between the technology, existing work practice and workflow, and communication; low system speed, accessibility, and stability; deficient computer literacy; more experience in health care profession; clinical content inadequacy and unavailability; as well as poor system usefulness and user interface design; and (c) Outcome-based barriers, which relate to the lack of measurement and monitoring of system effectiveness. Two additional dimensions underlining the importance of the ability of a CIS to change are proposed to extend the Sittig-Singh HSTF. First, advocacy would promote the articulation and influence of changes in the system and subsequent outcomes by CIS stakeholders, and second, adaptability would ensure the ability of the system to adjust to emerging needs. The broad set of discovered implementation shortcomings expands prior research on why CIS can fail in nursing home settings. Moreover, our investigation offers a knowledge base and recommendations that can serve as a guide for future implementation strategies and policies in CIS initiatives.

Incidental learning of probability information is differentially affected by the type of visual working memory representation.

PubMed

van Lamsweerde, Amanda E; Beck, Melissa R

2015-12-01

In this study, we investigated whether the ability to learn probability information is affected by the type of representation held in visual working memory. Across 4 experiments, participants detected changes to displays of coloured shapes. While participants detected changes in 1 dimension (e.g., colour), a feature from a second, nonchanging dimension (e.g., shape) predicted which object was most likely to change. In Experiments 1 and 3, items could be grouped by similarity in the changing dimension across items (e.g., colours and shapes were repeated in the display), while in Experiments 2 and 4 items could not be grouped by similarity (all features were unique). Probability information from the predictive dimension was learned and used to increase performance, but only when all of the features within a display were unique (Experiments 2 and 4). When it was possible to group by feature similarity in the changing dimension (e.g., 2 blue objects appeared within an array), participants were unable to learn probability information and use it to improve performance (Experiments 1 and 3). The results suggest that probability information can be learned in a dimension that is not explicitly task-relevant, but only when the probability information is represented with the changing dimension in visual working memory. (c) 2015 APA, all rights reserved).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Medeiros, Eduardo, E-mail: emedeiros@campus.ul.pt

The use of territorial impact assessment procedures is gaining increasing relevance in the European Union policy evaluation processes. However, no concrete territorial impact assessment tools have been applied to evaluating EU cross-border programmes. In this light, this article provides a pioneering analysis on how to make use of territorial impact assessment procedures on cross-border programmes. More specifically, it assesses the main territorial impacts of the Inner Scandinavian INTERREG-A sub-programme, in the last 20 years (1996–2016). It focuses on its impacts on reducing the barrier effect, in all its main dimensions, posed by the presence of the administrative border. The resultsmore » indicate a quite positive impact of the analysed cross-border cooperation programme, in reducing the barrier effect in all its main dimensions. The obtained potential impact values for each analysed dimension indicate, however, that the ‘economy-technology’ dimension was particularly favoured, following its strategic intervention focus in stimulating the economic activity and the attractiveness of the border area. - Highlights: • A territorial impact assessment method to assess cross-border cooperation is proposed. • This method rationale is based on the main dimensions of the barrier effect. • This method identified positive impacts in all analysed dimensions. • The economy-technological dimension was the most positively impacted one.« less

The "weakest link" as an indicator of cognitive vulnerability differentially predicts symptom dimensions of anxiety in adolescents in China.

PubMed

Wang, Junyi; Wang, Danyang; Cui, Lixia; McWhinnie, Chad M; Wang, Li; Xiao, Jing

2017-08-01

This multiwave longitudinal study examined the cognitive vulnerability-stress component of hopelessness theory to differentially predict symptom dimensions of anxiety using a "weakest link" approach in a sample of adolescents from Hunan Province, China. Baseline and 6-month follow-up data were obtained from 553 middle-school students. During an initial assessment, participants completed measures of assessing their weakest links, anxious symptoms, and the occurrence of stress. Participants subsequently completed measures assessing stress, and anxious symptoms one a month for six months. Higher weakest link scores were associated with greater increases in the harm avoidance and separation anxiety/panic dimensions, but not the physical or social anxiety dimension, of anxious symptoms following stress in Chinese adolescents. These results support the applicability of the "weakest link" approach, derived from hopelessness theory, in Chinese adolescents. Weakest link scores as cognitive vulnerability factors may play a role in the development of anxious symptoms, especially in the cognitive dimensions (e.g., harm avoidance and separation anxiety/panic). Our findings also have potential value in explaining the effectiveness of cognitive relevant therapy in treating the cognitive dimensions of anxious symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sibling differentiation, identity development, and the lateral dimension of psychic life.

PubMed

Vivona, Jeanine M

2007-01-01

The lateral dimension of psychic life, lived through relationships with siblings and their substitutes, is structured around a distinct psychic challenge: to find one's unique place in a world of similar others. Like the challenge that structures the vertical parent-child dimension, the lateral challenge is fraught with conflict and ambivalence; its resolution imbues psychic structure. That resolution may be accomplished through a process of differentiation, an active and unconscious process of identity development by which a child amplifies differences with siblings and minimizes similarities. Differentiation from siblings serves to mitigate interpersonal rivalry with them and to ease internal conflict associated with the lateral dimension. Three clinical examples are offered to illustrate the operation of sibling differentiation and its costs, particularly in terms of constricted identity and attenuated relationships with siblings and peers. Differentiation as a process of becoming what the other is not has been eclipsed by identification in psychoanalytic theories of identity development. Yet differentiation is a common strategy for resolving the primary rivalries and conflicts of the lateral dimension, and has unique developmental and clinical implications.

Incidental findings in multislice computed tomography prior to transcatheter aortic valve implantation: frequency, clinical relevance and outcome.

PubMed

Trenkwalder, Teresa; Lahmann, Anna Lena; Nowicka, Magdalena; Pellegrini, Costanza; Rheude, Tobias; Mayr, N Patrick; Voss, Stephanie; Bleiziffer, Sabine; Lange, Rüdiger; Joner, Michael; Kasel, Albert M; Kastrati, Adnan; Schunkert, Heribert; Husser, Oliver; Hadamitzky, Martin; Hengstenberg, Christian

2018-02-21

Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exact incidence, clinical relevance and further consequences of IF are unclear and it is controversial whether IF adversely affect patients' outcome. We analyzed MSCT data of 1050 patients screened for TAVI between January 2011 and December 2014. Median follow-up of patients was 20 months. In total, 3194 IF were identified, which were classified into clinically non-relevant IF (2872, 90%) and clinically relevant IF (322, 10%). In 25% of patients (258/1050) at least one clinically relevant IF was present. Age (80 ± 7 vs. 80 ± 7 years; p = 0.198) and EuroSCORE II (3.6% [2.1-5.7] vs. 3.6% [2.1-5.9]; p = 0.874) was similar between patients with and without a clinically relevant IF. TAVI was performed less frequently in patients with a clinically relevant IF (76% vs. 85%; p < 0.001), with more patients receiving surgical aortic valve replacement in that group (14% vs. 11%; p = 0.042), possibly due to the high rate of incidental aneurysms of the ascending aorta (n = 48). If TAVI was performed mortality did not differ (30-days: 4% vs. 3%; p = 0.339, 1-year: 11% vs. 14%; p = 0.226) between patients with and without a clinically relevant IF. Our study is the largest study to analyze prevalence, clinical relevance and therapeutic consequences of IF during screening for TAVI. IF in pre-procedural MSCT are common and clinically relevant in one-quarter of patients. However, these findings had no impact on overall mortality.

Dimensions of patient safety culture in family practice.

PubMed

Palacios-Derflingher, Luz; O'Beirne, Maeve; Sterling, Pam; Zwicker, Karen; Harding, Brianne K; Casebeer, Ann

2010-01-01

Safety culture has been shown to affect patient safety in healthcare. While the United States and United Kingdom have studied the dimensions that reflect patient safety culture in family practice settings, to date, this has not been done in Canada. Differences in the healthcare systems between these countries and Canada may affect the dimensions found to be relevant here. Thus, it is important to identify and compare the dimensions from the United States and the United Kingdom in a Canadian context. The objectives of this study were to explore the dimensions of patient safety culture that relate to family practice in Canada and to determine if differences and similarities exist between dimensions found in Canada and those found in previous studies undertaken in the United States and the United Kingdom. A qualitative study was undertaken applying thematic analysis using focus groups with family practice offices and supplementary key stakeholders. Analysis of the data indicated that most of the dimensions from the United States and United Kingdom are appropriate in our Canadian context. Exceptions included owner/managing partner/leadership support for patient safety, job satisfaction and overall perceptions of patient safety and quality. Two unique dimensions were identified in the Canadian context: disclosure and accepting responsibility for errors. Based on this early work, it is important to consider differences in care settings when understanding dimensions of patient safety culture. We suggest that additional research in family practice settings is critical to further understand the influence of context on patient safety culture.

Improved annotation of antibiotic resistance determinants reveals microbial resistomes cluster by ecology.

PubMed

Gibson, Molly K; Forsberg, Kevin J; Dantas, Gautam

2015-01-01

Antibiotic resistance is a dire clinical problem with important ecological dimensions. While antibiotic resistance in human pathogens continues to rise at alarming rates, the impact of environmental resistance on human health is still unclear. To investigate the relationship between human-associated and environmental resistomes, we analyzed functional metagenomic selections for resistance against 18 clinically relevant antibiotics from soil and human gut microbiota as well as a set of multidrug-resistant cultured soil isolates. These analyses were enabled by Resfams, a new curated database of protein families and associated highly precise and accurate profile hidden Markov models, confirmed for antibiotic resistance function and organized by ontology. We demonstrate that the antibiotic resistance functions that give rise to the resistance profiles observed in environmental and human-associated microbial communities significantly differ between ecologies. Antibiotic resistance functions that most discriminate between ecologies provide resistance to β-lactams and tetracyclines, two of the most widely used classes of antibiotics in the clinic and agriculture. We also analyzed the antibiotic resistance gene composition of over 6000 sequenced microbial genomes, revealing significant enrichment of resistance functions by both ecology and phylogeny. Together, our results indicate that environmental and human-associated microbial communities harbor distinct resistance genes, suggesting that antibiotic resistance functions are largely constrained by ecology.

[Relationship between early maladaptive schemas, attachment quality and fear of darkness].

PubMed

Kopcsó, Krisztina; Láng, András

2014-12-07

Although fear of darkness is most common in childhood, it is also a remarkable phenomenon in young adulthood. To examine the relationship between fear of darkness, early maladaptive schemas and attachment quality in young adults and assess fear related sex differences. A self-developed scale was used to measure fear of darkness' intensity and frequency. Young Schema Questionnaire - Short Form and two scales that measure attachment dimensions were also applied. 120 university students (68 women, 52 men) filled in the tests. Fear of darkness' frequency correlated with avoidant attachment, and intensity with independent and anxious attachment. Fear of darkness variables correlated with several early maladaptive schemas. Women reported more frequent and intensive fear of darkness than men. These results indicated that the elevated level of fear of darkness is related to specific cognitive style and attachment quality. This highlights the potential clinical relevance of fear of darkness.

Studying Hallucinations Within the NIMH RDoC Framework

PubMed Central

Ford, Judith M.; Morris, Sarah E.; Hoffman, Ralph E.; Sommer, Iris; Waters, Flavie; McCarthy-Jones, Simon; Thoma, Robert J.; Turner, Jessica A.; Keedy, Sarah K.; Badcock, Johanna C.; Cuthbert, Bruce N.

2014-01-01

We explore how hallucinations might be studied within the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which asks investigators to step back from diagnoses based on symptoms and focus on basic dimensions of functioning. We start with a description of the objectives of the RDoC project and its domains and constructs. Because the RDoC initiative asks investigators to study phenomena across the wellness spectrum and different diagnoses, we address whether hallucinations experienced in nonclinical populations are the same as those experienced by people with psychotic diagnoses, and whether hallucinations studied in one clinical group can inform our understanding of the same phenomenon in another. We then discuss the phenomenology of hallucinations and how different RDoC domains might be relevant to their study. We end with a discussion of various challenges and potential next steps to advance the application of the RDoC approach to this area of research. PMID:24847862

Cavitation measurement during sonic and ultrasonic activated irrigation.

PubMed

Macedo, Ricardo; Verhaagen, Bram; Rivas, David Fernandez; Versluis, Michel; Wesselink, Paul; van der Sluis, Luc

2014-04-01

The aims of this study were to quantify and to visualize the possible occurrence of transient cavitation (bubble formation and implosion) during sonic and ultrasonic (UAI) activated irrigation. The amount of cavitation generated around several endodontic instruments was measured by sonochemiluminescence dosimetry inside 4 root canal models of human dimensions and varying complexity. Furthermore, the spatial distribution of the sonochemiluminescence in the root canal was visualized with long-exposure photography. Instrument oscillation frequency, ultrasonic power, and file taper influenced the occurrence and amount of cavitation. In UAI, cavitation was distributed between the file and the wall extending beyond the file and inside lateral canals/isthmuses. In sonic activated irrigation, no cavitation was detected. Cavitation was shown to occur in UAI at clinically relevant ultrasonic power settings in both straight and curved canals but not around sonically oscillating instruments, driven at their highest frequency. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Interstitial ablation and imaging of soft tissue using miniaturized ultrasound arrays

NASA Astrophysics Data System (ADS)

Makin, Inder R. S.; Gallagher, Laura A.; Mast, T. Douglas; Runk, Megan M.; Faidi, Waseem; Barthe, Peter G.; Slayton, Michael H.

2004-05-01

A potential alternative to extracorporeal, noninvasive HIFU therapy is minimally invasive, interstitial ultrasound ablation that can be performed laparoscopically or percutaneously. Research in this area at Guided Therapy Systems and Ethicon Endo-Surgery has included development of miniaturized (~3 mm diameter) linear ultrasound arrays capable of high power for bulk tissue ablation as well as broad bandwidth for imaging. An integrated control system allows therapy planning and automated treatment guided by real-time interstitial B-scan imaging. Image quality, challenging because of limited probe dimensions and channel count, is aided by signal processing techniques that improve image definition and contrast. Simulations of ultrasonic heat deposition, bio-heat transfer, and tissue modification provide understanding and guidance for development of treatment strategies. Results from in vitro and in vivo ablation experiments, together with corresponding simulations, will be described. Using methods of rotational scanning, this approach is shown to be capable of clinically relevant ablation rates and volumes.

Alcohol enquiry by GPs - Understanding patients' perspectives: A qualitative study.

PubMed

Tam, Chun Wah Michael; Leong, Louis; Zwar, Nicholas; Hespe, Charlotte

2015-01-01

Patients' beliefs and attitudes toward receiving alcohol enquiry from general practitioners (GPs) are unclear. These need to be understood to implement pragmatic, early detection and brief intervention strategies. We purposively sampled 23 participants from respondents of an earlier survey conducted in a general practice clinic in Sydney, Australia. Semi-structured interviews were conducted between June and August 2014, recorded, transcribed and analysed using grounded theory method to develop an explanatory model. There were three factors that influenced patients' acceptability of alcohol enquiry by GPs: • perceived relevance of the alcohol enquiry dialogue to the consultation • approach and language used in the patient-doctor interaction • unease regarding the moral and stigmatising dimension of alcohol consumption. Patients are positive towards the role of GPs in health promotion, but nonetheless have reservations towards engaging in alcohol discussions. Setting the context for alcohol dialogue, linking it to patients' agendas, collaborative consultation styles and respecting patients' sensitivity may improve acceptability.

Integrated Genomic Analysis Identifies Clinically Relevant Subtypes of Glioblastoma Characterized by Abnormalities in PDGFRA, IDH1, EGFR, and NF1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Verhaak, Roel GW; Hoadley, Katherine A; Purdom, Elizabeth

The Cancer Genome Atlas Network recently cataloged recurrent genomic abnormalities in glioblastoma multiforme (GBM). We describe a robust gene expression-based molecular classification of GBM into Proneural, Neural, Classical, and Mesenchymal subtypes and integrate multidimensional genomic data to establish patterns of somatic mutations and DNA copy number. Aberrations and gene expression of EGFR, NF1, and PDGFRA/IDH1 each define the Classical, Mesenchymal, and Proneural subtypes, respectively. Gene signatures of normal brain cell types show a strong relationship between subtypes and different neural lineages. Additionally, response to aggressive therapy differs by subtype, with the greatest benefit in the Classical subtype and no benefitmore » in the Proneural subtype. We provide a framework that unifies transcriptomic and genomic dimensions for GBM molecular stratification with important implications for future studies.« less

The Architectural Organization of Human Stem Cell Cycle Regulatory Machinery

PubMed Central

Stein, Gary S.; Stein, Janet L.; Wijnen, Andre van J; Lian, Jane B.; Montecino, Martin; Medina, Ricardo; Kapinas, Kristie; Ghule, Prachi; Grandy, Rodrigo; Zaidi, Sayyed K.; Becker, Klaus A.

2013-01-01

Two striking features of human embryonic stem cells that support biological activity are an abbreviated cell cycle and reduced complexity to nuclear organization. The potential implications for rapid proliferation of human embryonic stem cells within the context of sustaining pluripotency, suppressing phenotypic gene expression and linkage to simplicity in the architectural compartmentalization of regulatory machinery in nuclear microenvironments is explored. Characterization of the molecular and architectural commitment steps that license human embryonic stem cells to initiate histone gene expression is providing understanding of the principal regulatory mechanisms that control the G1/S phase transition in primitive pluripotent cells. From both fundamental regulatory and clinical perspectives, further understanding of the pluripotent cell cycle in relation to compartmentalization of regulatory machinery in nuclear microenvironments is relevant to applications of stem cells for regenerative medicine and new dimensions to therapy where traditional drug discovery strategies have been minimally effective. PMID:22394165

Putting the value into biosimilar decision making: the judgment value criteria.

PubMed

Mendes de Abreu, Mirhelen; Strand, Vibeke; Levy, Roger Abramino; Araujo, Denizar Vianna

2014-06-01

Uncertainties remain the key issue surrounding biosimilars, although decisions regarding their use must be made. The challenges for policymakers, doctors, patients and others seeking to navigate in the uncharted waters of biosimilars must be clarified. At the most basic level, scientific understanding of the issue remains limited and when making decisions, policymakers must consider all those affected by health policy decisions, particularly the ultimate recipients of these medicines: the patients. The biosimilar-value chain relies on measurement of comparabilities. The goal is to demonstrate how, from a molecular perspective, closely similar they are or are not and how potential small differences may be relevant to clinical outcomes. To critically understand these points, this conceptual paper will present a knowledge-value chain and discuss each dimension assigning value in the decision making process re-utilization of biosimilars. Copyright © 2014 Elsevier B.V. All rights reserved.

[The function of philosophy of science in the teaching of medical history].

PubMed

Li, Yaming

2014-05-01

The philosophy of science yields 3 important functions in the teaching of medical history. Firstly, by analyzing the development of medicine from the perspective of philosophy, we can integrate medical history into the history of human thought and clearly show the close connection between the development of humanity and the development of medical science. Secondly, philosophical analysis on the general rules of scientific discoveries involved in medical history can help medical students to understand the methodology in the research of sciences in history. Thirdly, philosophy of science offers new dimensions for understanding the relationship between medicine and the society. By making use of the relevant theory in scientific philosophy to explore the relationship between medicine and the society, the nature of medicine and the social nature and function of science can be further understood by medical students so as to exert an active role in the research and clinical work in the future.

Initial Design of Culturally Informed Behavioral Intervention Technologies: Developing an mHealth Intervention for Young Sexual Minority Men With Generalized Anxiety Disorder and Major Depression

PubMed Central

Montague, Enid; Mohr, David C

2013-01-01

Background To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. Objective This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. Methods We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. Results General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users’ ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. Conclusions This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities. PMID:24311444

The reliability of using postero-anterior cephalometry and cone-beam CT to determine transverse dimensions in clinical practice.

PubMed

Tai, Benjamin; Goonewardene, Mithran Suresh; Murray, Kevin; Koong, Bernard; Islam, Syed Mohammed Shamsul

2014-11-01

This study primarily aimed to assess the accuracy of classically-advocated reference points for the measurement of transverse jaw-base and dental relationships using conventional Postero-Anterior Cephalometry (PAC) and Cone-Beam Computed Tomography (CBCT). PAC and CBCT images were collected from 31 randomly selected orthodontic patients (12 males, 19 females), all of whom had a full permanent dentition. The transverse widths of the maxilla, mandible and the dentition were measured using reference points on both image modalities. Confidence intervals, intra-class coefficients and Bland Altman plots were used to assess the measurement differences derived from the two acquirement methods. Measurements on PAC and CBCT images demonstrated statistically significant differences in the majority of the assessed variables. The interjugal (J-J) width was one of only two variables which did not demonstrate a statistically significant difference on image comparison. The mean differences of the antegonial width (Ag-Ag) (-4.44mm, 95% CI -5.38 to -3.51) represented the greatest difference between the imaging techniques. The application of these points to a transverse skeletal analysis (J-J/Ag-Ag ratio) revealed that five of the 31 subjects (16%) recorded 'false positive' readings according to the derived data. It is recommended that clinicians are cautious when interpreting and making decisions related to transverse dimensions derived from a PAC. The PAC has a higher tendency to falsely identify individuals who require maxillary expansion procedures based on conventional clinical criteria. The errors primarily associated with identifying structures which represent the width of the mandible are significant in both PAC and CBCT techniques and require further investigation. It is postulated that the confounding effects of overlying soft tissues have a sianificant impact on a clinician's ability to identify relevant landmarks.

The perception of the clinical relevance of the MDS-Home Care(C) tool by trainers in general practice in Belgium.

PubMed

Duyver, Corentin; Van Houdt, Sabine; De Lepeleire, Jan; Dory, Valerie; Degryse, Jean-Marie

2010-12-01

comprehensive geriatric assessment has been advocated as an effective way to first identify multidimensional needs and second to establish priorities for organizing an individual health care plan for community-dwelling elderly. This paper reports on the perception of an internationally evaluated assessment system for use in community care programmes, the Minimal Data Set-Home Care (MDS-HC), by a group of experienced GP trainers. the primary study aim was to determine the perception of a standardized home care assessment system (MDS-HC) by GP trainers in terms of acceptability, perceived clinical relevance, care planning empowerment and valorization of the GP. sixty-five first-year GP trainees were educated about the MDS-HC and the use of a first version of an electronic interface. Each trainee included two elderly patients, based on strict inclusion criteria. Prior to the assessment, GP trainers and trainees were invited to complete together a basic medical record on the basis of their knowledge of the included patients. Next, the collected data, covering the multiple domains by MDS-HC, were introduced in the electronic interface by the trainee. Based on the collected data for each patient, a series of clinical assessment protocols (CAP's) were generated. Afterwards, these CAP's were critically discussed with the trainer. To investigate how the application of the MDS-HC was perceived, a 21 Likert-type item scale was drawn up based on four dimensions regarding the tool. the perception questionnaire had a good internal consistency (Cronbach's alpha 0.93). The first version of the electronic interface was considered not 'user-friendly' enough and the introduction of data time-consuming. The perception of the GP's about the overall clinical relevance of the MDS-HC was found to have little added value for the GP in the establishment of a personal management plan. many developments in health care result in an increasing demand for a standardized home care assessment system. In Belgium, the federal public health service advised to promote the MDS-HC for use in the community setting. In this study, it appears that its added value was not perceived by this sample of 37 experienced GP trainers as an empowering tool in term of management of the patient and valorization of the role of GP.

Multidimensional poverty and health: evidence from a nationwide survey in Japan.

PubMed

Oshio, Takashi; Kan, Mari

2014-12-19

It is well known that lower income is associated with poorer health, but poverty has several dimensions other than income. In the current study, we investigated the associations between multidimensional poverty and health variables. Using micro data obtained from a nationwide population survey in Japan (N = 24,905), we focused on four dimensions of poverty (income, education, social protection, and housing conditions) and three health variables (self-rated health (SRH), psychological distress, and current smoking). We examined how health variables were associated with multidimensional poverty measures, based on descriptive and multivariable logistic regression analyses. Unions as composite measures of multiple poverty dimensions were more useful for identifying individuals in poor SRH or psychological distress than a single dimension such as income. In comparison, intersections of poverty dimensions reduced the coverage of individuals considered to be in poverty and tend to be difficult to justify without any explicit policy objective. Meanwhile, education as a unidimensional poverty indicator could be useful for predicting current smoking. Results obtained from the current study confirmed the practical relevance of multidimensional poverty for health.

Independent and additive repetition priming of motion direction and color in visual search.

PubMed

Kristjánsson, Arni

2009-03-01

Priming of visual search for Gabor patch stimuli, varying in color and local drift direction, was investigated. The task relevance of each feature varied between the different experimental conditions compared. When the target defining dimension was color, a large effect of color repetition was seen as well as a smaller effect of the repetition of motion direction. The opposite priming pattern was seen when motion direction defined the target--the effect of motion direction repetition was this time larger than for color repetition. Finally, when neither was task relevant, and the target defining dimension was the spatial frequency of the Gabor patch, priming was seen for repetition of both color and motion direction, but the effects were smaller than in the previous two conditions. These results show that features do not necessarily have to be task relevant for priming to occur. There is little interaction between priming following repetition of color and motion, these two features show independent and additive priming effects, most likely reflecting that the two features are processed at separate processing sites in the nervous system, consistent with previous findings from neuropsychology & neurophysiology. The implications of the findings for theoretical accounts of priming in visual search are discussed.

Solidarity and ambivalence: comparing two perspectives on intergenerational relations using longitudinal panel data.

PubMed

Hogerbrugge, Martijn J A; Komter, Aafke E

2012-05-01

Research on family relations has extensively used the intergenerational solidarity model proposed by Bengtson and colleagues. Recently, the relevance of this model for explaining changes in family relations has been questioned, and the concept of intergenerational ambivalence has been proposed as a relevant addition to the model, supposedly acting as a catalyst, and thus serving as an explanation for changes in family relations. This study tests both the viability of the intergenerational solidarity model and the hypothesized effect of ambivalence employing longitudinal data. We use data from 2 waves of the Netherlands' Kinship Panel Study on parent-adult child relationships to estimate latent variable structural equation models. Affection, association, and support between family members are core, mutually reinforcing dimensions of solidarity. The hypothesis that ambivalence is a catalyst for change in family relations was not confirmed. Adding conflict separately revealed that it only affects the core solidarity dimensions but is itself, like normative and structural solidarity, not influenced by them. The relevance of the concept of intergenerational ambivalence for studying changes in family relations can be questioned. The viability of the intergenerational solidarity model is, however, confirmed. The concept of intergenerational ambivalence might be further explored in qualitative studies on family change.

[Understanding and intervention: a dimension of collaboration of anthropology and epidemiology].

PubMed

Song, Lei-Ming; Wang, Ning

2012-10-01

'Epidemiological intervention' involves many social and cultural contents and can be recognized as a social cultural practice. If we know more about the relevant social cultural background of the objects on intervention measures and intervention, the goals would more successful and effective be reached. Since anthropology is specialized in understanding relevant social and cultural contents, the understanding of anthropology should be viewed both as important prerequisite and foundation of the epidemiological intervention programs.

Non-interventional 1-year follow-up study of peri-implant soft tissues following previous soft tissue augmentation and crown insertion in single-tooth gaps.

PubMed

Huber, Samuel; Zeltner, Marco; Hämmerle, Christoph H F; Jung, Ronald E; Thoma, Daniel S

2018-04-01

To assess peri-implant soft tissue dimensions at implant sites, previously augmented with a collagen matrix (VCMX) or an autogenous subepithelial connective tissue graft (SCTG), between crown insertion and 1 year. Twenty patients with single-tooth implants received soft tissue augmentation prior to abutment connection randomly using VCMX or SCTG. Following abutment connection 3 months later, final reconstructions were fabricated and inserted (baseline). Patients were recalled at 6 months (6M) and at 1 year (FU-1). Measurements included clinical data, soft tissue thickness, volumetric outcomes and patient-reported outcome measures (PROMs). The buccal soft tissue thickness showed a median decrease of -0.5 mm (-1.0;0.3) (VCMX) and 0.0 mm (-0.5;1.0) (SCTG) (p = .243) up to FU-1. The soft tissue volume demonstrated a median decrease between BL and FU-1 of -0.1 mm (-0.2;0.0) (p = .301) for VCMX and a significant decrease of -0.2 mm (-0.4; -0.1) (p = .002) for SCTG, respectively. Intergroup comparisons did not reveal any significant differences between the groups for peri-implant soft tissue dimensions and changes up to FU-1 (p > .05). PROMs did not show any significant changes over time nor differences between the groups. Between crown insertion and 1 year, the buccal peri-implant soft tissue dimensions remained stable without relevant differences between sites that had previously been grafted with VCMX or SCTG. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic’s Service Perspective

PubMed Central

Koo, Dong-Woo; Shin, Dong-Jin; Lee, Sae-Mi

2017-01-01

Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics’ servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics’ servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists’ loyalty to a medical clinic. PMID:29233057

Does clinical governance influence the appropriateness of hospital stay?

PubMed

Specchia, Maria Lucia; Poscia, Andrea; Volpe, Massimo; Parente, Paolo; Capizzi, Silvio; Cambieri, Andrea; Damiani, Gianfranco; Ricciardi, Walter; De Belvis, Antonio Giulio

2015-04-03

Clinical Governance provides a framework for assessing and improving clinical quality through a single coherent program. Organizational appropriateness is aimed at achieving the best health outcomes and the most appropriate use of resources. The goal of the present study is to verify the likely relationship between Clinical Governance and appropriateness of hospital stay. A cross-sectional study was conducted in 2012 in an Italian Teaching Hospital. The OPTIGOV(©) (Optimizing Health Care Governance) methodology was used to quantify the level of implementation of Clinical Governance globally and in its main dimensions. Organizational appropriateness was measured retrospectively using the Italian version of the Appropriateness Evaluation Protocol to analyze a random sample of medical records for each clinical unit. Pearson-correlation and multiple linear regression were used to test the relationship between the percentage of inappropriate days of hospital stay and the Clinical Governance implementation levels. 47 Units were assessed. The percentage of inappropriate days of hospital stay showed an inverse correlation with almost all the main Clinical Governance dimensions. Adjusted multiple regression analysis resulted in a significant association between the percentage of inappropriate days and the overall Clinical Governance score (β = -0.28; p < 0.001; R-squared = 0.8). EBM and Clinical Audit represented the Clinical Governance dimensions which had the strongest association with organizational appropriateness. This study suggests that the evaluation of both Clinical Governance and organizational appropriateness through standardized and repeatable tools, such as OPTIGOV(©) and AEP, is a key strategy for healthcare quality. The relationship between the two underlines the central role of Clinical Governance, and especially of EBM and Clinical Audit, in determining a rational improvement of appropriateness levels.

Quality of physical therapy from a patient's perspective; factor analysis on web-based survey data revealed three dimensions on patient experiences with physical therapy.

PubMed

Scholte, Marijn; Calsbeek, Hilly; Nijhuis-van der Sanden, Maria W G; Braspenning, Jozé

2014-06-18

Assessing quality of care from the patient's perspective has changed from patient satisfaction to the more general term patient experience, as satisfaction measures turned out to be less discriminative due to high scores. Literature describes four to ten dimensions of patient experience, tailored to specific conditions or types of care. Given the administrative burden on patients, less dimensions and items could increase feasibility. Ten dimensions of patient experiences with physical therapy (PT) were proposed in the Netherlands in a consensus-based process with patients, physical therapists, health insurers, and policy makers. The aim of this paper is to detect the number of dimensions from data of a field study using factor analysis at item level. A web-based survey yielded data of 2,221 patients from 52 PT practices on 41 items. Principal component factor analysis at item level was used to assess the proposed distinction between the ten dimensions. Factor analysis revealed two dimensions: 'personal interaction' and 'practice organisation'. The dimension 'patient reported outcome' was artificially established. The three dimensions 'personal interaction' (14 items) (median(practice level) = 91.1; IQR = 2.4), 'practice organisation' (9 items) (median(practice level) = 88.9; IQR = 6.0) and 'outcome' (3 items) (median(practice level) = 80.6; IQR = 19.5) reduced the number of dimensions from ten to three and the number of items by more than a third. Factor analysis revealed three dimensions and achieved an item reduction of more than a third. It is a relevant step in the development process of a quality measurement tool to reduce respondent burden, increase clarity, and promote feasibility.

Explaining the Development of False Memories.

ERIC Educational Resources Information Center

Reyna, Valerie F.; Holliday, Robyn; Marche, Tammy

2002-01-01

Reviews explanatory dimensions of children's false memory relevant to forensic practice: measurement, development, social factors, individual differences, varieties of memories and memory judgments, and varieties of procedures inducing false memories. Asserts that recent studies fail to use techniques that separate acquiescence from memory…

Ecological Dimensions of Information Literacy

ERIC Educational Resources Information Center

Steinerova, Jela

2010-01-01

Introduction: We examine relationships between information literacy and information ecology with regard to conceptual innovation in information science. We aim to expand our understanding of human information behaviour and relevance assessment in the electronic environment. Method: Conceptual analysis and conceptual mapping is used and…

Social-Emotional Development

ERIC Educational Resources Information Center

Moran, Lyndsey R.; Lengua, Liliana J.; Zalewski, Maureen

2013-01-01

Interactions between reactive and regulatory dimensions of temperament may be particularly relevant to children's adjustment but are examined infrequently. This study investigated these interactions by examining effortful control as a moderator of the relations of fear and frustration reactivity to children's social competence, internalizing, and…

Utilising symptom dimensions with diagnostic categories improves prediction of time to first remission in first-episode psychosis.

PubMed

Ajnakina, Olesya; Lally, John; Di Forti, Marta; Stilo, Simona A; Kolliakou, Anna; Gardner-Sood, Poonam; Dazzan, Paola; Pariante, Carmine; Reis Marques, Tiago; Mondelli, Valeria; MacCabe, James; Gaughran, Fiona; David, Anthony S; Stamate, Daniel; Murray, Robin M; Fisher, Helen L

2018-03-01

There has been much recent debate concerning the relative clinical utility of symptom dimensions versus conventional diagnostic categories in patients with psychosis. We investigated whether symptom dimensions rated at presentation for first-episode psychosis (FEP) better predicted time to first remission than categorical diagnosis over a four-year follow-up. The sample comprised 193 FEP patients aged 18-65years who presented to psychiatric services in South London, UK, between 2006 and 2010. Psychopathology was assessed at baseline with the Positive and Negative Syndrome Scale and five symptom dimensions were derived using Wallwork/Fortgang's model; baseline diagnoses were grouped using DSM-IV codes. Time to start of first remission was ascertained from clinical records. The Bayesian Information Criterion (BIC) was used to find the best fitting accelerated failure time model of dimensions, diagnoses and time to first remission. Sixty percent of patients remitted over the four years following first presentation to psychiatric services, and the average time to start of first remission was 18.3weeks (SD=26.0, median=8). The positive (BIC=166.26), excited (BIC=167.30) and disorganised/concrete (BIC=168.77) symptom dimensions, and a diagnosis of schizophrenia (BIC=166.91) predicted time to first remission. However, a combination of the DSM-IV diagnosis of schizophrenia with all five symptom dimensions led to the best fitting model (BIC=164.35). Combining categorical diagnosis with symptom dimension scores in FEP patients improved the accuracy of predicting time to first remission. Thus our data suggest that the decision to consign symptom dimensions to an annexe in DSM-5 should be reconsidered at the earliest opportunity. Copyright © 2017 Elsevier B.V. All rights reserved.

Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research

PubMed Central

Weng, Chunhua

2013-01-01

Objective To review the methods and dimensions of data quality assessment in the context of electronic health record (EHR) data reuse for research. Materials and methods A review of the clinical research literature discussing data quality assessment methodology for EHR data was performed. Using an iterative process, the aspects of data quality being measured were abstracted and categorized, as well as the methods of assessment used. Results Five dimensions of data quality were identified, which are completeness, correctness, concordance, plausibility, and currency, and seven broad categories of data quality assessment methods: comparison with gold standards, data element agreement, data source agreement, distribution comparison, validity checks, log review, and element presence. Discussion Examination of the methods by which clinical researchers have investigated the quality and suitability of EHR data for research shows that there are fundamental features of data quality, which may be difficult to measure, as well as proxy dimensions. Researchers interested in the reuse of EHR data for clinical research are recommended to consider the adoption of a consistent taxonomy of EHR data quality, to remain aware of the task-dependence of data quality, to integrate work on data quality assessment from other fields, and to adopt systematic, empirically driven, statistically based methods of data quality assessment. Conclusion There is currently little consistency or potential generalizability in the methods used to assess EHR data quality. If the reuse of EHR data for clinical research is to become accepted, researchers should adopt validated, systematic methods of EHR data quality assessment. PMID:22733976

Falsely elevated sodium levels during thiopental treatment in the ICU: technical interference on a laboratory device with important clinical relevance.

PubMed

Feyen, Bart F E; Coenen, Dries; Jorens, Philippe G; Wouters, Kristien; Maas, Andrew I R; Van Hoof, Viviane; Verbrugghe, Walter

2013-02-01

Thiopental is a cornerstone in the treatment of refractory status epilepticus and intractable intracranial hypertension. In our center we observed that thiopental might cause falsely elevated serum sodium levels. Triggered by a recent case experience of extremely elevated serum sodium levels during thiopental treatment, we retrospectively identified 53 patients treated with thiopental in our intensive care unit between 2007 and 2011 and evaluated electrolyte changes. We differentiated the analysis before and after introduction of a new device for sodium assays (Dimension Vista, Siemens) in the central laboratory in April 2010. Standardized in vitro laboratory tests were performed to study the effect of thiopental on sodium analysis. Before April 2010, serum sodium levels determined in the central laboratory showed a good agreement with the bedside point-of-care (POC) device during thiopental therapy with [sodium](laboratory) - [sodium](POC) of only 1.08 mmol/L (P = .0517). After April 2010, a strong discrepancy between laboratory values and POC values was observed with [sodium](laboratory) - [sodium](POC) = 11.57 mmol/L (P < .0001). Standardized in vitro testing confirmed that thiopental induced a dose-dependent false hypernatremia (P = .002). Thiopental treatment can result in falsely elevated serum sodium. This is a critical finding since high sodium levels preclude administrating mannitol or hypertonic saline for the treatment of elevated intracranial pressure. Moreover, a false high sodium level might lead to the inappropriate administration of hypotonic fluids potentially resulting in increased brain edema and even higher intracranial pressure. To our knowledge, this is the first paper describing this clinically relevant phenomenon.

Fixed functional appliances with multibracket appliances have no skeletal effect on the mandible: A systematic review and meta-analysis.

PubMed

Ishaq, Ramy Abdul Rahman; AlHammadi, Maged Sultan; Fayed, Mona M S; El-Ezz, Amr Abou; Mostafa, Yehya

2016-05-01

Our aim was to assess the skeletal mandibular changes (anteroposterior and vertical) in circumpubertal patients with fixed functional appliances installed on multibracket appliances compared with untreated patients. An open-ended electronic search of 4 databases (PubMed, Embase, Cochrane Library, and Web of Science) up to April 2014 was performed. Additional searches of relevant journals, reference lists of the retrieved articles, systematic reviews, and gray literature were performed. Specific inclusion and exclusion criteria were applied to identify relevant articles. Quality was evaluated using the Cochrane Collaboration risk of bias tool and the Newcastle-Ottawa scale for prospective controlled clinical trials. Meta-analyses were conducted with fixed and random effects models as appropriate. Statistical heterogeneity was also examined. Seven articles were included in the qualitative synthesis and 5 in the meta-analysis. The included randomized controlled trials were at high risk of bias, and the methodologic quality of the prospective controlled clinical trials was high. Based on assessment of the fixed functional appliance phase in isolation, no difference in mandibular anteroposterior positional changes (SNB angle) (standard mean difference, 0.11°; 95% CI, -0.28, 0.50) was found between the treated and control groups. The vertical dimension was not influenced by the fixed functional appliance treatment. There is little high-quality evidence concerning the relative influence of fixed functional appliances on skeletal and dentoalveolar changes. However, based on the limited evidence, it appears that they have little effect on the skeletal mandibular parameters. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Coroners' recommendations for prevention of resident deaths in aged care: The role of primary care providers

PubMed

Aitken, Georgia; Demosthenous, Athena; Bugeja, Lyndal; Willoughby, Melissa; Young, Carmel; E Ibrahim, Joseph

2018-05-01

Currently, very little is known about how coroners consider a role for general practitioners (GPs) and registered nurses (RNs) in recommendations for the prevention of premature death. Involving these professions in recommendations generally directed towards government organisations or residential aged care providers and management may contribute to more successful broader policy changes. The aim of this article was to examine whether coroners' recommendations describe a specific role for GPs and RNs in the prevention of premature death in residential aged care settings and, if so, what domains of practice were considered. This study was part of a larger retrospective cohort study. The National Coronial Information System (NCIS) was used to extract coroners' reports that included recommendations directed towards GPs and RNs. The following information was extracted: mechanism of death, incident location, text of coroners' recommendations. Of 162 unique recommendations, 14 (8.6%) were relevant to GPs and 10 (6.2%) were relevant to RNs. Most recommendations were made in the domains of 'applied professional knowledge and skills', 'organisations and legal dimensions' and 'provision and coordination of care'. Recommendations were primarily made in response to natural cause deaths and complications of clinical care. Coroners' recommendations have a limited focus directed towards GPs and RNs, and recommendations focus on their roles in application of skills and knowledge, legal domains, and provision and coordination of care. Recommendations were mainly made in response to deaths due to suboptimal care or from 'complications of clinical care'. Formulating recommendations for these health professions may increase accountability and the likelihood of a recommendation being effectively implemented.

Comparison of the cytotoxicity of clinically relevant cobalt-chromium and alumina ceramic wear particles in vitro.

PubMed

Germain, M A; Hatton, A; Williams, S; Matthews, J B; Stone, M H; Fisher, J; Ingham, E

2003-02-01

Concern over polyethylene wear particle induced aseptic loosening of metal-on-polyethylene hip prostheses has led to renewed interest in alternative materials such as metal-on-metal and alumina ceramic-on-alumina ceramic for total hip replacement. This study compared the effects of clinically relevant cobalt-chromium and alumina ceramic wear particles on the viability of U937 histiocytes and L929 fibroblasts in vitro. Clinically relevant cobalt-chromium wear particles were generated using a flat pin-on-plate tribometer. The mean size of the clinically relevant metal particles was 29.5+/-6.3 nm (range 5-200 nm). Clinically relevant alumina ceramic particles were generated in the Leeds MkII anatomical hip simulator from a Mittelmieier prosthesis using micro-separation motion. This produced particles with a bimodal size distribution. The majority (98%) of the clinically relevant alumina ceramic wear debris was 5-20 nm in size. The cytotoxicity of the clinically relevant wear particles was compared to commercially available cobalt-chromium (9.87 microm+/-5.67) and alumina ceramic (0.503+/-0.19 microm) particles. The effects of the particles on the cells over a 5 day period at different particle volume (microm(3)) to cell number ratios were tested and viability determined using ATP-Lite(TM). Clinically relevant cobalt-chromium particles 50 and 5 microm(3) per cell reduced the viability of U937 cells by 97% and 42% and reduced the viability of L929 cells by 95% and 73%, respectively. At 50 microm(3) per cell, the clinically relevant ceramic particles reduced U937 cell viability by 18%. None of the other concentrations of the clinically relevant particles were toxic. The commercial cobalt-chromium and alumina particles did not affect the viability of either the U937 histiocytes or the L929 fibroblasts.Thus at equivalent particle volumes the clinically relevant cobalt-chromium particles were more toxic then the alumina ceramic particles. This study has emphasised the fact that the nature, size and volume of particles are important in assessing biological effects of wear debris on cells in vitro.

The Davey-Stewartson Equation on the Half-Plane

NASA Astrophysics Data System (ADS)

Fokas, A. S.

2009-08-01

The Davey-Stewartson (DS) equation is a nonlinear integrable evolution equation in two spatial dimensions. It provides a multidimensional generalisation of the celebrated nonlinear Schrödinger (NLS) equation and it appears in several physical situations. The implementation of the Inverse Scattering Transform (IST) to the solution of the initial-value problem of the NLS was presented in 1972, whereas the analogous problem for the DS equation was solved in 1983. These results are based on the formulation and solution of certain classical problems in complex analysis, namely of a Riemann Hilbert problem (RH) and of either a d-bar or a non-local RH problem respectively. A method for solving the mathematically more complicated but physically more relevant case of boundary-value problems for evolution equations in one spatial dimension, like the NLS, was finally presented in 1997, after interjecting several novel ideas to the panoply of the IST methodology. Here, this method is further extended so that it can be applied to evolution equations in two spatial dimensions, like the DS equation. This novel extension involves several new steps, including the formulation of a d-bar problem for a sectionally non-analytic function, i.e. for a function which has different non-analytic representations in different domains of the complex plane. This, in addition to the computation of a d-bar derivative, also requires the computation of the relevant jumps across the different domains. This latter step has certain similarities (but is more complicated) with the corresponding step for those initial-value problems in two dimensions which can be solved via a non-local RH problem, like KPI.

The effects of aging on the interaction between reinforcement learning and attention.

PubMed

Radulescu, Angela; Daniel, Reka; Niv, Yael

2016-11-01

Reinforcement learning (RL) in complex environments relies on selective attention to uncover those aspects of the environment that are most predictive of reward. Whereas previous work has focused on age-related changes in RL, it is not known whether older adults learn differently from younger adults when selective attention is required. In 2 experiments, we examined how aging affects the interaction between RL and selective attention. Younger and older adults performed a learning task in which only 1 stimulus dimension was relevant to predicting reward, and within it, 1 "target" feature was the most rewarding. Participants had to discover this target feature through trial and error. In Experiment 1, stimuli varied on 1 or 3 dimensions and participants received hints that revealed the target feature, the relevant dimension, or gave no information. Group-related differences in accuracy and RTs differed systematically as a function of the number of dimensions and the type of hint available. In Experiment 2 we used trial-by-trial computational modeling of the learning process to test for age-related differences in learning strategies. Behavior of both young and older adults was explained well by a reinforcement-learning model that uses selective attention to constrain learning. However, the model suggested that older adults restricted their learning to fewer features, employing more focused attention than younger adults. Furthermore, this difference in strategy predicted age-related deficits in accuracy. We discuss these results suggesting that a narrower filter of attention may reflect an adaptation to the reduced capabilities of the reinforcement learning system. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[Parental stressors in a Pediatric Intensive Care Unit].

PubMed

Ramírez, Muriel; Navarro, Sandra; Clavería, Cristián; Molina, Yerko; Cox, Alfonso

2018-04-01

The hospitalization of a child is a situation that produces a high level of stress on parents, especially at the Pediatric Intensive Care Unit (PICU). To determine which are the main stressors perceived by the parents of children hospitalized at PICU and the associated variables. A quantitative, cross-sectional and correlational study, which considers the secondary analysis of data from the IDA project # 201403 of UC School of Nursing: Validation of "The parental stressor scale infant hospitalization in Spanish" (PSSIH modified). Sampling was non probabilistic by convenience, with 217 parents of children at the PICU of a University hospital, who answered a demographic questionnaire and the modified PSSIH instrument to measure stressors in the PICU environment. Three dimensions of stressors were identified: Clinical, Emotional and Communication with the professional team. The clinical dimension was the most stressful, with the factors images or sounds, procedures and interventions and the aspect of the child, dimensions related to behavior and communication with the team were less stressful. In addition, it is associated with a greater perception of stress in the different dimensions, when having: previous experiences in PICU, programmed admission, admission due tocardiac pathology, single child, higher educational level and no partner. The modified PSSIH instrument made it possible to determine the main stressors perceived by the parents of children in the PICU, the Clinical dimension being the major stressor. These results are useful for developing local intervention programs according to the particular characteristics of the PICU.

Spirituality, Religion, and Peace Education

ERIC Educational Resources Information Center

Brantmeier, Edward J., Ed.; Lin, Jing, Ed.; Miller, John P., Ed.

2010-01-01

"Spirituality, Religion, and Peace Education" attempts to deeply explore the universal and particular dimensions of education for inner and communal peace. This co-edited book contains fifteen chapters on world spiritual traditions, religions, and their connections and relevance to peacebuilding and peacemaking. This book examines the…

Dimensions of "Vernacular" Pedagogy

ERIC Educational Resources Information Center

Pickford, Steve

2008-01-01

What counts as appropriate and relevant teaching and learning in post-colonial settings is seldom accounted for in terms of "indigenous" or "vernacular" classroom practices. The pervasiveness of western-styled education and curricula means that, for the most part, education by indigenous teachers in indigenous settings is…

Dimensions of care for dementia sufferers in long-term care institutions: are they related to outcomes?

PubMed

Chappell, N L; Reid, R C

2000-07-01

This study empirically examined whether dimensions of care cluster in special care units (SCUs) compared with non-SCUs. The relationship between SCU status plus separate measures of the dimensions of care and outcomes for dementia sufferers was then investigated. Data were drawn from the Intermediate Care Facility Project. The sample (N = 510) included residents with dementia, aged 65 and older, in intermediate care facilities throughout the province of British Columbia. Canada. Longitudinal data included 6 outcomes: cognitive function, behavioral problems of agitation and social skills, physical functioning, and quality of life measured through affect and expressive language skills. Separate multiple linear regression equations were estimated, relating each of these outcomes to 5 dimensions of care: preadmission and admission procedures. staff training and education, nonuse of physical and chemical restraints, flexible care routines and resident-relevant activities, and the environment. The results showed there is virtually no clustering of dimensions along SCU/non-SCU lines. Neither SCU status nor the individual dimensions were highly predictive of outcomes. Residents' affect at t1 emerged as a characteristic that was significantly correlated with other outcomes. This Canadian research can be added to the few but growing number of rigorous studies that suggest SCUs are not homogeneous and do not necessarily provide better care than non-SCUs. Moreover, it raises questions about the benefits of "best practice" dimensions of care, regardless of SCU status.

Mental disorder and violence: personality dimensions and clinical features.

PubMed

Nestor, Paul G

2002-12-01

This review examines the role of personality dimensions in the greater rates of violence that have now been established to accompany certain classes of mental disorders. Empirical studies are reviewed that have often used objective measures of personality and epidemiological samples with low levels of subject selection biases. The risk of violence may be understood in terms of four fundamental personality dimensions: 1) impulse control, 2) affect regulation, 3) narcissism, and 4) paranoid cognitive personality style. Low impulse control and affect regulation increase the risk for violence across disorders, especially for primary and comorbid substance abuse disorders. By contrast, paranoid cognitive personality style and narcissistic injury increase the risk for violence, respectively, in persons with schizophrenia spectrum disorders and in samples of both college students and individuals with personality disorders. This review supports the hypothesis that these four fundamental personality dimensions operate jointly, and in varying degrees, as clinical risk factors for violence among groups with these classes of mental disorders.

Observer properties for understanding dynamical displays: Capacities, limitations, and defaults

NASA Technical Reports Server (NTRS)

Proffitt, Dennis R.; Kaiser, Mary K.

1991-01-01

People's ability to extract relevant information while viewing ongoing events is discussed in terms of human capabilities, limitations, and defaults. A taxonomy of event complexity is developed which predicts which dynamical events people can and cannot construe. This taxonomy is related to the distinction drawn in classical mechanics between particle and extended body motions. People's commonsense understandings of simple mechanical systems are impacted little by formal training, but rather reflect heuristical simplifications that focus on a single dimension of perceived dynamical relevance.

[Assessing adolescent's health in school medicine: quality of life as a complement to clinical indicators].

PubMed

Renard, F; Delpire, S; Deccache, A

2004-12-01

Current medical practices of school health for adolescents are more based on the screening of specific physical problems than on psychosocial and subjective aspects of their health. This study aimed at evaluating the usefulness of a quality of life (QoL) questionnaire during the consultations. Ninety-five adolescents (mean age: 16.9 years) present for the obligatory medical check-up in a health center in Brussels, were involved in the study. Data of the medical records were analysed and two questionnaires were administrated, one exploring the quality of life (VSP-A), the other the presence of depressive symptoms (CES-D). These adolescents were in good physical health and had a mean score of global quality of life of 62 (DS =11.2); 17% of the adolescents had significant depressive symptoms (score > or =24). There was a significant negative correlation between the scores of QoL and depression (R =-0.680, P <0.01), the QoL psychological dimension and depression (R =-0.656, P <0.01), the QoL energy-vitality dimension and depression (R= -0.763, P <0.01). An evaluation of the quality of life, approaching the mental health of the teenagers in a multidimensional and positive way, can be useful in school medicine for better identifying the medical and psychosocial adolescents needs. It can improve the relevance of the preventive consultation and the interventions of health promotion in schools.

Measuring Beliefs about Suffering: Development of the Views of Suffering Scale

PubMed Central

Hale-Smith, Amy; Park, Crystal L.; Edmondson, Donald

2013-01-01

Efforts to measure religion have intensified and many specific dimensions have been identified. However, although belief is a core dimension of all world religions, little attention has been given to assessment of religious beliefs. In particular, one essential set of religious beliefs, those concerning the reasons for human suffering, has remained virtually unexamined in spite of the potential clinical relevance of these beliefs. To fill the need for a measure of people’s beliefs about suffering, we developed the Views of Suffering Scale (VOSS). Analyses identified factors related to traditional Christian teachings, unorthodox theistic beliefs, karma, and randomness. Internal consistency and test-retest reliability for VOSS subscale scores were good (α’s and r’s ≥ .70). Comparisons to measures of related constructs suggest that the VOSS scores demonstrate good convergent validity. One subscale score was modestly correlated with social desirability related to image management, and seven were positively correlated to self-deceptive enhancement. These preliminary studies suggest that the VOSS differentiates religious perspectives on suffering among a sample of US university students, though more research is needed to confirm its utility in diverse populations. The VOSS provides a valid way to measure individuals’ beliefs about suffering, allowing for inquiry into the factors that lead to various beliefs about suffering and the roles of these beliefs in adjusting to stressful life events. PMID:22369650

Medical student perspectives on geriatrics and geriatric education.

PubMed

Bagri, Anita S; Tiberius, Richard

2010-10-01

To ascertain medical students' perspectives on geriatrics. Interpretative phenomenological analysis. An allopathic, Liaison Committee on Medical Education-accredited, former Donald W. Reynolds Foundation grant recipient, U.S. medical school. Thirty fourth-year medical students who completed geriatric educational activities in all 4 years of medical school. Two researchers independently reviewed verbatim transcripts from five focus groups and identified themes using the constant comparative method. Seventeen themes that elaborate on students' perspectives on geriatrics were identified. Students reported not feeling appropriately engaged in geriatrics, despaired at the futility of care, were depressed by the decline and death of their patients, were frustrated by low reimbursement rates and low prestige despite fellowship training, were concerned about patients' unrealistic expectations and opportunities for litigation, felt unsure how to handle ethical dilemmas, and found communicating with older adults to be enjoyable but time consuming and challenging. They felt they had too much exposure to geriatrics in medical school. Current attitude scales fail to capture some of the dimensions uncovered in this study, whereas students did not mention other dimensions commonly included in attitude scales. Regarding curriculum development, students may find an integrated preclinical geriatric curriculum to be more relevant to their careers than a stand-alone curriculum. Clinical clerkships might be in a better position to emphasize the positive aspects of geriatrics and develop strategies to address students' negative attitudes. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Numerical simulation of multi-rifled tube drawing - finding proper feedstock dimensions and tool geometry

NASA Astrophysics Data System (ADS)

Bella, P.; Buček, P.; Ridzoň, M.; Mojžiš, M.; Parilák, L.'

2017-02-01

Production of multi-rifled seamless steel tubes is quite a new technology in Železiarne Podbrezová. Therefore, a lot of technological questions emerges (process technology, input feedstock dimensions, material flow during drawing, etc.) Pilot experiments to fine tune the process cost a lot of time and energy. For this, numerical simulation would be an alternative solution for achieving optimal parameters in production technology. This would reduce the number of experiments needed, lowering the overall costs of development. However, to claim the numerical results to be relevant it is necessary to verify them against the actual plant trials. Searching for optimal input feedstock dimension for drawing of multi-rifled tube with dimensions Ø28.6 mm × 6.3 mm is what makes the main topic of this paper. As a secondary task, effective position of the plug - die couple has been solved via numerical simulation. Comparing the calculated results with actual numbers from plant trials a good agreement was observed.

A signal detection model predicts the effects of set size on visual search accuracy for feature, conjunction, triple conjunction, and disjunction displays

NASA Technical Reports Server (NTRS)

Eckstein, M. P.; Thomas, J. P.; Palmer, J.; Shimozaki, S. S.

2000-01-01

Recently, quantitative models based on signal detection theory have been successfully applied to the prediction of human accuracy in visual search for a target that differs from distractors along a single attribute (feature search). The present paper extends these models for visual search accuracy to multidimensional search displays in which the target differs from the distractors along more than one feature dimension (conjunction, disjunction, and triple conjunction displays). The model assumes that each element in the display elicits a noisy representation for each of the relevant feature dimensions. The observer combines the representations across feature dimensions to obtain a single decision variable, and the stimulus with the maximum value determines the response. The model accurately predicts human experimental data on visual search accuracy in conjunctions and disjunctions of contrast and orientation. The model accounts for performance degradation without resorting to a limited-capacity spatially localized and temporally serial mechanism by which to bind information across feature dimensions.

Risk factors at the low end of the psychosis continuum: much the same as at the upper end?

PubMed

Rössler, Wulf; Vetter, Stefan; Müller, Mario; Gallo, William Thomas; Haker, Helene; Kawohl, Wolfram; Lupi, Gianpiero; Ajdacic-Gross, Vladeta

2011-08-30

We investigated risk factors for subclinical symptoms of psychosis, and focused on two psychosis dimensions previously identified in the Zurich Study, namely "schizophrenia nuclear symptoms" and "schizotypal signs". We examined the data from 9814 Swiss conscripts from 2003. The psychosis symptom dimensions were derived from the Symptom-Checklist-90-R (SCL-90-R), and were regressed on a broad range of known risk factors for psychosis. Risk factors typically assigned to schizophrenia and other psychotic disorders - cannabis use, childhood adversity, reading and writing difficulties, attention deficit hyperactivity disorder (ADHD), psychiatric disorders and addiction in parents and the extended family - are relevant also at subclinical levels. Our analyses suggested that specific risk factors may be assigned to distinct psychosis dimensions, as previously determined in an analysis from the Zurich Study. If there are different pathways to psychosis characterized by specific symptom dimensions and risk factors, they mostly co-exist and interact at different symptom load levels. Copyright © 2011 Elsevier Ltd. All rights reserved.

Emotional connotations of words related to authority and community.

PubMed

Schauenburg, Gesche; Ambrasat, Jens; Schröder, Tobias; von Scheve, Christian; Conrad, Markus

2015-09-01

We present a database of 858 German words from the semantic fields of authority and community, which represent core dimensions of human sociality. The words were selected on the basis of co-occurrence profiles of representative keywords for these semantic fields. All words were rated along five dimensions, each measured by a bipolar semantic-differential scale: Besides the classic dimensions of affective meaning (valence, arousal, and potency), we collected ratings of authority and community with newly developed scales. The results from cluster, correlational, and multiple regression analyses on the rating data suggest a robust negativity bias for authority valuation among German raters recruited via university mailing lists, whereas community ratings appear to be rather unrelated to the well-established affective dimensions. Furthermore, our data involve a strong overall negative correlation-rather than the classical U-shaped distribution-between valence and arousal for socially relevant concepts. Our database provides a valuable resource for research questions at the intersection of cognitive neuroscience and social psychology. It can be downloaded as supplemental materials with this article.

Quality improvement in New Zealand healthcare. Part 3: achieving effective care through clinical audit.

PubMed

Seddon, Mary; Buchanan, John

2006-08-04

In this third article in the Series on quality improvement, we examine the effectiveness of dimension of healthcare quality. To satisfy this dimension, two equally important facets must be attended to. First the best available evidence must be sought through research, and second that evidence must be applied--this second function is the domain of quality improvement activities generally and clinical audit in particular. Clinical audit is one of the main tools to establish whether the best evidence is being used in practice, as it compares actual practice to a standard of practice. Clinical audit identifies any gaps between what is done and what should be done, and rectifies any deficiencies in the actual processes of care. In this article, the steps involved in a clinical audit, how it is different to research, and the question of whether clinical audit requires ethical approval are explored.

Social capital and health during pregnancy; an in-depth exploration from rural Sri Lanka.

PubMed

Agampodi, Thilini Chanchala; Rheinländer, Thilde; Agampodi, Suneth Buddhika; Glozier, Nicholas; Siribaddana, Sisira

2017-07-27

Dimensions of social capital relevant to health in pregnancy are sparsely described in the literature. This study explores dimensions of social capital and the mechanisms in which they could affect the health of rural Sri Lankan pregnant women. An exploratory qualitative study of solicited diaries written by pregnant women on their social relationships, diary interviews and in-depth interviews with key informants was conducted. A framework approach for qualitative data analysis was used. Pregnant women (41), from eight different communities completed diaries and 38 post-diary interviews. Sixteen key informant interviews were conducted with public health midwives and senior community dwellers. We identified ten cognitive and five structural constructs of social capital relevant to health in pregnancy. Domestic and neighborhood cohesion were the most commonly expressed constructs. Social support was limited to support from close family, friends and public health midwives. A high density of structural social capital was observed in the micro-communities. Membership in local community groups was not common. Four different pathways by which social capital could influence health in pregnancy were identified. These include micro-level cognitive social capital by promoting mental wellbeing; micro-level structural social capital by reducing minor ailments in pregnancy; micro-level social support mechanisms promoting physical and mental wellbeing through psychosocial resources and health systems at each level providing focused maternal care. Current tools available may not contain the relevant constructs to capture the unique dimensions of social capital in pregnancy. Social capital can influence health during pregnancy, mainly through improved psychosocial resources generated by social cohesion in micro-communities and by the embedded neighborhood public health services.

College clinic service quality and patient satisfaction.

PubMed

Deshwal, Pankaj; Ranjan, Vini; Mittal, Geetika

2014-01-01

The purpose of this paper is to identify the service quality dimensions that play an important role in patient satisfaction in campus clinics in Delhi; assess student satisfaction with service; and suggests ways to improve areas of dissatisfaction. A questionnaire was distributed to students who had completed at least two consultations at the college clinic. Convenience sampling was used to approach respondents. The questionnaire uses modified SERVQUAL and other instruments, including original dimensions and those constructed through detailed discussions. Factor analyses, reliability tests and the Kaiser-Meyer-Olkin measure of sampling adequacy were conducted. The final sample had a total of 445 respondents. After factor analysis, the authors found that the dimensions affecting patient satisfaction are: staff professionalism; clinic staff reliability; clinic accessibility and basic facilities; tangibles; cleanliness; awareness of the clinic/diseases and how clinic staff deals with emergencies. Most students were satisfied with the professionalism of the clinic staff. More than 70 percent of the respondents reported that the clinic staff paid good attention to them. The campus clinic was deemed reliable by more than 50 percent of respondents. The students found the clinic's location convenient, with more than 50 percent supporting its location. However, there was dissatisfaction among the students regarding the tangibles of the clinic, with more than 50 percent favoring upgrading. There was satisfaction among the respondents regarding the availability of the doctor after clinic hours, but contact details for the clinic staff were not easily accessible on campus. More than 60 percent of respondents were satisfied with the cleanliness of the campus clinic. More than 50 percent felt that the campus clinic was not equipped to deal with emergencies efficiently. At the same time, 90 percent of respondents reported the availability of referral facilities in case of emergencies. The authors believe that this is the first study conducted to assess patient satisfaction in the campus clinics of engineering institutes in Delhi region. This paper provides valuable information to college clinic administrators.

Metrology test object for dimensional verification in additive manufacturing of metals for biomedical applications.

PubMed

Teeter, Matthew G; Kopacz, Alexander J; Nikolov, Hristo N; Holdsworth, David W

2015-01-01

Additive manufacturing continues to increase in popularity and is being used in applications such as biomaterial ingrowth that requires sub-millimeter dimensional accuracy. The purpose of this study was to design a metrology test object for determining the capabilities of additive manufacturing systems to produce common objects, with a focus on those relevant to medical applications. The test object was designed with a variety of features of varying dimensions, including holes, cylinders, rectangles, gaps, and lattices. The object was built using selective laser melting, and the produced dimensions were compared to the target dimensions. Location of the test objects on the build plate did not affect dimensions. Features with dimensions less than 0.300 mm did not build or were overbuilt to a minimum of 0.300 mm. The mean difference between target and measured dimensions was less than 0.100 mm in all cases. The test object is applicable to multiple systems and materials, tests the effect of location on the build, uses a minimum of material, and can be measured with a variety of efficient metrology tools (including measuring microscopes and micro-CT). Investigators can use this test object to determine the limits of systems and adjust build parameters to achieve maximum accuracy. © IMechE 2014.

What's what in auditory cortices?

PubMed

Retsa, Chrysa; Matusz, Pawel J; Schnupp, Jan W H; Murray, Micah M

2018-08-01

Distinct anatomical and functional pathways are postulated for analysing a sound's object-related ('what') and space-related ('where') information. It remains unresolved to which extent distinct or overlapping neural resources subserve specific object-related dimensions (i.e. who is speaking and what is being said can both be derived from the same acoustic input). To address this issue, we recorded high-density auditory evoked potentials (AEPs) while participants selectively attended and discriminated sounds according to their pitch, speaker identity, uttered syllable ('what' dimensions) or their location ('where'). Sound acoustics were held constant across blocks; the only manipulation involved the sound dimension that participants had to attend to. The task-relevant dimension was varied across blocks. AEPs from healthy participants were analysed within an electrical neuroimaging framework to differentiate modulations in response strength from modulations in response topography; the latter of which forcibly follow from changes in the configuration of underlying sources. There were no behavioural differences in discrimination of sounds across the 4 feature dimensions. As early as 90ms post-stimulus onset, AEP topographies differed across 'what' conditions, supporting a functional sub-segregation within the auditory 'what' pathway. This study characterises the spatio-temporal dynamics of segregated, yet parallel, processing of multiple sound object-related feature dimensions when selective attention is directed to them. Copyright © 2018 Elsevier Inc. All rights reserved.

In Support of Clinical Case Reports: A System of Causality Assessment

PubMed Central

Hamre, Harald J.; Kienle, Gunver S.

2013-01-01

The usefulness of clinical research depends on an assessment of causality. This assessment determines what constitutes clinical evidence. Case reports are an example of evidence that is frequently overlooked because it is believed they cannot address causal links between treatment and outcomes. This may be a mistake. Clarity on the topic of causality and its assessment will be of benefit for researchers and clinicians. This article outlines an overall system of causality and causality assessment. The system proposed involves two dimensions: horizontal and vertical; each of these dimensions consists of three different types of causality and three corresponding types of causality assessment. Included in this system are diverse forms of case causality illustrated with examples from everyday life and clinical medicine. Assessing case causality can complement conventional clinical research in an era of personalized medicine. PMID:24416665

Reexamining the domain of hypochondriasis: comparing the Illness Attitudes Scale to other approaches.

PubMed

Fergus, Thomas A; Valentiner, David P

2009-08-01

The present study examined utility of the Illness Attitudes Scale (IAS; [Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger Publishers]) in a non-clinical college sample (N=235). Relationships among five recently identified IAS dimensions (fear of illness and pain, symptom effects, treatment experience, disease conviction, and health habits) and self-report measures of several anxiety-related constructs (health anxiety, body vigilance, intolerance of uncertainty, anxiety sensitivity, and non-specific anxiety symptoms) were examined. In addition, this study investigated the incremental validity of the IAS dimensions in predicting medical utilization. The fear of illness and pain dimension and the symptom effects dimension consistently shared stronger relations with the anxiety-related constructs compared to the other three IAS dimensions. The symptom effects dimension, the disease conviction dimension, and the health habits dimension showed incremental validity over the anxiety-related constructs in predicting medical utilization. Implications for the IAS and future conceptualizations of HC are discussed.

Anxiety sensitivity and intolerance of uncertainty as potential risk factors for cyberchondria: A replication and extension examining dimensions of each construct.

PubMed

Fergus, Thomas A

2015-09-15

Preliminary findings suggest that anxiety sensitivity (AS) and intolerance of uncertainty (IU) may confer vulnerability for cyberchondria, defined as repeated internet searches for medical information that exacerbates health anxiety. Prior studies are limited because it remains unclear whether specific AS or IU dimensions differentially relate to certain cyberchondria dimensions. The present study examined associations among AS, IU, and cyberchondria dimensions using a sample of community adults (N = 578) located in the United States. As predicted, physical AS and inhibitory IU were the only AS or IU dimensions to share unique associations with the distress cyberchondria dimension after controlling for the overlap among the AS dimensions, IU dimensions, and health anxiety. Cognitive AS and social AS unexpectedly evidenced unique associations with cyberchondria dimensions. The results are limited by the cross-sectional study design and use of a community, rather than clinical, sample. This study provides evidence that specific AS and IU dimensions may confer vulnerability to certain cyberchondria dimensions. Further clarifying associations among AS, IU, and cyberchondria may lead to improvements in our conceptualization and, ultimately, treatment of cyberchondria. Copyright © 2015 Elsevier B.V. All rights reserved.

EAWE: Examination of Anomalous World Experience.

PubMed

Sass, Louis; Pienkos, Elizabeth; Skodlar, Borut; Stanghellini, Giovanni; Fuchs, Thomas; Parnas, Josef; Jones, Nev

2017-01-01

The "EAWE: Examination of Anomalous World Experience" is a detailed semi-structured interview format whose aim is to elicit description and discussion of a person's experience of various aspects of their lived world. The instrument is grounded in the tradition of phenomenological psychopathology and aims to explore, in a qualitatively rich manner, six key dimensions of subjectivity - namely, a person's experience of: (1) Space and objects, (2) Time and events, (3) Other persons, (4) Language (whether spoken or written), (5) Atmosphere (overall sense of reality, familiarity, vitality, meaning, or relevance), and (6) Existential orientation (values, attitudes, and worldviews). The EAWE is based on and primarily directed toward experiences thought to be common in, and sometimes distinctive of, schizophrenia spectrum conditions. It can, however, also be used to investigate anomalies of world experience in other populations. After a theoretical and methodological introduction, the EAWE lists 75 specific items, often with subtypes, in its six domains, together with illustrative quotations from patients. The EAWE appears in a special issue of Psychopathology that also contains an orienting preface (where the difficulty as well as necessity of studying subjective life is acknowledged) and a brief reliability report. Also included are six ancillary or background articles, which survey phenomenologically oriented theory, research, and clinical lore relevant to the six experiential domains. © 2017 S. Karger AG, Basel.

Making Implicit Multivariable Calculus Representations Explicit: A Clinical Study

ERIC Educational Resources Information Center

McGee, Daniel; Moore-Russo, Deborah; Martinez-Planell, Rafael

2015-01-01

Reviewing numerous textbooks, we found that in both differential and integral calculus textbooks the authors commonly assume that: (i) students can generalize associations between representations in two dimensions to associations between representations of the same mathematical concept in three dimensions on their own; and (ii) explicit…

The relationships between perfectionism, pathological worry and generalised anxiety disorder.

PubMed

Handley, Alicia K; Egan, Sarah J; Kane, Robert T; Rees, Clare S

2014-04-02

The relationships between perfectionism, pathological worry and generalised anxiety disorder (GAD) were investigated in a clinical sample presenting for treatment of perfectionism. This study explored the utility of perfectionism in predicting pathological worry in a sample of individuals with elevated perfectionism and GAD (n = 36). Following this, the study examined whether perfectionism could predict a principal GAD diagnosis in the full sample (n = 42). Scores on the perfectionism dimensions Concern over Mistakes, Personal Standards, and Clinical Perfectionism significantly predicted pathological worry among participants with GAD after controlling for gender and depression. The perfectionism dimension Doubts about Actions significantly predicted whether individuals from the full sample received a principal diagnosis of GAD. These findings support certain dimensions of perfectionism having significant associations with pathological worry and GAD.

The Use of Multiple Correspondence Analysis to Explore Associations between Categories of Qualitative Variables in Healthy Ageing.

PubMed

Costa, Patrício Soares; Santos, Nadine Correia; Cunha, Pedro; Cotter, Jorge; Sousa, Nuno

2013-01-01

The main focus of this study was to illustrate the applicability of multiple correspondence analysis (MCA) in detecting and representing underlying structures in large datasets used to investigate cognitive ageing. Principal component analysis (PCA) was used to obtain main cognitive dimensions, and MCA was used to detect and explore relationships between cognitive, clinical, physical, and lifestyle variables. Two PCA dimensions were identified (general cognition/executive function and memory), and two MCA dimensions were retained. Poorer cognitive performance was associated with older age, less school years, unhealthier lifestyle indicators, and presence of pathology. The first MCA dimension indicated the clustering of general/executive function and lifestyle indicators and education, while the second association was between memory and clinical parameters and age. The clustering analysis with object scores method was used to identify groups sharing similar characteristics. The weaker cognitive clusters in terms of memory and executive function comprised individuals with characteristics contributing to a higher MCA dimensional mean score (age, less education, and presence of indicators of unhealthier lifestyle habits and/or clinical pathologies). MCA provided a powerful tool to explore complex ageing data, covering multiple and diverse variables, showing if a relationship exists and how variables are related, and offering statistical results that can be seen both analytically and visually.

Illness perceptions and personality traits of patients with mental disorders: the impact of ethnicity.

PubMed

Franz, M; Salize, H J; Lujic, C; Koch, E; Gallhofer, B; Jacke, C O

2014-02-01

To identify differences and similarities between immigrants of Turkish origin and native German patients in therapeutically relevant dimensions such as subjective illness perceptions and personality traits. Turkish and native German mentally disordered in-patients were interviewed in three psychiatric clinics in Hessen, Germany. The Revised Illness Perception Questionnaire (IPQ-Revised) and the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) were used. Differences of scales and similarities by k-means cluster analyses were estimated. Of the 362 total patients, 227 (123 immigrants and 104 native Germans) were included. Neither demographic nor clinical differences were detected. Socioeconomic gradients and differences on IPQ-R scales were identified. For each ethnicity, the cluster analysis identified four different patient types based on NEO-FFI and IPQ-R scales. The patient types of each ethnicity appeared to be very similar in their structure, but they differed solely in the magnitude of the cluster means on included subscales according to ethnicity. When subjective illness perceptions and personality traits are considered together, basic patient types emerge independent of the ethnicity. Thus, the ethnical impact on patient types diminishes and a convergence was detected. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Review of Psychodynamic diagnostics manual (PDM).

PubMed

Moses, Ira

2008-03-01

Reviews the book, Psychodynamic diagnostics manual (PDM) by Alliance of Psychoanalytic Organizations (2006). This volume is divided into three major sections, Part 1--Classification of Adult Mental Heath Disorder, Part 2--Classification of Child and Adolescent Mental Health Disorder, and Part 3--Conceptual and Research Foundations for a Psychodynamically Based Classification System for Mental Health Disorders. Unlike the standard DSM which highlights the patient's presenting symptom (Axis I) with secondary consideration given to an underlying personality disorder (Axis II), the major thesis of classification scheme of this volume is that diagnostic evaluation should provide a more patient centered and a more clinically useful picture of the individual by understanding the symptom(s) through the essential dimensions of the patient's personality and mental functions (interpersonal and cognitive capacities). Part 3, which could stand on its own as a separate volume, is a thorough critique of psychotherapy outcome research in which the authors delineate how major design flaws have derived from "favoring what is measurable over what is meaningful." The authors cogently demonstrate that diagnostic assessment is a continuous effort toward providing individualized and clinically relevant evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Conceptions of narcissism and the DSM-5 pathological personality traits.

PubMed

Wright, Aidan G C; Pincus, Aaron L; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Krueger, Robert F

2013-06-01

The Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) features two conceptions of Narcissistic Personality Disorder (NPD), one based on the retained DSM-IV's categorical diagnosis and the other based on a model that blends impairments in personality functioning with a specific trait profile intended to recapture DSM-IV NPD. Nevertheless, the broader literature contains a richer array of potential conceptualizations of narcissism, including distinguishable perspectives from psychiatric nosology, clinical observation and theory, and social/personality psychology. This raises questions about the most advantageous pattern of traits to use to reflect various conceptions of narcissistic pathology via the Personality Inventory for the DSM-5 (PID-5). In this study, we examine the associations of the Personality Disorder Questionnaire-Narcissistic Personality Disorder scale, Narcissistic Personality Inventory-16, and the Pathological Narcissism Inventory and the PID-5 dimensions and facets in a large sample (N = 1,653) of undergraduate student participants. Results point to strong associations with PID-5 Antagonism scales across narcissism measures, consistent with the DSM-5's proposed representation of NPD. However, additional notable associations emerged with PID-5 Negative Affectivity and Psychoticism scales when considering more clinically relevant narcissism measures.

Conformational features of cepacian: the exopolysaccharide produced by clinical strains of Burkholderia cepacia.

PubMed

Nogueira, Carlos E Sampaio; Ruggiero, Jose R; Sist, Paola; Cescutti, Paola; Urbani, Ranieri; Rizzo, Roberto

2005-04-11

Conformational energy calculations and molecular dynamics investigations, both in water and in dimethyl sulfoxide, were carried out on the exopolysaccharide cepacian produced by the majority of the clinical strains of Burkholderia cepacia, an opportunistic pathogen causing serious lung infection in patients affected by cystic fibrosis, The investigation was aimed at defining the structural and conformational features, which might be relevant for clarification of the structure-function relationships of the polymer. The molecular dynamics calculations were carried out by Ramachandran-type energy plots of the disaccharides that constitute the polymer repeating unit. The dynamics of an oligomer composed of three repeating units were investigated in water and in Me2SO, a non-aggregating solvent. Analysis of the time persistence of hydrogen bonds showed the presence of a large number of favourable interactions in water, which were less evident in Me2SO. The calculations on the cepacian chain indicated that polymer conformational features in water were affected by the lateral chains, but were also largely dictated by the presence of solvent. Moreover, the large number of intra-chain hydrogen bonds in water disappeared in Me2SO solution, increasing the average dimension of the polymer chains.

Dispositional fear, negative affectivity, and neuroimaging response to visually suppressed emotional faces.

PubMed

Vizueta, Nathalie; Patrick, Christopher J; Jiang, Yi; Thomas, Kathleen M; He, Sheng

2012-01-02

"Invisible" stimulus paradigms provide a method for investigating basic affective processing in clinical and non-clinical populations. Neuroimaging studies utilizing continuous flash suppression (CFS) have shown increased amygdala response to invisible fearful versus neutral faces. The current study used CFS in conjunction with functional MRI to test for differences in brain reactivity to visible and invisible emotional faces in relation to two distinct trait dimensions relevant to psychopathology: negative affectivity (NA) and fearfulness. Subjects consisted of college students (N=31) assessed for fear/fearlessness along with dispositional NA. The main brain regions of interest included the fusiform face area (FFA), superior temporal sulcus (STS), and amygdala. Higher NA, but not trait fear, was associated with enhanced response to fearful versus neutral faces in STS and right amygdala (but not FFA), within the invisible condition specifically. The finding that NA rather than fearfulness predicted degree of amygdala reactivity to suppressed faces implicates the input subdivision of the amygdala in the observed effects. Given the central role of NA in anxiety and mood disorders, the current data also support use of the CFS methodology for investigating the neurobiology of these disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

Left-sided and duplicate inferior vena cava: a case series and review.

PubMed

Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

2013-11-01

Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Copyright © 2012 Wiley Periodicals, Inc.

Good cognitive performances in a child with Prader-Willi syndrome.

PubMed

Nugnes, Rosa; Zito, Eugenio; Mozzillo, Enza; Camarca, Maria Erminia; Riccio, Maria Pia; Terrone, Gaetano; Melis, Daniela; Bravaccio, Carmela; Franzese, Adriana

2013-11-15

We report the case of a child affected by Prader-Willi syndrome (PWS) with good cognitive performances and without relevant behavioral abnormalities.The diagnosis of PWS, suspected on the basis of clinical features and past history, was confirmed by DNA methylation analysis. Additional genetic testing revealed a maternal uniparental disomy. Intellectual profile was analyzed by WISC-III and Raven's Progressive Matrices CPM, while the behavior was evaluated by K-SADS-PL and Child Behavior Checklist/4-18 to the parents.WISC-III test showed a Total Intelligence Quotient (T-IQ = 79) at the border level for age. The Verbal Intelligence Quotient (V-IQ) showed a lower score than the Performance Intelligence Quotient (P-IQ) (78 and 85, respectively). Raven's Matrices CPM showed an intelligence level at 75-90° percentile for age. Concerning behavioral evaluation, a difficulty in impulse control was observed, with persistent but controllable search for food, without a clear psychopathological meaning. Also according to K-SADS-PL no areas of psychopathological dimensions were detected. In conclusion, in presence of consisting clinical features of PWS and high diagnostic suspicion, the diagnosis of PWS should be considered even in presence of a borderline IQ and in absence of psychopathological abnormalities.

University community partnerships that promote evidence-based macro practice.

PubMed

Mulroy, Elizabeth A

2008-01-01

This article articulates three dimensions of EBP grounded in theory for macro practice: intention toward social change, planning and decision-making, and civic participation. These dimensions are then applied to university community partnerships that are complex community interventions. The goals of these partnerships are to improve the social environment in low-income neighborhoods through community development and reform the university as a social institution from neighborhood bystander to responsible, engaged citizen. Finally, the article introduces the concept of a planning triangle, a framework linking evidence derived from community assessments and practice-relevant research to decisive and timely action in the field.

[Concept frame for curricular innovation in health care schools].

PubMed

Hawes, Gustavo; Rojas-Serey, Ana María; Espinoza, Mónica; Oyarzo, Sandra; Castillo-Parra, Silvana; Castillo, Manuel; Romero, Luis

2017-09-01

We herein describe the conceptual dimension of the curricular innovation process carried out in the Faculty of Medicine of the University of Chile. We describe the context of innovation. The theoretical pertinence and relevance of a competence driven curriculum for health care professionals is discussed. The epistemological, ontological and didactic dimensions of the curricular innovation are examined. A main issue is the notion of competence and its significance in professional training. The curriculum is essentially considered as a moral endeavor, especially for health care professionals and their quest to improve the quality of life of the population.

Depression and anxiety among elderly earthquake survivors in China.

PubMed

Liang, Ying

2017-12-01

This study investigated depression and anxiety among Chinese elderly earthquake survivors, addressing relevant correlations. We sampled one earthquake-prone city, utilising the Geriatric Depression Scale and Beck Anxiety Inventory. In addition, explorative factor analysis and structural equation model methods were used. Results indicated elderly earthquake survivors exhibited symptoms of moderate depression and anxiety; depression and anxiety are highly positively correlated. The overlap between these two psychological problems may be due to subjective fear and motoric dimensions; subjective fear and motoric dimensions of Beck Anxiety Inventory are more strongly related to Geriatric Depression Scale domains. The two scales exhibit high reliability and validity.

Bootstrapping 3D fermions

DOE PAGES

Iliesiu, Luca; Kos, Filip; Poland, David; ...

2016-03-17

We study the conformal bootstrap for a 4-point function of fermions in 3D. We first introduce an embedding formalism for 3D spinors and compute the conformal blocks appearing in fermion 4-point functions. Using these results, we find general bounds on the dimensions of operators appearing in the ψ × ψ OPE, and also on the central charge C T. We observe features in our bounds that coincide with scaling dimensions in the GrossNeveu models at large N. Finally, we also speculate that other features could coincide with a fermionic CFT containing no relevant scalar operators.

Apollo 14 rock samples

NASA Technical Reports Server (NTRS)

Carlson, I. C.

1978-01-01

Petrographic descriptions of all Apollo 14 samples larger than 1 cm in any dimension are presented. The sample description format consists of: (1) an introductory section which includes information on lunar sample location, orientation, and return containers, (2) a section on physical characteristics, which contains the sample mass, dimensions, and a brief description; (3) surface features, including zap pits, cavities, and fractures as seen in binocular view; (4) petrographic description, consisting of a binocular description and, if possible, a thin section description; and (5) a discussion of literature relevant to sample petrology is included for samples which have previously been examined by the scientific community.

The Intergenerational Dimension of Credentialisation and Its Implications for Vocational Change in Education.

ERIC Educational Resources Information Center

Moore, Rob; Trenwith, John

1997-01-01

Explores how an advertising degree course had to be positioned between competing definitions of valid and relevant, academic and experiential knowledge. Locates the issues within the context of credential inflation--credentials become worth less as more people acquire them. (SK)

A multi-sector assessment of community organizational capacity for promotion of Chinese immigrant worker health.

PubMed

Tsai, Jenny H-C; Thompson, Elaine A

2017-12-01

Community-based collaborative approaches have received increased attention as a means for addressing occupational health disparities. Organizational capacity, highly relevant to engaging and sustaining community partnerships, however, is rarely considered in occupational health research. To characterize community organizational capacity specifically relevant to Chinese immigrant worker health, we used a cross-sectional, descriptive design with 36 agencies from six community sectors in King County, Washington. Joint interviews, conducted with two representatives from each agency, addressed three dimensions of organizational capacity: organizational commitment, resources, and flexibility. Descriptive statistics were used to capture the patterning of these dimensions by community sector. Organizational capacity varied widely across and within sectors. Chinese and Pan-Asian service sectors indicated higher capacity for Chinese immigrant worker health than did Chinese faith-based, labor union, public, and Pan-ethnic nonprofit sectors. Variation in organizational capacity in community sectors can inform selection of collaborators for community-based, immigrant worker health interventions. © 2017 Wiley Periodicals, Inc.

Reinforcement Learning in Multidimensional Environments Relies on Attention Mechanisms

PubMed Central

Daniel, Reka; Geana, Andra; Gershman, Samuel J.; Leong, Yuan Chang; Radulescu, Angela; Wilson, Robert C.

2015-01-01

In recent years, ideas from the computational field of reinforcement learning have revolutionized the study of learning in the brain, famously providing new, precise theories of how dopamine affects learning in the basal ganglia. However, reinforcement learning algorithms are notorious for not scaling well to multidimensional environments, as is required for real-world learning. We hypothesized that the brain naturally reduces the dimensionality of real-world problems to only those dimensions that are relevant to predicting reward, and conducted an experiment to assess by what algorithms and with what neural mechanisms this “representation learning” process is realized in humans. Our results suggest that a bilateral attentional control network comprising the intraparietal sulcus, precuneus, and dorsolateral prefrontal cortex is involved in selecting what dimensions are relevant to the task at hand, effectively updating the task representation through trial and error. In this way, cortical attention mechanisms interact with learning in the basal ganglia to solve the “curse of dimensionality” in reinforcement learning. PMID:26019331

Reinforcement learning in multidimensional environments relies on attention mechanisms.

PubMed

Niv, Yael; Daniel, Reka; Geana, Andra; Gershman, Samuel J; Leong, Yuan Chang; Radulescu, Angela; Wilson, Robert C

2015-05-27

In recent years, ideas from the computational field of reinforcement learning have revolutionized the study of learning in the brain, famously providing new, precise theories of how dopamine affects learning in the basal ganglia. However, reinforcement learning algorithms are notorious for not scaling well to multidimensional environments, as is required for real-world learning. We hypothesized that the brain naturally reduces the dimensionality of real-world problems to only those dimensions that are relevant to predicting reward, and conducted an experiment to assess by what algorithms and with what neural mechanisms this "representation learning" process is realized in humans. Our results suggest that a bilateral attentional control network comprising the intraparietal sulcus, precuneus, and dorsolateral prefrontal cortex is involved in selecting what dimensions are relevant to the task at hand, effectively updating the task representation through trial and error. In this way, cortical attention mechanisms interact with learning in the basal ganglia to solve the "curse of dimensionality" in reinforcement learning. Copyright © 2015 the authors 0270-6474/15/358145-13$15.00/0.

Optimism and well-being: a prospective multi-method and multi-dimensional examination of optimism as a resilience factor following the occurrence of stressful life events.

PubMed

Kleiman, Evan M; Chiara, Alexandra M; Liu, Richard T; Jager-Hyman, Shari G; Choi, Jimmy Y; Alloy, Lauren B

2017-02-01

Optimism has been conceptualised variously as positive expectations (PE) for the future , optimistic attributions , illusion of control , and self-enhancing biases. Relatively little research has examined these multiple dimensions of optimism in relation to psychological and physical health. The current study assessed the multi-dimensional nature of optimism within a prospective vulnerability-stress framework. Initial principal component analyses revealed the following dimensions: PEs, Inferential Style (IS), Sense of Invulnerability (SI), and Overconfidence (O). Prospective follow-up analyses demonstrated that PE was associated with fewer depressive episodes and moderated the effect of stressful life events on depressive symptoms. SI also moderated the effect of life stress on anxiety symptoms. Generally, our findings indicated that optimism is a multifaceted construct and not all forms of optimism have the same effects on well-being. Specifically, our findings indicted that PE may be the most relevant to depression, whereas SI may be the most relevant to anxiety.

21 CFR 1271.75 - How do I screen a donor?

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Risk factors for, and clinical evidence of, relevant communicable disease agents and diseases... risk factors for and clinical evidence of relevant cell-associated communicable disease agents and... having either of the following: (1) A risk factor for or clinical evidence of any of the relevant...

Fractal Dimension Analysis of Transient Visual Evoked Potentials: Optimisation and Applications.

PubMed

Boon, Mei Ying; Henry, Bruce Ian; Chu, Byoung Sun; Basahi, Nour; Suttle, Catherine May; Luu, Chi; Leung, Harry; Hing, Stephen

2016-01-01

The visual evoked potential (VEP) provides a time series signal response to an external visual stimulus at the location of the visual cortex. The major VEP signal components, peak latency and amplitude, may be affected by disease processes. Additionally, the VEP contains fine detailed and non-periodic structure, of presently unclear relevance to normal function, which may be quantified using the fractal dimension. The purpose of this study is to provide a systematic investigation of the key parameters in the measurement of the fractal dimension of VEPs, to develop an optimal analysis protocol for application. VEP time series were mathematically transformed using delay time, τ, and embedding dimension, m, parameters. The fractal dimension of the transformed data was obtained from a scaling analysis based on straight line fits to the numbers of pairs of points with separation less than r versus log(r) in the transformed space. Optimal τ, m, and scaling analysis were obtained by comparing the consistency of results using different sampling frequencies. The optimised method was then piloted on samples of normal and abnormal VEPs. Consistent fractal dimension estimates were obtained using τ = 4 ms, designating the fractal dimension = D2 of the time series based on embedding dimension m = 7 (for 3606 Hz and 5000 Hz), m = 6 (for 1803 Hz) and m = 5 (for 1000Hz), and estimating D2 for each embedding dimension as the steepest slope of the linear scaling region in the plot of log(C(r)) vs log(r) provided the scaling region occurred within the middle third of the plot. Piloting revealed that fractal dimensions were higher from the sampled abnormal than normal achromatic VEPs in adults (p = 0.02). Variances of fractal dimension were higher from the abnormal than normal chromatic VEPs in children (p = 0.01). A useful analysis protocol to assess the fractal dimension of transformed VEPs has been developed.

Towards a taxonomy for integrated care: a mixed-methods study

PubMed Central

Valentijn, Pim P.; Boesveld, Inge C.; van der Klauw, Denise M.; Ruwaard, Dirk; Struijs, Jeroen N.; Molema, Johanna J.W.; Bruijnzeels, Marc A.; Vrijhoef, Hubertus JM.

2015-01-01

Introduction Building integrated services in a primary care setting is considered an essential important strategy for establishing a high-quality and affordable health care system. The theoretical foundations of such integrated service models are described by the Rainbow Model of Integrated Care, which distinguishes six integration dimensions (clinical, professional, organisational, system, functional and normative integration). The aim of the present study is to refine the Rainbow Model of Integrated Care by developing a taxonomy that specifies the underlying key features of the six dimensions. Methods First, a literature review was conducted to identify features for achieving integrated service delivery. Second, a thematic analysis method was used to develop a taxonomy of key features organised into the dimensions of the Rainbow Model of Integrated Care. Finally, the appropriateness of the key features was tested in a Delphi study among Dutch experts. Results The taxonomy consists of 59 key features distributed across the six integration dimensions of the Rainbow Model of Integrated Care. Key features associated with the clinical, professional, organisational and normative dimensions were considered appropriate by the experts. Key features linked to the functional and system dimensions were considered less appropriate. Discussion This study contributes to the ongoing debate of defining the concept and typology of integrated care. This taxonomy provides a development agenda for establishing an accepted scientific framework of integrated care from an end-user, professional, managerial and policy perspective. PMID:25759607

Towards a taxonomy for integrated care: a mixed-methods study.

PubMed

Valentijn, Pim P; Boesveld, Inge C; van der Klauw, Denise M; Ruwaard, Dirk; Struijs, Jeroen N; Molema, Johanna J W; Bruijnzeels, Marc A; Vrijhoef, Hubertus Jm

2015-01-01

Building integrated services in a primary care setting is considered an essential important strategy for establishing a high-quality and affordable health care system. The theoretical foundations of such integrated service models are described by the Rainbow Model of Integrated Care, which distinguishes six integration dimensions (clinical, professional, organisational, system, functional and normative integration). The aim of the present study is to refine the Rainbow Model of Integrated Care by developing a taxonomy that specifies the underlying key features of the six dimensions. First, a literature review was conducted to identify features for achieving integrated service delivery. Second, a thematic analysis method was used to develop a taxonomy of key features organised into the dimensions of the Rainbow Model of Integrated Care. Finally, the appropriateness of the key features was tested in a Delphi study among Dutch experts. The taxonomy consists of 59 key features distributed across the six integration dimensions of the Rainbow Model of Integrated Care. Key features associated with the clinical, professional, organisational and normative dimensions were considered appropriate by the experts. Key features linked to the functional and system dimensions were considered less appropriate. This study contributes to the ongoing debate of defining the concept and typology of integrated care. This taxonomy provides a development agenda for establishing an accepted scientific framework of integrated care from an end-user, professional, managerial and policy perspective.

The Influence of Oropalatal Dimensions on the Measurement of Tongue Strength.

PubMed

Pitts, Laura L; Stierwalt, Julie A G; Hageman, Carlin F; LaPointe, Leonard L

2017-12-01

Tongue strength is routinely evaluated in clinical swallowing evaluations since lingual weakness is an established contributor to dysphagia. Tongue strength may be clinically quantified by the maximum isometric tongue pressure (MIP) generated by the tongue against the palate; however, wide ranges in normal performance remain to be fully explained. Although orthodontic theory has long suggested a relation between lingual function and oral cavity dimensions, little attention has been given to the potential influence of oral and palatal structure(s) on healthy variance in MIP generation. Therefore, anterior and posterior tongue strength measures and oropalatal dimensions were obtained across 147 healthy adults (aged 18-88 years). Age was confirmed as a significant, independent predictor explaining approximately 10.2% of the variance in anterior tongue strength, but not a significant predictor of posterior tongue strength. However, oropalatal dimensions predicted anterior tongue strength with over three times the predictive power of age alone (p < .001). Significant models for anterior tongue strength (R 2  = .457) and posterior tongue strength (R 2  = .283) included a combination of demographic predictors (i.e., age and/or gender) and oropalatal dimensions. Palatal width, estimated tongue volume, and gender were significant predictors of posterior tongue strength (p < .001). Therefore, oropalatal dimensions may warrant consideration when accurately differentiating between pathological lingual weakness and healthy individual difference.

Anthropometry of the proximal tibia of patients with knee arthritis in Shanghai.

PubMed

Liu, Zhihong; Yuan, Gaoxiang; Zhang, Weibin; Shen, Yuhui; Deng, Lianfu

2013-05-01

We measured the resected bony surface of the proximal tibia from reconstructed 3D models of the 179 arthritis knees using CT data. We found that the mediolateral (ML) dimension (69.6 ± 9.2 mm) and anteroposterior (AP) dimension (46.1 ± 6.1 mm) were less than those of Westerners. It was observed the medial anteroposterior (MAP) dimension (47.1 ± 7.2 mm) was much larger and closer to middle point of ML dimension than lateral anteroposterior (LAP) dimension (42.9 ± 6.3 mm). The aspect ratio (AR) (1.5 ± 0.07) was constant in Shanghai population. Only half of the prostheses we used in clinic mostly matched the resected bony surface of Shanghai population very well in ML, AP and AR dimension. Copyright © 2013 Elsevier Inc. All rights reserved.

Preoperative Assessment of Neural Elements in Lumbar Spinal Stenosis by Upright Magnetic Resonance Imaging: An Implication for Routine Practice?

PubMed

Lang, Gernot; Vicari, Marco; Siller, Alexander; Kubosch, Eva J; Hennig, Juergen; Südkamp, Norbert P; Izadpanah, Kaywan; Kubosch, David

2018-04-06

Introduction Lumbar spinal stenosis (LSS) is a kinetic-dependent disease typically aggravating during spinal loading. To date, assessment of LSS is usually performed with magnetic resonance imaging (MRI). However, conventional supine MRI is associated with significant drawbacks as it does not truly reflect physiological loads, experienced by discoligamentous structures during erect posture. Consequently, supine MRI often fails to reveal the source of pain and/or disability caused by LSS. The present study sought to assess neural dimensions via MRI in supine, upright, and upright-hyperlordotic position in order to evaluate the impact of patient positioning on neural narrowing. Therefore, radiological measures such as neuroforaminal dimensions, central canal volume, sagittal listhesis, and lumbar lordosis at spinal level L4/5 were extracted and stratified according to patient posture. Materials and methods Overall, 10 subjects were enclosed in this experimental study. MRI was performed in three different positions: (1) 0° supine (SP), (2) 80° upright (UP), and (3) 80° upright + hyperlordotic (HY) posture. Upright MRI was conducted utilizing a 0.25T open-configuration scanner equipped with a rotatable examination bed allowing for true standing MRI. Radiographic outcome of upright MRI imaging was extracted and evaluated according to patient positioning. Results Upright MRI-based assessment of neural dimensions was successfully accomplished in all subjects. Overall, radiographic parameters revealed a significant decrease of neural dimensions from supine to upright position: Specifically, mean foraminal area decreased from SP to UP by 13.3% (P ≤ 0.05) as well as from SP to HY position by 21% (P ≤ 0.05). Supplementation of hyperlordosis did not result in additional narrowing of neural elements (P ≥ 0.05). Furthermore, central canal volume revealed a decrease of 7% at HY and 8% at UP compared to SP position (P ≥ 0.05). Assessment of lumbar lordosis yielded in a significant increase when assessed at HY (+22.1%) or UP (+8.7%) compared to SP (P ≤ 0.05). Conclusions Our data suggest that neuroforaminal dimensions assessed by conventional supine MRI are potentially overestimated in patients with LSS. Especially, in patients having occult disease not visualized on conventional imaging modalities, upright MRI allows for a precise, clinically relevant, and at the same time non-invasive evaluation of neural elements in LSS when neural decompression is considered.

Dimensions of Psychopathy and Their Relationships to Cognitive Functioning in Children

ERIC Educational Resources Information Center

Fontaine, Nathalie; Barker, Edward D.; Salekin, Randall T.; Viding, Essi

2008-01-01

Individuals with psychopathic traits are hypothesized to be free of intellectual deficits and possibly even to exhibit good cognitive abilities. Previous studies, based on clinical and incarcerated youth, have shown inconsistent findings. We investigated the relationships between different dimensions of psychopathy (callous/unemotional traits,…

Mobile phone interference with medical equipment and its clinical relevance: a systematic review.

PubMed

Lawrentschuk, Nathan; Bolton, Damien M

2004-08-02

To conduct a systematic review of studies on clinically relevant digital mobile phone electromagnetic interference with medical equipment. MEDLINE and SUMSEARCH were searched for the period 1966-2004. The Cochrane Library and Database of Abstracts of Reviews of Effects were also searched for systematic reviews. Studies were eligible if published in a peer-reviewed journal in English, and if they included testing of digital mobile phones for clinically relevant interference with medical equipment used to monitor or treat patients, but not implantable medical devices. As there was considerable heterogeneity in medical equipment studied and the conduct of testing, results were summarised rather than subjected to meta-analysis. Clinically relevant electromagnetic interference (EMI) secondary to mobile phones potentially endangering patients occurred in 45 of 479 devices tested at 900 MHz and 14 of 457 devices tested at 1800 MHz. However, in the largest studies, the prevalence of clinically relevant EMI was low. Most clinically relevant EMI occurred when mobile phones were used within 1 m of medical equipment. Although testing was not standardised between studies and equipment tested was not identical, it is of concern that at least 4% of devices tested in any study were susceptible to clinically relevant EMI. All studies recommend some type of restriction of mobile phone use in hospitals, with use greater than 1 m from equipment and restrictions in clinical areas being the most common.

Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

PubMed

Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

2016-06-10

International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory can inform the preparation of candidates for high stakes bedside clinical skills examinations and for professional practice.

Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis.

PubMed

Tomicic, Alemka; Martínez, Claudio; Pérez, J Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane

2015-01-01

This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient-therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode.

Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.

PubMed

Hudson Smith, Mel; Smith, David

2018-06-03

To examine the influence of dimensions of service quality on patient experience of primary care. Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients' perspectives on health care, which has policy implications for patient education. © Health Research and Educational Trust.

Social and health dimensions of climate change in the Amazon.

PubMed

Brondízio, Eduardo S; de Lima, Ana C B; Schramski, Sam; Adams, Cristina

2016-07-01

The Amazon region has been part of climate change debates for decades, yet attention to its social and health dimensions has been limited. This paper assesses literature on the social and health dimensions of climate change in the Amazon. A conceptual framework underscores multiple stresses and exposures created by interactions between climate change and local social-environmental conditions. Using the Thomson-Reuter Web of Science, this study bibliometrically assessed the overall literature on climate change in the Amazon, including Physical Sciences, Social Sciences, Anthropology, Environmental Science/Ecology and Public, Environmental/Occupational Health. From this assessment, a relevant sub-sample was selected and complemented with literature from the Brazilian database SciELO. This sample discusses three dimensions of climate change impacts in the region: livelihood changes, vector-borne diseases and microbial proliferation, and respiratory diseases. This analysis elucidates imbalance and disconnect between ecological, physical and social and health dimensions of climate change and between continental and regional climate analysis, and sub-regional and local levels. Work on the social and health implications of climate change in the Amazon falls significantly behind other research areas, limiting reliable information for analytical models and for Amazonian policy-makers and society at large. Collaborative research is called for.

Disentangling Public Participation In Science and Biomedicine

PubMed Central

2014-01-01

Background This article provides a framework for disentangling the concept of participation, with emphasis on participation in genomic medicine. We have derived seven ‘dimensions’ of participation that are most frequently invoked in the extensive, heterogeneous literature on participation. To exemplify these dimensions, we use material from a database of 102 contemporary cases of participation, and focus here on cases specific to science and medicine. We describe the stakes of public participation in biomedical research, with a focus on genomic medicine and lay out the seven dimensions. Discussion We single out five cases of participation that have particular relevance to the field of genomic medicine, we apply the seven dimensions to show how we can differentiate among forms of participation within this domain. Summary We conclude with some provocations to researchers and some recommendations for taking variation in participation more seriously. PMID:24479693

Safety and Antioxidant Efficacy Profiles of Rutin-Loaded Ethosomes for Topical Application.

PubMed

Cândido, Thalita Marcílio; De Oliveira, Camila Areias; Ariede, Maíra Bueno; Velasco, Maria Valéria Robles; Rosado, Catarina; Baby, André Rolim

2018-05-01

Topical application of dermocosmetics containing antioxidant and/or the intake of antioxidants through diet or supplementation are remarkable tools in an attempt to slow down some of the harmful effects of free radicals. Rutin is a strong antioxidant compound used in food and pharmaceutical industries. It was established that rutin presents a low skin permeation rate, a property that could be considered an inconvenience to the satisfactory action for a dermocosmetic formulation to perform its antioxidant activity onto the skin. Therefore, it is indispensable to improve its delivery, aiming at increasing its antioxidant capacity in deeper layers of the epidermis, being a possibility to associate the rutin to liposomal vesicles, such as ethosomes. Thus, in this work, the pre-clinical safety of rutin-loaded ethosomes was investigated employing an in vitro method, and the clinical safety and efficacy were also assessed. Rutin-loaded ethosomes were efficaciously obtained in a nanoscale dimension with a relevant bioactive compound loading (80.2%) and provided antioxidant in vitro activity in comparison with the blank sample. Pre-clinical and clinical safety assays assured the innocuous profile of the rutin-loaded ethosomes. The ethosomes containing the bioactive compound accomplished a more functional delivery system profile, since in the tape stripping assay, the deeper layers presented higher rutin amounts than the active delivered in its free state. However, the ex vivo antioxidant efficacy test detected no positive antioxidant activity from the rutin-loaded ethosomes, even though the in vitro assay demonstrated an affirmative antioxidant action.

Sunnybrook's matrix organizational model--moving ahead.

PubMed

Ellis, P H; Gaskin, P M

1988-01-01

Traditionally, hospitals have denied the true intricacy of their organization by forcing all reporting relationships into a single structure. To address this complexity, Sunnybrook has developed three independent, yet interrelated, organization dimensions. Three structures--the traditional, the clinical unit and the programmatic dimension--provide a better link of accountability by holding departments responsible for the efficiency of their operations, holding physicians accountable for the resource implication of volume and case mix, and ensuring that the activities of the hospital's departments and clinical units are in line with hospital's overall mission and programs.

Embedding an Identity-Matching Task within a Prompting Hierarchy to Facilitate Acquisition of Conditional Discriminations in Children with Autism

PubMed Central

Fisher, Wayne W; Kodak, Tiffany; Moore, James W

2007-01-01

Least-to-most prompting hierarchies (e.g., progressing from verbal to modeled to physical prompts until the target response occurs) may be ineffective when the prompts do not cue the individual to attend to the relevant stimulus dimensions. In such cases, emission of the target response persistently requires one or more of the higher level prompts, a condition called prompt dependence (Clark & Green, 2004). Reinforcement of differential observing responses (DORs) has sometimes been used to ensure that participants attend to the relevant stimulus dimensions in matching-to-sample (MTS) tasks (e.g., Dube & McIlvane, 1999). For 2 participants with autism, we embedded an identity-matching task within a prompting hierarchy as a DOR to increase the likelihood that the participants attended to and discriminated the relevant features of the comparison stimuli in an MTS task. This procedure was compared with a traditional least-to-most prompting hierarchy and a no-reinforcement control condition in a multielement design. Results for both participants indicated that mastery-level acquisition of spoken-word-to-picture relations occurred only under the identity-matching condition. Findings are discussed relative to the use of DORs to facilitate acquisition of conditional discriminations in persons with autism or other conditions who do not attend to the comparison stimuli. PMID:17970262

Embedding an identity-matching task within a prompting hierarchy to facilitate acquisition of conditional discriminations in children with autism.

PubMed

Fisher, Wayne W; Kodak, Tiffany; Moore, James W

2007-01-01

Least-to-most prompting hierarchies (e.g., progressing from verbal to modeled to physical prompts until the target response occurs) may be ineffective when the prompts do not cue the individual to attend to the relevant stimulus dimensions. In such cases, emission of the target response persistently requires one or more of the higher level prompts, a condition called prompt dependence (Clark & Green, 2004). Reinforcement of differential observing responses (DORs) has sometimes been used to ensure that participants attend to the relevant stimulus dimensions in matching-to-sample (MTS) tasks (e.g., Dube & McIlvane, 1999). For 2 participants with autism, we embedded an identity-matching task within a prompting hierarchy as a DOR to increase the likelihood that the participants attended to and discriminated the relevant features of the comparison stimuli in an MTS task. This procedure was compared with a traditional least-to-most prompting hierarchy and a no-reinforcement control condition in a multielement design. Results for both participants indicated that mastery-level acquisition of spoken-word-to-picture relations occurred only under the identity-matching condition. Findings are discussed relative to the use of DORs to facilitate acquisition of conditional discriminations in persons with autism or other conditions who do not attend to the comparison stimuli.

Systematic literature searching in policy relevant, inter-disciplinary reviews: an example from culture and sport.

PubMed

Schucan Bird, Karen; Tripney, Janice

2011-09-01

Within the systematic review process, the searching phase is critical to the final synthesis product, its use and value. Yet, relatively little is known about the utility of different search strategies for reviews of complex, inter-disciplinary evidence. This article used a recently completed programme of work on cultural and sporting engagement to conduct an empirical evaluation of a comprehensive search strategy. Ten different types of search source were evaluated, according to three dimensions: (i) effectiveness in identifying relevant studies; (ii) efficiency in identifying studies; and (iii) adding value by locating studies that were not identified by any other sources. The study found that general bibliographic databases and specialist databases ranked the highest on all three dimensions. Overall, websites and journals were the next most valuable types of source. For reviewers, these findings highlight that general and specialist databases should remain a core component of the comprehensive search strategy, supplemented with other types of sources that can efficiently identify unique or grey literature. For policy makers and other research commissioners, this study highlights the value of methodological analysis for improving the understanding of, and practice in, policy relevant, inter-disciplinary systematic reviews. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Toward a Multicultural Model of the Stress Process.

ERIC Educational Resources Information Center

Slavin, Lesley A.; And Others

1991-01-01

Attempts to expand Lazarus and Folkman's stress model to include culture-relevant dimensions. Discusses cultural factors that influence each component of the stress model, including types and frequency of events experienced, appraisals of stressfulness of events, appraisals of available coping resources, selection of coping strategies, and…

Analysis of Functions of Delayed Echolalia in Autistic Children.

ERIC Educational Resources Information Center

Prizant, Barry M.; Rydell, Patrick J.

1984-01-01

Fourteen functional categories of delayed echolalia in three autistic children (4-14 years old) were derived from videotape analyses. Individual differences in functional usage were apparent across Ss. Delayed echolalia varied along the dimensions of interactiveness, comprehension of the utterance produced, and relevance to linguistic or…

A New Heterogeneous Multidimensional Unfolding Procedure

ERIC Educational Resources Information Center

Park, Joonwook; Rajagopal, Priyali; DeSarbo, Wayne S.

2012-01-01

A variety of joint space multidimensional scaling (MDS) methods have been utilized for the spatial analysis of two- or three-way dominance data involving subjects' preferences, choices, considerations, intentions, etc. so as to provide a parsimonious spatial depiction of the underlying relevant dimensions, attributes, stimuli, and/or subjects'…

Should School Administrators Be Leaders or Managers?

ERIC Educational Resources Information Center

Burke, W. Warner

Research in leadership relevant to school administrators is reviewed and summarized here. The author maintains that most previous authors identified two primary leader functions, concerns, types, or dimensions. These authors include Wortman, who, following in the footsteps of Zaleznick, saw a dichotomy between leaders and managers; Burns, who…

Entorhinal-Hippocampal Neuronal Circuits Bridge Temporally Discontiguous Events

ERIC Educational Resources Information Center

Kitamura, Takashi; Macdonald, Christopher J.; Tonegawa, Susumu

2015-01-01

The entorhinal cortex (EC)-hippocampal (HPC) network plays an essential role for episodic memory, which preserves spatial and temporal information about the occurrence of past events. Although there has been significant progress toward understanding the neural circuits underlying the spatial dimension of episodic memory, the relevant circuits…

Complex adaptive systems (CAS): an overview of key elements, characteristics and application to management theory.

PubMed

Ellis, Beverley; Herbert, Stuart Ian

2011-01-01

To identify key elements and characteristics of complex adaptive systems (CAS) relevant to implementing clinical governance, drawing on lessons from quality improvement programmes and the use of informatics in primary care. The research strategy includes a literature review to develop theoretical models of clinical governance of quality improvement in primary care organisations (PCOs) and a survey of PCOs. Complex adaptive system theories are a valuable tool to help make sense of natural phenomena, which include human responses to problem solving within the sampled PCOs. The research commenced with a survey; 76% (n16) of respondents preferred to support the implementation of clinical governance initiatives guided by outputs from general practice electronic health records. There was considerable variation in the way in which consultation data was captured, recorded and organised. Incentivised information sharing led to consensus on coding policies and models of data recording ahead of national contractual requirements. Informatics was acknowledged as a mechanism to link electronic health record outputs, quality improvement and resources. Investment in informatics was identified as a development priority in order to embed clinical governance principles in practice. Complex adaptive system theory usefully describes evolutionary change processes, providing insight into how the origins of quality assurance were predicated on rational reductionism and linearity. New forms of governance do not neutralise previous models, but add further dimensions to them. Clinical governance models have moved from deterministic and 'objective' factors to incorporate cultural aspects with feedback about quality enabled by informatics. The socio-technical lessons highlighted should inform healthcare management.

Depressive symptoms are associated with (sub)clinical psychotic symptoms in patients with non-affective psychotic disorder, siblings and healthy controls.

PubMed

Klaassen, R M C; Heins, M; Luteijn, L B; van der Gaag, M; van Beveren, N J M

2013-04-01

Depression is a clinically relevant dimension, associated with both positive and negative symptoms, in patients with schizophrenia. However, in siblings it is unknown whether depression is associated with subclinical positive and negative symptoms. Method Depressive symptoms and their association with positive and negative symptoms were examined in 813 healthy siblings of patients with a non-affective psychotic disorder, 822 patients and 527 healthy controls. Depressive episodes meeting DSM-IV-TR criteria (lifetime) and depressed mood (lifetime) were assessed with the Comprehensive Assessment of Symptoms and History (CASH) in all three groups. In the patient group, the severity of positive and negative psychosis symptoms was assessed with the CASH. In the siblings and healthy controls, the severity of subclinical psychosis symptoms was assessed with the Community Assessment of Psychic Experiences (CAPE). Patients reported more lifetime depressed mood and more depressive episodes than both siblings and controls. Siblings had a higher chance of meeting lifetime depressive episodes than the controls; no significant differences in depressed mood were found between siblings and controls. In all three groups the number and duration of depressive symptoms were associated with (sub)clinical negative symptoms. In the patients and siblings the number of depressive symptoms was furthermore associated with (sub)clinical positive symptoms. Finally, lifetime depressed mood showed familial clustering but this clustering was absent for lifetime depressive episodes. These findings suggest that a co-occurring genetic vulnerability for both depressive and psychotic symptomatology exists on a clinical and a subclinical level.

Dimensions of service quality in healthcare: a systematic review of literature.

PubMed

Fatima, Iram; Humayun, Ayesha; Iqbal, Usman; Shafiq, Muhammad

2018-06-13

Various dimensions of healthcare service quality were used and discussed in literature across the globe. This study presents an updated meaningful review of the extensive research that has been conducted on measuring dimensions of healthcare service quality. Systematic review method in current study is based on PRISMA guidelines. We searched for literature using databases such as Google, Google Scholar, PubMed and Social Science, Citation Index. In this study, we screened 1921 identified papers using search terms/phrases. Snowball strategies were adopted to extract published articles from January 1997 till December 2016. Two-hundred and fourteen papers were identified as relevant for data extraction; completed by two researchers, double checked by the other two to develop agreement in discrepancies. In total, 74 studies fulfilled our pre-defined inclusion and exclusion criteria for data analysis. Service quality is mainly measured as technical and functional, incorporating many sub-dimensions. We synthesized the information about dimensions of healthcare service quality with reference to developed and developing countries. 'Tangibility' is found to be the most common contributing factor whereas 'SERVQUAL' as the most commonly used model to measure healthcare service quality. There are core dimensions of healthcare service quality that are commonly found in all models used in current reviewed studies. We found a little difference in these core dimensions while focusing dimensions in both developed and developing countries, as mostly SERVQUAL is being used as the basic model to either generate a new one or to add further contextual dimensions. The current study ranked the contributing factors based on their frequency in literature. Based on these priorities, if factors are addressed irrespective of any context, may lead to contribute to improve healthcare quality and may provide an important information for evidence-informed decision-making.

Outcomes associated with community-based research projects in teaching undergraduate public health.

PubMed

Bouhaimed, Manal; Thalib, Lukman; Doi, Suhail A R

2008-01-01

Community based research projects have been widely used in teaching public health in many institutions. Nevertheless, there is a paucity of information on the learning outcomes of such a teaching strategy. We therefore attempted to evaluate our experience with such a project based teaching process. The objective of this study was to evaluate the factors related to quality, impact and relevance of a 6-week student project for teaching public health in the faculty of medicine at Kuwait University. Interactive sessions familiarized students with research methods. Concurrently, they designed and completed a participatory project with a Community Medicine mentor. Questionnaires were used to assess quality, impact and relevance of the project, and these were correlated with multiple demographic, statistical and research design factors. We evaluated a total of 104 projects that were completed during the period of September 2001 to June 2006. Three dimensions of outcome were assessed: quality; impact and relevance. The average (mean + SE; maximum of 5) scores across all projects were 2.6 + 0.05 (range 1.7-3.7) for quality, 2.8 + 0.06 (range 1.7-4.3) for impact and 3.3 + 0.08 (range 1.3-5) for relevance. The analysis of the relationship between various factors and the scores on each dimension of assessment revealed that various factors were associated with improved quality, impact or relevance to public health practice. We conclude that use of more objective measurement instruments with better a priori conceptualization along with appropriate use of statistics and a more developed study design were likely to result in more meaningful research outcomes. We also found that a biostatistics or epidemiology mentor improved the research outcome.

Solution of effective Hamiltonian of impurity hopping between two sites in a metal

NASA Astrophysics Data System (ADS)

Ye, Jinwu

1998-03-01

We analyze in detail all the possible fixed points of the effective Hamiltonian of a non-magnetic impurity hopping between two sites in a metal obtained by Moustakas and Fisher(MF). We find a line of non-fermi liquid fixed points which continuously interpolates between the 2-channel Kondo fixed point(2CK) and the one channel, two impurity Kondo (2IK) fixed point. There is one relevant direction with scaling dimension 1/2 and one leading irrelevant operator with dimension 3/2. There is also one marginal operator in the spin sector moving along this line. The additional non-fermi liquid fixed point found by MF has the same symmetry as the 2IK, it has two relevant directions with scaling dimension 1/2, therefore also unstable. The system is shown to flow to a line of fermi-liquid fixed points which continuously interpolates between the non-interacting fixed point and the 2 channel spin-flavor Kondo fixed point (2CSFK) discussed by the author previously. The effect of particle-hole symmetry breaking is discussed. The effective Hamiltonian in the external magnetic field is analysed. The scaling functions for the physical measurable quantities are derived in the different regimes; their predictions for the experiments are given. Finally the implications are given for a non-magnetic impurity hopping around three sites with triangular symmetry discussed by MF.

Personality Structure in Brown Capuchin Monkeys: Comparisons with Chimpanzees, Orangutans, and Rhesus Macaques

PubMed Central

Morton, F. Blake; Lee, Phyllis C.; Buchanan-Smith, Hannah M.; Brosnan, Sarah F.; Thierry, Bernard; Paukner, Annika; de Waal, Frans B. M.; Widness, Jane; Essler, Jennifer L.; Weiss, Alexander

2013-01-01

Species comparisons of personality structure (i.e. how many personality dimensions and the characteristics of those dimensions) can facilitate questions about the adaptive function of personality in nonhuman primates. Here we investigate personality structure in the brown capuchin monkey (Sapajus apella), a New World primate species, and compare this structure to those of chimpanzees (Pan troglodytes), orangutans (Pongo spp.), and rhesus macaques (Macaca mulatta). Brown capuchins evolved behavioral and cognitive traits that are qualitatively similar to those of great apes, and individual differences in behavior and cognition are closely associated with differences in personality. Thus, we hypothesized that brown capuchin personality structure would overlap more with great apes than with rhesus macaques. We obtained personality ratings from seven sites on 127 brown capuchin monkeys. Principal-components analysis identified five personality dimensions (Assertiveness, Openness, Neuroticism, Sociability, and Attentiveness), which were reliable across raters and, in a subset of subjects, significantly correlated with relevant behaviors up to a year later. Comparisons between species revealed that brown capuchins and great apes overlapped in personality structure, particularly chimpanzees in the case of Neuroticism. However, in some respects (i.e. capuchin Sociability and Openness) the similarities between capuchins and great apes were not significantly greater than those between capuchins and rhesus macaques. We discuss the relevance of our results to brown capuchin behavior, and the evolution of personality structure in primates. PMID:23668695

Visuospatial biases in preschool children: Evidence from line bisection in three-dimensional space.

PubMed

Patro, Katarzyna; Nuerk, Hans-Christoph; Brugger, Peter

2018-04-09

Spatial attention in adults is characterized by systematic asymmetries across all three spatial dimensions. These asymmetries are evident when participants bisect horizontal, vertical, or radial lines and misplace their midpoints to the left, the top, or far from the body, respectively. However, bisection errors are rarely examined during early childhood. In this study, we examined the development of spatial-attentional asymmetries in three-dimensional (3D) space by asking preschool children (aged 3-6 years) to bisect horizontal, vertical, and radial lines. Children erred to the left with horizontal lines and to the top with vertical lines, consistent with the pattern reported in adults. These biases got stronger with age and were absent in the youngest preschoolers. However, by controlling for a possible failure in hitting the line, we observed an additional unpredicted pattern: Children's pointing systematically deviated away from the line to an empty space on its left side (for vertical and radial lines) or above it (for horizontal lines). Notably, this task-irrelevant deviation was pronounced in children as young as 3 or 4 years. We conclude that asymmetries in spatial-attentional functions should be measured not only in task-relevant dimensions but also in task-irrelevant dimensions because the latter may reveal biases in very young children not typically observed in task-relevant measures. Copyright © 2018 Elsevier Inc. All rights reserved.

Research: the third dimension of librarianship.

PubMed Central

Love, E

1980-01-01

The rapid accumulation of data through increasingly sophisticated computer technology has created an unprecedented information explosion which might better be called an ignorance explosion. Data gathering emphasizing quantity rather than quality, speed of transmission rather than reliability or relevance, poses a challenge to the future of librarianship. Two concerns are discussed: (1) Relationship of technology to the information age. Librarians must be concerned with the methodology used in data collection, including the value judgments reflected in this activity. (2) Preparation of medical librarianship for the future. The profession will grow only as a result of individual effort, the recognition of people, and an appreciation of human values. Thus far, attempts to evaluate needs focus on technology while neglecting research into the human aspect. The author proposes that dimensions of the total professional model for medical librarianship must include research, as well as education and practice. The need to aid in the development of library researchers at the Ph.D. level through a National Library of Medicine program similar to that offered to researchers by the National Institutes of Health is stressed. By way of federal assistance and scholarships made available through national library associations, library research can become the vital and effective third dimension that will redefine the traditional concept of information storage and service in human terms, thus introducing a new relevance into the area of medical librarianship during the coming decades. PMID:7356492

Bridging the gap between interviewer and interviewee: developing an interview guide for individual interviews by means of a focus group.

PubMed

Pedersen, Birgith; Delmar, Charlotte; Falkmer, Ursula; Grønkjaer, Mette

2016-09-01

In developing an interview guide, pre-existing knowledge about the research topic is essential. In a recent study, we were interested in exploring the experiences of weight changes among women treated for breast cancer using individual interviews. However, to develop an interview guide for the individual interviews that covered relevant thematic and dynamic dimensions, we found existing literature insufficient. Thus, we turned our attention to the benefit of the focus group method. This study aims to discuss how a focus group prior to individual interviews may contribute in developing the thematic dimension and translating the dynamic dimension of an interview guide into everyday language. We conducted one focus group interview of five women treated for breast cancer with experiences in weight changes. Data were analysed using content and conversation analysis and discussed with relevant literature on interview guide development. The study is approved by the Danish Data Protection Agency (2008-58-0028) and follows the ethical guidelines for qualitative research. Data generation and analysis resulted in themes for the thematic dimension, as well as three dynamic areas to consider in the individual interviews to bridge the gap between the interviewer and the interviewee. The dynamic areas are as follows: The use of words, images and metaphors - a shield and self-protection, Multiple meanings to explore and Staying close to the everyday language. The analysis made us more familiar with the content and meaning of weight changes among breast cancer survivors. Furthermore, it provided images and metaphors, multiple meanings and a sense of the women's everyday language that calls for an open interview frame to be used in subsequent individual interviews. © 2015 Nordic College of Caring Science.

Electrophysiological correlates of preparation and implementation for different types of task shifts.

PubMed

Hsieh, Shulan; Wu, Mengyao

2011-11-14

The ability to flexibly shift between tasks is central to cognitive control, but whether the same brain mechanisms mediate shifting across different tasks is unknown. In this study, we investigated whether variations in stimulus-dimensions or response-mapping might influence task switching in terms of its preparatory processes, as reflected in cue-locked event-related potentials (ERPs), and its implementation processes, as reflected in stimulus-locked ERPs. Participants judged pairs of digits as same or different in one of two conditions. In one condition, the task-relevant stimulus-dimension was either repeated or switched across trials while the response-mapping rule was kept constant. In the other condition, the task-relevant stimulus-dimension was kept constant while the response-mapping rule was repeated or switched across trials. The length of the preparatory interval was manipulated. Data revealed switch-related preparatory ERP components (including N2 and a late slow positivity) that were associated with both types of task shifting and an N400-like negativity that distinguished between the two types. Several switch-related implementation ERP components associated with both types of task shifting were found at posterior sites. Distinct frontal modulations of the N1, P2, and N2 were found to associate with the implementation of the response-mapping shift, whereas a slow positivity was associated with the implementation of the stimulus-dimension shift. Therefore, this study demonstrates that there are shared and distinct processes across different types of task shifting. Finally, because the same transition-cue was used for different task shifts, the distinct processes cannot be explained simply by differences in cue processing. Copyright © 2011 Elsevier B.V. All rights reserved.

Some further clarifications on age-related differences in Stroop interference.

PubMed

Augustinova, Maria; Clarys, David; Spatola, Nicolas; Ferrand, Ludovic

2018-04-01

Both the locus and processes underlying the age-related differences in Stroop interference are usually inferred from changes in magnitudes of standard (i.e., overall) Stroop interference. Therefore, this study addressed these still-open issues directly. To this end, a sample of younger (18-26 years old) and healthy older (72-97 years old) was administered the semantic Stroop paradigm (that assesses the relative contribution of semantic compared to response conflict both of which contribute to overall Stroop interference) combined with a single-letter coloring and cuing (SLCC) procedure. Independently of an increased attentional focus on the relevant color dimension of Stroop words induced by SLCC (as compared to all letters colored and cued, ALCC), greater magnitudes of standard Stroop interference were observed in older (as compared to younger) adults. These differences were due to greater magnitudes of response conflict whereas magnitudes of semantic conflict remained significant and unchanged by healthy aging and SLCC. Thus, this direct evidence places the locus of age-related differences in Stroop interference at the level of response conflict (as opposed to semantic and/or both conflicts). In terms of processes underlying these differences, the reported evidence shows that both age-groups are equally (in)efficient in (a) focusing on the relevant color dimension and (b) suppressing the meaning of the irrelevant word-dimension of Stroop words. Healthy older adults are simply less efficient in suppressing the (pre-)response activity primed by the fully processed meaning of the irrelevant word-dimension. Standard interpretations of age-related differences in Stroop interference and a more general issue of how attentional selectivity actually operates in the Stroop task are therefore reconsidered in this paper.

Clinical relevance of findings in trials of CBT for depression.

PubMed

Lepping, P; Whittington, R; Sambhi, R S; Lane, S; Poole, R; Leucht, S; Cuijpers, P; McCabe, R; Waheed, W

2017-09-01

Cognitive behavioural therapy (CBT) is beneficial in depression. Symptom scores can be translated into Clinical Global Impression (CGI) scale scores to indicate clinical relevance. We aimed to assess the clinical relevance of findings of randomised controlled trials (RCTs) of CBT in depression. We identified RCTs of CBT that used the Hamilton Rating Scale for Depression (HAMD). HAMD scores were translated into Clinical Global Impression - Change scale (CGI-I) scores to measure clinical relevance. One hundred and seventy datasets from 82 studies were included. The mean percentage HAMD change for treatment arms was 53.66%, and 29.81% for control arms, a statistically significant difference. Combined active therapies showed the biggest improvement on CGI-I score, followed by CBT alone. All active treatments had better than expected HAMD percentage reduction and CGI-I scores. CBT has a clinically relevant effect in depression, with a notional CGI-I score of 2.2, indicating a significant clinical response. The non-specific or placebo effect of being in a psychotherapy trial was a 29% reduction of HAMD. Copyright © 2017. Published by Elsevier Masson SAS.

SU-F-T-224: Importance of Timely Review of Daily Cone-Beam CTs: Dosimetric Evaluation of Rejected CBCTs for Head and Neck Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andrews, M; Yu, N; Joshi, N

Purpose: To dosimetrically evaluate the importance of timely reviewing daily CBCTs for patients with head and neck cancer. Methods: After each fraction daily cone-beam CT (CBCT) for head and neck patients are reviewed by physicians prior to next treatment. Physician rejected image registrations of CBCT were identified and analyzed for 17 patients. These CBCT images were rigidly fused with planning CT images and the contours from the planning CT were transferred to CBCTs. Because of limited extension in the superior-inferior dimension contours with partial volumes in CBCTs were discarded. The treatment isocenter was placed by applying the clinically recorded shiftsmore » to the volume isocenter of the CBCT. Dose was recalculated at the shifted isocenter using a homogeneous dose calculation algorithm. Dosimetrically relevant changes defined as greater than 5% deviation from the clinically accepted plans but with homogeneous dose calculation were evaluated for the high dose (HD), intermediate dose (ID), and low dose (LD) CTVs, spinal cord, larynx, oropharynx, parotids, and submandibular glands. Results: Among seventeen rejected CBCTS, HD-CTVs, ID-CTVs, and LD-CTVs were completely included in the CBCTs for 17, 1, and 15 patients, respectively. The prescription doses to the HD-CTV, ID-CTV, and LD-CTV were received by < 95% of the CTV volumes in 5/17, 1/1, and 5/15 patients respectively. For the spinal cord, the maximum doses (D0.03cc) were increased > 5% in 13 of 17 patients. For the oropharynx, larynx, parotid, and submandibular glands, the mean dose of these organs at risk was increased > 5% in 7/17, 8/12, 11/16 and 6/16 patients, respectively. Conclusion: Timely review daily CBCTs for head and neck patients under daily CBCT guidance is important, and uncorrected setup errors can translate to dosimetrically relevant dose increases in organsat- risk and dose decreases in the clinical target volumes.« less

Health-Related Quality of Life 2 Years After Treatment With Radical Prostatectomy, Prostate Brachytherapy, or External Beam Radiotherapy in Patients With Clinically Localized Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferrer, Montserrat; CIBER en Epidemiologia y Salud Publica; Suarez, Jose Francisco

Purpose: To compare treatment impact on health-related quality of life (HRQL) in patients with localized prostate cancer, from before treatment to 2 years after the intervention. Methods and Materials: This was a longitudinal, prospective study of 614 patients with localized prostate cancer treated with radical prostatectomy (134), three-dimensional external conformal radiotherapy (205), and brachytherapy (275). The HRQL questionnaires administered before and after treatment (months 1, 3, 6, 12, and 24) were the Medical Outcomes Study 36-Item Short Form, the Functional Assessment of Cancer Therapy (General and Prostate Specific), the Expanded Prostate Cancer Index Composite (EPIC), and the American Urological Associationmore » Symptom Index. Differences between groups were tested by analysis of variance and within-group changes by univariate repeated-measures analysis of variance. Generalized estimating equations (GEE) models were constructed to assess between-group differences in HRQL at 2 years of follow-up after adjusting for clinical variables. Results: In each treatment group, HRQL initially deteriorated after treatment with subsequent partial recovery. However, some dimension scores were still significantly lower after 2 years of treatment. The GEE models showed that, compared with the brachytherapy group, radical prostatectomy patients had worse EPIC sexual summary and urinary incontinence scores (-20.4 and -14.1; p < 0.001), and external radiotherapy patients had worse EPIC bowel, sexual, and hormonal summary scores (-3.55, -5.24, and -1.94; p < 0.05). Prostatectomy patients had significantly better EPIC urinary irritation scores than brachytherapy patients (+4.16; p < 0.001). Conclusions: Relevant differences between treatment groups persisted after 2 years of follow-up. Radical prostatectomy had a considerable negative effect on sexual functioning and urinary continence. Three-dimensional conformal radiotherapy had a moderate negative impact on bowel functioning, and brachytherapy caused moderate urinary irritation. These results provide relevant information for clinical decision making.« less

The relationships between perfectionism, pathological worry and generalised anxiety disorder

PubMed Central

2014-01-01

Background The relationships between perfectionism, pathological worry and generalised anxiety disorder (GAD) were investigated in a clinical sample presenting for treatment of perfectionism. Method This study explored the utility of perfectionism in predicting pathological worry in a sample of individuals with elevated perfectionism and GAD (n = 36). Following this, the study examined whether perfectionism could predict a principal GAD diagnosis in the full sample (n = 42). Results Scores on the perfectionism dimensions Concern over Mistakes, Personal Standards, and Clinical Perfectionism significantly predicted pathological worry among participants with GAD after controlling for gender and depression. The perfectionism dimension Doubts about Actions significantly predicted whether individuals from the full sample received a principal diagnosis of GAD. Conclusions These findings support certain dimensions of perfectionism having significant associations with pathological worry and GAD. PMID:24693946

Assessment of depression in medical patients: a systematic review of the utility of the Beck Depression Inventory-II.

PubMed

Wang, Yuan-Pang; Gorenstein, Clarice

2013-09-01

To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depression Inventory-II for measuring depression in medical settings to provide guidelines for practicing clinicians. Considering the inclusion and exclusion criteria seventy articles were retained. Validation studies of the Beck Depression Inventory-II, in both primary care and hospital settings, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The Beck Depression Inventory-II showed high reliability and good correlation with measures of depression and anxiety. Its threshold for detecting depression varied according to the type of patients, suggesting the need for adjusted cut-off points. The somatic and cognitive-affective dimension described the latent structure of the instrument. The Beck Depression Inventory-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in patients with medical conditions, the clinician should seek evidence for how to interpret the score before using the Beck Depression Inventory-II to make clinical decisions.

Drug development in neuropsychopharmacology.

PubMed

Fritze, Jürgen

2008-03-01

Personalized medicine is still in its infancy concerning drug development in neuropsychopharmacology. Adequate biomarkers with clinical relevance to drug response and/or tolerability and safety largely remain to be identified. Possibly, this kind of personalized medicine will first gain clinical relevance in the dementias. The clinical relevance of the genotyping of drug-metabolizing enzymes as suggested by drug licensing authorities for the pharmacokinetic evaluation of medicinal products needs to be proven in sound clinical trials.

Restoration of dimensional reduction in the random-field Ising model at five dimensions

NASA Astrophysics Data System (ADS)

Fytas, Nikolaos G.; Martín-Mayor, Víctor; Picco, Marco; Sourlas, Nicolas

2017-04-01

The random-field Ising model is one of the few disordered systems where the perturbative renormalization group can be carried out to all orders of perturbation theory. This analysis predicts dimensional reduction, i.e., that the critical properties of the random-field Ising model in D dimensions are identical to those of the pure Ising ferromagnet in D -2 dimensions. It is well known that dimensional reduction is not true in three dimensions, thus invalidating the perturbative renormalization group prediction. Here, we report high-precision numerical simulations of the 5D random-field Ising model at zero temperature. We illustrate universality by comparing different probability distributions for the random fields. We compute all the relevant critical exponents (including the critical slowing down exponent for the ground-state finding algorithm), as well as several other renormalization-group invariants. The estimated values of the critical exponents of the 5D random-field Ising model are statistically compatible to those of the pure 3D Ising ferromagnet. These results support the restoration of dimensional reduction at D =5 . We thus conclude that the failure of the perturbative renormalization group is a low-dimensional phenomenon. We close our contribution by comparing universal quantities for the random-field problem at dimensions 3 ≤D <6 to their values in the pure Ising model at D -2 dimensions, and we provide a clear verification of the Rushbrooke equality at all studied dimensions.

Restoration of dimensional reduction in the random-field Ising model at five dimensions.

PubMed

Fytas, Nikolaos G; Martín-Mayor, Víctor; Picco, Marco; Sourlas, Nicolas

2017-04-01

The random-field Ising model is one of the few disordered systems where the perturbative renormalization group can be carried out to all orders of perturbation theory. This analysis predicts dimensional reduction, i.e., that the critical properties of the random-field Ising model in D dimensions are identical to those of the pure Ising ferromagnet in D-2 dimensions. It is well known that dimensional reduction is not true in three dimensions, thus invalidating the perturbative renormalization group prediction. Here, we report high-precision numerical simulations of the 5D random-field Ising model at zero temperature. We illustrate universality by comparing different probability distributions for the random fields. We compute all the relevant critical exponents (including the critical slowing down exponent for the ground-state finding algorithm), as well as several other renormalization-group invariants. The estimated values of the critical exponents of the 5D random-field Ising model are statistically compatible to those of the pure 3D Ising ferromagnet. These results support the restoration of dimensional reduction at D=5. We thus conclude that the failure of the perturbative renormalization group is a low-dimensional phenomenon. We close our contribution by comparing universal quantities for the random-field problem at dimensions 3≤D<6 to their values in the pure Ising model at D-2 dimensions, and we provide a clear verification of the Rushbrooke equality at all studied dimensions.

Reference ranges of kidney dimensions in term newborns: sonographic measurements.

PubMed

Erdemir, Aydin; Kahramaner, Zelal; Arik, Bilal; Bilgili, Gokmen; Tekin, Mehmet; Genc, Yeliz

2014-11-01

Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease during the neonatal period, when renal abnormalities are common and renal size rapidly changes with age. To determine the reference ranges of kidney dimensions in newborns and to provide a reference chart for daily practice. In this prospective study, kidney dimensions were evaluated in 385 healthy newborns with a gestational age ≥37 weeks. Each neonate seen at an obstetrics clinic and neonatal intensive care unit was examined with sonography within the first week of life. Relationships of all dimensions with gender, gestational age, height and weight were statistically analyzed. All dimensions of the kidneys were smaller in girls than in boys (P < 0.05). The dimensions of the left kidney were larger than those in the right kidney in both genders (P < 0.01). Longitudinal and anteroposterior dimensions of the right and left kidneys showed no correlation with the gestational age in either gender. The dimensions correlated with the height in boys (P < 0.01), while no correlation was seen between the dimensions and height in girls (P < 0.05). Weight had the best correlation with all dimensions in both genders. The reference values of kidney lengths and diagrams from this study may be useful in the sonographic evaluation of kidneys in newborns.

Symptom Dimensions in Obsessive-Compulsive Disorder and Obsessive Beliefs.

PubMed

Cordeiro, Trinette; Sharma, Mahendra P; Thennarasu, Kandavel; Reddy, Y C Janardhan

2015-01-01

Obsessive-compulsive disorder (OCD) is a heterogeneous condition with a few major symptom dimensions. These symptom dimensions are thought to have unique clinical and neurobiological correlates. There seems to be a specific relation between OCD symptom dimensions and obsessive beliefs, but the findings are not consistent across studies. There is also a paucity of literature from culturally diverse settings. One of the reasons for the varied findings could be due to the method employed in measuring OCD symptoms. In this study, we examined the relation between symptom dimensions and obsessive beliefs using the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire respectively in 75 patients with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition OCD. Perfectionism predicted both aggressive and symmetry dimensions whereas responsibility beliefs predicted sexual and religious dimensions. The findings suggest that certain obsessive beliefs predicted certain OCD symptom dimensions, but results are not entirely consistent with the published literature suggesting the possibility of cross-cultural variations. That the symptom dimensions have unique belief domains support the argument that symptom dimensions could be targeted to reduce the heterogeneity in etiological and treatment studies of OCD. Therapeutic interventions may have to aim at modifying unique belief domains underlying certain symptom dimensions rather than having generic cognitive-behavioral strategies.

Stimulus-response correspondence effect as a function of temporal overlap between relevant and irrelevant information processing.

PubMed

Wang, Dong-Yuan Debbie; Richard, F Dan; Ray, Brittany

2016-01-01

The stimulus-response correspondence (SRC) effect refers to advantages in performance when stimulus and response correspond in dimensions or features, even if the common features are irrelevant to the task. Previous research indicated that the SRC effect depends on the temporal course of stimulus information processing. The current study investigated how the temporal overlap between relevant and irrelevant stimulus processing influences the SRC effect. In this experiment, the irrelevant stimulus (a previously associated tone) preceded the relevant stimulus (a coloured rectangle). The irrelevant and relevant stimuli onset asynchrony was varied to manipulate the temporal overlap between the irrelevant and relevant stimuli processing. Results indicated that the SRC effect size varied as a quadratic function of the temporal overlap between the relevant stimulus and irrelevant stimulus. This finding extends previous experimental observations that the SRC effect size varies in an increasing or decreasing function with reaction time. The current study demonstrated a quadratic function between effect size and the temporal overlap.

Symptom Dimensions as Outcomes in Interventions for Patients With Cancer: A Systematic Review

PubMed

Henoch, Ingela; Olsson, Cecilia; Larsson, Maria; Ahlberg, Karin

2018-03-01

Symptom experience in patients with cancer consists of several dimensions, often measured descriptively within various populations but seldom used as intervention outcomes. This review aims at describing symptom dimensions as outcomes of interventions designed to alleviate symptoms in patients with cancer and to describe these interventions' effects on at least two symptom dimensions. 
. The PRISMA statement for reporting systematic reviews was used. Searches were undertaken in various indexing sites.
. Extracted data included design, participants, intervention and control group treatment, targeted symptom dimension, and summary of results.
. 2,041 articles were identified and 15 were included. The symptom dimensions were intensity, distress, prevalence, frequency, consequences, and quality. Eleven interventions had significant effect on symptom dimensions, mostly on intensity and distress.
. Oncology nurses need clinical skills to be able to understand patients' experiences through their narratives. Various interventions are targeted at symptoms, and these need to be implemented to provide evidence-based symptom management.

A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder.

PubMed

Muñoz-Negro, José E; Ibanez-Casas, Inmaculada; de Portugal, Enrique; Ochoa, Susana; Dolz, Montserrat; Haro, Josep M; Ruiz-Veguilla, Miguel; de Dios Luna Del Castillo, Juan; Cervilla, Jorge A

2015-12-01

Since the early description of paranoia, the nosology of delusional disorder has always been controversial. The old idea of unitary psychosis has now gained some renewed value from the dimensional continuum model of psychotic symptoms. 1. To study the psychopathological dimensions of the psychosis spectrum; 2. to explore the association between psychotic dimensions and categorical diagnoses; 3. to compare the different psychotic disorders from a psychopathological and functional point of view. This is an observational study utilizing a sample of some 550 patients with a psychotic disorder. 373 participants had a diagnosis of schizophrenia, 137 had delusional disorder and 40 with a diagnosis of schizoaffective disorder. The PANSS was used to elicit psychopathology and global functioning was ascertained using the GAF measure. Both exploratory and confirmatory factor analyses of the PANSS items were performed to extract psychopathological dimensions. Associations between diagnostic categories and dimensions were subsequently studied using ANOVA tests. 5 dimensions - manic, negative symptoms, depression, positive symptoms and cognitive - emerged. The model explained 57.27% of the total variance. The dimensional model was useful to explained differences and similarities between all three psychosis spectrum categories. The potential clinical usefulness of this dimensional model within and between clinical psychosis spectrum categories is discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

An Aggregate Measure of Sleep Health Is Associated With Prevalent and Incident Clinically Significant Depression Symptoms Among Community-Dwelling Older Women.

PubMed

Furihata, Ryuji; Hall, Martica H; Stone, Katie L; Ancoli-Israel, Sonia; Smagula, Stephen F; Cauley, Jane A; Kaneita, Yoshitaka; Uchiyama, Makoto; Buysse, Daniel J

2017-03-01

Sleep can be characterized along multiple dimensions. We investigated whether an aggregate measure of sleep health was associated with prevalent and incident clinically significant depression symptoms in a cohort of older women. Participants were older women (mean age 80.1 years) who completed baseline (n = 6485) and follow-up (n = 3806) visits, approximately 6 years apart, in the Study of Osteoporotic Fractures (SOF). Self-reported sleep over the past 12 months was categorized as "good" or "poor" across 5 dimensions: satisfaction with sleep duration, daytime sleepiness, mid-sleep time, sleep onset latency, and sleep duration. An aggregate measure of sleep health was calculated by summing the number of "poor" dimensions. Clinically significant depression symptoms were defined as a score ≥6 on the Geriatric Depression Scale. Relationships between sleep health and depression symptoms were evaluated with multivariate logistic regression, adjusting for health measures and medications. Individual sleep health dimensions of sleep satisfaction, daytime sleepiness, mid-sleep time, and sleep onset latency were significantly associated with prevalent depression symptoms (odds ratios [OR] = 1.26-2.69). Sleep satisfaction, daytime sleepiness, and sleep onset latency were significantly associated with incident depression symptoms (OR = 1.32-1.79). The number of "poor" sleep health dimensions was associated in a gradient fashion with greater odds of prevalent (OR = 1.62-5.41) and incident (OR = 1.47-3.15) depression symptoms. An aggregate, multidimensional measure of sleep health was associated with both prevalent and incident clinically-significant depression symptoms in a gradient fashion. Future studies are warranted to extend these findings in different populations and with different health outcomes. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Career Interests of Students in Psychology Specialties Degrees: Psychometric Evidence and Correlations with the RIASEC Dimensions

ERIC Educational Resources Information Center

Ferreira, Aristides I.; Rodrigues, Rosa I.; da Costa Ferreira, Paula

2016-01-01

In this study, we present the development of a vocational interest scale for university students studying psychology. Three dimensions were extracted through principal component analysis, namely, organizational, educational, and clinical psychology. A second study with confirmatory factor analysis replicated the same three factors obtained in the…

Annual Research Review: Re-Thinking the Classification of Autism Spectrum Disorders

ERIC Educational Resources Information Center

Lord, Catherine; Jones, Rebecca M.

2012-01-01

Background: The nosology of autism spectrum disorders (ASD) is at a critical point in history as the field seeks to better define dimensions of social-communication deficits and restricted/repetitive behaviors on an individual level for both clinical and neurobiological purposes. These different dimensions also suggest an increasing need for…

Robust Dimensions of Anxiety Sensitivity: Development and Initial Validation of the Anxiety Sensitivity Index-3

ERIC Educational Resources Information Center

Taylor, Steven; Zvolensky, Michael J.; Cox, Brian J.; Deacon, Brett; Heimberg, Richard G.; Ledley, Deborah Roth; Abramowitz, Jonathan S.; Holaway, Robert M.; Sandin, Bonifacio; Stewart, Sherry H.; Coles, Meredith; Eng, Winnie; Daly, Erin S.; Arrindell, Willem A.; Bouvard, Martine; Cardenas, Samuel Jurado

2007-01-01

Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because…

Pitfalls in the statistical examination and interpretation of the correspondence between physician and patient satisfaction ratings and their relevance for shared decision making research

PubMed Central

2011-01-01

Background The correspondence of satisfaction ratings between physicians and patients can be assessed on different dimensions. One may examine whether they differ between the two groups or focus on measures of association or agreement. The aim of our study was to evaluate methodological difficulties in calculating the correspondence between patient and physician satisfaction ratings and to show the relevance for shared decision making research. Methods We utilised a structured tool for cardiovascular prevention (arriba™) in a pragmatic cluster-randomised controlled trial. Correspondence between patient and physician satisfaction ratings after individual primary care consultations was assessed using the Patient Participation Scale (PPS). We used the Wilcoxon signed-rank test, the marginal homogeneity test, Kendall's tau-b, weighted kappa, percentage of agreement, and the Bland-Altman method to measure differences, associations, and agreement between physicians and patients. Results Statistical measures signal large differences between patient and physician satisfaction ratings with more favourable ratings provided by patients and a low correspondence regardless of group allocation. Closer examination of the raw data revealed a high ceiling effect of satisfaction ratings and only slight disagreement regarding the distributions of differences between physicians' and patients' ratings. Conclusions Traditional statistical measures of association and agreement are not able to capture a clinically relevant appreciation of the physician-patient relationship by both parties in skewed satisfaction ratings. Only the Bland-Altman method for assessing agreement augmented by bar charts of differences was able to indicate this. Trial registration ISRCTN: ISRCT71348772 PMID:21592337

Form Follows Function: Learning about Function Helps Children Learn about Shape

ERIC Educational Resources Information Center

Ware, Elizabeth A.; Booth, Amy E.

2010-01-01

Object functions help young children to organize new artifact categories. However, the scope of their influence is unknown. We explore whether functions highlight property dimensions that are relevant to artifact categories in general. Specifically, using a longitudinal training procedure, we assessed whether experience with functions highlights…

Reassessing the causal structure of enduring involvement

Treesearch

Jinhee Jun; Gerard T. Kyle; James D. Absher; William E. Hammitt

2009-01-01

Guided by tenets of identity theory, we hypothesized a causal structure of enduring involvement suggesting that self-relevant components precede the other dimensions. We used Kyle et al.'s (2004a) Modified Involvement Scale, in which leisure involvement is conceptualized as a multidimensional construct consisting of identity affirmation, identity expression,...

Interaction Rescaled: How Monastic Debate Became a Diasporic Pedagogy

ERIC Educational Resources Information Center

Lempert, Michael

2012-01-01

Rather than assume the relevance of "a priori" scalar distinctions (micro-, macro-, meso-), this article examines scale as an emergent dimension of sociospatial practice in educational institutions. Focusing on Buddhist debate at Tibetan monasteries in India, I describe how this educational practice has been placed as a rite of…

Leadership Practices for Student Engagement in Challenging Conditions

ERIC Educational Resources Information Center

Trowler, Vicki

2013-01-01

Student Engagement is the investment of time, effort and other relevant resources by both students and their institutions intended to optimise the student experience and enhance the learning outcomes and development of students, and the performance and reputation of the institution. As such, it has affective, behavioural and cognitive dimensions,…

Teachers' Conceptions of Gifted and Average-Ability Students on Achievement-Relevant Dimensions

ERIC Educational Resources Information Center

Baudson, Tanja Gabriele; Preckel, Franzis

2016-01-01

Stereotyping of gifted students may not only hinder identification and actualization of potential but also personality development ("stigma of giftedness"). This is obvious in the case of negative stereotyping (e.g., the disharmony hypothesis, which sees gifted students as intellectually strong, but emotionally and socially inferior),…

Five-Factor Model of Personality and Career Exploration

ERIC Educational Resources Information Center

Reed, Mary Beth; Bruch, Monroe A.; Haase, Richard F.

2004-01-01

This study investigates whether the dimensions of the five-factor model (FFM) of personality are related to specific career exploration variables. Based on the FFM, predictions were made about the relevance of particular traits to career exploration variables. Results from a canonical correlation analysis showed that variable loadings on three…

The Development and Validation of a Scale Measuring Teacher Autonomous Behaviour

ERIC Educational Resources Information Center

Evers, Arnoud T.; Verboon, Peter; Klaeijsen, Andrea

2017-01-01

In the current study a multi-dimensional scale that measures teacher autonomous behaviour is presented. The scale is applicable across the following educational sectors: primary education, secondary education and vocational education. Based on an elaborate literature study, four theoretically relevant dimensions of teacher autonomous behaviour…

Attachment, Self-Esteem and Test Anxiety in Adolescence and Early Adulthood

ERIC Educational Resources Information Center

Dan, Orrie; Bar Ilan, Omrit; Kurman, Jenny

2014-01-01

The purpose of this study was to assess how attachment dimensions (anxiety and avoidance), self-esteem, and three subscales of test anxiety--cognitive obstruction, social derogation and tenseness are related in two age groups: adolescents and college students. Participants (N?=?327) completed relevant questionnaires. Results showed that college…

Penetrative convection

NASA Technical Reports Server (NTRS)

Moore, D. R.

1981-01-01

The current state of understanding of the most directly observable solar convection, the granulation and supergranulation is summarized. The body of work in which the complete time dependent Navier-Stokes equations and entropy transport equation are solved for a fully compressible atmosphere is considered. Relevant anelastic and incompressible calculations in two dimensions are also discussed.

Adult Education: Some Reflections. Series 173.

ERIC Educational Resources Information Center

Mohanty, B. B.

This book is a compilation of 12 articles and papers on topics of relevance to adult education in India. "Nonformal Education in the Learning Society" highlights the importance of this type of education. "Adult Education in India" presents one educator's views about this topic, the size and dimensions of the problems, and the…

The Habit of Reading: A Neglected Dimension of Adult Reading Instruction.

ERIC Educational Resources Information Center

Fink, Katherine T.; Devine, Thomas G.

1993-01-01

Less competent adult readers have not developed the habit of reading. Ways to cultivate adult reading habits include relevant material, environment saturated with reading material, reading aloud to adults, having them read to children, sustained silent reading, modeling, book sharing, author conferences, and recognition. (SK)

The economic dimension of wildland fires

Treesearch

Armando Gonzalez-Caban

2013-01-01

The economic relevance of wildland fire management and protection programs is ever growing, particularly considering mounting wildfire costs and losses globally, and the justifications required for budget allocations to management and protection of forest ecosystems. However, there are major difficulties in grappling with the problem of rapidly increasing wildland fire...

Personalization of Instruction: Design Dimensions and Implications for Cognition

ERIC Educational Resources Information Center

Walkington, Candace; Bernacki, Matthew L.

2018-01-01

Instruction can be made relevant to students when it draws upon and utilizes their interests, experiences, and "funds of knowledge" in productive ways to support classroom learning. This approach has been referred to as "context personalization." In this paper, we discuss the cognitive basis of personalization interventions,…

The Structure of Vocational Interests in Filipino Adolescents

ERIC Educational Resources Information Center

Primavera, Michele T.; Church, A. Timothy; Katigbak, Marcia S.; Bruna, Lisa; White, Joy R.; Peradilla, Imelda

2010-01-01

The structure of vocational interests was investigated in Filipino high school students (N = 503), who rated their interest in 303 culture-relevant occupational titles and 93 major fields of study. Item-level principal components analyses identified general interest, prestige, and sex-type dimensions, rather than Prediger's (1982) People/Things…

Manual for Scoring the Test of Directed Imagination.

ERIC Educational Resources Information Center

Veldman, Donald J.; And Others

A scoring manual for the Directed Imagination Test, a projective technique wherein the subject is instructed to write four fictional stories (four minutes are allowed for each) about teachers and their experiences, is presented. The manual provides detailed instructions for rating each story by fifteen dimensions relevant to teacher education…

Imaginary Subjects: School Science, Indigenous Students, and Knowledge-Power Relations

ERIC Educational Resources Information Center

Kidman, Joanna; Abrams, Eleanor; McRae, Hiria

2011-01-01

The perspectives of indigenous science learners in developed nations offer an important but frequently overlooked dimension to debates about the nature of science, the science curriculum, and calls from educators to make school science more culturally responsive or "relevant" to students from indigenous or minority groups. In this paper…

Tops as building blocks for G 2 manifolds

NASA Astrophysics Data System (ADS)

Braun, Andreas P.

2017-10-01

A large number of examples of compact G 2 manifolds, relevant to supersymmetric compactifications of M-Theory to four dimensions, can be constructed by forming a twisted connected sum of two building blocks times a circle. These building blocks, which are appropriate K3-fibred threefolds, are shown to have a natural and elegant construction in terms of tops, which parallels the construction of Calabi-Yau manifolds via reflexive polytopes. In particular, this enables us to prove combinatorial formulas for the Hodge numbers and other relevant topological data.

Questionnaires for assessment of female sexual dysfunction: a review and proposal for a standardized screener.

PubMed

Giraldi, Annamaria; Rellini, Alessandra; Pfaus, James G; Bitzer, Johannes; Laan, Ellen; Jannini, Emmanuele A; Fugl-Meyer, Axel R

2011-10-01

There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories of FSD. The aim of this study was to review the strengths and weaknesses of different questionnaires currently available to assess different dimensions of women's sexual function and dysfunction, and to suggest a simple screener for FSD. A literature search of relevant databases, books, and articles in journals was used to identify questionnaires that have been used in basic or epidemiological research, clinical trials, or in clinical settings. Measures were grouped in four levels based on their purposes and degree of development, and were reviewed for their psychometric properties and utility in clinical or research settings. A Sexual Complaints Screener for Women (SCS-W) was then proposed based on epidemiological methods. Although many questionnaires are adequate for their own purposes, our review revealed a serious lack of standardized, internationally (culturally) acceptable questionnaires that are truly epidemiologically validated in general populations and that can be used to assess FSD in women with or without a partner and independent of the partner's gender. The SCS-W is proposed as a 10-item screener to aid clinicians in making a preliminary assessment of FSD. The definition of FSD continues to change and basic screening tools are essential to help advance clinical diagnosis and treatment, or to slate patients adequately into the right diagnostic categories for basic and epidemiological research or clinical trials. © 2011 International Society for Sexual Medicine.