When you see it, let it be: Urgency, mindfulness and adolescent substance use

PubMed Central

Robinson, Joanna M.; Ladd, Benjamin O.; Anderson, Kristen G.

2015-01-01

The emotion-based domains of impulsivity, positive and negative urgency, are facets that have garnered attention due to their associations with substance use, and mindfulness based strategies have shown promise in reducing substance use in adults. The aim of the current study was to examine relations among urgency, mindfulness, and substance use in adolescence. Cross-sectional data were collected from students (N = 1,051) at a large, private high school in the Pacific Northwest. Both positive and negative urgency were uniquely associated with greater likelihood of lifetime and current alcohol use; only positive urgency predicted lifetime marijuana use. Mindfulness was associated with a lower likelihood of lifetime alcohol or marijuana use. Interactions between urgency and mindfulness were not supported. Our findings highlight the need to explore relations among baseline mindfulness, skills based mindfulness, and personality in adolescent alcohol and other drug use. PMID:24629324

Gender-moderated links between urgency, binge drinking, and excessive exercise.

PubMed

Reilly, Erin E; Dmochowski, Sasha; Schaumberg, Katherine; Earleywine, Mitch; Anderson, Drew

2016-01-01

Exercise correlates with alcohol use, but the nature of this relation and the extent to which it is maladaptive remains unclear. Urgency and motives for engaging in drinking and exercise might indicate when these behaviors are problematic. The current study examined whether urgency moderated the association between exercise motivated by weight loss and drinking. College students (N = 589, 45.7% male) completed the study during the spring of 2012. Participants completed self-report assessment measures, including frequency/quantity of alcohol consumption, exercise for weight loss, and urgency, during a single session. Negative urgency moderated the relation between exercise and alcohol consumption in men but not women; the link between excessive exercise and alcohol use was stronger for men with higher levels of urgency. Further clarification of the mechanisms underlying alcohol use and physical activity-particularly maladaptive approaches to exercise-will inform health interventions among college students.

Negative Urgency, Mood Induction, and Alcohol Seeking Behaviors

PubMed Central

VanderVeen, J. Davis; Plawecki, Martin H.; Millward, James B.; Hays, James; Kareken, David A.; O’Connor, Sean; Cyders, Melissa A.

2016-01-01

BACKGROUND Negative urgency, defined as impulsive risk-taking during extreme negative emotional states, is the most important impulsivity-related trait for alcohol-related problems and alcohol dependence. However, how negative urgency imparts risk for alcohol-related problems is not yet well understood. Therefore, the goal of the current study was to examine how negative urgency relates to separable aspects of the emotional experience and alcohol-seeking behaviors. METHODS A total of 34 (19 women) community-dwelling, alcohol-using adults aged 21–32 (mean age=24.86, SD=3.40, 74.3% Caucasian) completed two counterbalanced intravenous alcohol self-administration sessions: one during a neutral mood condition and one during a negative mood condition. RESULTS Negative urgency was associated with 1) greater mood change following negative mood induction (F=4.38, df=15, p=.002, η2=0.87), but was unrelated to changes in craving or cortisol release in response to mood induction; 2) greater alcohol craving prior to and after an alcohol prime (F=3.27, p=.02, η2=0.86), but only in the negative and not the neutral mood condition; and 3) higher peak BrAC (F=2.13, df=42, p=.02, η2=0.48), continuing to increase intoxication level over a longer period (F=3.77, df=42, p<.001, η2=0.62), and more alcohol seeking (F=21.73, df=22, p<.001, η2=0.94) throughout the negative session. Negative urgency was associated with overall lower cortisol release. CONCLUSIONS These results highlight the importance of assessing behavioral indicators of negative urgency under mood condition, and suggest that negative urgency may amplify alcohol self-administration through increased negative emotional reactivity to mood events and increased alcohol craving after initial alcohol exposure, leading to maintenance of alcohol related behavior. PMID:27291583

How impulsivity relates to compulsive buying and the burden perceived by caregivers after moderate-to-severe traumatic brain injury.

PubMed

Rochat, Lucien; Beni, Catia; Billieux, Joël; Annoni, Jean-Marie; Van der Linden, Martial

2011-01-01

Impulsivity is a core feature in patients with traumatic brain injury (TBI). The aim of the study is to investigate how a specific dimension of impulsivity, namely urgency (the tendency to act rashly when distressed), might shed new light on the aetiology of compulsive buying proneness in patients with TBI and to explore how urgency and compulsive buying relate to the burden perceived by the caregivers. Caregivers of 74 patients with TBI were given 3 questionnaires in order to assess their subjective burden as well as patients' impulsivity and compulsive buying proneness. Both urgency and compulsive buying tendencies significantly increased after TBI. Furthermore, path analyses revealed that current urgency was both directly and indirectly related to the subjective burden perceived by the caregivers, and this indirect pathway was mediated by compulsive buying. Urgency plays a central role in understanding specific problematic behaviours after TBI and their impact on caregivers. These findings are discussed in light of the cognitive processes underlying the urgency component of impulsivity in relation to the occurrence of compulsive buying behaviours after TBI. Copyright © 2011 S. Karger AG, Basel.

Negative Affect Mediates the Relation Between Trait Urgency and Behavioral Distress Tolerance

PubMed Central

Borges, Allison M.; Dahne, Jennifer; Lim, Aaron C.; MacPherson, Laura

2017-01-01

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. PMID:28080084

Negative affect mediates the relation between trait urgency and behavioral distress tolerance.

PubMed

Borges, Allison M; Dahne, Jennifer; Lim, Aaron C; MacPherson, Laura

2017-06-01

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impulsivity-like Traits and Risky Driving Behaviors among College Students

PubMed Central

Murphy, Elaine M.; Doane, Ashley N.

2017-01-01

The present study examined the predictive effects of five impulsivity-like traits (Premeditation, Perseverance, Sensation Seeking, Negative Urgency, and Positive Urgency) on driving outcomes (driving errors, driving lapses, driving violations, cell phone driving, traffic citations, and traffic collisions). With a convenience sample of 266 college student drivers, we found that each of the impulsivity-like traits was related to multiple risky driving outcomes. Positive Urgency (tendency to act impulsively when experiencing negative affect) was the most robust predictor of risky driving outcomes. Positive Urgency is a relatively newly conceptualized impulsivity-like trait that was not examined in the driving literature previously, suggesting a strong need to further examine its role as a personality trait related to risky driving. These findings generally support the multidimensional assessment of impulsivity-like traits, and they specifically support the addition of Positive Urgency to a list of risk factors for risky driving behaviors. PMID:23428428

Impulsivity-like traits and risky driving behaviors among college students.

PubMed

Pearson, Matthew R; Murphy, Elaine M; Doane, Ashley N

2013-04-01

The present study examined the predictive effects of five impulsivity-like traits (Premeditation, Perseverance, Sensation Seeking, Negative Urgency, and Positive Urgency) on driving outcomes (driving errors, driving lapses, driving violations, cell phone driving, traffic citations, and traffic collisions). With a convenience sample of 266 college student drivers, we found that each of the impulsivity-like traits was related to multiple risky driving outcomes. Positive Urgency (tendency to act impulsively when experiencing negative affect) was the most robust predictor of risky driving outcomes. Positive Urgency is a relatively newly conceptualized impulsivity-like trait that was not examined in the driving literature previously, suggesting a strong need to further examine its role as a personality trait related to risky driving. These findings generally support the multidimensional assessment of impulsivity-like traits, and they specifically support the addition of Positive Urgency to a list of risk factors for risky driving behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

Relationships between trait urgency, smoking reinforcement expectancies, and nicotine dependence

PubMed Central

Pang, Raina D.; Hom, Marianne S.; Geary, Bree A.; Doran, Neal; Spillane, Nichea S.; Guillot, Casey R.; Leventhal, Adam M.

2014-01-01

Urgency (i.e. the tendency to act rashly during negative/positive affect) may increase vulnerability to a variety of risky behaviors. This cross-sectional study of non-treatment-seeking smokers examined the relationship between urgency, level of nicotine dependence, and smoking reinforcement expectancies. Both positive and negative urgency were associated with nicotine dependence. Mediational analyses illustrated that smoking reinforcement expectancies significantly accounted for urgency-dependence relations, with negative reinforcement expectancies displaying incremental mediational effects. If replicated and extended, these findings may support the use of treatments that modify beliefs regarding smoking reinforcement outcomes as a means of buffering the risk of nicotine dependence carried by urgency. PMID:24784229

Role of muscarinic receptor antagonists in urgency and nocturia.

PubMed

Michel, Martin C; de la Rosette, Jean J M C H

2005-09-01

The overactive bladder (OAB) syndrome is defined as urgency, with or without urgency incontinence, usually accompanied by frequency and nocturia. Muscarinic receptor antagonists are the most established form of treatment for OAB, but until recently their effectiveness was only confirmed for symptoms of incontinence and frequency. In recent studies, selected muscarinic antagonists, including darifenacin, solifenacin, tolterodine and trospium, significantly reduced the number of urgency episodes per day relative to placebo. While some data raise the possibility that certain of these agents may be more effective than others in this regard, this variability in their effect on urgency needs to be confirmed in future studies. Moreover, it remains to be determined whether counting the number of urgency episodes or assessing the subjective intensity of the sensation of urgency more adequately reflects patient needs and therapeutic efficacy. For nocturia, muscarinic receptor antagonists have only inconsistently shown statistically greater effects than placebo. This inconsistency may relate to the multifactorial nature of nocturia, which even in patients with OAB can have many causes, not all of which may respond/be sensitive to muscarinic receptor antagonism.

Negative Urgency Mediates the Relationship between Amygdala and Orbitofrontal Cortex Activation to Negative Emotional Stimuli and General Risk-Taking

PubMed Central

Cyders, Melissa A.; Dzemidzic, Mario; Eiler, William J.; Coskunpinar, Ayca; Karyadi, Kenny A.; Kareken, David A.

2015-01-01

The tendency toward impulsive behavior under emotional duress (negative and positive urgency) predicts a wide range of maladaptive risk-taking and behavioral disorders. However, it remains unclear how urgency relates to limbic system activity as induced from emotional provocation. This study used functional magnetic resonance imaging to examine the relationship between brain responses to visual emotional stimuli and urgency traits. Twenty-seven social drinkers (mean age = 25.2, 14 males) viewed negative (Neg), neutral (Neu), and positive (Pos) images during 6 fMRI scans. Brain activation was extracted from a priori limbic regions previously identified in studies of emotional provocation. The right posterior orbitofrontal cortex (OFC) and left amygdala were activated in the [Neg>Neu] contrast, whereas the left posterior OFC was activated in the [Pos>Neu] contrast. Negative urgency was related to the right lateral OFC (r = 0.43, P = 0.03) and the left amygdala (r = 0.39, P = 0.04) [Neg>Neu] activation. Negative urgency also mediated the relationship between [Neg>Neu] activation and general risk-taking (regression weights = 3.42 for right OFC and 2.75 for the left amygdala). Emotional cue-induced activation in right lateral OFC and left amygdala might relate to emotion-based risk-taking through negative urgency. PMID:24904065

A Comparative Study on the Efficacy of Solifenacin Succinate in Patients with Urinary Frequency with or without Urgency

PubMed Central

Han, Ji-Yeon; Lee, Kyu-Sung; Park, Won Hee; Park, Choal Hee; Lee, Jeong Gu; Lee, Jeong Zoo; Kim, Duk Yoon; Na, Yong Gil; Kwon, Dong Deuk; Choo, Myung-Soo

2014-01-01

Objectives Patients with overactive bladder (OAB) often have trouble perceiving urgency because of difficulties in distinguishing between urgency and desire to void. Empirical antimuscarinic treatment of patients with frequency only may be reasonable if conservative management has failed. We compared the efficacy of solifenacin in patients with frequency with or without urgency. Materials and Methods This multicenter, 12-week, open-label, comparative, non-inferiority clinical trial assessed whether the solifenacin efficacy for frequency without urgency is non-inferior to its efficacy for frequency with urgency. All patients had micturition frequency ≥8 voids/day with or without urgency. Primary efficacy variable: daily frequency change at 12 weeks relative to baseline. Secondary efficacy variables: change at 12 weeks relative to baseline in Patients' Perception of Bladder Condition (PPBC), OAB Symptom Score (OABSS), and Benefit, Satisfaction, Willingness to continue (BSW) questionnaire. Results Of the 286 enrolled patients, 240 (83.9%) completed the study (without urgency n = 115; with urgency n = 125). Full dataset analysis revealed that the groups without and with urgency exhibited significant reductions in daily micturition frequency of −2.49±0.35 (mean ± standard error) and −2.63±0.37, respectively. The lower limit of the 95% two-sided CI of the comparison of the two group means was −1.14, which is smaller than the −0.8 margin of clinical equivalence. The two groups did not differ in improvement in PPBC, OABSS, or BSW scores. Both tolerated the treatment well. Conclusions It was not possible to verify that the solifenacin efficacy for frequency alone was non-inferior to its efficacy for OAB. Nevertheless, solifenacin tended to be effective for frequency regardless of urgency. Trial Registration ClinicalTrials.gov NCT00979472 PMID:25401784

Impulsivity and Alcohol-Related Risk among College Students: Examining Urgency, Sensation Seeking and the Moderating Influence of Beliefs about Alcohol's Role in the College Experience

PubMed Central

LaBrie, Joseph W.; Kenney, Shannon R.; Napper, Lucy E.; Miller, Kevin

2013-01-01

The personality trait of impulsivity is predictive of heavy drinking and consequences among college students. The current study examined how impulsivity—measured via positive urgency, negative urgency, and sensation seeking—and a person's beliefs about the role alcohol plays in the college experience relate to drinking and consequences in a sample of 470 college students (mean age = 19 years, 61.3% female, 59.8% white). In support of hypotheses, sensation seeking independently predicted greater drinking, and both positive and negative urgency predicted greater experience of alcohol-related negative consequences after controlling for consumption level. Moreover, alcohol beliefs moderated the relationship between impulsivity types and alcohol outcomes. Among students high (versus low) in sensation seeking, strong beliefs about alcohol's role in college life were related to significantly greater drinking, and among students high (versus low) in negative urgency, endorsing strong beliefs about alcohol's role in college life were related to greater levels of alcohol-related negative consequences. Overall, findings inform college prevention efforts by highlighting the need to distinguish unique facets of impulsivity and examine how they intersect with students’ beliefs about alcohol in college. PMID:24120644

Urgency of micturition and detrusor contractility in men with prostatic obstruction and overactive bladders.

PubMed

Cucchi, A; Quaglini, S; Giannantoni, A; Guarnaschelli, C; Rovereto, B

2005-01-01

In men with prostatic obstruction and detrusor overactivity (DO), to ascertain whether urgency of micturition affects bladder contractility. We urodynamically assessed five groups of 20 men each who had bladder outflow obstruction (BOO) from benign prostatic enlargement-Groups 1 (with no DO and no urgency), 2 (with DO and no urgency), 3A (with DO and moderate urgency), 3B (with DO and severe urgency), and 4 (with DO, severe urgency and chronic ischemic cerebral lesions). Urgency was graded as moderate or severe by the ability to avert an urgent void at cystometry for > or =2 or <2 min, respectively. BOO was assessed by the "Abrams-Griffiths number" (AG) and bladder contractility by the parameters PIP and WF(max). AG did not differ significantly in Groups 2, 3A, and 3B, proved higher in such groups than in Group 1, and was nearly the same in Groups 1 and 4. PIP and WF(max) were significantly higher in Groups 2, 3A, and 3B than in Groups 1 and 4, had the highest levels in Group 3B, and did not differ significantly in Groups 1-4 and 2-3A. In DO patients with prostatic obstruction there seems to be a DO-related facilitation of bladder contractility. In the same patients, severe urgency of micturition might over-amplify (i.e., enhance a DO-related facilitation of) bladder contractility, provided there are no neurogenic (chronic ischemic cerebral) lesions.

Basic mechanisms of urgency: preclinical and clinical evidence.

PubMed

Michel, Martin C; Chapple, Christopher R

2009-08-01

Urgency is the core symptom of the overactive bladder symptom complex, but the underlying mechanisms are not fully understood. To review clinical and experimental studies related to how bladder filling and urgency are sensed and what causes urgency and to discuss how this process affects potential therapeutic strategies. Review of published reports. The definition of urgency as a desire implies that it can only be assessed in cognitively intact patients and that animal studies have to rely on surrogate markers thereof, such as detrusor overactivity (DO); however, DO and urgency are not always associated. While the precise mechanisms of how urgency is sensed remain unclear, accumulating evidence suggests that they may differ from the physiologic sensation of bladder filling. Studies on the neurophysiology of urgency sensing are hampered by reliance on the surrogate marker DO. Functional brain imaging may help to understand the central neurophysiology, but, until now, it has not specifically focused on urgency. With regard to causes of urgency, multiple theories have been forwarded. While none of them has been proven, it should be noted that they are not mutually exclusive, and, in specific patients, different causes may be present. The development of improved therapeutic strategies against urgency will be helped by a better understanding of how urgency is perceived and the underlying causes. Rigorous use of existing definitions and the search for reliable surrogate markers will aid such attempts.

The interaction of stress and urgency urinary incontinence and its effect on quality of life.

PubMed

Minassian, Vatché A; Sun, Haiyan; Yan, Xiaowei S; Clarke, Deseraé N; Stewart, Walter F

2015-02-01

The objective was to estimate the impact of stress and urgency urinary incontinence (UI) on the quality of life (QOL), and to determine whether the impact varies according to UI severity. We used data from the General Longitudinal Overactive Bladder Evaluation-UI study in women. Stress and urgency UI symptom severity scores ranged from 0 to 8. We used logistic regression to test the relation among different severity levels of stress and urgency UI, and their interaction with the Incontinence Impact Questionnaire (IIQ-7). This was categorized according to percentage ranges as 0-40% (reference), 41-80%, and 81-100%. Both stress and urgency UI were significantly associated with IIQ-7. Higher scores had higher odds ratios (ORs). The OR for urgency vs stress UI was greater at the same severity level. For instance, comparing IIQ-7 quintiles (0-40% vs 41-80%), the OR for an association with an urgency UI score of 5-6 was 5.27 (95% CI = 3.78-7.33) vs 2.76 (95% CI = 2.07-3.68) for a stress UI score of 5-6. Both UI subtypes were more strongly related to the upper (81-100%) than the to the lower (41-80%) quintiles. There was a strong positive urgency UI and stress UI interaction with the upper (i.e., 81-100%) but not the two next lower (41-80%) quintiles. The impact of UI subtypes on QOL varies according to the score of IIQ-7, stress and urgency UI, and their interaction. Urgency vs stress UI has a stronger impact. The effect is greatest for high IIQ-7 scores with a significant share mediated by the interaction of the two UI subtypes.

The structure of the UPPS-R-Child impulsivity scale and its relations with substance use outcomes among treatment-seeking adolescents.

PubMed

Tomko, Rachel L; Prisciandaro, James J; Falls, Sandhya Kutty; Magid, Viktoriya

2016-04-01

A youth version of the UPPS Impulsivity Scale (UPPS-R-C) was previously shown to predict drinking initiation among pre-adolescents. The goals of the current study were to confirm the structure of the UPPS-R-C using a sample of treatment-seeking adolescents and to examine the scales' relations with alcohol use, marijuana use, and problems related to substance use. Participants (N=120; ages 12-18; M=15.7) completed questionnaires at treatment intake. Confirmatory factor analysis (CFA) of the UPPS-R-C was conducted using a 5-factor model with factors corresponding to negative urgency, positive urgency, lack of perseverance, lack of premeditation, and sensation seeking. Relations between UPPS-R-C factors and binge drinking, marijuana use, and problems resulting from substance use were examined using path analysis. CFA suggested the 5-factor model provided adequate fit to the data. The hypothesized path model was partially supported, positive urgency was associated with frequency of binge drinking, and both negative urgency and frequency of binge drinking was associated with problems due to substance use. Other hypothesized paths were not significant. Although not hypothesized, negative urgency was associated with frequency of marijuana use and lack of perseverance was associated with problems due to use. Results suggest that the UPPS-R-C can be used with a treatment-seeking sample of adolescents. Furthermore, negative urgency, positive urgency, and lack of perseverance may be indicative of more severe substance use problems in a treatment setting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Interactive and Indirect Effects of Anxiety and Negative Urgency on Alcohol-Related Problems

PubMed Central

Menary, Kyle R.; Corbin, William R.; Leeman, Robert F.; Fucito, Lisa M.; Toll, Benjamin A.; DeMartini, Kelly; O’Malley, Stephanie S.

2015-01-01

Background Although drinking for tension reduction has long been posited as a risk factor for alcohol-related problems, studies investigating anxiety in relation to risk for alcohol problems have returned inconsistent results, leading researchers to search for potential moderators. Negative urgency (the tendency to become behaviorally dysregulated when experiencing negative affect) is a potential moderator of theoretical interest because it may increase risk for alcohol problems among those high in negative affect. The present study tested a cross-sectional mediated moderation hypothesis whereby an interactive effect of anxiety and negative urgency on alcohol problems is mediated through coping-related drinking motives. Method The study utilized baseline data from a hazardously drinking sample of young adults (N = 193) evaluated for participation in a randomized controlled trial of naltrexone and motivational interviewing for drinking reduction. Results The direct effect of anxiety on physiological dependence symptoms was moderated by negative urgency such that the positive association between anxiety and physiological dependence symptoms became stronger as negative urgency increased. Indirect effects of anxiety and negative urgency on alcohol problems (operating through coping motives) were also observed. Conclusions Although results of the current cross-sectional study require replication using longitudinal data, the findings suggest that the simultaneous presence of anxiety and negative urgency may be an important indicator of risk for AUDs via both direct interactive effects and indirect additive effects operating through coping motives. These findings have potentially important implications for prevention/intervention efforts for individuals who become disinhibited in the context of negative emotional states. PMID:26031346

The Structure of the UPPS-R-Child Impulsivity Scale and its Relations with Substance Use Outcomes Among Treatment-Seeking Adolescents

PubMed Central

Prisciandaro, James J.; Kutty Falls, Sandhya; Magid, Viktoriya

2016-01-01

Background A youth version of the UPPS Impulsivity Scale (UPPS-R-C) was previously shown to predict drinking initiation among pre-adolescents. The goals of the current study were to confirm the structure of the UPPS-R-C using a sample of treatment-seeking adolescents and to examine the scales’ relations with alcohol use, marijuana use, and problems related to substance use. Method Participants (N = 120; ages 12–18; M = 15.7) completed questionnaires at treatment intake. Confirmatory factor analysis (CFA) of the UPPS-R-C was conducted using a 5-factor model with factors corresponding to negative urgency, positive urgency, lack of perseverance, lack of premeditation, and sensation seeking. Relations between UPPS-R-C factors and binge drinking, marijuana use, and problems resulting from substance use were examined using path analysis. Results CFA suggested the 5-factor model provided adequate fit to the data. The hypothesized path model was partially supported, positive urgency was associated with frequency of binge drinking, and both negative urgency and frequency of binge drinking was associated with problems due to substance use. Other hypothesized paths were not significant. Although not hypothesized, negative urgency was associated with frequency of marijuana use and lack of perseverance was associated with problems due to use. Conclusions Results suggest that the UPPS-R-C can be used with a treatment-seeking sample of adolescents. Furthermore, negative urgency, positive urgency, and lack of perseverance may be indicative of more severe substance use problems in a treatment setting. PMID:26905208

Gender-Moderated Links between Urgency, Binge Drinking, and Excessive Exercise

ERIC Educational Resources Information Center

Reilly, Erin E.; Dmochowski, Sasha; Schaumberg, Katherine; Earleywine, Mitch; Anderson, Drew

2016-01-01

Objective: Exercise correlates with alcohol use, but the nature of this relation and the extent to which it is maladaptive remains unclear. Urgency and motives for engaging in drinking and exercise might indicate when these behaviors are problematic. The current study examined whether urgency moderated the association between exercise motivated by…

The role of urgency and its underlying psychological mechanisms in problematic behaviours.

PubMed

Billieux, Joël; Gay, Philippe; Rochat, Lucien; Van der Linden, Martial

2010-11-01

The urgency facet of impulsivity, that is, the tendency to act rashly in response to intense emotional contexts [Cyders, M. A., & Smith, G. T. (2008). Emotion-based dispositions to rash action: positive and negative urgency. Psychological Bulletin, 134, 807-828], has been related to a wide range of maladaptive behaviours. The present study further investigates the role of urgency in problematic behaviours by considering distinct psychological mechanisms that may underlie this component of impulsivity. With this aim, 95 volunteer participants were screened with self-reported questionnaires assessing urgency and three problematic behaviours (compulsive buying, excessive mobile phone use, excessive Internet use). They performed two laboratory tasks: a stop-signal task designed to assess the capacity to inhibit prepotent responses in response to both neutral and emotional stimuli; and the Iowa Gambling Task (IGT) measuring the ability to take into account the future consequences of an action. A poor ability to inhibit prepotent responses in the emotional condition of the stop-signal task was found to predict more disadvantageous choices in the IGT, which ultimately results in higher urgency and more problematic behaviours. These findings shed new light on the construct of urgency, its related psychological mechanisms, and its role in problematic behaviours. Copyright © 2010 Elsevier Ltd. All rights reserved.

Changes in negative urgency, positive urgency, and sensation seeking across adolescence

PubMed Central

Littlefield, Andrew K.; Stevens, Angela K.; Ellingson, Jarrod M.; King, Kevin M.; Jackson, Kristina M.

2016-01-01

The development and potential co-development of traits related to impulsivity and sensation seeking across adolescence has garnered substantial attention within the extant literature. Some prior research suggests that facets show distinct patterns of change across adolescence and that intraindividual changes in these traits may be unrelated. However, the extant literature is somewhat hampered by measurement issues and inconsistent findings. Using an accelerated longitudinal design in a sample of adolescents (n = 1018; ages 11–16), changes in negative urgency, positive urgency, and sensation seeking were examined. The three facets showed similar trajectories across time (i.e., increasing during early adolescence before leveling off). Across all facets, there was strong evidence of correlated change, suggesting these traits are, developmentally, strongly related phenomena. PMID:26949280

Changes in negative urgency, positive urgency, and sensation seeking across adolescence.

PubMed

Littlefield, Andrew K; Stevens, Angela K; Ellingson, Jarrod M; King, Kevin M; Jackson, Kristina M

2016-02-01

The development and potential co-development of traits related to impulsivity and sensation seeking across adolescence has garnered substantial attention within the extant literature. Some prior research suggests that facets show distinct patterns of change across adolescence and that intraindividual changes in these traits may be unrelated. However, the extant literature is somewhat hampered by measurement issues and inconsistent findings. Using an accelerated longitudinal design in a sample of adolescents ( n = 1018; ages 11-16), changes in negative urgency, positive urgency, and sensation seeking were examined. The three facets showed similar trajectories across time (i.e., increasing during early adolescence before leveling off). Across all facets, there was strong evidence of correlated change, suggesting these traits are, developmentally, strongly related phenomena.

Associations between Negative Affect and Binge/Purge Behaviors in Women with Anorexia Nervosa: Considering the Role of Negative Urgency

PubMed Central

Culbert, Kristen M.; Lavender, Jason M.; Crosby, Ross D.; Wonderlich, Stephen A.; Engel, Scott G.; Peterson, Carol B.; Mitchell, James E.; Crow, Scott J.; Grange, Daniel Le; Cao, Li; Fischer, Sarah

2016-01-01

Objective Evidence implicates negative affect in the occurrence of binge/purge behaviors, although the extent to which theoretically relevant individual difference variables may impact this association remains unclear. Negative urgency, the dispositional tendency to engage in rash action when experiencing negative affect, is a unique facet of impulsivity that may play a key role. Moreover, it was hypothesized that women with anorexia nervosa (AN) who are higher on measures of negative urgency, relative to those lower on negative urgency, would exhibit: 1) greater binge eating and purging frequencies on high negative affect days, and 2) a greater change in negative affect prior to and following binge eating and purging episodes. Method Women with AN (n = 82) completed a self-report measure of negative urgency and a 2-week ecological momentary assessment protocol in which they recorded binge eating, purging, and negative affect ratings. Results Women with higher levels of negative urgency exhibited a greater frequency of binge eating and purging; however, in comparison to women low on negative urgency, they: 1) were more likely to binge eat on days corresponding with low-to-moderate negative affect (similar rates of binge eating were observed on high negative affect days), and 2) displayed substantially elevated levels of negative affect across time, and thus, smaller degrees of change in negative affect prior to and following binge eating and purging episodes. Discussion Negative urgency underlies individual differences in the daily experience of negative affect. Women with AN who are high on negative urgency may have an increased propensity for binge eating and purging via a relatively persistent and heightened state of negative emotions. PMID:26995243

Associations between negative affect and binge/purge behaviors in women with anorexia nervosa: Considering the role of negative urgency.

PubMed

Culbert, Kristen M; Lavender, Jason M; Crosby, Ross D; Wonderlich, Stephen A; Engel, Scott G; Peterson, Carol B; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Cao, Li; Fischer, Sarah

2016-04-01

Evidence implicates negative affect in the occurrence of binge/purge behaviors, although the extent to which theoretically relevant individual difference variables may impact this association remains unclear. Negative urgency, the dispositional tendency to engage in rash action when experiencing negative affect, is a unique facet of impulsivity that may play a key role. Moreover, it was hypothesized that women with anorexia nervosa (AN) who are higher on measures of negative urgency, relative to those lower on negative urgency, would exhibit: 1) greater binge eating and purging frequencies on high negative affect days, and 2) a greater change in negative affect prior to and following binge eating and purging episodes. Women with AN (n=82) completed a self-report measure of negative urgency and a 2-week ecological momentary assessment protocol in which they recorded binge eating, purging, and negative affect ratings. Women with higher levels of negative urgency exhibited a greater frequency of binge eating and purging; however, in comparison to women low on negative urgency, they: 1) were more likely to binge eat on days corresponding with low-to-moderate negative affect (similar rates of binge eating were observed on high negative affect days), and 2) displayed substantially elevated levels of negative affect across time, and thus, smaller degrees of change in negative affect prior to and following binge eating and purging episodes. Negative urgency underlies individual differences in the daily experience of negative affect. Women with AN who are high on negative urgency may have an increased propensity for binge eating and purging via a relatively persistent and heightened state of negative emotions. Copyright © 2016 Elsevier Inc. All rights reserved.

Drinking motives as mediators of the impulsivity-substance use relation: pathways for negative urgency, lack of premeditation, and sensation seeking.

PubMed

Adams, Zachary W; Kaiser, Alison J; Lynam, Donald R; Charnigo, Richard J; Milich, Richard

2012-07-01

Trait impulsivity is a reliable, robust predictor of risky, problematic alcohol use. Mounting evidence supports a multidimensional model of impulsivity, whereby several distinct traits serve as personality pathways to rash action. Different impulsivity-related traits may predispose individuals to drink for different reasons (e.g., to enhance pleasure, to cope with distress) and these different motives may, in turn, influence drinking behavior. Previous findings support such a mediational model for two well-studied traits: sensation seeking and lack of premeditation. This study addresses other impulsivity-related traits, including negative urgency. College students (N=432) completed questionnaires assessing personality, drinking motives, and multiple indicators of problematic drinking. Negative urgency, sensation seeking, and lack of premeditation were all significantly related to problematic drinking. When drinking motives were included in the model, direct effects for sensation seeking and lack of premeditation remained significant, and indirect effects of sensation seeking and lack of premeditation on problematic drinking were observed through enhancement motives. A distinct pathway was observed for negative urgency. Negative urgency bore a significant total effect on problematic drinking through both coping and enhancement motives. This study highlights unique motivational pathways through which different impulsive traits may operate, suggesting that interventions aimed at preventing or reducing problematic drinking should be tailored to individuals' personalities. For instance, individuals high in negative urgency may benefit from learning healthier strategies for coping with distress. Copyright © 2012 Elsevier Ltd. All rights reserved.

Drinking Motives as Mediators of the Impulsivity-Substance Use Relation: Pathways for Negative Urgency, Lack of Premeditation, and Sensation Seeking

PubMed Central

Adams, Zachary W.; Kaiser, Alison J.; Lynam, Donald R.; Charnigo, Richard J.; Milich, Richard

2012-01-01

Trait impulsivity is a reliable, robust predictor of risky, problematic alcohol use. Mounting evidence supports a multidimensional model of impulsivity, whereby several distinct traits serve as personality pathways to rash action. Different impulsivity-related traits may predispose individuals to drink for different reasons (e.g., to enhance pleasure, to cope with distress) and these different motives may, in turn, influence drinking behavior. Previous findings support such a mediational model for two well-studied traits: sensation seeking and lack of premeditation. This study addresses other impulsivity-related traits, including negative urgency. College students (N = 432) completed questionnaires assessing personality, drinking motives, and multiple indicators of problematic drinking. Negative urgency, sensation seeking, and lack of premeditation were all significantly related to problematic drinking. When drinking motives were included in the model, direct effects for sensation seeking and lack of premeditation remained significant, and indirect effects of sensation seeking and lack of premeditation on problematic drinking were observed through enhancement motives. A distinct pathway was observed for negative urgency. Negative urgency bore a significant total effect on problematic drinking through both coping and enhancement motives. This study highlights unique motivational pathways through which different impulsive traits may operate, suggesting that interventions aimed at preventing or reducing problematic drinking should be tailored to individuals' personalities. For instance, individuals high in negative urgency may benefit from learning healthier strategies for coping with distress. PMID:22472524

Impulsivity Dimensions and Risky Sex Behaviors in an At-Risk Young Adult Sample.

PubMed

Curry, Inga; Luk, Jeremy W; Trim, Ryan S; Hopfer, Christian J; Hewitt, John K; Stallings, Michael C; Brown, Sandra A; Wall, Tamara L

2018-02-01

Impulsivity is a personality-based risk factor that has been well studied in relation to risky sexual behavior. Recent conceptualizations of impulsivity have proposed multidimensional facets comprised of premeditation, perseverance, sensation seeking, negative urgency, and positive urgency (UPPS-P model). Prior studies have found that these facets are associated with risky sexual behavior in adolescent and college student samples, but no prior studies have evaluated them in clinical samples. The current study examined how impulsivity-related traits related to two different risky sexual behaviors in a clinical sample of at-risk young adults who had both conduct disorder and substance use disorder symptoms as adolescents (n = 529). Lack of premeditation was also tested as a moderator of the relationship between facets of impulsivity and both risky sex outcomes. Results demonstrated that sensation seeking, negative urgency, and positive urgency were correlated with risky sex behaviors. Additionally, multiple regression analyses indicated that sensation seeking was uniquely associated with the number of sexual partners in the past 5 years, whereas positive urgency was uniquely associated with unprotected sex while under the influence. Finally, a significant interaction between lack of premeditation and negative urgency suggests that at-risk young adults with both high negative urgency and lack of premeditation were the likeliest to have the most sexual partners in the past 5 years. This study adds to the current understanding of the relationship between reward- and affect-driven facets of impulsivity and risky sexual behaviors and may lend utility to the development of interventions for at-risk populations.

The role of urgency, frequency, and nocturia in defining overactive bladder adaptive behavior.

PubMed

Minassian, Vatche; Stewart, Walter; Hirsch, Annemarie; Kolodner, Ken; Fitzgerald, Mary; Burgio, Kathryn; Cundiff, Geoffrey; Blaivas, Jerry; Newman, Diane; Dilley, Anne

2011-03-01

To determine the relation between urgency alone, or in combination with frequency and nocturia, and adaptive behavior in overactive bladder (OAB) syndrome. We used survey data from the General Longitudinal Overactive Bladder Evaluation (GLOBE) of primary care patients over 40. Participants (n=2,752: 1,557 females; 1,195 males) completed the same survey at two time points, 6 months apart. Questions assessed OAB symptoms and adaptive behavior. We estimated correlation coefficients (R(2)) between urgency, frequency, and nocturia symptom scores (alone and in combination) and adaptive behavior measures at baseline and change in symptom scores and behavioral measures from baseline to 6 months. At baseline, urgency was the dominant predictor of all behavioral measures for females (R(2)=0.19-0.48) and males (R(2)=0.15-0.39). Lower R(2) values were observed for the change in measures from baseline to 6 months, but again change in urgency was the strongest predictor of change in adaptive behavior (R(2)=0.04-0.13 in females, and 0.02-0.08 in males). The correlation between symptoms and measures of adaptive behavior was almost completely explained by the urgency score. Frequency and nocturia did not substantially improve the overall correlation. The relation between measures of OAB symptoms and adaptive behavior at baseline and over time are largely explained by urgency, not by frequency and nocturia. Copyright © 2011 Wiley-Liss, Inc.

Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents

PubMed Central

Marmorstein, Naomi R.

2015-01-01

This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents (N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms. PMID:27512337

Investigating the moderating role of emotional awareness in the association between urgency and binge eating.

PubMed

Manjrekar, Eishita; Berenbaum, Howard; Bhayani, Natasha

2015-04-01

Binge eating has been found to be associated with urgency (the tendency to act impulsively in response to negative affect) and emotional awareness (i.e., attention to emotions, clarity of emotions). The present study tested the hypothesis that the relation between binge eating and urgency would be moderated by emotional awareness, over and above negative affect. Participants were 249 female college students. Items from the Trait Meta Mood Scale (TMMS), the Urgency subscale of the UPPS Impulsive Behavior Scale, and the Bulimia (B) subscale of the Eating Disorders Inventory (EDI-3) were administered. As predicted, emotional awareness moderated the link between urgency and binge eating. Both Urgency×Attention to emotions and Urgency×Clarity of emotions significantly predicted binge eating scores, even after taking into account negative affect. Consistent with past research, higher levels of urgency were associated with higher levels of binge eating, even after taking negative affect into account. However, the associations were particularly strong among individuals with low levels of attention to emotions and low levels of clarity of emotions. The findings from this study have implications for future research examining binge eating. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anxiety sensitivity and negative urgency: a pathway to negative reinforcement-related smoking expectancies.

PubMed

Guillot, Casey R; Pang, Raina D; Leventhal, Adam M

2014-01-01

Anxiety sensitivity--fear of anxiety symptoms--may increase motivation to smoke by influencing the development of cognitive expectations regarding smoking's negative reinforcing effects; yet, the nature and mechanisms of this pathway are unclear. We hypothesized that relations between anxiety sensitivity and negative reinforcement-related smoking expectancies would be mediated by negative urgency, that is, a trait tendency to act impulsively during negative affect. In a cross-sectional design, we administered self-report measures of anxiety sensitivity, negative urgency, and negative reinforcement-related smoking outcome and abstinence expectancies to 205 smokers (≥10 cigarettes/d, 34% female, M age = 44.4 years). Anxiety sensitivity was associated with stronger expectancies that smoking alleviates negative affect (β = 0.30; P < 0.0001) and smoking abstinence exacerbates aversive withdrawal symptoms (β = 0.24; P = 0.0004). Negative urgency partially mediated the relation between anxiety sensitivity and both types of negative reinforcement-related smoking expectancies (βs ≥ 0.057; Ps ≤ 0.007). Results remained significant after statistically controlling for anxiety and nicotine dependence symptoms. Smokers high in anxiety sensitivity tend to display negative urgency, which in turn is related to greater expectations of negative reinforcement consequences of smoking and smoking abstinence. Treatments that mitigate fear of anxiety symptoms and the tendency to act impulsively in response to negative affect (eg, interoceptive exposure, distress tolerance skills training, and mindfulness training) may be particularly useful in assisting with smoking cessation for high-anxiety sensitivity smokers.

Dimensions of impulsivity in relation to eating disorder recovery.

PubMed

Bardone-Cone, Anna M; Butler, Rachel M; Balk, Margaret R; Koller, Katherine A

2016-11-01

Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031). © 2016 Wiley Periodicals, Inc.

The relationship between negative urgency and generalized anxiety disorder symptoms: the role of intolerance of negative emotions and intolerance of uncertainty.

PubMed

Pawluk, Elizabeth J; Koerner, Naomi

2016-11-01

GAD symptoms are associated with greater negative urgency, a dimension of impulsivity defined as the tendency to act rashly when distressed. This study examined the degree to which intolerance of negative emotional states and intolerance of uncertainty account for the association between negative urgency and GAD symptoms. An analysis of indirect effects evaluated whether intolerance of negative emotions and intolerance of uncertainty uniquely account for the association between negative urgency and GAD symptom severity. Undergraduate students (N = 308) completed measures of GAD symptoms, trait anxiety, negative urgency, distress tolerance, and intolerance of uncertainty. Greater symptoms of GAD, intolerance of negative emotional states, and intolerance of uncertainty were associated with greater negative urgency. There was an indirect relationship between negative urgency and GAD symptoms through intolerance of negative emotional states and intolerance of uncertainty even when controlling for trait anxiety. Intolerance of negative emotional states and intolerance of uncertainty each had an indirect relationship with GAD severity through negative urgency, suggesting possible bi-directional relations. Future studies should examine the role of intolerance of negative emotional states and intolerance of uncertainty in the impulsive behavior of individuals with GAD, and whether impulsive behavior reinforces these processes.

Influence of Parental Expressed Emotions on Children's Emotional Eating via Children's Negative Urgency.

PubMed

Munsch, Simone; Dremmel, Daniela; Kurz, Susanne; De Albuquerque, Jiske; Meyer, Andrea H; Hilbert, Anja

2017-01-01

We investigated whether parental expressed emotion (criticism and emotional overinvolvement) is related to children's emotional eating and whether this relationship is mediated by children's negative urgency. One hundred children, aged 8 to 13 years, either healthy or have binge-eating disorder and/or attention-deficit/hyperactivity disorder, completed the questionnaires, along with their parents. Parental criticism and, to a lesser extent, parental emotional overinvolvement were both positively related to children's emotional eating, and this relationship was mediated by children's negative urgency. Further exploratory analyses revealed that the mediating role of children's negative urgency in the relationship between parental criticism and children's emotional eating was pronounced in the clinical group of children with binge-eating disorder and attention-deficit/hyperactivity disorder but almost absent in the healthy control group. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Differential effects of social stress on laboratory-based decision-making are related to both impulsive personality traits and gender.

PubMed

Wise, Richard J; Phung, Alissa L; Labuschagne, Izelle; Stout, Julie C

2015-01-01

Urgency is the tendency to make impulsive decisions under extreme positive or negative emotional states. Stress, gender and impulsive personality traits are all known to influence decision-making, but no studies have examined the interplay of all of these factors. We exposed 78 men and women to a stress or a non-stress condition, and then administered the Balloon Analogue Risk Task. We found that stress effects varied as a function of gender and urgency traits. Under stress, women low in negative urgency and men high in negative urgency made fewer risky decisions. Positive urgency yielded a similar pattern. Thus, decisions under stress depend on a complex interplay between gender and impulsive personality traits. These findings have implications for clinical disorders, such as substance use disorders, in which there are known deficits in decision-making and high levels of impulsive traits.

Negative urgency and emotion regulation predict positive smoking expectancies in non-smoking youth.

PubMed

Dir, Allyson L; Banks, Devin E; Zapolski, Tamika C B; McIntyre, Elizabeth; Hulvershorn, Leslie A

2016-07-01

The purpose of the study was to better understand early risk for positive smoking expectancies, which have been shown to be consistent predictors of smoking initiation among youth. Two affect-based risk factors-negative urgency and emotion dysregulation-associated with smoking behaviors among youth, were examined for unique and interactive effects on positive smoking expectancies among substance-naïve youth. Participants were 61 10-14-year-old children with virtually no drug use (less than 5 substance use incidents across the lifetime), who were drawn from the community. Both negative urgency and emotion dysregulation were significantly associated with positive social facilitation smoking expectancies. Further, negative urgency was significantly related to positive social facilitation smoking expectancies at higher levels of emotion dysregulation (b=.09, p=.001). The findings provide evidence that both emotion dysregulation and negative urgency are positively associated with positive social-related smoking expectancies among a sample of 10-14-year-olds. Children who are emotionally dysregulated and who act rashly in response to negative emotions appear more likely to endorse beliefs regarding the socially enhancing effects of smoking, suggesting that these youth may be at high risk for smoking initiation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development and psychometric evaluation of the urgency questionnaire for evaluating severity and health-related quality of life impact of urinary urgency in overactive bladder.

PubMed

Coyne, Karin S; Sexton, Chris C; Thompson, Christine; Bavendam, Tamara; Brubaker, Linda

2015-03-01

Urinary urgency is the cardinal symptom of overactive bladder (OAB). However, there is no single instrument that assesses the context, severity, intensity, and daily life impact of urinary urgency. The purpose of this manuscript is to describe the methods and results of the qualitative and quantitative research conducted to develop a new tool for this purpose, the Urgency Questionnaire (UQ). Qualitative data from interviews with patients with urinary urgency were used to develop and refine the items and response options of the UQ. Three studies were used to evaluate psychometric properties: a clinical trial of tolterodine (Detrol; n = 974); a psychometric validation study (n = 163); and a test-retest validation study (n = 47). Item and exploratory factor analysis (EFA) were performed to assess the subscale structure, and the psychometric performance of the resulting scales was evaluated. Fifteen Likert-scale items and four VAS questions were retained. A four-factor solution was shown to best fit the data, with the subscales: Impact on Daily Activities, Time to Control Urgency, Nocturia, and Fear of Incontinence. All subscales and VAS items demonstrated good reliability (Cronbach's α 0.79-0.94), convergent and discriminant validity, and responsiveness to change. The UQ differentiated between OAB patients and controls. The results provide quantitative evidence that urinary urgency, as assessed by the UQ, is a pathological sensation distinctive from the normal urge to void and suggest that the UQ might be a reliable, valid, and responsive instrument for evaluating the severity and HRQL impact of urinary urgency in OAB.

Judging the urgency of non-verbal auditory alarms: a case study.

PubMed

Arrabito, G Robert; Mondor, Todd; Kent, Kimberley

2004-06-22

When designed correctly, non-verbal auditory alarms can convey different levels of urgency to the aircrew, and thereby permit the operator to establish the appropriate level of priority to address the alarmed condition. The conveyed level of urgency of five non-verbal auditory alarms presently used in the Canadian Forces CH-146 Griffon helicopter was investigated. Pilots of the CH-146 Griffon helicopter and non-pilots rated the perceived urgency of the signals using a rating scale. The pilots also ranked the urgency of the alarms in a post-experiment questionnaire to reflect their assessment of the actual situation that triggers the alarms. The results of this investigation revealed that participants' ratings of perceived urgency appear to be based on the acoustic properties of the alarms which are known to affect the listener's perceived level of urgency. Although for 28% of the pilots the mapping of perceived urgency to the urgency of their perception of the triggering situation was statistically significant for three of the five alarms, the overall data suggest that the triggering situations are not adequately conveyed by the acoustic parameters inherent in the alarms. The pilots' judgement of the triggering situation was intended as a means of evaluating the reliability of the alerting system. These data will subsequently be discussed with respect to proposed enhancements in alerting systems as it relates to addressing the problem of phase of flight. These results call for more serious consideration of incorporating situational awareness in the design and assignment of auditory alarms in aircraft.

Alcohol Sensitivity Moderates the Indirect Associations between Impulsive Traits, Impaired Control over Drinking, and Drinking Outcomes

PubMed Central

Wardell, Jeffrey D.; Quilty, Lena C.; Hendershot, Christian S.

2017-01-01

Objective To examine impaired control over drinking behavior as a mediator of unique pathways from impulsive traits to alcohol outcomes in young adults and to investigate the moderating influence of self-reported sensitivity to alcohol on these pathways. Method Young adult heavy drinkers (N=172; n=82 women) recruited from the community completed self-report measures of impulsive traits (positive urgency, negative urgency, sensation seeking), alcohol sensitivity (Self-Rating of the Effects of Alcohol scale), impaired control over drinking, and alcohol use and problems. Multiple-groups path analysis was used to analyze the data. Results Path coefficients between urgency and impaired control were larger for individuals with lower versus higher self-reported sensitivity to alcohol. The same was true for the association between impaired control and alcohol problems. For participants lower on alcohol sensitivity, significant indirect paths were observed from both positive and negative urgency to all alcohol outcomes (quantity, frequency, and problems) mediated via impaired control. For participants higher on alcohol sensitivity, only the paths from negative urgency (but not positive urgency) to the three alcohol outcomes via impaired control were statistically significant. Sensation seeking was not uniquely associated with impaired control. Conclusions The findings indicate that relatively low sensitivity to the pharmacological effects of alcohol may exacerbate the association of urgency – especially positive urgency – with impaired control, supporting the notion that personality and level of response to alcohol may interact to increase risk for impaired control over drinking. PMID:25785803

A comprehensive model of food addiction in patients with binge-eating symptomatology: The essential role of negative urgency.

PubMed

Wolz, Ines; Granero, Roser; Fernández-Aranda, Fernando

2017-04-01

Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Impulsive Personality and Alcohol Use: Bidirectional Relations Over One Year

PubMed Central

Kaiser, Alison; Bonsu, Jacqueline A.; Charnigo, Richard J.; Milich, Richard; Lynam, Donald R.

2016-01-01

Objective: Impulsive personality traits have been found to be robust predictors of substance use and problems in both cross-sectional and longitudinal research. Studies examining the relations of substance use and impulsive personality over time indicate a bidirectional relation, where substance use is also predictive of increases in later impulsive personality. The present study sought to build on these findings by examining the bidirectional relations among the different impulsive personality traits assessed by the UPPS-P Impulsive Behavior Scale, with an interest in urgency (the tendency to act rashly when experiencing strong affect). Method: Participants were 525 first-year college students (48.0% male, 81.1% White), who completed self-report measures assessing personality traits and a structured interview assessing past and current substance use. Data collection took place at two different time points: the first occurred during the participants’ first year of college, and the second occurred approximately 1 year later. Bidirectional relations were examined using structural equation modeling. Results: Time 1 (T1) positive urgency predicted higher levels of alcohol use at Time 2 (T2), whereas T1 lack of perseverance predicted lower levels of alcohol use at T2. T1 alcohol use predicted higher levels of positive urgency, negative urgency, sensation seeking, and lack of premeditation at T2. Conclusions: Findings provide greater resolution in characterizing the bidirectional relation between impulsive personality traits and substance use. PMID:27172580

Circadian Activity Rhythms, Time Urgency, and Achievement Concerns.

ERIC Educational Resources Information Center

Watts, Barbara L.

Many physiological and psychological processes fluctuate throughout the day in fairly stable, rhythmic patterns. The relationship between individual differences in circadian activity rhythms and a sense of time urgency were explored as well as a number of achievement-related variables. Undergraduates (N=308), whose circadian activity rhythms were…

Negative Urgency, Distress Tolerance, and Substance Abuse Among College Students

PubMed Central

Kaiser, Alison J.; Milich, Richard; Lynam, Donald R.; Charnigo, Richard J.

2012-01-01

Objective Negative affect has been consistently linked with substance use/problems in prior research. The present study sought to build upon these findings by exploring how an individual’s characteristic responding to negative affect impacts substance abuse risk. Trait negative affect was examined in relation to substance abuse outcomes along with two variables tapping into response to negative affect: Distress Tolerance, an individual’s perceived ability to tolerate negative affect, and Negative Urgency, the tendency to act rashly while experiencing distress. Method Participants were 525 first-year college students (48.1% male, 81.1% Caucasian), who completed self-report measures assessing personality traits and alcohol-related problems, and a structured interview assessing past and current substance use. Relations were tested using Zero-Inflated Negative Binomial regression models, and each of the personality variables was tested in a model on its own, and in a model where all three traits were accounted for. Results Negative Urgency emerged as the best predictor, relating to every one of the substance use outcome variables even when trait negative affect and Distress Tolerance were accounted for. Conclusions These findings suggest that Negative Urgency is an important factor to consider in developing prevention and intervention efforts aimed at reducing substance use and problems. PMID:22698894

Impact of solifenacin on diary-recorded and patient-reported urgency in patients with severe overactive bladder (OAB) symptoms.

PubMed

Serels, Scott R; Toglia, Marc R; Forero-Schwanhaeuser, Sergio; He, Weizhong

2010-10-01

It is widely recognized that patient perception of overactive bladder (OAB) symptoms can vary considerably from mild to severe bother. This post hoc analysis reports outcomes in patients with severe OAB symptoms at baseline taken from the VESIcare Efficacy and Safety in PatieNts with Urgency Study (VENUS). VENUS was a 12-week, randomized, double-blind, placebo-controlled trial of solifenacin (5 or 10 mg/day, flexibly dosed) in OAB patients. The primary endpoint in VENUS was mean change from baseline to study end in urgency episodes/day using 3-day bladder diaries. Secondary endpoints included other diary endpoints (frequency, incontinence, and nocturia), warning time (WT; time between first sensation of urgency to voiding), and patient-reported outcome (PRO) measures of urgency (the Indevus Urgency Severity Scale [IUSS] and Urgency Perception Scale [UPS]) and of symptom bother and health-related quality of life (HRQL) (the Patient Perception of Bladder Condition [PPBC] and Overactive Bladder Questionnaire). For this analysis, severe OAB was defined as baseline PPBC score ≥5 (1 = no problems, 6 = many severe problems). NCT00454896. In total, 158/707 (22.3%) patients in the full analysis set (FAS) reported severe OAB symptoms. Solifenacin reduced mean urgency episodes/day versus placebo in the severe subgroup (-4.6 vs. -3.1, p = 0.1150), similar to the significant reduction observed in the FAS (-3.9 vs. -2.7, p < 0.0001). Solifenacin also improved the other diary endpoints and PRO measures in the severe subgroup; these changes were consistent with the significant solifenacin- versus placebo-related improvements for the FAS. Treatment-emergent adverse events were mostly mild/moderate, and few patients taking solifenacin or placebo discontinued treatment in the severe subgroup (4.5% vs. 6.5%) or FAS (6.5% vs. 4.6%). Key limitations are that VENUS was not powered to detect treatment differences in subgroups, and that the lack of a standardized definition of OAB symptom severity may limit the generalizability of the findings. Patients with severe OAB symptoms showed objective and subjective improvements in symptoms, symptom bother, HRQL, and urgency severity with solifenacin similar to the FAS. Solifenacin was also well-tolerated in this subgroup.

Verbal collision avoidance messages during simulated driving: perceived urgency, alerting effectiveness and annoyance.

PubMed

Baldwin, Carryl L

2011-04-01

Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Two experiments describe the impact of acoustic and semantic parameters on ratings of perceived urgency, annoyance and alerting effectiveness and on alarm response speed. Within a simulated driving context, participants rated and responded to collision avoidance system (CAS) messages spoken by a female or male voice (experiments 1 and 2, respectively). Results indicated greater perceived urgency and faster alarm response times as intensity increased from -2 dB signal to noise (S/N) ratio to +10 dB S/N, although annoyance ratings increased as well. CAS semantic content interacted with alarm intensity, indicating that at lower intensity levels participants paid more attention to the semantic content. Results indicate that both acoustic and semantic parameters independently and interactively impact CAS alert perceptions in divided attention conditions and this work can inform auditory alarm design for effective hazard matching. Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Here, both acoustic and semantic parameters independently and interactively impacted CAS alert perceptions in divided attention conditions. This work can inform auditory alarm design for effective hazard matching. STATEMENT OF RELEVANCE: Results indicate that both acoustic parameters and semantic content can be used to design collision warnings with a range of urgency levels. Further, these results indicate that verbal warnings tailored to a specific hazard situation may improve hazard-matching capabilities without substantial trade-offs in perceived annoyance.

[EPIDEMIOLOGY OF OVER-ACTIVE BLADDER (OAB) SYNDROME].

PubMed

Eshkoli, Tamar; Yohai, David; Laron, Elad; Weintraub, Adi Y

2016-11-01

An over-active bladder is a common disorder which influences women's health and quality of life. There is difficulty defining the exact prevalence of the disorder since there are various definitions in the literature. The ICS definition from 2002 on the over-active bladder (OAB) syndrome enables more uniformity, by declaring that OAB syndrome is a symptomatic syndrome defined as presence of urgency with or without urinary incontinence, mostly accompanied by frequency and nocturia. In this article we reviewed the current medical literature on the prevalence of the OAB syndrome by focusing on relevant crosssectional and longitudinal studies, the trend changes during life, co-morbidities, the influence of quality of life and the economic burden following the disorder and its treatment. The authors' hope is that elevating awareness of the OAB syndrome will help improve its diagnosis and treatment.

Do Different Facets of Impulsivity Predict Different Types of Aggression?

PubMed Central

Derefinko, Karen; DeWall, C. Nathan; Metze, Amanda V.; Walsh, Erin C.; Lynam, Donald R.

2011-01-01

The current study examined the relations between impulsivity-related traits (as assessed by the UPPS-P Impulsive Behavior Scale) and aggressive behaviors. Results indicated that UPPS-P Lack of Premeditation and Sensation Seeking were important in predicting general violence. In contrast, UPPS-P Urgency was most useful in predicting intimate partner violence. To further explore relations between intimate partner violence and Urgency, a measure of autonomic response to pleasant and aversive stimuli and facets of Neuroticism from the NEO PI-R were used as control variables. Autonomic responsivity was correlated with intimate partner violence at the zero-order level, and predicted significant variance in intimate partner violence in regression equations. However, UPPS-P Urgency was able to account for unique variance in intimate partner violence above and beyond measures of Neuroticism and arousal. Implications regarding the use of a multifaceted conceptualization of impulsivity in the prediction of different types of violent behavior are discussed. PMID:21259270

Emotion-Based Dispositions to Rash Action: Positive and Negative Urgency

ERIC Educational Resources Information Center

Cyders, Melissa A.; Smith, Gregory T.

2008-01-01

Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of 2 related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme…

Posttraumatic Stress Disorder Symptoms and Risky Behaviors among Trauma-exposed Inpatients with Substance Dependence: The Influence of Negative and Positive Urgency

PubMed Central

Weiss, Nicole H.; Tull, Matthew T.; Sullivan, Tami P.; Dixon-Gordon, Katherine L.; Gratz, Kim L.

2015-01-01

Background Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively). Methods Participants were 158 trauma-exposed inpatients with (n = 91) and without (n = 67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age = 34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires. Results Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency. Conclusions Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors. PMID:26278196

Negative affect, negative urgency, thought suppression, and bulimic symptoms: a moderated mediation analysis in a sample at-risk for bulimic symptoms.

PubMed

Lavender, Jason M; Green, Daniel; Anestis, Michael D; Tull, Matthew T; Gratz, Kim L

2015-05-01

Research suggests that negative affect, negative urgency, and thought suppression are related to bulimic symptoms, either directly or indirectly. This study examined associations between these constructs in a sample at-risk for bulimic symptoms. Participants (N = 80) recruited from a residential substance abuse treatment facility completed self-report questionnaires. A regression-based bootstrapping approach was used to examine the indirect effect of negative affect on bulimic symptoms through negative urgency and the moderating role of thought suppression in the association between negative affect and negative urgency. Results revealed a significant indirect effect, significant moderation, and a significant moderated mediation effect, with an indirect effect of negative affect on bulimic symptoms through negative urgency, conditional upon low to moderate (but not high) levels of thought suppression. These findings suggest that negative affect may promote rash actions, particularly in the context of low to moderate thought suppression, leading to increased risk of bulimic symptoms. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Living in the Here and Now: Interrelationships between Impulsivity, Mindfulness, and Alcohol Misuse

PubMed Central

Murphy, Cara; MacKillop, James

2013-01-01

Rationale Impulsivity and mindfulness both emphasize orientation to the present, and both have been linked to alcohol misuse, but the relationship between the two is not clearly understood. Objectives To examine the relationships between elements of impulsivity and mindfulness, and to examine both variables in relation to alcohol misuse. Method Young adults (N = 116) were assessed for alcohol use, mindfulness, and impulsivity using psychometrically validated measures. Results Numerous significant associations were present among the facets of impulsivity and mindfulness. The variable most substantially associated with alcohol misuse was Negative Urgency (NU; i.e., proneness to act out under conditions of negative affect). After controlling for other variables, Negative Urgency (NU), Positive Urgency (PU), and delay discounting (DD) were significantly related to alcohol consumption. When examining drinking related consequences, only Lack of Premeditation (LoP) and Negative Urgency (NU) were significant associated. Conclusions There was considerable overlap between some elements of impulsivity and mindfulness while the overlap was negligible for other facets. The associations between mindfulness and alcohol misuse were entirely a function of impulsivity. In particular, acting on impulses while experiencing negative affect was significantly associated with level of alcohol consumption and level of alcohol-related risk. Steep discounting of future rewards was associated with alcohol consumption while poor premeditation was associated with adverse drinking consequences. These findings illustrate the importance of jointly studying impulsivity when examining purported effects of mindfulness traits. PMID:22169883

17 CFR 250.22 - Applications and declarations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... § 250.22 Applications and declarations. (a) Joinder. As far as practicable combined or joint applications or declarations shall be filed with respect to the same or related transactions or where related... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Applications and declarations...

Peer group impulsivity moderated the individual-level relationship between depressive symptoms and adolescent nonsuicidal self-injury.

PubMed

You, Jianing; Zheng, Chuhua; Lin, Min-Pei; Leung, Freedom

2016-02-01

This study examined the influence of impulsive friendship group contexts on nonsuicidal self-injury (NSSI) and how peer group impulsivity (i.e. negative urgency and premeditation) moderated the individual level relationship between depression and NSSI among 1701 Chinese secondary school students (1147 females). Participants were assessed twice over a 6-month interval. After controlling for direct socialization effects for NSSI, multilevel analysis indicated that friendship group negative urgency exerted a significant influence on NSSI. Additionally, friendship group premeditation weakened the relation between individual depression and NSSI, while friendship group negative urgency strengthened the relation between depression and NSSI. The results suggest the contribution of indirect peer influence effects to NSSI. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Heart rate differentiates urgency and emergency in hypertensive crisis.

PubMed

Al Bannay, Rashed; Böhm, Michael; Husain, Aysha

2013-08-01

To study the clinical significance of presenting blood pressure parameters and heart rate in patients with hypertensive crisis. In patients admitted with hypertensive crisis between January 2011 and May 2011, demography, mode of presentation, co-morbidities, blood pressure readings, and heart rate at presentation were documented. Further clustering of hypertensive crisis into emergency or urgency was based on the presence or absence of target organ involvement. The relationship between blood pressure parameters, heart rate, and other variables was analyzed. 189 patients in sinus rhythm were enrolled in this pilot study. The rate of hypertensive urgency was 56 %, whereas the rate of hypertensive emergency was 44 %, respectively. Subjects with hypertensive emergency had a higher mean heart rate (93 ± 22.7 bpm) than those with urgency (81 ± 11.5 bpm) (P = 0.015). Women had higher heart rates (92 ± 18.5 bpm) than men (86 ± 17.6 bpm) (P = 0.014). Heart rates below 100 bpm had a specificity of 94 %, classifying patients as hypertensive urgency. Tachycardia had a powerful statistical association with hypertensive left ventricular failure (P < 0.0001). Other hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, pulse pressure, and mean blood pressure relates neither to urgency nor to emergency. Diabetic patients with HBA1c levels of more than 53 mmol/mol had a heart rate of more than 100 bpm (P = 0.015) during hypertensive crisis. Normal heart rate is characteristic of hypertensive urgency. Tachycardia in this setting is an ominous sign and denotes hypertensive complications in particular left ventricular failure. Among diabetics, elevated heart rate is associated with poor glycemic control.

Exploring the Relationship between Negative Urgency and Dysregulated Eating: Etiologic Associations and the Role of Negative Affect

PubMed Central

Racine, Sarah E.; Keel, Pamela K.; Burt, S. Alexandra; Sisk, Cheryl L.; Neale, Michael; Boker, Steven; Klump, Kelly L.

2013-01-01

Negative urgency (i.e., the tendency to engage in rash action in response to negative affect) has emerged as a critical personality trait contributing to individual differences in binge eating. However, studies investigating the extent to which genetic and/or environmental influences underlie the effects of negative urgency on binge eating are lacking. Moreover, it remains unclear whether negative urgency-binge eating associations are simply due to the well-established role of negative affect in the development/maintenance of binge eating. The current study addresses these gaps by examining phenotypic and etiologic associations between negative urgency, negative affect, and dysregulated eating (i.e., binge eating, emotional eating) in a sample of 222 same-sex female twin pairs from the Michigan State Twin Registry. Negative urgency was significantly associated with both dysregulated eating symptoms, even after controlling for the effects of negative affect. Genetic factors accounted for the majority (62–77%) of this phenotypic association, although a significant proportion of this genetic covariation was due to genetic influences in common with negative affect. Non-shared environmental factors accounted for a relatively smaller (23–38%) proportion of the association, but these non-shared environmental effects were independent of negative affect. Findings suggest that the presence of emotion-based rash action, combined with high levels of negative affect, may significantly increase genetic risk for dysregulated eating. PMID:23356217

Exploring the relationship between negative urgency and dysregulated eating: etiologic associations and the role of negative affect.

PubMed

Racine, Sarah E; Keel, Pamela K; Burt, S Alexandra; Sisk, Cheryl L; Neale, Michael; Boker, Steven; Klump, Kelly L

2013-05-01

Negative urgency (i.e., the tendency to engage in rash action in response to negative affect) has emerged as a critical personality trait contributing to individual differences in binge eating. However, studies investigating the extent to which genetic and/or environmental influences underlie the effects of negative urgency on binge eating are lacking. Moreover, it remains unclear whether negative urgency-binge eating associations are simply a result of the well-established role of negative affect in the development/maintenance of binge eating. The current study addresses these gaps by examining phenotypic and etiologic associations between negative urgency, negative affect, and dysregulated eating (i.e., binge eating, emotional eating) in a sample of 222 same-sex female twin pairs from the Michigan State University Twin Registry. Negative urgency was significantly associated with both dysregulated eating symptoms, even after controlling for the effects of negative affect. Genetic factors accounted for the majority (62-77%) of this phenotypic association, although a significant proportion of this genetic covariation was due to genetic influences in common with negative affect. Nonshared environmental factors accounted for a relatively smaller (23-38%) proportion of the association, but these nonshared environmental effects were independent of negative affect. Findings suggest that the presence of emotion-based rash action, combined with high levels of negative affect, may significantly increase genetic risk for dysregulated eating. © 2013 American Psychological Association

The Relationship between Coping Strategies and Perceived Stress in Telephone Intervention Volunteers at a Suicide Prevention Center.

ERIC Educational Resources Information Center

Mishara, Brian L.; Giroux, Guy

1993-01-01

Examined stress perceived by telephone intervention volunteers (N=80) at suicide prevention center. Only amount of experience in telephone intervention with suicidal persons predicted stress level before shift. Stress during high-urgency call was related to level of urgency of call; total length of all calls received; and coping mechanisms of…

Trait urgency and gambling problems in young people by age: the mediating role of decision-making processes.

PubMed

Canale, Natale; Vieno, Alessio; Griffiths, Mark D; Rubaltelli, Enrico; Santinello, Massimo

2015-07-01

Although the personality trait of urgency has been linked to problem gambling, less is known about psychological mechanisms that mediate the relationship between urgency and problem gambling. One individual variable of potential relevance to impulsivity and addictive disorders is age. The aims of this study were to examine: (i) a theoretical model associating urgency and gambling problems, (ii) the mediating effects of decision-making processes (operationalized as preference for small/immediate rewards and lower levels of deliberative decision-making); and (iii) age differences in these relationships. Participants comprised 986 students (64% male; mean age=19.51 years; SD=2.30) divided into three groups: 16-17 years, 18-21 years, and 22-25 years. All participants completed measures of urgency, problem gambling, and a delay-discounting questionnaire involving choices between a smaller amount of money received immediately and a larger amount of money received later. Participants were also asked to reflect on their decision-making process. Compared to those aged 16-17 years and 22-25 years, participants aged 18-21 years had a higher level of gambling problems and decreased scores on lower levels of deliberative decision-making. Higher levels of urgency were associated with higher levels of gambling problems. The association was mediated by a lower level of deliberative decision-making and preference for an immediate/small reward. A distinct pathway was observed for lower levels of deliberative decision-making. Young people who tend to act rashly in response to extreme moods, had lower levels of deliberative decision-making, that in turn were positively related to gambling problems. This study highlights unique decision-making pathways through which urgency trait may operate, suggesting that those developing prevention and/or treatment strategies may want to consider the model's variables, including urgency, delay discounting, and deliberative decision-making. Copyright © 2015 Elsevier Ltd. All rights reserved.

Self-reported toileting behaviors in employed women: Are they associated with lower urinary tract symptoms?

PubMed

Palmer, Mary H; Willis-Gray, Marcella G; Zhou, Fang; Newman, Diane K; Wu, Jennifer M

2018-02-01

To describe toileting behaviors working women habitually use and investigate behaviors associated with lower urinary tract symptoms (LUTS), especially urinary urgency with or without leakage. Non-pregnant female employees of a large academic medical center 18 years and over were eligible to complete an online survey about bladder health and toileting behaviors. One hundred eighty-two women participated in the survey. The majority were white (83.52%), married (52.49%), had ≥1 pregnancy (54.40%), and in excellent health (93.41%). The average age and body mass index were 47.28 ± 13.56 years and 27.92 ± 6.78, respectively. The sample was further sub-divided into two groups: urinary urgency (N = 119) or no urinary urgency symptoms (N = 51). Habitual toileting behaviors for these groups (N = 170) included: sitting to urinate at home (98.24%), emptying the bladder completely (88.82%), emptying the bladder before leaving home (80.00%), and sitting to urinate when away from home (68.82%). Logistic regression analysis showed age increased the odds of urinary urgency (aOR 1.06, 95%CI 1.02-1.09). Women who waited too long to urinate at work (aOR 7.85, 95%CI 1.57-39.24) and wore panty liners for urinary leakage (aOR 2.86, 95%CI 1.25-6.56) had greater odds of urinary urgency than women who did neither. Most habitual toileting behaviors were not associated with urinary urgency except waiting too long to urinate when at work. Logistic regression revealed significant relationships among health-related factors, personal characteristics, behaviors, and urinary urgency. LUTS in women is both a women's health and occupational health issue. © 2017 Wiley Periodicals, Inc.

The nature of declarative and nondeclarative knowledge for implicit and explicit learning.

PubMed

Kirkhart, M W

2001-10-01

Using traditional implicit and explicit artificial-grammar learning tasks, the author investigated the similarities and differences between the acquisition of declarative knowledge under implicit and explicit learning conditions and the functions of the declarative knowledge during testing. Results suggested that declarative knowledge was not predictive of or required for implicit learning but was related to consistency in implicit learning performance. In contrast, declarative knowledge was predictive of and required for explicit learning and was related to consistency in performance. For explicit learning, the declarative knowledge functioned as a guide for other behavior. In contrast, for implicit learning, the declarative knowledge did not serve as a guide for behavior but was instead a post hoc description of the most commonly seen stimuli.

Emotion-based Dispositions to Rash Action: Positive and Negative Urgency

PubMed Central

Cyders, Melissa A.; Smith, Gregory T.

2008-01-01

Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of two related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme positive and negative affect, respectively. The authors provide evidence that these traits are distinct from other dispositions toward rash action, and that they play distinct roles in predicting problem levels of involvement in behaviors such as alcohol consumption, binge eating, drug use, and risky sexual behavior. The authors identify facilitative conditions for the emergence of the urgency traits from neuroscience. Certain gene polymorphisms are associated with low levels of serotonin and high levels of dopamine; that pattern of neurotransmitter activity in a brain system linking the orbitofrontal cortex and the amygdala appears to facilitate development of positive and negative urgency. The authors discuss the implications of this theory. PMID:18954158

Emotional regulation, attachment to possessions and hoarding symptoms.

PubMed

Phung, Philip J; Moulding, Richard; Taylor, Jasmine K; Nedeljkovic, Maja

2015-10-01

This study aimed to test which particular facets of emotion regulation (ER) are most linked to symptoms of hoarding disorder, and whether beliefs about emotional attachment to possessions (EA) mediate this relationship. A non-clinical sample of 150 participants (108 females) completed questionnaires of emotional tolerance (distress tolerance, anxiety sensitivity, negative urgency - impulsivity when experiencing negative emotions), depressed mood, hoarding, and beliefs about emotional attachment to possessions. While all emotional tolerance measures related to hoarding, when considered together and controlling for depression and age, anxiety sensitivity and urgency were the significant predictors. Anxiety sensitivity was fully mediated, and urgency partially mediated, via beliefs regarding emotional attachment to possessions. These findings provide further support for (1) the importance of anxiety sensitivity and negative urgency for hoarding symptoms, and (2) the view that individuals with HD symptoms may rely on items for emotion regulation, leading to stronger beliefs that items are integral to emotional wellbeing. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Assessing outcomes to determine whether symptoms related to hypertension justify renal artery stenting.

PubMed

Modrall, J Gregory; Rosero, Eric B; Timaran, Carlos H; Anthony, Thomas; Chung, Jayer; Valentine, R James; Trimmer, Clayton

2012-02-01

The goal of the study was to determine the blood pressure (BP) response to renal artery stenting (RAS) for patients with hypertension urgency, hypertension emergency, and angina with congestive heart failure (angina/congestive heart failure [CHF]). Patients who underwent RAS for hypertension emergencies (n = 13), hypertension urgencies (n = 25), and angina/CHF (n = 14) were included in the analysis. By convention, hypertension urgency was defined by a sustained systolic BP ≥ 180 mm Hg or diastolic BP ≥ 120 mm Hg, while the definition of hypertension emergency required the same BP parameters plus hypertension-related symptoms prompting hospitalization. Patient-specific response to RAS was defined according to modified American Heart Association reporting guidelines. The study cohort of 52 patients had a median age of 66 years (interquartile range 58-72). The BP response to RAS varied significantly according to the indication for RAS. Hypertension emergency provided the highest BP response rate (85%), while the response rate was significantly lower for hypertension urgency (52%) and angina/CHF (7%; P = .03). Only 1 of 14 patients with angina/CHF was a BP responder. Multivariate analysis showed that hypertension urgency or emergency were not independent predictors of BP response to RAS. Instead, the only independent predictor of a favorable BP response was the number of preoperative antihypertensive medications (odds ratio 7.5; 95% confidence interval 2.5-22.9; P = .0004), which is another indicator of the severity of hypertension. Angina/CHF was an independent predictor of failure to respond to RAS (odds ratio 118.6; 95% confidence interval 2.8-999.9; P = .013). Hypertension urgency and emergency are clinical manifestations of severe hypertension, but the number of preoperative antihypertensive medications proved to be a better predictor of a favorable BP response to RAS. In contrast, angina/CHF was a predictor of failure to respond to stenting, providing further evidence against the practice of incidental stenting during coronary interventions. Copyright © 2012 Society for Vascular Surgery. All rights reserved.

Does drinking refusal self-efficacy mediate the impulsivity-problematic alcohol use relation?

PubMed

Stevens, Angela K; Littlefield, Andrew K; Blanchard, Brittany E; Talley, Amelia E; Brown, Jennifer L

2016-02-01

There is consistent evidence that impulsivity-like traits relate to problematic alcohol involvement; however, identifying mechanisms that account for this relation remains an important area of research. Drinking refusal self-efficacy (or a person's ability to resist alcohol; DRSE) has been shown to predict alcohol use among college students and may be a relevant mediator of the impulsivity-alcohol relation. The current study examined the indirect effect of various constructs related to impulsivity (i.e., urgency, sensation seeking, and deficits in conscientiousness) via several facets of DRSE (i.e., social pressure, opportunistic, and emotional relief) on alcohol-related problems among a large sample of college students (N=891). Overall, results indicated that certain DRSE facets were significant mediators of the relation between impulsivity-related constructs and alcohol problems. More specifically, emotional-relief DRSE was a mediator for the respective relations between urgency and deficits in conscientiousness and alcohol problems, whereas social-DRSE was a significant mediator of the respective relations between urgency and sensation seeking with alcohol problems. Results from this study suggest particular types of DRSE are important mediators of the relations between specific impulsivity constructs and alcohol-related problems. These findings support prevention and intervention efforts that seek to enhance drinking refusal self-efficacy skills of college students, particularly those high in certain personality features, in order to reduce alcohol-related problems among this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

47 CFR 80.327 - Urgency signals and messages.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...

47 CFR 80.327 - Urgency signals and messages.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...

47 CFR 80.327 - Urgency signals and messages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...

47 CFR 80.327 - Urgency signals and messages.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...

47 CFR 80.327 - Urgency signals and messages.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...

37 CFR 1.69 - Foreign language oaths and declarations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... declaration cannot understand English, the oath or declaration must be in a language that such individual can... declaration relates. (b) Unless the text of any oath or declaration in a language other than English is in a... accompanied by an English translation together with a statement that the translation is accurate, except that...

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers

PubMed Central

Stojek, Monika M.; Fischer, Sarah; Murphy, Cara M.; MacKillop, James

2016-01-01

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating. PMID:24816318

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers.

PubMed

Stojek, Monika M; Fischer, Sarah; Murphy, Cara M; MacKillop, James

2014-09-01

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating. Copyright © 2014. Published by Elsevier Ltd.

The Role of Impulsivity Dimensions in the Relation Between Probable Posttraumatic Stress Disorder and Aggressive Behavior Among Substance Users.

PubMed

Weiss, Nicole H; Connolly, Kevin M; Gratz, Kim L; Tull, Matthew T

2017-01-01

Individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder report heightened levels of numerous risky and health-compromising behaviors, including aggressive behaviors. Given evidence that aggressive behavior is associated with negative substance use disorder treatment outcomes, research is needed to identify the factors that may account for the association between PTSD and aggressive behavior among patients with substance use disorder. Thus, the goal of this study was to examine the role of impulsivity dimensions (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) in the relations between probable PTSD status and both verbal and physical aggression. Participants were 92 patients in residential substance use disorder treatment (75% male; 59% African American; M age = 40.25) who completed self-report questionnaires. Patients with co-occurring PTSD-substance use disorder (vs. substance use disorder alone) reported significantly greater verbal and physical aggression as well as higher levels of negative urgency and lack of premeditation. Lack of premeditation and lack of perseverance were significantly positively associated with verbal aggression, whereas negative urgency, lack of premeditation, and lack of perseverance were significantly positively associated with physical aggression. The indirect relation of probable PTSD status to physical aggression through negative urgency was significant. Results highlight the potential utility of incorporating skills focused on controlling impulsive behaviors in the context of negative emotional arousal in interventions for physical aggression among patients with co-occurring PTSD-substance use disorder.

The location of pain and urgency sensations during cystometry.

PubMed

Veit-Rubin, Nikolaus; Cartwright, Rufus; Esmail, Alisha; Digesu, G Alessandro; Fernando, Ruwan; Khullar, Vikram

2017-03-01

The relationship between bladder pain and urinary urgency sensations is poorly understood. We analyzed the relationship between locations and intensities of urgency and pain sensations felt during filling cystometry. Participants completed the King's Health Questionnaire (KHQ) to indicate presence of bladder pain or urgency. During cystometry, participants scored the intensity of urgency and pain, both in the suprapubic and the urethral region, on a VAS scale of 0-10 at a baseline, at first desire, normal desire, strong desire to void, and at maximum cystometric capacity during filling. We allocated the participants to six groups; those reporting urgency or not, pain or not, both symptoms and neither. Friedman's Test was used to ascertain if all scores increased significantly, the Wilcoxon Signed Rank Test was used to demonstrate the difference between scores, and agreement for findings during cystometry was tested with Mann-Whitney U. A total of 68 women participated; 38 participants reported pain, 57 reported urgency, and 33 reported both symptoms. Pain and urgency scores significantly increased during cystometry (P < 0.0001). For participants reporting pain, suprapubic pain was rated significantly higher than urethral pain. Participants reporting both symptoms, felt more urgency than pain, and again pain more suprapubically than urethrally. Participants reporting only urgency scored suprapubic and urethral urgency similarly at all desires. Pain and urgency are well differentiated sensations and are felt at different locations although pain is seemingly easier localized. Neurourol. Urodynam. 36:620-625, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia.

PubMed

Hur, Won Sok; Kim, Joon Chul; Kim, Hyo Sin; Koh, Jun Sung; Kim, Sang Hoon; Kim, Hyun Woo; Cho, Su Yeon; Cho, Kang Jun

2016-11-01

To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH). We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups. In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement. A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.

The perceived urgency of auditory warning alarms used in the hospital operating room is inappropriate.

PubMed

Mondor, Todd A; Finley, G Allen

2003-03-01

To examine the perceived urgency of 13 auditory warning alarms commonly occurring in the hospital operating room. Undergraduate students, who were naïve with respect to the clinical situation associated with the alarms, judged perceived urgency of each alarm on a ten-point scale. The perceived urgency of the alarms was not consistent with the actual urgency of the clinical situation that triggers it. In addition, those alarms indicating patient condition were generally perceived as less urgent than those alarms indicating the operation of equipment. Of particular interest were three sets of alarms designed by equipment manufacturers to indicate specific priorities for action. Listeners did not perceive any differences in the urgency of the 'information only', 'medium' and 'high' priority alarms of two of the monitors with all judged as low to moderate in urgency. In contrast, the high priority alarm of the third monitor was judged as significantly more urgent than its low and medium urgency counterparts. The alarms currently in use do not convey the intended sense of urgency to naïve listeners, and this holds even for two sets of alarms designed specifically by manufacturers to convey different levels of urgency.

Prevalence of storage lower urinary tract symptoms in male patients attending Spanish urology office. Urinary urgency as predictor of quality of life.

PubMed

Cambronero Santos, J; Errando Smet, C

2016-12-01

The study sought to determine the symptomatic profile of men with lower urinary tract symptoms (LUTS) who visited a urology clinic in Spain and its impact on their health-related quality of life (HRQL). A national, epidemiological cross-sectional study was conducted and included 291 urology clinics. The prevalence of storage LUTS was investigated in 25,482 men. The study collected sociodemographic and clinical data from a subgroup of 1015 patients with storage LUTS who filled out the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OABq-SF) and Patient Perception of Bladder Condition (PPBC) questionnaires. The impact of urinary urgency on HRQL was analysed. The prevalence of storage LUTS was 41%, increasing with age: 14.1%, 41.5% and 60.8% for patients aged 18-49, 50-64 and ≥65 years, respectively. Of the 1015 selected patients, only 2.6% had storage symptoms exclusively. Symptom severity (IPSS) increased with age. Nocturia, frequency and urgency were the most common symptoms and had the most impact on HRQL (IPSS and OABq-SF). The number of urgency episodes was inversely correlated with the HRQL (r=-.773; P<.0001). In the multivariate analysis, only the IPSS and OABq-SF bother scores were significant predictors of HRQL (P<.001). Storage LUTS are highly prevalent among patients attending urology clinics in Spain. The severity of the urgency (number of urgency episodes) predicted a poorer quality of life for the patient. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Refractory urgency urinary incontinence treatment in women: impact of age on outcomes and complications.

PubMed

Komesu, Yuko M; Amundsen, Cindy L; Richter, Holly E; Erickson, Stephen W; Ackenbom, Mary F; Andy, Uduak U; Sung, Vivian W; Albo, Michael; Gregory, W Thomas; Paraiso, Marie Fidela; Wallace, Dennis

2018-01-01

Women with refractory urgency urinary incontinence (ie, unresponsive to behavioral and pharmacological interventions) are treated with onabotulinumtoxinA or sacral neuromodulation. The objective of the study was to compare treatment efficacy and adverse events in women <65 and ≥65 years old treated with onabotulinumtoxinA or sacral neuromodulation. This study was a planned secondary analysis of a multicenter, randomized trial that enrolled community-dwelling women with refractory urgency urinary incontinence to onabotulinumtoxinA or sacral neuromodulation treatments. The primary outcome was a change in mean daily urgency urinary incontinence episodes on a bladder diary over 6 months. Secondary outcomes included ≥75% urgency urinary incontinence episode reduction, change in symptom severity/quality of life, treatment satisfaction, and treatment-related adverse events. Both age groups experienced improvement in mean urgency urinary incontinence episodes per day following each treatment. There was no evidence that mean daily urgency urinary incontinence episode reduction differed between age groups for onabotulinumtoxinA (adjusted coefficient, -0.127, 95% confidence interval, -1.233 to 0.979; P = .821) or sacral neuromodulation (adjusted coefficient, -0.698, 95% confidence interval, -1.832 to 0.437; P = .227). Among those treated with onabotulinumtoxinA, women <65 years had 3.3-fold greater odds of ≥75% resolution than women ≥65 years (95% confidence interval, 1.56 -7.02). Women <65 years had a greater reduction in Overactive Bladder Questionnaire Short Form symptom bother scores compared with women ≥65 years by 7.49 points (95% confidence interval, -3.23 to -11.74), regardless of treatment group. There was no difference between quality of life improvement by age. Women ≥65 years had more urinary tract infections following onabotulinumtoxinA and sacral neuromodulation (odds ratio, 1.9, 95% confidence interval, 1.2-3.3). There was no evidence of age differences in sacral neuromodulation revision/removal or catheterization following onabotulinumtoxinA treatment. Younger women experienced greater absolute continence, symptom improvement, and fewer urinary tract infections; both older and younger women had beneficial urgency urinary incontinence episode reduction, similar rates of other treatment adverse events, and improved quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Procrastination as a Self-Regulation Failure: The Role of Impulsivity and Intrusive Thoughts.

PubMed

Rebetez, Marie My Lien; Rochat, Lucien; Barsics, Catherine; Van der Linden, Martial

2018-02-01

Procrastination has been described as the quintessence of self-regulatory failure. This study examines the relationships between this self-regulatory failure and other manifestations of self-regulation problems, namely impulsivity and intrusive thoughts. One hundred and forty-one participants completed questionnaires assessing procrastination, impulsivity (in particular, the urgency and lack of perseverance dimensions), and intrusive thoughts (i.e., rumination and daydreaming). Main results show that urgency mediated the association between rumination and procrastination, whereas rumination did not mediate the relation between urgency and procrastination. Lack of perseverance mediated the association between daydreaming and procrastination, and daydreaming mediated the relation between lack of perseverance and procrastination. This study highlights the role of impulsivity and intrusive thoughts in procrastination, specifies the links between these self-regulation problems, and provides insights into their (potential) underlying mechanisms. It also opens interesting prospects for management strategies for implementing targeted psychological interventions to reduce impulsive manifestations and/or thought control difficulties accompanying procrastination.

Accounting for Change in Declarative Memory: A Cognitive Neuroscience Perspective

ERIC Educational Resources Information Center

Richmond, Jenny; Nelson, Charles A.

2007-01-01

The medial temporal lobe memory system matures relatively early and supports rudimentary declarative memory in young infants. There is considerable development, however, in the memory processes that underlie declarative memory performance during infancy. Here we consider age-related changes in encoding, retention, and retrieval in the context of…

29 CFR 18.803 - Hearsay exceptions; availability of declarant immaterial.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., or immediately thereafter. (2) Excited utterance. A statement relating to a startling event or condition made while the declarant was under the stress of excitement caused by the event or condition. (3... remembered or believed unless it relates to the execution, revocation, identification, or terms of declarant...

A psychophysiological evaluation of the perceived urgency of auditory warning signals

NASA Technical Reports Server (NTRS)

Burt, J. L.; Bartolome, D. S.; Burdette, D. W.; Comstock, J. R. Jr

1995-01-01

One significant concern that pilots have about cockpit auditory warnings is that the signals presently used lack a sense of priority. The relationship between auditory warning sound parameters and perceived urgency is, therefore, an important topic of enquiry in aviation psychology. The present investigation examined the relationship among subjective assessments of urgency, reaction time, and brainwave activity with three auditory warning signals. Subjects performed a tracking task involving automated and manual conditions, and were presented with auditory warnings having various levels of perceived and situational urgency. Subjective assessments revealed that subjects were able to rank warnings on an urgency scale, but rankings were altered after warnings were mapped to a situational urgency scale. Reaction times differed between automated and manual tracking task conditions, and physiological data showed attentional differences in response to perceived and situational warning urgency levels. This study shows that the use of physiological measures sensitive to attention and arousal, in conjunction with behavioural and subjective measures, may lead to the design of auditory warnings that produce a sense of urgency in an operator that matches the urgency of the situation.

The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS.

PubMed

Coyne, Karin S; Sexton, Chris C; Kopp, Zoe S; Ebel-Bitoun, Caty; Milsom, Ian; Chapple, Chris

2011-11-01

• To examine the prevalence and burden of overactive bladder (OAB) with bother in the UK and Sweden compared to OAB without bother and no/minimal OAB/lower urinary tract (LUTS) symptoms, respectively. • A cross-sectional population-representative survey was conducted via the Internet in the UK, Sweden and USA. • Participants rated the frequency and bother of OAB and LUTS. Patient outcomes included the Overactive Bladder Questionnaire Short Form, Patient Perception of Bladder Condition, Short Form-12, Hospital Anxiety and Depression Scale-Anxiety and Hospital Anxiety and Depression Scale-Depression, as well as questions about treatment seeking and work productivity. • OAB was defined as urgency at least sometimes or the presence of urinary urgency incontinence. Three subgroups were compared: no/minimal symptoms, OAB without bother and OAB with bother. • Analyses were conducted by gender and country using general linear and logistic regression models to examine bothersome OAB and treatment seeking. • Survey response was 59.2%; 10,000 people (4724 men and 5276 women) participated. • The prevalence of OAB with bother at least 'somewhat' was 10.9% and 14.6% for men in the UK and Sweden, and 22.5% and 33.7% for women in the UK and Sweden, respectively. • Men and women with bothersome OAB were significantly more likely to seek treatment, report the lowest levels of health-related quality of life and work productivity and the highest levels of anxiety and depression compared to those with no/minimal symptoms and OAB without bother. • Greater symptom severity of urgency, urgency urinary incontinence, frequency, nocturia, and increasing levels of anxiety were strongly predictive of OAB bother in both men and women. • Predictors of treatment seeking included frequency, bother as a result of urgency, and lower levels of depressive symptoms in men, and frequency, nocturia and urgency in women. • OAB is common in the UK and Sweden, and women are more likely to be affected then men. • The impact of OAB is evident across generic and condition-specific domains of health-related quality of life. © 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.

Adolescent gambling and impulsivity: Does employment during high school moderate the association?

PubMed

Canale, Natale; Scacchi, Luca; Griffiths, Mark D

2016-09-01

The aim of the present study was to examine the potential moderating relationships between adolescent gambling and impulsivity traits (negative urgency, positive urgency, lack of premeditation, lack of perseverance and sensation seeking) with employment status. High-school students (N=400; 69% male; mean age=18.35years; SD=1.16; past year gamblers) were surveyed to provide data on impulsivity and employment. Multiple linear regression analysis was applied to examine associations with gambling and related problems. Positive urgency was associated with stronger scores of both gambling frequency and problem gambling. Students in employment had substantially higher frequency of gambling and greater problem gambling. Moreover, the combination of having a job and low perseverance was associated with a particularly high frequency on gambling. These findings further support the importance of positive urgency and employment status in adolescent gambling. The study highlights unique moderating relationship between gambling and lack of perseverance with employment status. Youth with a low perseverance and having a job may have particular need for interventions to reduce gambling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Declarative memory and skill-related knowledge: Evidence from a case study of amnesia and implications for theories of memory.

PubMed

Gregory, Emma; McCloskey, Michael; Ovans, Zoe; Landau, Barbara

2016-01-01

Theoretical and empirical studies of memory have long been framed by a distinction between declarative and non-declarative memory. We question the sharpness of the distinction by reporting evidence from amnesic L.S.J., who despite retrograde memory losses in declarative knowledge domains, shows sparing of declarative knowledge related to premorbid skill (e.g., playing an instrument). We previously showed that L.S.J. had severe losses of retrograde declarative knowledge across areas of premorbid expertise (e.g., artists of famous works) and everyday knowledge (e.g., company names for logos). Here we present evidence that L.S.J. has sparing of what we call skill-related declarative knowledge, in four domains in which she had premorbid skill (art, music, aviation, driving). L.S.J.'s pattern of loss and sparing raises questions about the strict separation between classically-defined memory types and aligns with a recent proposal by Stanley and Krakauer [2013. Motor skill depends on knowledge of facts. Frontiers in Human Neuroscience, 7,1-11].

Social interaction anxiety and personality traits predicting engagement in health risk sexual behaviors.

PubMed

Rahm-Knigge, Ryan L; Prince, Mark A; Conner, Bradley T

2018-06-01

Individuals with social interaction anxiety, a facet of social anxiety disorder, withdraw from or avoid social encounters and generally avoid risks. However, a subset engages in health risk sexual behavior (HRSB). Because sensation seeking, emotion dysregulation, and impulsivity predict engagement in HRSB among adolescents and young adults, the present study hypothesized that latent classes of social interaction anxiety and these personality traits would differentially predict likelihood of engagement in HRSB. Finite mixture modeling was used to discern four classes: two low social interaction anxiety classes distinguished by facets of emotion dysregulation, positive urgency, and negative urgency (Low SIAS High Urgency and Low SIAS Low Urgency) and two high social interaction anxiety classes distinguished by positive urgency, negative urgency, risk seeking, and facets of emotion dysregulation (High SIAS High Urgency and High SIAS Low Urgency). HRSB were entered into the model as auxiliary distal outcomes. Of importance to this study were findings that the High SIAS High Urgency class was more likely to engage in most identified HRSB than the High SIAS Low Urgency class. This study extends previous findings on the heterogeneity of social interaction anxiety by identifying the effects of social interaction anxiety and personality on engagement in HRSB. Copyright © 2018 Elsevier Ltd. All rights reserved.

Negative urgency and reward/punishment sensitivity in intermittent explosive disorder.

PubMed

Puhalla, Alexander A; Ammerman, Brooke A; Uyeji, Lauren L; Berman, Mitchell E; McCloskey, Michael S

2016-09-01

Intermittent explosive disorder (IED) is the sole psychiatric diagnosis in which affective aggression is the cardinal symptom. Previous research has been equivocal with regard to the relationship between IED and impulsivity. This inconsistency may reflect the varied facets of impulsivity, with some aspects of impulsivity (e.g. negative urgency) as well as some overlapping, albeit distinct constructs (e.g. reward and punishment sensitivity) yet to be studied. The present study compared individuals diagnosed with IED (n=81) with psychiatric controls (PCs; n=52) and healthy volunteers (HVs; n=58) on the impulsivity domains of negative and positive urgency, perseverance, sensation seeking, and premeditation, as well as on reward and punishment sensitivity. We hypothesized that individuals with IED would show greater negative and positive urgency, reward sensitivity, punishment sensitivity, with negative urgency independently predicting IED status. We also hypothesized that negative urgency would predict levels of anger, aggression, and aggression control among those with IED. The IED participants reported greater negative urgency than both comparison groups, and greater levels of positive urgency, reward sensitivity, and punishment sensitivity compared to HVs. Further, heightened negative urgency was the sole predictor an IED diagnosis. Within the IED group negative urgency uniquely predicted decreased aggression control and increased trait anger. Limitations included reliance on self-report measures to assess RS/PS, impulsivity, and aggression. These findings suggest that negative urgency is a key factor associated with IED and is associated with dampened control of aggression within those with IED. Copyright © 2016 Elsevier B.V. All rights reserved.

Examining the Conditions Under Which Internalized Homophobia Is Associated with Substance Use and Condomless Sex in Young MSM: the Moderating Role of Impulsivity.

PubMed

Puckett, Jae A; Newcomb, Michael E; Garofalo, Robert; Mustanski, Brian

2017-08-01

Internalized homophobia (IH) is the internalization of homophobic attitudes by sexual minorities due to social bias. IH has been inconsistently related to substance use and condomless sex for young men who have sex with men (YMSM). We examined negative urgency (the tendency to act impulsively in response to negative emotional experiences), positive urgency (the tendency to act impulsively in response to positive emotional experiences), and sensation seeking as independent moderators of the association of IH with binge drinking, drug use, and condomless anal sex. Data were collected from 450 YMSM (mean age = 18.9) over the course of 18 months (baseline, 6-, 12-, and 18-month follow-up). Hierarchical generalized linear modeling revealed that there was a significant moderation for binge drinking and receptive condomless anal sex, with the association between IH and these risk behaviors increased for those with higher levels of negative urgency and positive urgency. IH is important to the negative health outcomes of binge drinking and condomless anal sex for individuals high in negative and/or positive urgency, who may act impulsively to avoid subjective negative experiences or in the face of positive emotional experiences. Future research is needed to further establish additional conditions under which IH may be important to understanding risk behaviors in YMSM, which is essential to developing targeted prevention and intervention efforts.

Temporal binding function of dorsal CA1 is critical for declarative memory formation

PubMed Central

Sellami, Azza; Al Abed, Alice Shaam; Brayda-Bruno, Laurent; Etchamendy, Nicole; Valério, Stéphane; Oulé, Marie; Pantaléon, Laura; Lamothe, Valérie; Potier, Mylène; Bernard, Katy; Jabourian, Maritza; Herry, Cyril; Mons, Nicole; Piazza, Pier-Vincenzo; Eichenbaum, Howard; Marighetto, Aline

2017-01-01

Temporal binding, the process that enables association between discontiguous stimuli in memory, and relational organization, a process that enables the flexibility of declarative memories, are both hippocampus-dependent and decline in aging. However, how these two processes are related in supporting declarative memory formation and how they are compromised in age-related memory loss remain hypothetical. We here identify a causal link between these two features of declarative memory: Temporal binding is a necessary condition for the relational organization of discontiguous events. We demonstrate that the formation of a relational memory is limited by the capability of temporal binding, which depends on dorsal (d)CA1 activity over time intervals and diminishes in aging. Conversely, relational representation is successful even in aged individuals when the demand on temporal binding is minimized, showing that relational/declarative memory per se is not impaired in aging. Thus, bridging temporal intervals by dCA1 activity is a critical foundation of relational representation, and a deterioration of this mechanism is responsible for the age-associated memory impairment. PMID:28874586

Temporal binding function of dorsal CA1 is critical for declarative memory formation.

PubMed

Sellami, Azza; Al Abed, Alice Shaam; Brayda-Bruno, Laurent; Etchamendy, Nicole; Valério, Stéphane; Oulé, Marie; Pantaléon, Laura; Lamothe, Valérie; Potier, Mylène; Bernard, Katy; Jabourian, Maritza; Herry, Cyril; Mons, Nicole; Piazza, Pier-Vincenzo; Eichenbaum, Howard; Marighetto, Aline

2017-09-19

Temporal binding, the process that enables association between discontiguous stimuli in memory, and relational organization, a process that enables the flexibility of declarative memories, are both hippocampus-dependent and decline in aging. However, how these two processes are related in supporting declarative memory formation and how they are compromised in age-related memory loss remain hypothetical. We here identify a causal link between these two features of declarative memory: Temporal binding is a necessary condition for the relational organization of discontiguous events. We demonstrate that the formation of a relational memory is limited by the capability of temporal binding, which depends on dorsal (d)CA1 activity over time intervals and diminishes in aging. Conversely, relational representation is successful even in aged individuals when the demand on temporal binding is minimized, showing that relational/declarative memory per se is not impaired in aging. Thus, bridging temporal intervals by dCA1 activity is a critical foundation of relational representation, and a deterioration of this mechanism is responsible for the age-associated memory impairment.

Measuring urgency in clinical practice.

PubMed

Dmochowski, Roger R; FitzGerald, Mary P; Wyndaele, Jean-Jacques

2009-12-01

The study of urinary urgency is challenging for a number of reasons, including our lack of understanding of the normal physiology of urinary sensation and the pathophysiology of abnormal sensation. Issues with nomenclature and lack of agreement about the nature of the experience of normal and abnormal urinary sensation add to this difficulty. Review of published literature and critique. Currently available tools for measurement of urgency include validated questionnaires that describe the severity of urgency and its impact on quality of life, modified bladder diaries, body maps of urgency, and measures of urinary sensation during filling cystometry. All these provide some information about the experience of urinary urgency, but no single measure currently captures its multidimensional nature. Measurement of urgency in clinical practice and indeed the optimal treatment strategy has yet to come of age.

77 FR 37915 - Hawaii; Major Disaster Declarations and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

.... FEMA-4062-DR; Docket ID FEMA-2012-0002] Hawaii; Major Disaster Declarations and Related Determinations... Presidential declaration of a major disaster for the State of Hawaii (FEMA-4062-DR), dated April 18, 2012, and... follows: I have determined that the damage in certain areas of the State of Hawaii resulting from severe...

Relationship between voided volume and the urge to void among patients with lower urinary tract symptoms.

PubMed

Blaivas, Jerry G; Tsui, Johnson F; Amirian, Michael; Ranasinghe, Buddima; Weiss, Jeffrey P; Haukka, Jari; Tikkinen, Kari A O

2014-12-01

The aim of this study was to explore the relationship between voided volume (VV) and urge to void among patients with lower urinary tract symptoms. Consecutive adult patients (aged 23-90 years) were enrolled, and completed a 24 h bladder diary and the Urgency Perception Scale (UPS). Patients were categorized as urgency or non-urgency based on the Overactive Bladder Symptom Score. The relationship between UPS and VV (based on the bladder diary) was analyzed by Spearman's rho and proportional odds model. In total, 1265 micturitions were evaluated in 117 individuals (41 men, 76 women; 56 individuals in the urgency and 61 in the non-urgency group). The mean (± SD) VV and UPS were 192 ± 127 ml and 2.4 ± 1.2 ml in the urgency group and 173 ± 124 ml and 1.7 ± 1.1 ml in the non-urgency group, respectively. Spearman's rho (between UPS and VV) was 0.21 [95% confidence interval (CI) 0.13-029, p < 0.001] for the urgency group, 0.32 (95% CI 0.25-0.39, p < 0.001) for the non-urgency group, and 0.28 (95% CI 0.23-0.33, p < 0.001) for the total cohort. Urgency patients had higher UPS [odds ratio (OR) 3.1, 95% CI 2.5-3.8]. Overall, each additional 50 ml VV increased the odds of having a higher UPS with OR 1.2 (95% CI 1.2-1.3). The relationship between VV and UPS score was similar in both groups (p = 0.548 for interaction). Although urgency patients void with a higher UPS score, among both urgency and non-urgency patients there is only a weak correlation between VV and the urge to void. This suggests that there are factors other than VV that cause the urge to void.

Solifenacin in the treatment of urgency and other symptoms of overactive bladder: results from a randomized, double-blind, placebo-controlled, rising-dose trial.

PubMed

Cardozo, Linda; Hessdörfer, Elke; Milani, Rodolfo; Arañó, Pedro; Dewilde, Luc; Slack, Mark; Drogendijk, Ted; Wright, Mark; Bolodeoku, John

2008-11-01

To examine the effects of the antimuscarinic agent solifenacin on urinary urgency, using a range of novel and established outcome measures, as urgency is the principal symptom of the overactive bladder syndrome (OAB). The study (SUNRISE, solifenacin in the treatment of urgency symptoms of OAB in a rising dose, randomized, placebo-controlled, double-blind, efficacy trial) was a randomized, double-blind, 16-week, placebo-controlled, multicentre study of solifenacin 5/10 mg in 863 patients with symptoms of OAB for > or = 3 months. The primary efficacy variable was the change from baseline to endpoint in the number of episodes of severe urgency with or without urgency incontinence per 24 h, as measured using the Patient Perception of Intensity of Urgency Scale, grade 3 + 4. Secondary efficacy variables included patient-reported outcomes for bladder condition, urgency bother and treatment satisfaction. A 3-day voiding diary was used to record micturition frequency and episodes of urgency and incontinence. A 7-day diary was used to assess speed of onset of effect. Solifenacin 5/10 mg was significantly more effective than placebo in reducing the mean number of episodes of severe urgency with or without incontinence per 24 h from baseline to endpoint (-2.6 vs -1.8, P < 0.001). There were also statistically significant differences in favour of solifenacin 5/10 mg over placebo for all secondary variables measured at endpoint, including patient-reported outcomes. There was a significant improvement in urgency as early as day 3 of treatment. Treatmente-mergent adverse events with solifenacin 5/10 mg were mainly mild or moderate in severity, and only led to discontinuation in 3.6% of patients. Solifenacin significantly reduced the number of urgency episodes and the extent of urgency bother, and was well tolerated; it was effective as early as day 3 of treatment.

Do general practice patients with and without appointment differ? Cross-sectional study.

PubMed

Riedl, Bernhard; Kehrer, Simon; Werner, Christoph U; Schneider, Antonius; Linde, Klaus

2018-06-23

Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. Consecutive patients visiting five primary care practices without an appointment and following patients with an appointment were asked to fill in a four-page questionnaire addressing socio-demographic characteristics, the reason for encounter, urgency of seeing a physician, depressive, somatic and anxiety symptoms, personality traits, and satisfaction with the practice. Physicians also documented the reason for encounter and assessed the urgency. Data were analyzed using univariate and multivariate methods. Two hundred fifty-one patients without and 250 patients with appointment participated. Patients without appointment were significantly younger (mean age 44 vs. 50 years) and reported less often chronic diseases (29% vs. 45%). Also, reasons for encounter differed (e.g., 27% vs. 16% with a respiratory problem). Patients' ratings of urgency did not differ between groups (p = 0.46), but physicians rated urgency higher among patients without appointment (p < 0.001). In logistic regression analyses younger age, male gender, absence of chronic disease, positive screening for at least one mental disorder, low values on the personality trait openness for experience, a high urgency rating by the physician, and a respiratory or musculoskeletal problem as reason for encounter were significantly associated with a higher likelihood of being a patient without appointment. In this study, younger age and a high urgency rating by physicians were the variables most consistently associated with the likelihood of being a patient without appointment. Overall, differences between patients seeking general practices with a comprehensive appointment system without prior notice and patients with appointments were relatively minor.

Bladder pain syndrome/interstitial cystitis: a sense of urgency.

PubMed

Hanno, Philip M; Chapple, Chris R; Cardozo, Linda D

2009-12-01

A classic triad of symptoms (bladder pain, urinary frequency, and urgency) has served to define bladder pain syndrome/painful bladder syndrome/interstitial cystitis (BPS/PBS/IC) syndrome. BPS/PBS/IC is a distinct condition and it is likely that the urgency experienced by these patients differs from that experienced by those with overactive bladder syndrome. It is unclear how best to define urgency in the BPS/PBS/IC setting. Differences in the other primary symptoms associated with these conditions probably influence how urgency is perceived. Advances in research into the pathophysiology of urgency and underlying disease processes will help to optimize both the diagnosis and treatment of BPS/PBS/IC.

Cognitive foundations of organizational learning: re-introducing the distinction between declarative and non-declarative knowledge

PubMed Central

Kump, Barbara; Moskaliuk, Johannes; Cress, Ulrike; Kimmerle, Joachim

2015-01-01

Contemporary research into socio-cognitive foundations of organizational learning tends to disregard the distinction between declarative and non-declarative knowledge. By reviewing the literature from organizational learning research and cognitive psychology we explain that this distinction is crucial. We describe the foundations of organizational learning by referring to models that consider the interplay between individual and collective knowledge-related processes in organizations. We highlight the existence of a research gap resulting from the finding that these approaches have widely neglected the existence of different types of knowledge. We then elaborate on characteristics of declarative and non-declarative knowledge in general, consider organizations as structures of distributed cognition, and discuss the relationship between organizational knowledge and practice. Subsequently, we examine the role of declarative and non-declarative knowledge in the context of organizational learning. Here, we analyze (1) the cognitive and social mechanisms underlying the development of declarative and non-declarative knowledge within structures of distributed cognition; and (2) the relationship between alterations in declarative and non-declarative types of knowledge on the one hand and changes in organizational practice on the other. Concluding, we discuss implications of our analysis for organizational learning research. We explain how our integrative perspective may offer starting points for a refined understanding of the sub-processes involved in organizational learning and unlearning and may support a better understanding of practical problems related to organizational learning and change. PMID:26483739

Perceptions of "urgency" in women with interstitial cystitis/bladder pain syndrome or overactive bladder.

PubMed

Clemens, J Quentin; Bogart, Laura M; Liu, Karin; Pham, Chau; Suttorp, Marika; Berry, Sandra H

2011-03-01

To compare urgency symptoms in women with interstitial cystitis/bladder pain syndrome (IC/BPS) and overactive bladder (OAB). Women with diagnoses of IC/BPS (n=194) and OAB (n=85) were recruited from the clinical practices of Urologists (n=8) and Gynecologists (n=16) with recognized expertise in the diagnosis and management of these conditions. Subjects completed a comprehensive telephone survey about their current symptoms. The questionnaire included 11 questions about urinary urgency. Responses were compared between the two groups. Urgency was commonly reported as a symptom by women with both conditions (81% IC/BPS and 91% OAB). Compared with IC/BPS, urgency in OAB more often resulted in leakage, and was perceived to be more of a problem. In IC/BPS, the urgency was primarily reported as due to pain, pressure, or discomfort, while in OAB the urgency was more commonly due to fear of leakage. However, approximately 40% of women with OAB also report urgency due to pain, pressure, or discomfort. Similar proportions of both groups (∼ 60%) indicated that the urgency occurred "suddenly" instead of more gradually over a period of minutes or hours. Urgency symptoms differed in women diagnosed with IC/BPS versus those diagnosed with OAB, but there was significant overlap. This suggests that "urgency" is not a well-defined and commonly understood symptom that can be utilized to clearly discriminate between IC/BPS and OAB. These findings reinforce the clinical observation that it is often challenging to differentiate between these two conditions. Copyright © 2010 Wiley-Liss, Inc.

Differential Associations of UPPS-P Impulsivity Traits With Alcohol Problems.

PubMed

McCarty, Kayleigh N; Morris, David H; Hatz, Laura E; McCarthy, Denis M

2017-07-01

The UPPS-P model posits that impulsivity comprises five factors: positive urgency, negative urgency, lack of planning, lack of perseverance, and sensation seeking. Negative and positive urgency are the traits most consistently associated with alcohol problems. However, previous work has examined alcohol problems either individually or in the aggregate, rather than examining multiple problem domains simultaneously. Recent work has also questioned the utility of distinguishing between positive and negative urgency, as this distinction did not meaningfully differ in predicting domains of psychopathology. The aims of this study were to address these issues by (a) testing unique associations of UPPS-P with specific domains of alcohol problems and (b) determining the utility of distinguishing between positive and negative urgency as risk factors for specific alcohol problems. Associations between UPPS-P traits and alcohol problem domains were examined in two cross-sectional data sets using negative binomial regression models. In both samples, negative urgency was associated with social/interpersonal, self-perception, risky behaviors, and blackout drinking problems. Positive urgency was associated with academic/occupational and physiological dependence problems. Both urgency traits were associated with impaired control and self-care problems. Associations for other UPPS-P traits did not replicate across samples. Results indicate that negative and positive urgency have differential associations with alcohol problem domains. Results also suggest a distinction between the type of alcohol problems associated with these traits-negative urgency was associated with problems experienced during a drinking episode, whereas positive urgency was associated with alcohol problems that result from longer-term drinking trends.

47 CFR 80.1131 - Transmissions of urgency communications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...

47 CFR 80.1131 - Transmissions of urgency communications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...

47 CFR 80.1131 - Transmissions of urgency communications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...

47 CFR 80.1131 - Transmissions of urgency communications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...

47 CFR 80.1131 - Transmissions of urgency communications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...

Shifting towards an Opt-Out System in Greece: A General Practice Based Pilot Study

PubMed Central

Symvoulakis, Emmanouil K.; Markaki, Adelais; Galanakis, Christos; Klinis, Spyridon; Morgan, Myfanwy; Jones, Roger

2013-01-01

New legislation in Greece towards presumed consent for organ donation, effective as of June 2013, has come at a critical moment. This pilot study aims to explore awareness, specific concerns and intentions about the new organ donation framework among patients attending Greek general practices in a rural and urban setting. Only 2.6% of respondents had a donor card, a mere 9.6% was aware of new legislation, whereas only 3.8% considered that the public had been adequately informed. Higher income respondents were more likely to be aware that they would be considered organ donors upon death, unless declared differently. Urban practice respondents were less likely to have previously discussed with a significant other their intentions in regards to presumed consent. One quarter of all respondents (22.4%) intended to carry out their right to prohibit organ removal upon death. Survey results reveal that organ donation reform has yet to be disseminated by the Greek society, underscoring the urgency for targeted information campaigns. PMID:24046530

Event-Related Potential Correlates of Declarative and Non-Declarative Sequence Knowledge

ERIC Educational Resources Information Center

Ferdinand, Nicola K.; Runger, Dennis; Frensch, Peter A.; Mecklinger, Axel

2010-01-01

The goal of the present study was to demonstrate that declarative and non-declarative knowledge acquired in an incidental sequence learning task contributes differentially to memory retrieval and leads to dissociable ERP signatures in a recognition memory task. For this purpose, participants performed a sequence learning task and were classified…

Dysfunctional decision-making in pathological gambling: pattern specificity and the role of impulsivity.

PubMed

Kräplin, Anja; Dshemuchadse, Maja; Behrendt, Silke; Scherbaum, Stefan; Goschke, Thomas; Bühringer, Gerhard

2014-03-30

Dysfunctional decision-making in individuals with pathological gambling (PGs) may result from dominating reward-driven processes, indicated by higher impulsivity. In the current study we examined (1) if PGs show specific decision-making impairments related to dominating reward-driven processes rather than to strategic planning deficits and (2) whether these impairments are related to impulsivity. Nineteen PGs according to DSM-IV and 19 matched control subjects undertook the Cambridge Gambling Task (CGT) to assess decision-making. The delay discounting paradigm (DDP) as well as the UPPS Impulsive Behavior Scale (measuring urgency, premeditation, perseverance and sensation seeking) were administered as multidimensional measures of impulsivity. Results revealed that (1) PGs exhibited higher risk seeking and an immediate reward focus in the CGT and, in contrast, comparable strategic planning to the control group. (2) Decision-making impairments were related to more severe delay discounting and, specifically, to increased urgency and less premeditation. Our findings suggest (1) the necessity to disentangle decision-making components in order to improve etiological models of PGs, and (2) that urgency and premeditation are specifically related to disadvantageous decision-making and should be tackled in intervention strategies focusing on emotion tolerance and control strategies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Macrovascular Complications and Prevalence of Urgency Incontinence in Japanese Patients with Type 2 Diabetes Mellitus: The Dogo Study.

PubMed

Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Kanzaki, Sayaka; Maruyama, Koutatsu; Tanaka, Keiko; Ueda, Teruhisa; Senba, Hidenori; Torisu, Masamoto; Minami, Hisaka; Onji, Morikazu; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

2017-01-01

Objective Macrovascular diseases and urgency incontinence are common among Japanese patients with type 2 diabetes mellitus. However, little evidence exists regarding the association between stroke and urgency incontinence among patients with type 2 diabetes mellitus. We examined the associations between macrovascular complications and urgency incontinence among Japanese patients with type 2 diabetes mellitus. Methods The study subjects were 818 Japanese patients with type 2 diabetes mellitus. Urgency incontinence was defined as present when a subject answered "once a week or more" to the question: "Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate?" We adjusted our analyses for sex, age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, dyslipidemia, glycated hemoglobin, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy. Results The prevalence of urgency incontinence was 9.2%. Stroke was independently positively associated with urgency incontinence, with an adjusted odds ratio of 2.34 (95% confidence interval: 1.03-4.95). The associations between ischemic heart disease or peripheral artery disease and the prevalence of urgency incontinence were not significant. Conclusion In Japanese patients with type 2 diabetes mellitus, stroke, but not ischemic heart diseases or peripheral artery disease, was independently positively associated with urgency incontinence.

Perceptions of urgency: defining the gap between what physicians and nurses perceive to be an urgent issue.

PubMed

Quan, S D; Morra, D; Lau, F Y; Coke, W; Wong, B M; Wu, R C; Rossos, P G

2013-05-01

Through our research into the design and evaluation of technology systems to improve the quality and safety of clinical communication, we have discovered that physicians and nurses differ in perspective regarding clinical prioritization and desirable response times. This has a number of important consequences including unnecessary interruptions, escalating conflict and deterioration in interprofessional relationships. Understanding the differing perspectives on clinical prioritization, or the gap in perceived urgency, may improve interprofessional relationships. We conducted a mixed-methods study utilizing both qualitative (semi-structured interviews) and quantitative (surveys) methods to determine the gap between perceived urgency among physicians and nurses. The survey comprised of real messages extracted from the clinical communication system that was implemented. Physicians and nurses reviewed the messages and assigned an urgency level to each. The semi-structured interviews used open-ended questions to act as a guide to highlight key themes of interest. Thematic analysis, frequency tabulation, and triangulation were used to analyze the data. Although the surveys demonstrated concordance between physicians and nurses when independently ranking the urgency of clinical messages (kappa=0.66 SE 0.15), agreement was only fair in comparison to the urgency identified by the original nurse who sent the message (kappa=0.22 SE 0.18). We hypothesize that clinical context has a major role in defining urgency and may explain this finding. The survey data was triangulated with the semi-structured interview data and it was determined that the desired response time significantly impacted the sender's message prioritization. For example, shift changes and anxious family members were associated with discordant prioritizations. This study demonstrated that the perceived communication urgency gap between sending nurses and receiving physicians was primarily related to timeframe and context, not clinical condition. Most disagreement occurred when nurses used urgent messaging for time sensitive but not clinically urgent issues in an effort to expedite the resolution of their issue by the physicians. These results indicate the need for clinical communication systems to incorporate decision support around both clinical prioritization and expected response time in their design. Effective interprofessional communication is essential to the provision of safe, quality-based healthcare; these results highlight some of the sociotechnical aspects of health information technology implementation that must be considered. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation.

PubMed

Racine, Sarah E; VanHuysse, Jessica L; Keel, Pamela K; Burt, S Alexandra; Neale, Michael C; Boker, Steven; Klump, Kelly L

2017-07-01

Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Differences in Radiation Dosimetry and Anorectal Function Testing Imply That Anorectal Symptoms May Arise From Different Anatomic Substrates

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

Smeenk, Robert Jan, E-mail: r.smeenk@rther.umcn.nl; Hopman, Wim P.M.; Hoffmann, Aswin L.

2012-01-01

Purpose: To explore the influence of functional changes and dosimetric parameters on specific incontinence-related anorectal complaints after prostate external beam radiotherapy and to estimate dose-effect relations for the anal wall and rectal wall. Methods and Materials: Sixty patients, irradiated for localized prostate cancer, underwent anorectal manometry and barostat measurements to evaluate anal pressures, rectal capacity, and rectal sensory functions. In addition, 30 untreated men were analyzed as a control group. In 36 irradiated patients, the anal wall and rectal wall were retrospectively delineated on planning computed tomography scans, and dosimetric parameters were retrieved from the treatment plans. Functional and dosimetricmore » parameters were compared between patients with and without complaints, focusing on urgency, incontinence, and frequency. Results: After external beam radiotherapy, reduced anal pressures and tolerated rectal volumes were observed, irrespective of complaints. Patients with urgency and/or incontinence showed significantly lower anal resting pressures (mean 38 and 39 vs. 49 and 50 mm Hg) and lower tolerated rectal pressures (mean 28 and 28 vs. 33 and 34 mm Hg), compared to patients without these complaints. In patients with frequency, almost all rectal parameters were reduced. Several dosimetric parameters to the anal wall and rectal wall were predictive for urgency (e.g., anal D{sub mean}>38Gy), whereas some anal wall parameters correlated to incontinence and no dose-effect relation for frequency was found. Conclusions: Anorectal function deteriorates after external beam radiotherapy. Different incontinence-related complaints show specific anorectal dysfunctions, suggesting different anatomic and pathophysiologic substrates: urgency and incontinence seem to originate from both anal wall and rectal wall, whereas frequency seems associated with rectal wall dysfunction. Also, dose-effect relations differed between these complaints. This implies that anal wall and rectal wall should be considered separate organs in radiotherapy planning.« less

Urinary urgency - translating the evidence base into daily clinical practice.

PubMed

Cardozo, L; Chapple, C R; Dmochowski, R; Fitzgerald, M P; Hanno, P; Michel, M C; Staskin, D; Van Kerrebroeck, P; Wyndaele, J-J; Yamaguchi, O; Yoshida, M

2009-12-01

To consider the currently available knowledge and understanding of the symptom of urgency. Each faculty member reviewed the literature base of a different aspect of urgency and along with their personal clinical experience provided a base of evidence for discussion. This overview summarises relevant published literature and the current clinical experience of the authors. Whilst the mechanisms producing the sensation of urgency are still not fully understood and we are working within a definition that may complicate measurement and treatment, our pressing need is to effectively manage our patients for whom the practical nature of urgency can be all too apparent. Health care professionals have an important role to play today in helping to alleviate the widespread problem of urgency and its consequences.

Exploring divergent trajectories: Disorder-specific moderators of the association between negative urgency and dysregulated eating.

PubMed

Racine, Sarah E; Martin, Shelby J

2016-08-01

Negative urgency (i.e., the tendency to act impulsively when experiencing negative emotions) is a well-established risk factor for dysregulated eating (e.g., binge eating, loss of control eating, emotional eating). However, negative urgency is transdiagnostic, in that it is associated with multiple forms of psychopathology. It is currently unclear why some individuals with high negative urgency develop dysregulated eating while others experience depressive symptoms or problematic alcohol use. Investigating disorder-specific moderators of the association between negative urgency and psychopathology may help elucidate these divergent trajectories. The current study examined interactions among negative urgency and eating disorder-specific risk factors specified in the well-established dual-pathway model of bulimic pathology (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint). We hypothesized that these interactions would predict dysregulated eating, but not depressive symptoms or problematic alcohol use. Latent moderated structural equation modeling was used to test this hypothesis in a large (N = 313) sample of female college students. Negative urgency was significantly associated with dysregulated eating, depressive symptoms, and problematic alcohol use. However, interactions among negative urgency and dual-pathway model variables were specific to dysregulated eating and accounted for an additional 3-5% of the variance beyond main effects. Findings suggest that eating disorder-specific risk factors may shape negative urgency into manifesting as dysregulated eating versus another form of psychopathology. Future research should use longitudinal designs to further test the impact of interactions among disorder-specific risk factors and negative urgency on divergent psychopathology trajectories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bowel urgency in patients with irritable bowel syndrome.

PubMed

Basilisco, Guido; De Marco, Elisabetta; Tomba, Carolina; Cesana, Bruno Mario

2007-01-01

Bowel urgency is the most bothersome symptom in irritable bowel syndrome patients with diarrhea, but its pathophysiology is poorly understood. Our aim was to assess the relationships among reporting the symptom, the reservoir functions of the colon and rectum, and the patients' psychologic profile. The study involved 28 consecutive patients with irritable bowel syndrome and 17 healthy subjects. The presence or absence of bowel urgency was verified by means of a questionnaire during the 3 days required for the ingestion of radio-opaque markers. On the fourth day, an abdominal x-ray was taken to assess colonic transit time, and rectal sensory and motor responses were measured during rectal distention. The subjects' psychologic profiles were assessed using a psychologic symptoms checklist. Forty-six percent of the patients reported urgency associated with at least 1 defecation. The multivariate logistic regression analysis showed that colonic transit was the only variable independently associated with reported bowel urgency, but the threshold for the sensation of urgency was not removed from the model since its borderline significance level. Rectal compliance was closely associated with the threshold for the sensation of urgency during rectal distention but was not an independent factor for reporting the sensation. The patients with and without urgency showed altered psychologic profiles. The symptom of urgency is associated with objective alterations in the colonic and rectal reservoir of patients with irritable bowel syndrome.

The effects of urgency to reach agreement on the process and outcome of multi-party natural resource negotiations

USGS Publications Warehouse

Lamb, B.L.; Taylor, J.G.; Burkardt, N.; Gillette, S.C.

2005-01-01

We studied seven hydropower license consultations to examine the role of a sense of urgency to reach agreement. Hydropower licensing consultations were studied because the statutory requirement for consultation encourages negotiation, all such consultations are similar, and a negotiated settlement is not a foregone result. Cases selected for analysis met screening criteria. Structured interviews were conducted with participants after the negotiations had been concluded. Respondent recollections were checked against the documentary record. A sense of urgency to reach agreement was a significant factor in the completion of these negotiations; where there was no shared sense of urgency, purposeful delay adversely affected the negotiations. Although a sense of urgency was experienced by at least one party in each case, only a shared sense of urgency at the end of the process proved significant. Delay did not prevent ultimate agreement but a shared sense of urgency brought speedier agreement and greater satisfaction with the negotiation.

Predictors of fitness to practise declarations in UK medical undergraduates.

PubMed

Paton, Lewis W; Tiffin, Paul A; Smith, Daniel; Dowell, Jon S; Mwandigha, Lazaro M

2018-04-05

Misconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students. Data were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report 'personality measures' for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations. Significant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher 'self-esteem' (OR 1.45) were independently associated with an increased risk of a conduct issue. Female gender, a non-professional background, and lower self-reported 'confidence' were, among others, associated with increased odds of a health-related declaration. Only 'confidence' was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower 'confidence' scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression. White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the 'personality measures' suggest they would offer little potential benefit for selection, over and above those measures already in use.

The social and policy contexts of the New Brunswick Declaration on Research Ethics, Integrity, and Governance: a commentary.

PubMed

van den Hoonaard, Will C

2013-04-01

This paper explores the social and policy implications of the "New Brunswick Declaration on Research Ethics, Integrity, and Governance" developed at the Ethics Rupture Summit in Fredericton, N.B., Canada, October 2012. It discusses the Declaration and the Summit in relation to the usual criticism and analysis of research ethics regimes, and considers reasons why the immense prior literature has had little impact on regulatory bodies. Because the Declaration, like the Illinois White Paper, has quickly achieved considerable attention relative to most other such documents, and because much further deliberation has evolved since the Summit, we offer here a commentary on each of the eight principles contained in the Declaration in the hope of further stimulating discussion and consolidating the progress that now seems underway.

Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

PubMed

Giesen, Paul; Ferwerda, Rosa; Tijssen, Roelie; Mokkink, Henk; Drijver, Roeland; van den Bosch, Wil; Grol, Richard

2007-06-01

In recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed. To investigate whether triage nurses accurately estimate the urgency level of health complaints when using the national telephone guidelines, and to examine the relationship between the performance of triage nurses and their education and training. A cross-sectional, multicentre, observational study employing five mystery (simulated) patients who telephoned triage nurses in four GP cooperatives. The mystery patients played standardised roles. Each role had one of four urgency levels as determined by experts. The triage nurses called were asked to estimate the level of urgency after the contact. This level of urgency was compared with a gold standard. Triage nurses estimated the level of urgency of 69% of the 352 contacts correctly and underestimated the level of urgency of 19% of the contacts. The sensitivity and specificity of the urgency estimates provided by the triage nurses were found to be 0.76 and 0.95, respectively. The positive and negative predictive values of the urgency estimates were 0.83 and 0.93, respectively. A significant correlation was found between correct estimation of urgency and specific training on the use of the guidelines. The educational background (primary or secondary care) of the nurses had no significant relationship with the rate of underestimation. Telephone triage by triage nurses is efficient but possibly not safe, with potentially severe consequences for the patient. An educational programme for triage nurses is recommended. Also, a direct second safety check of all cases by a specially trained GP telephone doctor is advisable.

Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

PubMed Central

Giesen, Paul; Ferwerda, Rosa; Tijssen, Roelie; Mokkink, Henk; Drijver, Roeland; van den Bosch, Wil; Grol, Richard

2007-01-01

Background In recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed. Objectives To investigate whether triage nurses accurately estimate the urgency level of health complaints when using the national telephone guidelines, and to examine the relationship between the performance of triage nurses and their education and training. Method A cross‐sectional, multicentre, observational study employing five mystery (simulated) patients who telephoned triage nurses in four GP cooperatives. The mystery patients played standardised roles. Each role had one of four urgency levels as determined by experts. The triage nurses called were asked to estimate the level of urgency after the contact. This level of urgency was compared with a gold standard. Results Triage nurses estimated the level of urgency of 69% of the 352 contacts correctly and underestimated the level of urgency of 19% of the contacts. The sensitivity and specificity of the urgency estimates provided by the triage nurses were found to be 0.76 and 0.95, respectively. The positive and negative predictive values of the urgency estimates were 0.83 and 0.93, respectively. A significant correlation was found between correct estimation of urgency and specific training on the use of the guidelines. The educational background (primary or secondary care) of the nurses had no significant relationship with the rate of underestimation. Conclusion Telephone triage by triage nurses is efficient but possibly not safe, with potentially severe consequences for the patient. An educational programme for triage nurses is recommended. Also, a direct second safety check of all cases by a specially trained GP telephone doctor is advisable. PMID:17545343

Quantitative Changes in Cerebral Perfusion during Urinary Urgency in Women with Overactive Bladder

PubMed Central

Weissbart, Steven J.; Xu, Sihua; Bhavsar, Rupal; Rao, Hengyi

2017-01-01

Purpose To quantitatively measure changes in cerebral perfusion in select regions of interest in the brain during urinary urgency in women with overactive bladder (OAB) using arterial spin labeling (ASL). Methods Twelve women with OAB and 10 controls underwent bladder filling and rated urinary urgency (scale 0–10). ASL fMRI scans were performed (1) in the low urgency state after voiding and (2) high urgency state after drinking oral fluids. Absolute regional cerebral blood flow (rCBF) in select regions of interest was compared between the low and high urgency states. Results There were no significant differences in rCBF between the low and high urgency states in the control group. In the OAB group, rCBF (mean ± SE, ml/100 g/min) increased by 10–14% from the low to the high urgency state in the right anterior cingulate cortex (ACC) (44.56 ± 0.59 versus 49.52 ± 1.49, p < 0.05), left ACC (49.29 ± 0.85 versus 54.02 ± 1.46, p < 0.05), and left insula (50.46 ± 1.72 versus 54.99 ± 1.09, p < 0.05). Whole-brain analysis identified additional areas of activation in the right insula, right dorsolateral prefrontal cortex, and pons/midbrain area. Conclusions Urinary urgency is associated with quantitative increase in cerebral perfusion in regions of the brain associated with processing emotional response to discomfort. PMID:28904950

Urgency is a non-monotonic function of pulse rate.

PubMed

Russo, Frank A; Jones, Jeffery A

2007-11-01

Magnitude estimation was used to assess the experience of urgency in pulse-train stimuli (pulsed white noise) ranging from 3.13 to 200 Hz. At low pulse rates, pulses were easily resolved. At high pulse rates, pulses fused together leading to a tonal sensation with a clear pitch level. Urgency ratings followed a nonmonotonic (polynomial) function with local maxima at 17.68 and 200 Hz. The same stimuli were also used in response time and pitch scaling experiments. Response times were negatively correlated with urgency ratings. Pitch scaling results indicated that urgency of pulse trains is mediated by the perceptual constructs of speed and pitch.

Impulsivity traits and addiction-related behaviors in youth.

PubMed

Rømer Thomsen, Kristine; Callesen, Mette Buhl; Hesse, Morten; Kvamme, Timo Lehmann; Pedersen, Michael Mulbjerg; Pedersen, Mads Uffe; Voon, Valerie

2018-04-12

Background and aims Impulsivity is a risk factor for addictive behaviors. The UPPS-P impulsivity model has been associated with substance addiction and gambling disorder, but its role in other non-substance addiction-related behaviors is less understood. We sought to examine associations between UPPS-P impulsivity traits and indicators of multiple substance and non-substance addiction-related behaviors in youth with varying involvement in these behaviors. Methods Participants (N = 109, aged 16-26 years, 69% males) were selected from a national survey based on their level of externalizing problems to achieve a broad distribution of involvement in addiction-related behaviors. Participants completed the UPPS-P Questionnaire and standardized questionnaires assessing problematic use of substances (alcohol, cannabis, and other drugs) and non-substances (Internet gaming, pornography, and food). Regression analyses were used to assess associations between impulsivity traits and indicators of addiction-related behaviors. Results The UPPS-P model was positively associated with indicators of all addiction-related behaviors except problematic Internet gaming. In the fully adjusted models, sensation seeking and lack of perseverance were associated with problematic use of alcohol, urgency was associated with problematic use of cannabis, and lack of perseverance was associated with problematic use of other drugs than cannabis. Furthermore, urgency and lack of perseverance were associated with binge eating and lack of perseverance was associated with problematic use of pornography. Discussion and conclusions We emphasize the role of trait impulsivity across multiple addiction-related behaviors. Our findings in at-risk youth highlight urgency and lack of perseverance as potential predictors for the development of addictions and as potential preventative therapeutic targets.

Impulsivity in men with prescription of benzodiazepines and methadone in prison.

PubMed

Moreno-Ramos, Luis; Fernández-Serrano, María José; Pérez-García, Miguel; Verdejo-García, Antonio

2016-06-14

Benzodiazepines and methadone use has been associated with various neuropsychological impairments. However, to the best of our knowledge, no studies have been carried out on the effect of these substances (either separately or combined) on impulsive personality, including studies in prisoners. The aim of this study is to examine the impulsive personality of a sample of 134 male prisoners using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (Torrubia, Avila, Molto, & Caseras, 2001) and the UPPS-P Scale (Cyders et al., 2007). Some of these were methadone users, methadone and benzodiazepines users, polydrug users in abstinence and non-dependent drug users. The results showed that drug users have greater sensitivity to reward, positive urgency, negative urgency and sensation seeking than non-dependent users. Methadone users showed more sensitivity to punishment and lack of perseverance with respect to other users. No differences were found between methadone+benzodiazepines users and other groups. The secondary aim is to examine which impulsive personality dimensions are related to the two motivational systems proposed by Gray (BIS-BAS) using exploratory factor analysis. Results showed two different components. One component was defined by the subscales sensitivity to reinforcement, positive urgency, negative urgency and sensation seeking. The second component was defined by the subscales sensitivity to punishment, lack of perseverance and lack of premeditation.

Examination of the heterogeneity in PTSD and impulsivity facets: A latent profile analysis.

PubMed

Contractor, Ateka A; Caldas, Stephanie; Weiss, Nicole H; Armour, Cherie

2018-04-15

The experience of traumatizing events and resulting posttraumatic stress disorder (PTSD) symptomology relates to a range of impulsive behaviors. While both PTSD and impulsivity are heterogeneous and multidimensional constructs, no research has used person-centered approaches to examine subgroups of individuals based on these response endorsements. Hence, our study examined PTSD-impulsivity typologies and their construct validity in two samples: university students ( n = 412) and community participants recruited through Amazon's MTurk ( n = 346). Measures included the Stressful Life Events Screening Questionnaire (PTEs), PTSD Checklist for DSM-5 (PTSD severity), UPPS Impulsive Behavior Scale (negative urgency, lack of premeditation, lack of perseverance, sensation seeking). Dimensions of Anger Reaction Scale (anger), and the Patient Health Questionnaire-9 (depression). For both samples, results of latent profile analyses indicated a best-fitting 3-class solution: High, Moderate, and Low PTSD-Negative Urgency. Negative urgency was the most distinguishing impulsivity facet. Anger and depression severity significantly predicted membership in the more severe symptomatology classes. Thus, individuals can be meaningfully categorized into three subgroups based on PTSD and impulsivity item endorsements. We provide some preliminary evidence for a negative urgency subtype of PTSD characterized by greater depression and anger regulation difficulties; and underscore addressing emotional regulation skills for these subgroup members.

Which dimensions of impulsivity are related to problematic practice of physical exercise?

PubMed

Kotbagi, Gayatri; Morvan, Yannick; Romo, Lucia; Kern, Laurence

2017-06-01

Background and aims Problematic practice of physical exercise (PPPE) has been suggested to be a behavioral addiction. Impulsivity represents a core dimension of behavioral addictions. However, little is known about impulsivity facets in PPPE. The aim of this study was to investigate the role of impulsivity facets in PPPE. Methods A total of 684 students (between 18 and 25 years) took part in this study and filled up a battery of questionnaire, which consisted of following measures - Global Physical Activity Questionnaire, Exercise Dependence Scale - Revised, and the UPPS Impulsive Behavior Scale. Multiple regression analyses were utilized to investigate the predictive role of each impulsivity facet in PPPE. Results Age, the total level of physical activity per day, sex (male), negative urgency, and sensation seeking were found to be significant predictors of PPPE. A categorical analysis of PPPE revealed that negative urgency, positive urgency, and sensation seeking were significantly higher in the dependent category of PPPE. Discussion and conclusions Associations to negative urgency and sensation seeking might indicate that PPPE serves to regulate or alleviate negative affect or aversive emotional states. Thus, PPPE could be conceptualized as a short-term coping strategy dedicated to relieving negative affective states, like other maladaptive behaviors such as binge eating, binge drinking, or compulsive buying.

78 FR 41942 - Alaska; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C...; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared Disaster...

78 FR 32414 - Illinois; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency..., Disaster Housing Assistance to Individuals and Households In Presidentially Declared Disaster Areas; 97.049...

Brain Structural Differences between Normal and Obese Adults and their Links with Lack of Perseverance, Negative Urgency, and Sensation Seeking.

PubMed

Wang, Haifeng; Wen, Baohong; Cheng, Jingliang; Li, Hongpeng

2017-01-16

In order to examine the difference in brain structure between obese and normal weight individuals, and to explore the relationship between the neuroanatomical changes and impulsivity traits, this study used a voxel-based morphometry method to examine gray matter (GM) volume alterations related to impulsive personality traits in obese individuals relative to normal weight. Eighty adults that completed the UPPS-P Impulsive Behavior Scale were analyzed. Possible GM volume alterations were first analyzed at the whole brain level, and then the relationship between regional GM volume differences and UPPS-P scores were examined in selected regions of interest. Reduced GM volumes were found in the frontal and limbic regions in the obese group compared to normal weight individuals. In the normal weight group, lack of perseverance was negatively correlated with GM volume in the anterior cingulate cortex, and negative urgency was negatively correlated with GM volume in the insula. In the obese group, sensation seeking was negatively correlated with GM volume in the left amygdala and right pallidum. These findings might improve our understanding of the relationship between lack of perseverance, negative urgency, and sensation seeking and body weight fluctuations.

Brain Structural Differences between Normal and Obese Adults and their Links with Lack of Perseverance, Negative Urgency, and Sensation Seeking

PubMed Central

Wang, Haifeng; Wen, Baohong; Cheng, Jingliang; Li, Hongpeng

2017-01-01

In order to examine the difference in brain structure between obese and normal weight individuals, and to explore the relationship between the neuroanatomical changes and impulsivity traits, this study used a voxel-based morphometry method to examine gray matter (GM) volume alterations related to impulsive personality traits in obese individuals relative to normal weight. Eighty adults that completed the UPPS-P Impulsive Behavior Scale were analyzed. Possible GM volume alterations were first analyzed at the whole brain level, and then the relationship between regional GM volume differences and UPPS-P scores were examined in selected regions of interest. Reduced GM volumes were found in the frontal and limbic regions in the obese group compared to normal weight individuals. In the normal weight group, lack of perseverance was negatively correlated with GM volume in the anterior cingulate cortex, and negative urgency was negatively correlated with GM volume in the insula. In the obese group, sensation seeking was negatively correlated with GM volume in the left amygdala and right pallidum. These findings might improve our understanding of the relationship between lack of perseverance, negative urgency, and sensation seeking and body weight fluctuations. PMID:28091559

Public Relations in Contemporary India: Current Demands and Strategy.

ERIC Educational Resources Information Center

Singh, Raveena

2000-01-01

Discusses India's new direction and the persistent and insistent demand for public relations. Explains the strategic plan of the professional body in running the gauntlet in this new milieu and the pertinaciousness and urgency of the challenges ahead for public relations. (SC)

Multimodal urgency coding: auditory, visual, and tactile parameters and their impact on perceived urgency.

PubMed

Baldwin, Carryl L; Eisert, Jesse L; Garcia, Andre; Lewis, Bridget; Pratt, Stephanie M; Gonzalez, Christian

2012-01-01

Through a series of investigations involving different levels of contextual fidelity we developed scales of perceived urgency for several dimensions of the auditory, visual, and tactile modalities. Psychophysical ratings of perceived urgency, annoyance, and acceptability as well as behavioral responses to signals in each modality were obtained and analyzed using Steven's Power Law to allow comparison across modalities. Obtained results and their implications for use as in-vehicle alerts and warnings are discussed.

Bladder sensation measures and overactive bladder.

PubMed

Rapp, David E; Neil, Nancy J; Govier, Fred E; Kobashi, Kathleen C

2009-09-01

We performed a prospective multicomponent study to determine whether subjective and objective bladder sensation instruments may provide data on sensory dysfunction in patients with overactive bladder. We evaluated 70 prospectively enrolled patients with urodynamics and questionnaires on validated urgency (Urgency Perception Score), general overactive bladder (Urogenital Distress Inventory) and quality of life (Incontinence Impact Questionnaire). We first sought a correlation between sensory specific (Urgency Perception Score) and quality of life questionnaire scores. We then assessed a correlation between sensory questionnaire scores and urodynamic variables, exploring the hypothesis that certain urodynamic parameters may be bladder sensation measures. We evaluated 2 urodynamic derivatives (first sensation ratio and bladder urgency velocity) to increase sensory finding discrimination. We noted a moderate correlation between the Urgency Perception Score (0.56) and the Urogenital Distress Inventory (0.74) vs the Incontinence Impact Questionnaire (each p <0.01). A weak negative correlation was seen between Urgency Perception Score and bladder capacity (-0.25, p <0.05). No correlation was noted for the other urodynamics parameters. First sensation ratio and bladder urgency velocity statistically significantly correlated with the Urgency Perception Score despite the lesser or absent correlation associated with the individual components of these derivatives. Bladder sensation questionnaires may be valuable to identify patients with sensory dysfunction and provide additional data not obtained in generalized symptom questionnaires. Urodynamic variables correlated with bladder sensation questionnaire scores and may be an objective method to assess sensory dysfunction.

Schizophrenia patients demonstrate a dissociation on declarative and non-declarative memory tests.

PubMed

Perry, W; Light, G A; Davis, H; Braff, D L

2000-12-15

Declarative memory refers to the recall and recognition of factual information. In contrast, non-declarative memory entails a facilitation of memory based on prior exposure and is typically assessed with priming and perceptual-motor sequencing tasks. In this study, schizophrenia patients were compared to normal comparison subjects on two computerized memory tasks: the Word-stem Priming Test (n=30) and the Pattern Sequence Learning Test (n=20). Word-stem Priming includes recall, recognition (declarative) and priming (non-declarative) components of memory. The schizophrenia patients demonstrated an impaired performance on recall of words with relative improvement during the recognition portion of the test. Furthermore, they performed normally on the priming portion of the test. Thus, on tests of declarative memory, the patients had retrieval deficits with intact performance on the non-declarative memory component. The Pattern Sequence Learning Test utilizes a serial reaction time paradigm to assess non-declarative memory. The schizophrenia patients' serial reaction time was significantly slower than that of comparison subjects. However, the patients' rate of acquisition was not different from the normal comparison group. The data suggest that patients with schizophrenia process more slowly than normal, but have an intact non-declarative memory. The schizophrenia patients' dissociation on declarative vs. non-declarative memory tests is discussed in terms of possible underlying structural impairment.

The role of urgency in maladaptive behaviors.

PubMed

Anestis, Michael D; Selby, Edward A; Joiner, Thomas E

2007-12-01

Prior work on maladaptive behaviors has cited impulsivity as a risk factor. The concept of impulsivity, however, fails to address the potential role of negative affect in such behaviors. The UPPS Impulsive Behavior Scale addresses this weakness by dividing impulsivity into four subscales: Urgency, Sensation Seeking, (lack of) Premeditation, and (lack of) Perseverance. We predicted that urgency, defined as the tendency, specifically in the face of negative affect, to act quickly and without planning, would predict elevations on three maladaptive behaviors--excessive reassurance seeking, drinking to cope, and bulimic symptoms as measured by the Eating Disorder Inventory--in both cross-sectional and longitudinal analyses in an undergraduate sample (N=70). Participants were assessed at two time points, 3-4 weeks apart. Urgency significantly predicted all three outcome variables cross-sectionally at both Time 1 and Time 2. Time 1 urgency significantly predicted Time 2 excessive reassurance seeking. Changes in urgency from Time 1 to Time 2 predicted changes in all three outcome variables. Results indicate a clear cross-sectional relationship between urgency and certain maladaptive behaviors. Additionally, some form of longitudinal relationship may exist between these variables, although the use of residual change scores precluded distinction between true change and change due to error.

A longitudinal study of the reciprocal relationship between ever smoking and urgency in early adolescence.

PubMed

Burris, Jessica L; Riley, Elizabeth; Puleo, Gabriella E; Smith, Gregory T

2017-09-01

Among early adolescents in the United States (U.S.), the prevalence of cigarette smoking is at its lowest level in recent decades. Nonetheless, given the risks of smoking in early development, it remains critically important to study both risk factors for smoking and risks from smoking. This longitudinal study with U.S. early adolescents examines smoking initiation and tests a model of reciprocal prediction between ever smoking and the personality trait of urgency (i.e., mood-based impulsivity), a trait that increases risk for multiple forms of dysfunction. Participants (n=1906; 90% 10-11 years old, 50% female, 39% racial minorities at baseline) completed questionnaires 1-2 times per year starting in 5th grade and ending in 9th grade. Structural equation modeling allowed tests of bidirectional relationships between ever smoking and urgency controlling for pubertal status and negative affect at each wave. Incidence of ever smoking increased from 5% to 27% over time, with current smoking around 5% at the last wave. Urgency at each wave predicted ever smoking at the next wave above and beyond covariates and prior smoking (all p<0.01). Likewise, with one exception, ever smoking predicted an increase in urgency at the subsequent wave above and beyond covariates and prior urgency (all p<0.05). Results show that risk for smoking increases with higher levels of urgency and urgency increases secondary to engagement in smoking. Future work should therefore explore urgency as a point of prevention for smoking and smoking cessation as a means to mitigate mood-based impulsivity. Copyright © 2017 Elsevier B.V. All rights reserved.

Dimensions of sensation assessed in urinary urgency: a systematic review.

PubMed

Das, Rebekah; Buckley, Jonathan; Williams, Marie

2013-10-01

Urinary urgency is an adverse sensory experience. Confirmation of the multidimensional nature of other adverse sensory experiences such as pain and dyspnea has improved the understanding of neurophysiological and perceptual mechanisms leading to innovations in assessment and treatment. It has been suggested that the sensation of urgency may include multiple dimensions such as intensity, suddenness and unpleasantness. In this systematic review we determine which dimensions of sensation have been assessed by instruments used to measure urinary urgency. A systematic search was undertaken of MEDLINE, Embase, AMED, CINAHL, Ageline, Web of Science, InformIT Health and Scopus databases to identify studies that included assessments of urinary urge or urgency. Articles were included in the analysis if they were primary studies that described the method used to measure urge/urgency in adults and published in English in peer reviewed publications since January 1, 2000. Articles were excluded from study if urgency was measured only in conjunction with other symptoms (eg frequency or incontinence) or if there was no English version of the instrument. Secondary analyses and systematic reviews were retained to hand search references for additional primary studies. Data were extracted for the instruments used to measure urge/urgency. For each instrument the items specific to urinary urgency were reviewed using a prospectively developed categorization process for the sensory dimension and the measurement metric. Items used to assess urinary urgency were collated in a matrix (sensory dimensions vs assessment metric). The most frequently used dimensions, metrics and combinations were descriptively analyzed. After removal of duplicate articles 1,048 full text articles were screened and 411 were excluded, leaving 637 eligible articles from which data were extracted. A total of 216 instruments were identified which were 1 of 6 types, namely 1) wider symptom questionnaires, 2) urgency specific questionnaires, 3) ordinal scales, 4) visual analog scales, 5) event records or 6) body maps. These 216 instruments contained a total of 309 urgency specific items. Of the instruments 51% did not define a dimension of sensation and 26% did not define the metric used. From the remaining instruments 8 dimensions of sensation and 5 types of metrics were identified. From most common to least common, the sensory dimensions assessed were behavioral response, intensity, suddenness, bother, affective response, unpleasantness, quality (descriptors) and problems associated with sensation. Metrics were magnitude, frequency, presence, time frame or location. The most common sensory dimension/metric combinations were frequency of a behavioral response (14% of items) and magnitude of bother caused by the sensation (8% of items). The hypothesis that urinary urgency is multidimensional is supported by the range of dimensions assessed with available instruments. To clarify the nature of urinary urgency compared with the normal desire to void, prospective studies are required to determine whether sensory dimensions are distinct, and which may delineate between normal and pathological sensation. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Should I stay or should I go? Hospital emergency department waiting times and demand.

PubMed

Sivey, Peter

2018-03-01

In the absence of the price mechanism, hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper estimates by how much the number of treatments demanded is reduced by a higher waiting time. I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25 and is highest for the lowest-urgency patients. Copyright © 2017 John Wiley & Sons, Ltd.

The influence of patient acuity on satisfaction with emergency care: perspectives of family, friends and carers.

PubMed

Ekwall, Anna; Gerdtz, Marie; Manias, Elizabeth

2008-03-01

To investigate the factors that influence satisfaction with emergency care among individuals accompanying patients to the emergency department and explore agreement between the triage nurse and accompanying person regarding urgency. Many patients seeking treatment in hospital are escorted by an accompanying person, who may be a friend, family member or carer. Several factors influence patient satisfaction with emergency care, including waiting time and time to treatment. It is also influenced by provision of information and interpersonal relations between staff and patients. Research on satisfaction has focused on the patient perspective; however, individuals who accompany patients are potential consumers. Knowledge about the ways accompanying persons perceive the patient's medical condition and level of urgency will identify areas for improved patient outcomes. A prospective cross-sectional survey with a consecutive sample (n = 128 response rate 83.7%) was undertaken. Data were collected in an Australian metropolitan teaching hospital with about 32,000 visits to the emergency department each year. The Consumer Emergency Satisfaction Scale was used to measure satisfaction with nursing care. Significant differences in perceptions of patient urgency between accompanying persons and nurses were found. Those people accompanying patients of a higher urgency were significantly more satisfied than those accompanying patients of a lower urgency. These results were independent of real waiting time or the accompanying person's knowledge of the patients' triage status. In addition, older accompanying persons were more satisfied with emergency care than younger accompanying persons. Little attention has been paid to the social interactions that occur between nurses and patients at triage and the ways in which these interactions might impact satisfaction with emergency care. Good interpersonal relationships can positively influence satisfaction with the emergency visit. This relationship can contribute to improved patient care and health outcomes.

Multicenter, randomized, sham-controlled study on the efficacy of magnetic stimulation for women with urgency urinary incontinence.

PubMed

Yamanishi, Tomonori; Homma, Yukio; Nishizawa, Osamu; Yasuda, Kosaku; Yokoyama, Osamu

2014-04-01

To evaluate the efficacy and safety of magnetic stimulation for the treatment of urinary incontinence in women with overactive bladder. A total of 151 women with urgency incontinence were randomized to the active stimulation group or the sham stimulation group in a 2:1 order. An armchair type magnetic stimulator was used for 25-min magnetic stimulation twice a week, with the maximum magnetic flux density of 560 mT peak at 10 Hz. The sham device was set to deliver in a 5-s "on"-5-s "off" pulsing manner with the maximum intensity of 20.4% of active stimulation at 1 Hz. The study consisted of a baseline period for 1 week, and a treatment period for 6 weeks. The primary end-point was the number of leaks/week from the bladder diary. The secondary end-points were the number of voids and urgency/24 h, mean and maximum voided volume, and the quality of life assessment. Changes from baseline in the active and sham group, respectively, were -13.08 ± 11.00 and -8.68 ± 13.49 in leaks/week (P = 0.038), -2.65 ± 2.52 and -1.53 ± 2.39 in number of urgency/24 h (P = 0.011), and 14.03 ± 34.53 mL and -4.15 ± 40.60 mL in mean voided volume (P = 0.0056). As for safety, except for diarrhea and constipation, no patients experienced any device-related adverse event. Magnetic stimulation is effective for the treatment of urgency incontinence in female patients with overactive bladder. © 2013 The Japanese Urological Association.

Negative Urgency: A Personality Predictor of Externalizing Behavior Characterized by Neuroticism, Low Conscientiousness, and Disagreeableness

PubMed Central

Settles, Regan E.; Fischer, Sarah; Cyders, Melissa A.; Combs, Jessica L.; Gunn, Rachel L.; Smith, Gregory T.

2012-01-01

Negative urgency, the tendency to act rashly when distressed, is characterized by high Neuroticism, low Conscientiousness, and low Agreeableness. Because of this set of characteristics, the authors hypothesized that (1) negative urgency (NU) is a particularly important predictor of externalizing dysfunction; (2) traits that reflect primarily high Neuroticism predict internalizing dysfunction and (3) traits that reflect primarily low Conscientiousness predict those types of externalizing dysfunction that include intense affect less strongly than does NU. In three studies, the authors showed that negative urgency concurrently predicted alcohol dependence symptoms in disordered women, drinking problems and smoker status in pre-adolescents, and aggression, risky sex, illegal drug use, drinking problems, and conduct disordered behavior in college students. High Neuroticism traits predicted internalizing dysfunction but predicted none of these externalizing criteria beyond negative urgency. Low Conscientiousness did not add to prediction from negative urgency, except in a few cases. The tendency toward affect-driven rash action may underlie many externalizing behaviors. PMID:21859164

The interactive effects of affect lability, negative urgency, and sensation seeking on young adult problematic drinking.

PubMed

Karyadi, Kenny; Coskunpinar, Ayca; Dir, Allyson L; Cyders, Melissa A

2013-01-01

Prior studies have suggested that affect lability might reduce the risk for problematic drinking among sensation seekers by compensating for their deficiencies in emotional reactivity and among individuals high on negative urgency by disrupting stable negative emotions. Due to the high prevalence of college drinking, this study examined whether affect lability interacted with sensation seeking and negative urgency to influence college student problematic drinking. 414 college drinkers (mean age: 20, 77% female, and 74% Caucasian) from a US Midwestern University completed self-administered questionnaires online. Consistent with our hypotheses, our results indicated that the effects of sensation seeking and negative urgency on problematic drinking weakened at higher levels of affect lability. These findings emphasize the importance of considering specific emotional contexts in understanding how negative urgency and sensation seeking create risk for problematic drinking among college students. These findings might also help us better understand how to reduce problematic drinking among sensation seekers and individuals high on negative urgency.

The Interactive Effects of Affect Lability, Negative Urgency, and Sensation Seeking on Young Adult Problematic Drinking

PubMed Central

Karyadi, Kenny; Coskunpinar, Ayca; Dir, Allyson L.; Cyders, Melissa A.

2013-01-01

Prior studies have suggested that affect lability might reduce the risk for problematic drinking among sensation seekers by compensating for their deficiencies in emotional reactivity and among individuals high on negative urgency by disrupting stable negative emotions. Due to the high prevalence of college drinking, this study examined whether affect lability interacted with sensation seeking and negative urgency to influence college student problematic drinking. 414 college drinkers (mean age: 20, 77% female, and 74% Caucasian) from a US Midwestern University completed self-administered questionnaires online. Consistent with our hypotheses, our results indicated that the effects of sensation seeking and negative urgency on problematic drinking weakened at higher levels of affect lability. These findings emphasize the importance of considering specific emotional contexts in understanding how negative urgency and sensation seeking create risk for problematic drinking among college students. These findings might also help us better understand how to reduce problematic drinking among sensation seekers and individuals high on negative urgency. PMID:24826366

Urgency: the cornerstone symptom of overactive bladder.

PubMed

Brubaker, Linda

2004-12-01

Urgency, defined as the compelling feeling of impending incontinence that is difficult to defer, is the cornerstone symptom of overactive bladder. Unfortunately, controversy continues to surround this term and its definition, a fact that has constrained the performance of clinical research in this field. It is important to note that the definition assumes an abnormal sensation that is distinguishable from the normal feeling of "urge to void," which occurs during a normal bladder-filling cycle. The cause of urgency is not fully understood and may vary from patient to patient. Urgency may be controlled by central nervous system mechanisms, lower urinary tract mechanisms, including detrusor myogenic functions (ie, overt detrusor contractions, micromotions, myofibroblast abnormalities), or afferent neural factors. Recently, a number of articles that attempt to quantify urgency have appeared in the literature. Attempts to measure urgency are confounded by difficulties in understanding its definition, the context of normal urge to void, and the power of suggestion in most clinical environments.

Striatal activation reflects urgency in perceptual decision making.

PubMed

van Maanen, Leendert; Fontanesi, Laura; Hawkins, Guy E; Forstmann, Birte U

2016-10-01

Deciding between multiple courses of action often entails an increasing need to do something as time passes - a sense of urgency. This notion of urgency is not incorporated in standard theories of speeded decision making that assume information is accumulated until a critical fixed threshold is reached. Yet, it is hypothesized in novel theoretical models of decision making. In two experiments, we investigated the behavioral and neural evidence for an "urgency signal" in human perceptual decision making. Experiment 1 found that as the duration of the decision making process increased, participants made a choice based on less evidence for the selected option. Experiment 2 replicated this finding, and additionally found that variability in this effect across participants covaried with activation in the striatum. We conclude that individual differences in susceptibility to urgency are reflected by striatal activation. By dynamically updating a response threshold, the striatum is involved in signaling urgency in humans. Copyright © 2016 Elsevier Inc. All rights reserved.

System and method of self-properties for an autonomous and automatic computer environment

NASA Technical Reports Server (NTRS)

Sterritt, Roy (Inventor); Hinchey, Michael G. (Inventor)

2010-01-01

Systems, methods and apparatus are provided through which in some embodiments self health/urgency data and environment health/urgency data may be transmitted externally from an autonomic element. Other embodiments may include transmitting the self health/urgency data and environment health/urgency data together on a regular basis similar to the lub-dub of a heartbeat. Yet other embodiments may include a method for managing a system based on the functioning state and operating status of the system, wherein the method may include processing received signals from the system indicative of the functioning state and the operating status to obtain an analysis of the condition of the system, generating one or more stay alive signals based on the functioning status and the operating state of the system, transmitting the stay-alive signal, transmitting self health/urgency data, and transmitting environment health/urgency data. Still other embodiments may include an autonomic element that includes a self monitor, a self adjuster, an environment monitor, and an autonomic manager.

Negative and positive urgency may both be risk factors for compulsive buying.

PubMed

Rose, Paul; Segrist, Daniel J

2014-06-01

Descriptions of compulsive buying often emphasize the roles of negative moods and trait impulsivity in the development of problematic buying habits. Trait impulsivity is sometimes treated as a unidimensional trait in compulsive buying research, but recent factor analyses suggest that impulsivity consists of multiple components that are probably best treated as independent predictors of problem behavior. In order to draw greater attention to the role of positive moods in compulsive buying, in this study we tested whether negative urgency (the tendency to act rashly while in negative moods) and positive urgency (the tendency to act rashly while in positive moods) account for similar amounts of variance in compulsive buying. North American adults (N = 514) completed an online survey containing the Richmond Compulsive Buying Scale (Ridgway, Kukar-Kinney & Monroe, 2008), established measures of positive and negative urgency (Cyders et al., 2007), ad hoc measures of buying-specific positive and negative urgency, measures of extraversion and neuroticism obtained from the International Personality Item Pool (http://ipip.ori.org/), and demographic questions. In several multiple regression analyses, when demographic variables, neuroticism, and extraversion were controlled, positive urgency and negative urgency both emerged as significant predictors of compulsive buying. Whether the two urgency variables were domain-general or buying-specific, they accounted for similar amounts of variance in compulsive buying. Preventing and reducing compulsive buying may require attention not only to the purchasing decisions people make while in negative states, but also to the purchasing decisions they make while in positive states.

The relationship between the UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis.

PubMed

Hershberger, Alexandra R; Um, Miji; Cyders, Melissa A

2017-09-01

Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy. Studies were identified by conducting a comprehensive review of the literature. For aim one (k=6), significant effects were found for lack of premeditation (g=0.60, SE=0.30, 95% CI 0.01-1.20; z=1.99, p=0.05) and negative urgency (g=0.55, SE=0.17, 95% CI 0.22-0.88, z=3.30, p=0.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k=10), decreases in sensation seeking (g=-0.10, SE=0.05, 95% CI -0.20 to 0.004; z=-1.88, p=0.02) and negative urgency (g=-0.25, SE=0.14, 95% CI -0.53 to 0.03; z=-1.75, p=0.03) during SUD psychotherapy were significant. Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

The process of implementation of emergency care units in Brazil.

PubMed

O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

2017-12-11

To analyze the process of implementation of emergency care units in Brazil. We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network.

The process of implementation of emergency care units in Brazil

PubMed Central

O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

2017-01-01

ABSTRACT OBJECTIVE To analyze the process of implementation of emergency care units in Brazil. METHODS We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. RESULTS Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. CONCLUSIONS The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network. PMID:29236876

Declarative and nondeclarative memory: multiple brain systems supporting learning and memory.

PubMed

Squire, L R

1992-01-01

Abstract The topic of multiple forms of memory is considered from a biological point of view. Fact-and-event (declarative, explicit) memory is contrasted with a collection of non conscious (non-declarative, implicit) memory abilities including skills and habits, priming, and simple conditioning. Recent evidence is reviewed indicating that declarative and non declarative forms of memory have different operating characteristics and depend on separate brain systems. A brain-systems framework for understanding memory phenomena is developed in light of lesion studies involving rats, monkeys, and humans, as well as recent studies with normal humans using the divided visual field technique, event-related potentials, and positron emission tomography (PET).

44 CFR 206.209 - Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR... determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR-1604, DR-1605, DR...

44 CFR 206.209 - Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR... determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR-1604, DR-1605, DR...

44 CFR 206.209 - Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR... determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR-1604, DR-1605, DR...

44 CFR 206.209 - Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Arbitration for Public Assistance determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR... determinations related to Hurricanes Katrina and Rita (Major disaster declarations DR-1603, DR-1604, DR-1605, DR...

75 FR 2883 - New York; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

.... FEMA-1869-DR; Docket ID FEMA-2008-0018] New York; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New York (FEMA-1869-DR), dated December 31, 2009, and related..., the President issued a major disaster declaration under the authority of the Robert T. Stafford...

Identification of organic pigments in tattoo inks and permanent make-up using laser desorption ionisation mass spectrometry

PubMed Central

Niederer, Markus; Hauri, Urs; Kroll, Lydia; Hohl, Christopher

2018-01-01

Nowadays, about 12% of the European and 20% of the US population are tattooed. Rising concerns regarding consumer safety, led to legal restrictions on tattoo and permanent make-up (PMU) inks. Restrictions also include bans on certain colourants. Both ink types use organic pigments for colour-giving, plus inorganic pigments for white and black and colour tones. Pigments are only sparingly soluble in common solvents and occur as suspended particles in the ink matrix. Their detection and identification therefore pose a major challenge for laboratories involved in monitoring the legal compliance of tattoo inks and PMU. We overcame this challenge by developing a direct laser desorption ionisation time-of-flight mass spectrometry method, which included an easy sample clean up. The method proved to be capable of detecting and identifying organic pigments in almost all of the tested ink samples. Method validation and routine deployment during market surveys showed the method to be fit for purpose. Pigment screening of 396 tattoo inks and 55 PMU taken from the Swiss market between 2009 and 2017 lead to the following conclusions: Pigment variety is much greater in tattoo inks (18) than in PMU (10); four prohibited pigments (Pigment Green 7, Pigment Red 122, Pigment Violet 19 and 23) were found in both ink types; for PMU, these four pigments made up 12% of the pigment findings, compared to 32% for tattoo inks. Therefore, legal compliance of PMU was at a higher level. A comparison of pigments found with those declared on tattoo ink labels clearly showed that banned pigments are rarely declared, but rather masked by listing non present legal pigments and label forging; therefore, highlighting the urgency of widespread market controls. PMID:29259773

Identification of organic pigments in tattoo inks and permanent make-up using laser desorption ionisation mass spectrometry.

PubMed

Niederer, Markus; Hauri, Urs; Kroll, Lydia; Hohl, Christopher

2017-01-01

Nowadays, about 12% of the European and 20% of the US population are tattooed. Rising concerns regarding consumer safety, led to legal restrictions on tattoo and permanent make-up (PMU) inks. Restrictions also include bans on certain colourants. Both ink types use organic pigments for colour-giving, plus inorganic pigments for white and black and colour tones. Pigments are only sparingly soluble in common solvents and occur as suspended particles in the ink matrix. Their detection and identification therefore pose a major challenge for laboratories involved in monitoring the legal compliance of tattoo inks and PMU. We overcame this challenge by developing a direct laser desorption ionisation time-of-flight mass spectrometry method, which included an easy sample clean up. The method proved to be capable of detecting and identifying organic pigments in almost all of the tested ink samples. Method validation and routine deployment during market surveys showed the method to be fit for purpose. Pigment screening of 396 tattoo inks and 55 PMU taken from the Swiss market between 2009 and 2017 lead to the following conclusions: Pigment variety is much greater in tattoo inks (18) than in PMU (10); four prohibited pigments (Pigment Green 7, Pigment Red 122, Pigment Violet 19 and 23) were found in both ink types; for PMU, these four pigments made up 12% of the pigment findings, compared to 32% for tattoo inks. Therefore, legal compliance of PMU was at a higher level. A comparison of pigments found with those declared on tattoo ink labels clearly showed that banned pigments are rarely declared, but rather masked by listing non present legal pigments and label forging; therefore, highlighting the urgency of widespread market controls.

Stress and Performance: Effects of Subjective Work Load and Time Urgency.

ERIC Educational Resources Information Center

Friend, Kenneth E.

1982-01-01

Measured subjective work load, time urgency, and other stress/motivation variables for management personnel taking a demanding problem-solving exam. Data suggest increases in psychological stresses like subjectively high work load and time urgency uniformly impair performance across the whole range of these variables. (Author)

Neuroticism and Negative Urgency in Problematic Alcohol Use: A Pilot Study.

PubMed

Papachristou, Harilaos; Nederkoorn, Chantal; Jansen, Anita

2016-09-18

Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run. We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use. Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behaviour scale (UPPS-P), the Alcohol Use Disorders Identification Test (AUDIT), and the Neuroticism subscale of the Eysenck Personality Questionnaire Revised short form (EPQ-RSS). The results confirmed our hypothesis as we found an indirect effect of negative urgency on the relationship between neuroticism and problematic alcohol use. It appears that it is not distress but the tendency to act rashly when distressed that is important in developing problematic alcohol drinking in university students.

[Cultural diversity and pluralism in the Universal Declaration on Bioethics and Human Rights].

PubMed

Romeo Casabona, Carlos María

2011-01-01

The Universal Declaration on Bioethics and Human Rights represents a significant milestone in the history of Law, particularly in the application of International Law to an important area of human activity, namely the medical sciences, the life sciences and the technologies which, linked to both, can be applied to human relations. In parallel with this, and as will be analysed in this article, the Declaration has involved adopting a clear position regarding cultural diversity and pluralism in relation to Biomedicine. In this paper the author highlights the fact that perspectives have been opened which have hardly been explored concerning Biomedicine, such as the recognition of the value and respect which cultural diversity (multiculturalism), economic and social diversity deserve in relation to the issues covered by the Declaration, and the acceptance that the owners of the rights are not only individuals, but can also be groups.

Vibegron, a Novel Potent and Selective β3-Adrenoreceptor Agonist, for the Treatment of Patients with Overactive Bladder: A Randomized, Double-blind, Placebo-controlled Phase 3 Study.

PubMed

Yoshida, Masaki; Takeda, Masayuki; Gotoh, Momokazu; Nagai, Shinji; Kurose, Takafumi

2018-05-01

Vibegron is a novel, potent, and selective β 3 -adrenoreceptor agonist for the treatment of patients with overactive bladder (OAB). To evaluate the efficacy and safety of vibegron versus placebo in Japanese OAB patients. Patients with OAB entered a 2-wk placebo run-in phase. Once eligibility (≥8 micturition/d and either ≥1 urgency episodes/d or ≥1 urgency incontinence episodes/d) was confirmed, patients entered a 12-wk double-blind treatment phase. The anticholinergic imidafenacin was used as an active reference. A total of 1232 patients were randomly assigned to one of the four 12-wk treatment groups: vibegron (50mg or 100mg once daily), placebo, or imidafenacin (0.1mg twice daily). The primary endpoint was change in the mean number of micturitions/d at wk 12 from baseline. The secondary endpoints were changes from baselines in OAB symptom variables (daily episodes of urgency, urgency incontinence, incontinence, and nocturia, and voided volume/micturition). Quality of life (QoL) and safety were assessed. A constrained longitudinal data analysis model was used for analysis of efficacy. Patients taking vibegron 50mg and 100mg orally for 12 wk had significant improvements over the placebo in the primary and secondary endpoints. The proportions of patients with normalization of micturition, resolution of urgency, urgency incontinence, and incontinence were significantly greater than placebo. Vibegron significantly improved QoL, with high patient satisfaction. Incidences of drug-related adverse events with vibegron 50mg and 100mg were 7.6%, 5.4%, similar to placebo (5.1%), and less than imidafenacin (10.3%). Treatment was for just 12 wk and a long-term study is needed. The 12-wk treatment with vibegron is effective and well tolerated in patients with OAB. This randomized study demonstrated that vibegron is clinically useful for treatment of patients with OAB. Trial registration ​JapicCTI-152936. http://www.clinicaltrials.jp/user/cteDetail.jsp. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

The impact of intonation and valence on objective and subjective attention capture by auditory alarms.

PubMed

Ljungberg, Jessica K; Parmentier, Fabrice

2012-10-01

The objective was to study the involuntary capture of attention by spoken words varying in intonation and valence. In studies of verbal alarms, the propensity of alarms to capture attention has been primarily assessed with the use of subjective ratings of their perceived urgency. Past studies suggest that such ratings vary with the alarms' spoken urgency and content. We measured attention capture by spoken words varying in valence (negative vs. neutral) and intonation (urgently vs. nonurgently spoken) through subjective ratings and behavioral measures. The key behavioral measure was the response latency to visual stimuli in the presence of spoken words breaking away from the periodical repetition of a tone. The results showed that all words captured attention relative to a baseline standard tone but that this effect was partly counteracted by a relative speeding of responses for urgently compared with nonurgently spoken words. Word valence did not affect behavioral performance. Rating data showed that both intonation and valence increased significantly perceived urgency and attention grabbing without any interaction. The data suggest a congruency between subjective ratings and behavioral performance with respect to spoken intonation but not valence. This study demonstrates the usefulness and feasibility of objective measures of attention capture to help design efficient alarm systems.

Negative Urgency Is Associated With Heightened Negative Affect and Urge During Tobacco Abstinence in Regular Smokers.

PubMed

Park, Annie D; Farrahi, Layla N; Pang, Raina D; Guillot, Casey R; Aguirre, Claudia G; Leventhal, Adam M

2016-09-01

Negative urgency-the tendency to act rashly during negative affective states-is a risk factor for regular cigarette smoking. This human laboratory study tested a novel theoretical model of the underlying mechanisms linking negative urgency and smoking motivation, which purports that smokers with high negative urgency are at increased susceptibility to abstinence-induced increases in negative affect, which, in turn, provokes the urge to smoke to suppress negative affect. Smokers (N = 180, >10 cigarettes/day) attended a baseline session at which they completed self-report measures of negative urgency and other co-factors and subsequently attended two counterbalanced within-subject experimental sessions (i.e., 16 hours of smoking abstinence or smoking as usual). At both experimental sessions, self-reported tobacco withdrawal symptoms, affect, and smoking urge were assessed. Negative urgency was associated with larger abstinence-induced increases in tobacco withdrawal symptoms, negative affect, and urge to smoke to alleviate negative affect, both with and without controlling for anxiety, depression, tobacco dependence, and sensation seeking (βs > .18, ps < .05). The association between negative urgency and abstinence-induced increases in urge to smoke to alleviate negative affect was mediated by greater abstinence-induced increases in negative affect (βs > .062, ps = .01). These results provide initial support of this model by providing evidence that smokers with higher (vs. lower) negative urgency may be more prone to greater negative affect during withdrawal, which in turn may promote urge to smoke to suppress negative emotion. Research extending this model to other settings, measures, and methodological approaches may be fruitful.

Defining urinary urgency: patient descriptions of "gotta go".

PubMed

Coyne, Karin S; Harding, Gale; Jumadilova, Zhanna; Weiss, Jeffrey P

2012-04-01

Urgency is a key symptom in the diagnosis of overactive bladder (OAB), yet its definition and measurement are subject to continuing debate whether urinary urgency is a pathologic sensation or an intensification of normal desire to pass urine. The objective of this research was to explore the concept of urgency among participants with OAB symptoms and to evaluate the content validity of the urinary sensation scale (USS). Two qualitative studies were conducted among participants with OAB symptoms. For both studies, participants were interviewed on the USS to ascertain their ability to complete and interpret each response. Study 2 included open-ended questions to explore the concept of urgency with participants asked to describe "normal urge" and "urgency." Thirty-one men and women (Study 1, n = 12; Study 2, n = 19) participated. Nearly all participants (n = 29) thought the word descriptions for the 1-5 scale were easy to comprehend and were able to differentiate among ratings by degree of severity. Study 2 noted little difference between continent (n = 9) and incontinent (n = 10) participant descriptions of "urge or desire to urinate" and "typical sensation." The majority of the continent (n = 6) and incontinent (n = 7) participants stated they have both "regular" sensations to urinate and "urgent" sensations to urinate. This qualitative research provides evidence that men and women with OAB symptoms can distinguish between "normal" urge (desire) to urinate and "urgency" suggesting that urinary urgency is a continuum, rather than an all-or-none phenomenon. The USS demonstrated content validity and was acceptable to patients. Copyright © 2012 Wiley Periodicals, Inc.

Assessing urgency in interstitial cystitis/painful bladder syndrome.

PubMed

Diggs, Christina; Meyer, Walter A; Langenberg, Patricia; Greenberg, Patty; Horne, Linda; Warren, John W

2007-02-01

Interstitial cystitis/painful bladder syndrome (IC/PBS) at present is a symptom-based diagnosis. The Interstitial Cystitis Symptom Index (ICSI), also known as the O'Leary-Sant Symptom Index, is a widely used scale that assesses the four cardinal symptoms of IC/PBS (ie, bladder pain, urgency, frequency, and nocturia), by asking how often each is experienced. In an ongoing case-control study of recent-onset IC/PBS, we compared the ICSI with a series of questions that addressed the severity of these symptoms. Recruiting nationally, we enrolled women with IC/PBS symptoms of 12 months' duration or less. We assessed the severity of pain, frequency, and urgency using Likert and categorical scales, and how often these symptoms were experienced using the ICSI. We compared these scales by frequency distributions and interscale correlations. In 138 women with recent-onset IC/PBS, the scores for frequency were correlated and, for pain, appeared to be complementary. However, for urgency, the ICSI question of "the strong need to urinate with little or no warning" consistently yielded lower scores than the severity question of "the compelling urge to urinate that is difficult to postpone." Some patients denied urgency to the ICSI question yet reported intense urgency to the severity question. Compared with the severity question, the ICSI underestimated the prevalence and degree of urgency. This observation is consistent with the views of others that sudden urgency does not define the sensation experienced by many patients with IC/PBS. Clarifying this symptom description may assist in developing a usable case definition for IC/PBS.

Negative and positive urgency may both be risk factors for compulsive buying

PubMed Central

ROSE, PAUL; SEGRIST, DANIEL J.

2014-01-01

Background and aims: Descriptions of compulsive buying often emphasize the roles of negative moods and trait impulsivity in the development of problematic buying habits. Trait impulsivity is sometimes treated as a unidimensional trait in compulsive buying research, but recent factor analyses suggest that impulsivity consists of multiple components that are probably best treated as independent predictors of problem behavior. In order to draw greater attention to the role of positive moods in compulsive buying, in this study we tested whether negative urgency (the tendency to act rashly while in negative moods) and positive urgency (the tendency to act rashly while in positive moods) account for similar amounts of variance in compulsive buying. Methods: North American adults (N = 514) completed an online survey containing the Richmond Compulsive Buying Scale (Ridgway, Kukar-Kinney & Monroe, 2008), established measures of positive and negative urgency (Cyders et al., 2007), ad hoc measures of buying-specific positive and negative urgency, measures of extraversion and neuroticism obtained from the International Personality Item Pool (http://ipip.ori.org/), and demographic questions. Results: In several multiple regression analyses, when demographic variables, neuroticism, and extraversion were controlled, positive urgency and negative urgency both emerged as significant predictors of compulsive buying. Whether the two urgency variables were domain-general or buying-specific, they accounted for similar amounts of variance in compulsive buying. Conclusions: Preventing and reducing compulsive buying may require attention not only to the purchasing decisions people make while in negative states, but also to the purchasing decisions they make while in positive states. PMID:25215224

"Urgency tip": a portable patient-activated device for objective measurement of urinary urgency.

PubMed

Kobayashi, Hideki; Araki, Isao; Tsuchida, Takayuki; Zakoji, Hidenori; Mikami, Yuki; Takeda, Masayuki; Kiyohiro, Noriaki

2007-03-01

For clinical practice and research of overactive bladder syndrome, it is essential to evaluate urgency symptoms in daily life. We have developed a portable patient-activated device to record bladder sensations. This electronic device is pocket-size and light, with five grading buttons and another button for cancellation.

Does the cholinesterase inhibitor, donepezil, benefit both declarative and non-declarative processes in mild to moderate Alzheimer's disease?

PubMed

Winstein, Carolee J; Bentzen, Kirk R; Boyd, Lara; Schneider, Lon S

2007-07-01

Previous research suggests separate neural networks for implicit (non-declarative) and explicit (declarative) memory processes. A core cognitive impairment in mild to moderate Alzheimer's disease (AD) is a pronounced declarative memory and learning deficit with relative preservation of non-declarative memory. Cholinesterase inhibitors has been purported to enhance cognitive function, and previous clinical trials consistently showed that donepezil, a reversible inhibitor of acetylcholinesterase (AChE), led to statistically significant improvements in cognition and patient function. This prospective pilot study is a randomized, double blind, placebo-controlled clinical trial investigating 10 patients with AD. Our purpose was to examine the relationship between declarative and non-declarative capability with particular emphasis on implicit sequence learning. Patients were assessed at baseline and again at 4-weeks. After participants' baseline data were obtained, each was double-blindly randomized to one of two groups: donepezil or placebo. At baseline participants were tested with two outcome measures (Serial Reaction Time Task, Alzheimer's Disease Assessment Scale-Cognitive Subscale). Participants were given either 5 mg donepezil or an identically appearing placebo to be taken nightly for 4 weeks (28 tablets), and then retested. The donepezil group demonstrated a greater likelihood of increases in both non-declarative and declarative processes. The placebo group was mixed without clearly definable trends or patterns. When the data were examined for coincidental changes in the two outcome measures together they are suggestive of a benefit from donepezil treatment for non-declarative and declarative processes.

[Nondeclarative memory--neuropsychological findings and neuroanatomic principles].

PubMed

Daum, I; Ackermann, H

1997-03-01

The contents of long-term memory will influence behaviour, even if the acquired knowledge or the original learning episode are not remembered. These phenomena have been termed "non-declarative" or "implicit" memory, and they are contrasted with "declarative" or "explicit" memory which is characterised by conscious search and retrieval procedures. Non-declarative memory encompasses non-associative learning, simple conditioning, priming effects as well as motor, perceptual and cognitive skill acquisition. The dissociation of both forms of memory is documented by studies in health subjects which indicated that experimental manipulations or drugs may differentially affect declarative and non-declarative memory processes. Damage to the medial temporal or the medial thalamic regions is known to result in declarative memory deficits whereas non-declarative memory is largely unaffected by such lesions. Animal research and clinical findings indicate that several components of non-declarative memory such as motor and cognitive skill acquisition or certain types of classical conditioning are dependent upon the integrity of the basal ganglia or the cerebellum. These issues are therefore of increasing importance for the understanding of extrapyramidal and cerebellar diseases. This paper presents recent neuropsychological findings and neuroanatomical data relating to the issue of non-declarative memory.

Long-term memory: A review and meta-analysis of studies of declarative and procedural memory in specific language impairment

PubMed Central

Lum, Jarrad A. G.; Conti-Ramsden, Gina

2014-01-01

This review examined the status of long-term memory systems in specific language impairment (SLI), in particular declarative memory and aspects of procedural memory. Studies included in the review were identified following a systematic search of the literature and findings combined using meta-analysis. This review showed individuals with SLI are poorer than age matched controls in the learning and retrieval of verbal information from the declarative memory. However, there is evidence to suggest that the problems with declarative learning and memory for verbal information in SLI might be due to difficulties with verbal working memory and language. The learning and retrieval of non-verbal information from declarative memory appears relatively intact. In relation to procedural learning and memory, evidence indicates poor implicit learning of verbal information. Findings pertaining to nonverbal information have been mixed. This review of the literature indicates there are now substantial grounds for suspecting that multiple memory systems may be implicated in the impairment. PMID:24748707

The evaluation of a formalized queue management system for coronary angiography waiting lists.

PubMed

Alter, D A; Newman, Alice M; Cohen, Eric A; Sykora, Kathy; Tu, Jack V

2005-11-01

Lengthy waiting lists for coronary angiography have been described in many health care systems worldwide. The extent to which formal queue management systems may improve the prioritization and survival of patients in the angiography queue is unknown. To prospectively evaluate the performance of a formal queue management system for patients awaiting coronary angiography in Ontario. The coronary angiography urgency scale, a formal queue management system developed in 1993 using a modified Delphi panel, allocates recommended maximum waiting times (RMWTs) in accordance with clinical necessity. By using a provincial clinical registry, 35,617 consecutive patients referred into the coronary angiography queue between April 1, 2001, and March 31, 2002, were prospectively tracked. Cox proportional hazards models were used to examined mortality risk across urgency after adjusting for additional clinical and comorbid factors. Good agreement was determined in urgency ratings between scores from the coronary angiography urgency scale and implicit physician judgement, which was obtained independently at the time of the index referral (weighted kappa = 0.49). The overall mortality in the queue was 0.3% (0.47%, 0.26% and 0.13% for urgent, semiurgent and elective patients, respectively). Urgency, as specified by the coronary angiography urgency scale, was the strongest predictor of death in the queue (P<0.001). However, when patients were censored according to their RMWTs, mortality was similar across different levels of urgency. Consequently, up to 18.5 deaths per 10,000 patients could have potentially been averted had patients been triaged and undergone coronary angiography within the RMWT as specified by the coronary angiography urgency scale. The incorporation of the coronary angiography urgency scale as a formal queue management system may decrease mortality in the coronary angiography queue. The authors recommend its implementation in health care systems where patients experience excessive waiting time delays for coronary angiography.

37 CFR 7.39 - Acknowledgment of receipt of and correcting deficiencies in affidavit or declaration of use in...

Code of Federal Regulations, 2013 CFR

2013-07-01

... and correcting deficiencies in affidavit or declaration of use in commerce or excusable nonuse. 7.39... COMMERCE RULES OF PRACTICE IN FILINGS PURSUANT TO THE PROTOCOL RELATING TO THE MADRID AGREEMENT CONCERNING... or declaration of use in commerce or excusable nonuse. The Office will issue a notice as to whether...

75 FR 18519 - District of Columbia; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... Presidential declaration of a major disaster for the District of Columbia (FEMA-1890-DR), dated March 24, 2010, and related determinations. DATES: Effective Date: March 24, 2010. FOR FURTHER INFORMATION CONTACT... March 24, 2010, the President issued a major disaster declaration under the authority of the Robert T...

22 CFR 192.1 - Declarations of hostile action.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Declarations of hostile action. 192.1 Section 192.1 Foreign Relations DEPARTMENT OF STATE HOSTAGE RELIEF VICTIMS OF TERRORISM COMPENSATION General... Terrorism Compensation Act, codified in 5 U.S.C. 5569 and 5570 and Executive Order 12598. (2) The Secretary...

22 CFR 192.1 - Declarations of hostile action.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Declarations of hostile action. 192.1 Section 192.1 Foreign Relations DEPARTMENT OF STATE HOSTAGE RELIEF VICTIMS OF TERRORISM COMPENSATION General... Terrorism Compensation Act, codified in 5 U.S.C. 5569 and 5570 and Executive Order 12598. (2) The Secretary...

22 CFR 192.1 - Declarations of hostile action.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Declarations of hostile action. 192.1 Section 192.1 Foreign Relations DEPARTMENT OF STATE HOSTAGE RELIEF VICTIMS OF TERRORISM COMPENSATION General... Terrorism Compensation Act, codified in 5 U.S.C. 5569 and 5570 and Executive Order 12598. (2) The Secretary...

22 CFR 192.1 - Declarations of hostile action.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Declarations of hostile action. 192.1 Section 192.1 Foreign Relations DEPARTMENT OF STATE HOSTAGE RELIEF VICTIMS OF TERRORISM COMPENSATION General... Terrorism Compensation Act, codified in 5 U.S.C. 5569 and 5570 and Executive Order 12598. (2) The Secretary...

22 CFR 192.1 - Declarations of hostile action.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Declarations of hostile action. 192.1 Section 192.1 Foreign Relations DEPARTMENT OF STATE HOSTAGE RELIEF VICTIMS OF TERRORISM COMPENSATION General... Terrorism Compensation Act, codified in 5 U.S.C. 5569 and 5570 and Executive Order 12598. (2) The Secretary...

Impact of adenotonsillectomy on urinary storage symptoms in children with sleep-disordered breathing.

PubMed

Lee, Jong Cheol; Moon, Kyung Hyun; Kwon, Taekmin; Yang, Seong Kyeong; Park, Sungchan

2018-06-01

To prospectively evaluate the effectiveness of adenotonsillectomy on resolving urinary storage symptoms such as frequency, urgency, and urgency urinary incontinence (UUI) in indicated sleep disordered breathing (SDB) patients. We prospectively analyzed changes in storage symptoms and SDB score before and after surgery in 102 children (74 males, 28 females, mean age 8.4 ± 2.8 years) who underwent adenotonsillectomy between July 2011 and Feb 2012. Before and 3 months after surgery, all children and their parents were requested to answer a self-reported SDB scale-questionnaire (22 questions, 0-22 points) and a urinary storage symptoms questionnaire. The prevalence of urgency in the overall patients was 31.2%. After adenotonsillectomy, prevalence of frequency and, urgency in addition to SDB score were significantly decreased (p ≦ 0.001). The prevalence of UUI was also significantly lower (11.6%-7.4%, p < 0.001). Patients with urgency had a significantly higher SDB score than those without (11.4 ± 4.3 vs. 7.8 ± 4.0, p < 0.001). After treatment, there was no difference between these two groups. Adenotonsillectomy markedly improved both SDB score and decreased the prevalence of voiding symptoms (frequency, urgency, and UUI). There was a strong correlation between preoperative SDB score and severity of urgency in children with SDB. Copyright © 2018 Elsevier B.V. All rights reserved.

How Do Negative Emotions Impair Self-Control? A Neural Model of Negative Urgency

PubMed Central

Chester, David S.; Lynam, Donald R.; Milich, Richard; Powell, David K.; Andersen, Anders H.; DeWall, C. Nathan

2016-01-01

Self-control often fails when people experience negative emotions. Negative urgency represents the dispositional tendency to experience such self-control failure in response to negative affect. The neural underpinnings of negative urgency are not fully understood, nor is the more general phenomenon of self-control failure in response to negative emotions. Previous theorizing suggests that an insufficient, inhibitory response from the prefrontal cortex may be the culprit behind such self-control failure. However, we entertained an alternative hypothesis: negative emotions lead to self-control failure because they excessively tax inhibitory regions of the prefrontal cortex. Using fMRI, we compared the neural activity of people high in negative urgency with controls on an emotional, inhibitory Go/No-Go task. While experiencing negative (but not positive or neutral) emotions, participants high in negative urgency showed greater recruitment of inhibitory brain regions than controls. Suggesting a compensatory function, inhibitory accuracy among participants high in negative urgency was associated with greater prefrontal recruitment. Greater activity in the anterior insula on negatively-valenced, inhibitory trials predicted greater substance abuse one month and one year after the MRI scan among individuals high in negative urgency. These results suggest that, among people whose negative emotions often lead to self-control failure, excessive reactivity of the brain’s regulatory resources may be the culprit. PMID:26892861

Comparisons of urodynamic findings and voiding habits in patients with concomitant benign prostatic hyperplasia and detrusor overactivity presenting with or without the symptom of urgency.

PubMed

Tong, Yat-Ching

2007-01-01

The urodynamic findings and voiding habits in patients with concomitant clinical benign prostatic hyperplasia (BPH) and detrusor overactivity (DO) presenting with or without the symptom of urgency were compared. 84 BPH patients with an urodynamic diagnosis of DO by conventional cystometry were included in the study. The patients were grouped according to the presence or absence of the symptom of urgency. The urodynamic findings, urinary diary and clinical information were analyzed. Among the 84 BPH-DO patients, 52 reported the symptom of urgency while 32 did not. There were no significant differences in mean age, International Prostate Symptom Score and flow rate between the two groups. Patients without urgency had a higher incidence of terminal DO and abnormal bladder sensation. The occurrence of unfelt phasic DO was also significantly higher in this group. Sphincter electromyography showed conscious and subconscious sphincter contractions associated with DO. The urinary diary showed lower 24-hour urinary output, smaller bladder functional capacity and average voided volume in the BPH-DO patients without urgency. BPH patients with DO may neglect the symptom of urgency due to abnormal bladder sensation, or negate the symptom by subconscious sphincter contraction to abort the overactivity. Some may avoid the symptom by drinking less fluid and emptying the bladder at a smaller volume. Copyright 2007 S. Karger AG, Basel.

Early life stress predicts negative urgency through brooding, depending on 5-HTTLPR genotype: A pilot study with 6-month follow-up examining suicide ideation.

PubMed

Valderrama, Jorge; Miranda, Regina

2017-12-01

The present study examined the interaction between early life stress and 5-HTT genotypes in predicting two risk factors for suicidal behavior - the brooding subtype of rumination and impulsivity, in the form of negative urgency - over time. Furthermore, we examined early life stress, brooding, and impulsivity as predictors of suicidal ideation over time. Participants with and without a history of early life stress were genotyped for the 5-HTTLPR polymorphism and completed assessments assessing brooding and negative urgency at baseline and 6-month follow up. Early life emotional abuse was associated with negative urgency at follow-up. We found an indirect effect of early life emotional abuse on negative urgency through brooding among individuals with 5-HTT low expressing genotypes but not among individuals with 5-HTT high expressing genotypes. Further, a logistic regression analysis revealed that negative urgency was associated with higher odds (O.R. = 16.2) of reporting suicide ideation (versus no ideation) at follow-up. Our findings suggest that brooding and negative urgency may result from the interaction between early life emotional abuse and 5-HTT low expressing genotypes. Further research is necessary to understand how early life stress interacts with 5-HTT genotypes to confer risk for suicidal behavior through psychological mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

Create a Sense of Urgency to Spark Learning

ERIC Educational Resources Information Center

Kelleher, Joanne

2015-01-01

While recent state and federal education policies convey a sense of urgency in regard to the need for education reforms, there are teachers for whom this sense of urgency has long been woven into the fabric of their practice. Fortified by their high expectations for their students, these teachers utilize strategies that convey the message that the…

Bladder sensory desensitization decreases urinary urgency.

PubMed

Silva, Carlos; Silva, João; Castro, Helder; Reis, Frederico; Dinis, Paulo; Avelino, António; Cruz, Francisco

2007-06-11

Bladder desensitization has been investigated as an alternative treatment for refractory detrusor overactivity. Most open and controlled clinical trials conducted with intravesical RTX showed that desensitization delays the appearance of involuntary detrusor contractions during bladder filling and decreases the number of episodes of urgency incontinence. Urgency is being recognised as the fundamental symptom of overactive bladder (OAB), a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency. Twenty-three OAB patients with refractory urgency entered, after given informed consent, a 30 days run-in period in which medications influencing the bladder function were interrupted. At the end of this period patients filled a seven-day voiding chart where they scored, using a 0-4 scale, the bladder sensations felt before each voiding. Then, patients were instilled with 100 ml of 10% ethanol in saline (vehicle solution) and 30 days later a second seven-day voiding chart was collected. Finally, patients were instilled with 100 ml of 50 nM RTX in 10% ethanol in saline. At 1 and 3 months additional voiding charts were collected. At the end of the vehicle and 3 months period patients were asked to give their subjective impression about the outcome of the treatment and about the willingness to repeat the previous instillation. At the end of the run-in period the mean number of episodes of urgency per week was 71 +/- 12 (mean +/- SEM). After vehicle instillation, the mean number of episodes of urgency was 56 +/- 11, but only 4 patients (17%) considered that their urinary condition had improved enough to repeat the treatment. At 1 and 3 months after RTX the number of episodes of urgency decreased to 39 +/- 9 (p = 0.002) and 37 +/- 6 (p = 0.02), respectively (p indicates statistical differences against vehicle). The percentage of patients with subjective improvement after RTX and willing to repeat the instillation at a later occasion was 69%. In OAB patients with refractory urgency bladder desensitization should be further investigated as an alternative to the standard management. Additionally, the specific effect of RTX on TRPV1 receptors suggests that urothelium and sub-urothelial C-fibers play an important role to the generation of urgency sensation.

Microvascular complications and prevalence of urgency incontinence in Japanese patients with type 2 diabetes mellitus: The dogo study.

PubMed

Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Maruyama, Koutatsu; Ueda, Teruhisa; Senba, Hidenori; Todo, Yasuhiko; Torisu, Masamoto; Minami, Hisaka; Onji, Morikazu; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

2016-11-01

Diabetes was significantly positively associated with urgency incontinence in several epidemiological studies. We examine the association between diabetic neuropathy, which we defined based on neuropathic symptoms, the absence of the Achilles reflex, and/or abnormal vibration perception, and urgency incontinence among Japanese patients with type 2 diabetes mellitus. Study subjects were 742 Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. Urgency incontinence was defined as present when a subject answered "once a week or more" to the question: "Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate ?". Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, the absence of the Achilles reflex, and/or abnormal vibration perception. Adjustment was made for sex, age, body mass index, duration of type 2 diabetes mellitus, current smoking, hypertension, dyslipidemia, glycated hemoglobin, stroke, coronary artery disease, insulin therapy, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. The prevalence of urgency incontinence was 8.6%. Diabetic neuropathy was independently positively associated with urgency incontinence: the adjusted OR was 2.20 (95%CI: 1.16-4.36). Associations between diabetic retinopathy or nephropathy and the prevalence of urgency incontinence were not significant. In Japanese patients with type 2 diabetes mellitus, only diabetic neuropathy was independently positively associated with urgency incontinence. Neurourol. Urodynam. 35:1024-1027, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Dissociable roles of dopamine and serotonin transporter function in a rat model of negative urgency.

PubMed

Yates, Justin R; Darna, Mahesh; Gipson, Cassandra D; Dwoskin, Linda P; Bardo, Michael T

2015-09-15

Negative urgency is a facet of impulsivity that reflects mood-based rash action and is associated with various maladaptive behaviors in humans. However, the underlying neural mechanisms of negative urgency are not fully understood. Several brain regions within the mesocorticolimbic pathway, as well as the neurotransmitters dopamine (DA) and serotonin (5-HT), have been implicated in impulsivity. Extracellular DA and 5-HT concentrations are regulated by DA transporters (DAT) and 5-HT transporters (SERT); thus, these transporters may be important molecular mechanisms underlying individual differences in negative urgency. The current study employed a reward omission task to model negative urgency in rats. During reward trials, a cue light signaled the non-contingent delivery of one sucrose pellet; immediately following the non-contingent reward, rats responded on a lever to earn sucrose pellets (operant phase). Omission trials were similar to reward trials, except that non-contingent sucrose was omitted following the cue light prior to the operant phase. As expected, contingent responding was higher following omission of expected reward than following delivery of expected reward, thus reflecting negative urgency. Upon completion of behavioral training, Vmax and Km were obtained from kinetic analysis of [(3)H]DA and [(3)H]5-HT uptake using synaptosomes prepared from nucleus accumbens (NAc), dorsal striatum (Str), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC) isolated from individual rats. Vmax for DAT in NAc and for SERT in OFC were positively correlated with negative urgency scores. The current findings suggest that mood-based impulsivity (negative urgency) is associated with enhanced DAT function in NAc and SERT function in OFC. Copyright © 2015 Elsevier B.V. All rights reserved.

Double Dissociation of Conditioning and Declarative Knowledge Relative to the Amygdala and Hippocampus in Humans

NASA Astrophysics Data System (ADS)

Bechara, Antoine; Tranel, Daniel; Damasio, Hanna; Adolphs, Ralph; Rockland, Charles; Damasio, Antonio R.

1995-08-01

A patient with selective bilateral damage to the amygdala did not acquire conditioned autonomic responses to visual or auditory stimuli but did acquire the declarative facts about which visual or auditory stimuli were paired with the unconditioned stimulus. By contrast, a patient with selective bilateral damage to the hippocampus failed to acquire the facts but did acquire the conditioning. Finally, a patient with bilateral damage to both amygdala and hippocampal formation acquired neither the conditioning nor the facts. These findings demonstrate a double dissociation of conditioning and declarative knowledge relative to the human amygdala and hippocampus.

75 FR 158 - New Jersey; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

.... FEMA-1867-DR; Docket ID FEMA-2008-0018] New Jersey; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the State of New Jersey (FEMA-1867-DR), dated December 22, 2009, and... dated December 22, 2009, the President issued a major disaster declaration under the authority of the...

76 FR 70467 - Puerto Rico; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

.... FEMA-4040-DR; Docket ID FEMA-2011-0001] Puerto Rico; Major Disaster and Related Determinations AGENCY... declaration of a major disaster for the Commonwealth of Puerto Rico (FEMA-4040-DR), dated October 18, 2011... declare that such a major disaster exists in the Commonwealth of Puerto Rico. In order to provide Federal...

The cost-effectiveness of solifenacin vs fesoterodine, oxybutynin immediate-release, propiverine, tolterodine extended-release and tolterodine immediate-release in the treatment of patients with overactive bladder in the UK National Health Service.

PubMed

Cardozo, Linda; Thorpe, Andrew; Warner, Juliet; Sidhu, Manpreet

2010-08-01

To assess the cost-effectiveness of solifenacin vs other antimuscarinic strategies commonly used in UK clinical practice, based on the results of a recent published review. Overactive bladder (OAB) syndrome is characterized by symptoms of urgency, frequency, incontinence and nocturia. Pharmacological treatment comprises oral antimuscarinic agents, which are divided into older-generation treatments, including oxybutynin, and new-generation treatments, comprising solifenacin, tolterodine, darifenacin and fesoterodine. The latter have reduced central nervous system penetration and have better selectivity for the M3 subclass of acetylcholine receptors, resulting in improved tolerability. A recent systematic review and meta-analysis of the efficacy and safety of antimuscarinics provided an opportunity for an economic evaluation of these agents using a rigorous assessment of efficacy. A cost-utility analysis was undertaken using a 1-year decision-tree model. Treatment success was defined separately for urgency, frequency and incontinence, with efficacy data taken from the recent review. Treatment persistence rates were taken from the Information Management System database. Utility values for the calculation of quality-adjusted life-years (QALYs) were taken from published sources. The analysis included costs directly associated with treatment for OAB, i.e. antimuscarinic therapy, consultations with general practitioners, and outpatient contacts. Resource use was based on expert opinion. Costs were reported at 2007/2008 prices. Extensive deterministic and probabilistic analyses were conducted to test the robustness of the base-case results. Solifenacin was associated with the highest QALY gains (per 1000 patients) for all three outcomes of interest, i.e. urgency (712.3), frequency (723.1) and incontinence (695.0). Solifenacin was dominant relative to fesoterodine, tolterodine extended-release (ER) and tolterodine immediate-release (IR), and cost-effective relative to propiverine ER for urgency, frequency and incontinence. Solifenacin was not found to be cost-effective relative to oxybutynin IR for the frequency and incontinence outcomes, with an incremental cost-effectiveness ratio of > pound30,000/QALY threshold. Solifenacin provided the greatest clinical benefit and associated QALYs for all three outcomes of interest across all therapies considered, and to be either dominant or cost-effective relative to all other new-generation agents, but not cost-effective relative to oxybutynin for frequency and incontinence.

The Different Faces of Impulsivity as Links between Childhood Maltreatment and Young Adult Crime

PubMed Central

Shin, Sunny H.; Cook, Amy K.; Morris, Nancy A.; McDougle, Robyn; Groves, Lauren Peasley

2016-01-01

Crime is a major public health and safety threat. Many studies have suggested that early exposure to child maltreatment increases an individual's risk for persistent serious crime in adulthood. Despite these findings about the connection between child maltreatment and criminal behavior, there is a paucity of empirically-based knowledge about the processes or pathways that link child maltreatment to later involvement in crime. Using a community sample of 337 young adults (ages 18-25) in a U.S. metropolitan area, the present study examined the role of various facets of impulsivity in linking child maltreatment to crime. A series of factor analyses identified three types of crime including property crime, violent crime, and fraud. Structural equation modelings were conducted to examine the associations among childhood maltreatment, four facets of impulsivity, and criminal behavior, controlling for sociodemographic information, family income and psychological symptoms. The present study found that child emotional abuse was indirectly related to property crime and fraud through urgency while a lack of premeditation mediates the relationship between child neglect and property crime. Child physical abuse was directly related to all three types of crime. Personality traits of urgency and lack of premeditation may play a significant role in the maltreatment-crime link. Preventive interventions targeting impulsivity traits such as urgency and a lack of premeditation might have promising impacts in curbing criminal behavior among maltreatment victims. PMID:27083525

From the Quixotic to the Pragmatic: The "Hamburg Declaration", Adult Education, and Work

ERIC Educational Resources Information Center

Rose, Amy

2013-01-01

The "Hamburg Declaration" (UNESCO, 1997) is perhaps most quixotic and prescient in laying out the changing world of work as envisioned in 1997. It includes particular commitments to promote the rights to work and to work-related adult learning, to increase access to work-related adult learning for different target groups, and to…

Celebrating Human Rights: The 50th Anniversary of the U.N. Declaration.

ERIC Educational Resources Information Center

Murphey, Carol E.

1998-01-01

Responds to the 50th anniversary of the United Nations' Universal Declaration of Human Rights (UDHR) by arguing that elementary school is an appropriate place to begin teaching about human rights. Outlines the rights enumerated in the UDHR, provides related activities for primary and intermediate grades, and suggests related Web sites. (DSK)

The Theory of Planned Behavior and E-cig Use: Impulsive Personality, E-cig Attitudes, and E-cig Use.

PubMed

Hershberger, Alexandra; Connors, Miranda; Um, Miji; Cyders, Melissa A

2018-04-01

The current paper applied the Theory of Planned Behavior (TPB; Ajzen & Fishbein, 1988) to understand how impulsive personality traits and attitudes concerning e-cig use relate to the likelihood of electronic cigarette (e-cig) use. Seven hundred and fourteen participants (Mean age = 34.04, SD = 10.89, 48.6% female) completed cross-sectional measures of e-cig use attitudes (CEAC) and the Short UPPS-P Impulsive Behavior Scale. A structural path analysis suggested that urgency and deficits in conscientiousness were significantly related to e-cig attitudes (CFI = 0.99, TLI = 0.99, RMSEA = 0.02; urgency: β = 0.32, p = .001; deficits in conscientiousness: β = -0.48, p < .001). E-cig attitude scores were significantly higher for e-cig users than non-users, β = 0.85, p < .001. There was no significant direct path from impulsive personality traits to e-cig use. Findings provide initial support for a model in which impulsive traits are related to e-cig use through positive e-cig attitudes.

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood☆

PubMed Central

Shin, Sunny H.; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A.

2015-01-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18–25 (N = 268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. PMID:25743371

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood.

PubMed

Shin, Sunny H; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A

2015-12-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18-25 (N=268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. Copyright © 2015. Published by Elsevier Ltd.

Virtually ‘in the heat of the moment’: insula activation in safe sex negotiation among risky men

PubMed Central

Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

2018-01-01

Abstract HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual ‘hook up’ game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM’s rash risky sexual decision-making. PMID:29149326

Bidirectional Relations of Impulsive Personality and Alcohol Use Across Three Waves of Data Collection.

PubMed

Kaiser, Alison J; Davis, Heather A; Milich, Richard; Smith, Gregory T; Charnigo, Richard

2018-06-11

To explore the bidirectional relations between alcohol use and three impulsive personality traits, to advance understanding of risk processes. 525 college students (mean age = 18.95 years) recruited in August 2008 and 2009 and followed up annually for three years. Personality and past/current substance use were assessed. T2 sensation seeking mediated the predictive relationship between T1 and T3 alcohol use, and T2 alcohol use mediated the predictive relationship between T1 and T3 sensation seeking. In addition, T2 alcohol problems mediated the predictive relationship between T1 alcohol use and T3 negative urgency. Findings support a bidirectional relationship between sensation seeking and alcohol use, and drinking anticipates drinking problems, which predict increases in negative urgency. For some individuals, there appears to be an ongoing process of increased risk in the form of increases in both drinking and high-risk personality traits.

Prediction of pilot reserve attention capacity during air-to-air target tracking

NASA Technical Reports Server (NTRS)

Onstott, E. D.; Faulkner, W. H.

1977-01-01

Reserve attention capacity of a pilot was calculated using a pilot model that allocates exclusive model attention according to the ranking of task urgency functions whose variables are tracking error and error rate. The modeled task consisted of tracking a maneuvering target aircraft both vertically and horizontally, and when possible, performing a diverting side task which was simulated by the precise positioning of an electrical stylus and modeled as a task of constant urgency in the attention allocation algorithm. The urgency of the single loop vertical task is simply the magnitude of the vertical tracking error, while the multiloop horizontal task requires a nonlinear urgency measure of error and error rate terms. Comparison of model results with flight simulation data verified the computed model statistics of tracking error of both axes, lateral and longitudinal stick amplitude and rate, and side task episodes. Full data for the simulation tracking statistics as well as the explicit equations and structure of the urgency function multiaxis pilot model are presented.

Problematic Drinking, Impulsivity, and Physical IPV Perpetration: A Dyadic Analysis

PubMed Central

Leone, Ruschelle M.; Crane, Cory A.; Parrott, Dominic J.; Eckhardt, Christopher I.

2016-01-01

Alcohol use and impulsivity are two known risk factors for intimate partner violence (IPV). The current study examined the independent and interactive effects of problematic drinking and five facets of impulsivity (i.e., negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance) on perpetration of physical IPV within a dyadic framework. Participants were 289 heavy drinking heterosexual couples (total N = 578) with a recent history of psychological and/or physical IPV recruited from two metropolitan U.S. cities. Parallel multilevel Actor Partner Interdependence Models were utilized and demonstrated Actor problematic drinking, negative urgency, and lack of perseverance were associated with physical IPV. Findings also revealed associations between Partner problematic drinking and physical IPV as well as significant Partner Problematic Drinking x Actor Impulsivity (Negative Urgency and Positive Urgency) interaction effects on physical IPV. Findings highlight the importance of examining IPV within a dyadic framework and are interpreted using the I3 meta-theoretical model. PMID:26828640

Effects of inter-stimulus interval and intensity on the perceived urgency of tactile patterns.

PubMed

White, Timothy L; Krausman, Andrea S

2015-05-01

This research examines the feasibility of coding urgency into tactile patterns. Four tactile patterns were presented at either, 12 or 23.5 dB above mean threshold, with an ISI of either 0 (no interval) or 500 msec. Measures included pattern identification and urgency rating on a scale of 1 (least urgent) to 10 (most urgent). Two studies were conducted, a laboratory study and a field study. In the laboratory study, participants received the tactile patterns while seated in front of a computer. For the field study, participants performed dismounted Soldier maneuvers while receiving the tactile patterns. Higher identification rates were found for the 23.5 dB intensity. Patterns presented at the 23.5 dB intensity and no ISI were rated most urgent. No differences in urgency ratings were found for 12 dB based on ISI. Findings support the notion of coding urgency into tactile patterns as a way of augmenting tactile communication. Published by Elsevier Ltd.

[The preamble of the Universal Declaration on Bioethics and Human Rights of the UNESCO].

PubMed

Gros Espiell, Héctor

2006-01-01

This article deals with the importance that the preamble has in relation with the Declaration. There is an emphasis on the legal nature of such, as well as the characteristics of the preamble as an international instrument, as it shapes the "context of the document". All this is in reference to the Universal Declaration on Bioethics and Human Rights, whose preamble will be the object of a detailed study.

Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review.

PubMed

Tapia, Crisanta I; Khalaf, Kristin; Berenson, Karina; Globe, Denise; Chancellor, Michael; Carr, Lesley K

2013-01-31

Patients with neurologic diseases often have neurogenic detrusor overactivity (NDO), which can result in a loss of voluntary bladder control and uncontrollable urinary incontinence (UI).The impact of UI due to NDO on patients' lives has not been well studied. The objective of this review was to assess the health-related quality of life (HRQoL) and economic burden in patients with urgency UI due to NDO in select countries in North America, the European Union, Asia, and Australia. Systematic literature searches and reviews of articles published in English (January 2000 to February 2011) were conducted using MEDLINE®, EMBASE®, and the Cochrane Library. Studies assessing the impact of UI on HRQoL of patients with an underlying neurologic condition of interest (i.e., multiple sclerosis, spinal cord injury, Parkinson's disease, stroke, or spina bifida) were included. Economic studies in urgency UI also were included. Of 876 citations generated in the initial search, a total of 27 articles were deemed relevant: 16 articles presented HRQoL data and 11 articles presented information on the economic burden of UI. Humanistic studies used a range of HRQoL instruments to measure HRQoL burden, and the economic studies included different cost components to quantify the economic burden, making meaningful comparisons challenging. Despite this heterogeneity, the literature suggests that HRQoL in patients with UI due to NDO is worse than patients with UI in general or those with the same underlying neurologic condition without UI. In addition, urgency UI also results in substantial economic costs. Incontinent patients with underlying neurologic conditions have impaired HRQoL as well as substantial economic burden attributable to UI due to NDO. There is a need for urgency UI treatments that improve HRQoL of these patients and alleviate the economic burden of this condition.

Dose-Effect Relationships for Individual Pelvic Floor Muscles and Anorectal Complaints After Prostate Radiotherapy

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

Smeenk, Robert Jan, E-mail: r.smeenk@rther.umcn.nl; Hoffmann, Aswin L.; Hopman, Wim P.M.

2012-06-01

Purpose: To delineate the individual pelvic floor muscles considered to be involved in anorectal toxicity and to investigate dose-effect relationships for fecal incontinence-related complaints after prostate radiotherapy (RT). Methods and Materials: In 48 patients treated for localized prostate cancer, the internal anal sphincter (IAS) muscle, the external anal sphincter (EAS) muscle, the puborectalis muscle (PRM), and the levator ani muscles (LAM) in addition to the anal wall (Awall) and rectal wall (Rwall) were retrospectively delineated on planning computed tomography scans. Dose parameters were obtained and compared between patients with and without fecal urgency, incontinence, and frequency. Dose-effect curves were constructed.more » Finally, the effect of an endorectal balloon, which was applied in 28 patients, was investigated. Results: The total volume of the pelvic floor muscles together was about three times that of the Awall. The PRM was exposed to the highest RT dose, whereas the EAS received the lowest dose. Several anal and rectal dose parameters, as well as doses to all separate pelvic floor muscles, were associated with urgency, while incontinence was associated mainly with doses to the EAS and PRM. Based on the dose-effect curves, the following constraints regarding mean doses could be deduced to reduce the risk of urgency: {<=}30 Gy to the IAS; {<=}10 Gy to the EAS; {<=}50 Gy to the PRM; and {<=}40 Gy to the LAM. No dose-effect relationships for frequency were observed. Patients treated with an endorectal balloon reported significantly less urgency and incontinence, while their treatment plans showed significantly lower doses to the Awall, Rwall, and all pelvic floor muscles. Conclusions: Incontinence-related complaints show specific dose-effect relationships to individual pelvic floor muscles. Dose constraints for each muscle can be identified for RT planning. When only the Awall is delineated, substantial components of the continence apparatus are excluded.« less

Dose-effect relationships for individual pelvic floor muscles and anorectal complaints after prostate radiotherapy.

PubMed

Smeenk, Robert Jan; Hoffmann, Aswin L; Hopman, Wim P M; van Lin, Emile N J Th; Kaanders, Johannes H A M

2012-06-01

To delineate the individual pelvic floor muscles considered to be involved in anorectal toxicity and to investigate dose-effect relationships for fecal incontinence-related complaints after prostate radiotherapy (RT). In 48 patients treated for localized prostate cancer, the internal anal sphincter (IAS) muscle, the external anal sphincter (EAS) muscle, the puborectalis muscle (PRM), and the levator ani muscles (LAM) in addition to the anal wall (Awall) and rectal wall (Rwall) were retrospectively delineated on planning computed tomography scans. Dose parameters were obtained and compared between patients with and without fecal urgency, incontinence, and frequency. Dose-effect curves were constructed. Finally, the effect of an endorectal balloon, which was applied in 28 patients, was investigated. The total volume of the pelvic floor muscles together was about three times that of the Awall. The PRM was exposed to the highest RT dose, whereas the EAS received the lowest dose. Several anal and rectal dose parameters, as well as doses to all separate pelvic floor muscles, were associated with urgency, while incontinence was associated mainly with doses to the EAS and PRM. Based on the dose-effect curves, the following constraints regarding mean doses could be deduced to reduce the risk of urgency: ≤ 30 Gy to the IAS; ≤ 10 Gy to the EAS; ≤ 50 Gy to the PRM; and ≤ 40 Gy to the LAM. No dose-effect relationships for frequency were observed. Patients treated with an endorectal balloon reported significantly less urgency and incontinence, while their treatment plans showed significantly lower doses to the Awall, Rwall, and all pelvic floor muscles. Incontinence-related complaints show specific dose-effect relationships to individual pelvic floor muscles. Dose constraints for each muscle can be identified for RT planning. When only the Awall is delineated, substantial components of the continence apparatus are excluded. Copyright © 2012 Elsevier Inc. All rights reserved.

Urgency in overactive bladder: translating experimental data into clinical practice.

PubMed

Wyndaele, Jean-Jacques; De Wachter, Stefan

2008-05-01

In overactive bladder (OAB) syndrome, urgency is considered to be the key symptom that generates or affects all other symptoms. Urgency has been defined by the latest International Continence Society (ICS) terminology report as "the complaint of a sudden compelling desire to pass urine, which is difficult to defer". This definition has caused some debate and a final terminology has not yet been agreed upon. However, many would agree that urgency is different from urge when describing bladder sensation, and "urgency" has become one of the leading topics in OAB diagnosis and a primary endpoint in evaluation of treatment. Despite the many potential targets for pharmacological treatment, few drugs other than antimuscarinic agents have passed the proof-of-concept stage. There are multiple mechanisms, some proven in concept but more theoretical, by which a pharmacological agent may facilitate lower urinary tract filling/urine storage, bladder sensation and bladder emptying, although organ selectivity is often a problem. Oxybutynin, tolterodine, darifenacin, solifenacin and trospium have shown superiority to placebo, with a different incidence of side effects among the different drugs. Larger randomized, controlled trials in clinical settings are required to further establish the role of these medications in the management of urgency and OAB syndrome. Copyright 2008 Prous Science, S.A.U. or its licensors. All rights reserved.

Drinking Motives and Alcohol Outcome Expectancies as Mediators of the Association between Negative Urgency and Alcohol Consumption

PubMed Central

Anthenien, Amber M.; Lembo, Jordanna; Neighbors, Clayton

2017-01-01

Objective To determine whether the effects of negative urgency, a unique facet of impulsivity marked by engaging in potentially unhealthy and rash behaviors in order to cope with anxiety or negative moods, on drinking behavior can be explained by positive and negative alcohol outcome expectancies and specific drinking motives (i.e., coping and enhancement). Methods College students (N = 194) completed web-based surveys in exchange for course credit. Students completed measures of negative urgency, comprehensive effects of alcohol, drinking motives, and alcohol use behaviors. Results Results of path analysis indicated significant indirect effects of negative urgency and alcohol use through both alcohol outcome expectancies and enhancement motives. The effects of enhancement motives on drinking were mediated by positive alcohol outcome expectancies. The effects of coping motives on drinking were not attributable to negative expectancies. Conclusions Individuals high on negative urgency may consume alcohol in order to ameliorate their emotional distress due to strong desires to increase positive and decrease negative experiences associated with drinking. Emotion-focused impulsivity’s influence on drinking outcomes can be ascribed to enhancement motives for drinking as well as positive and negative alcohol outcome expectancies. Prevention efforts should target drinking motives and alcohol outcome expectancies among those higher in negative urgency. PMID:27914226

Drinking motives and alcohol outcome expectancies as mediators of the association between negative urgency and alcohol consumption.

PubMed

Anthenien, Amber M; Lembo, Jordanna; Neighbors, Clayton

2017-03-01

To determine whether the effects of negative urgency, a unique facet of impulsivity marked by engaging in potentially unhealthy and rash behaviors in order to cope with anxiety or negative moods, on drinking behavior can be explained by positive and negative alcohol outcome expectancies and specific drinking motives (i.e., coping and enhancement). College students (N=194) completed web-based surveys in exchange for course credit. Students completed measures of negative urgency, comprehensive effects of alcohol, drinking motives, and alcohol use behaviors. Results of path analysis indicated significant indirect effects of negative urgency and alcohol use through both alcohol outcome expectancies and enhancement motives. The effects of enhancement motives on drinking were mediated by positive alcohol outcome expectancies. The effects of coping motives on drinking were not attributable to negative expectancies. Individuals high on negative urgency may consume alcohol in order to ameliorate their emotional distress due to strong desires to increase positive and decrease negative experiences associated with drinking. Emotion-focused impulsivity's influence on drinking outcomes can be ascribed to enhancement motives for drinking as well as positive and negative alcohol outcome expectancies. Prevention efforts should target drinking motives and alcohol outcome expectancies among those higher in negative urgency. Copyright © 2016 Elsevier Ltd. All rights reserved.

Time-Lag in Responses of Birds to Atlantic Forest Fragmentation: Restoration Opportunity and Urgency.

PubMed

Uezu, Alexandre; Metzger, Jean Paul

2016-01-01

There are few opportunities to evaluate the relative importance of landscape structure and dynamics upon biodiversity, especially in highly fragmented tropical landscapes. Conservation strategies and species risk evaluations often rely exclusively on current aspects of landscape structure, although such limited assumptions are known to be misleading when time-lag responses occur. By relating bird functional-group richness to forest patch size and isolation in ten-year intervals (1956, 1965, 1978, 1984, 1993 and 2003), we revealed that birds with different sensitivity to fragmentation display contrasting responses to landscape dynamics in the Brazilian Atlantic Forest. For non-sensitive groups, there was no time-lag in response: the recent degree of isolation best explains their variation in richness, which likely relates to these species' flexibility to adapt to changes in landscape structure. However, for sensitive bird groups, the 1978 patch area was the best explanatory variable, providing evidence for a 25-year time-lag in response to habitat reduction. Time-lag was more likely in landscapes that encompass large patches, which can support temporarily the presence of some sensitive species, even when habitat cover is relatively low. These landscapes potentially support the most threatened populations and should be priorities for restoration efforts to avoid further species loss. Although time-lags provide an opportunity to counteract the negative consequences of fragmentation, it also reinforces the urgency of restoration actions. Fragmented landscapes will be depleted of biodiversity if landscape structure is only maintained, and not improved. The urgency of restoration action may be even higher in landscapes where habitat loss and fragmentation history is older and where no large fragment remained to act temporarily as a refuge.

Can urgency classification of the Manchester triage system predict serious bacterial infections in febrile children?

PubMed

Nijman, Ruud G; Zwinkels, Rob L J; van Veen, Mirjam; Steyerberg, Ewout W; van der Lei, Johan; Moll, Henriëtte A; Oostenbrink, Rianne

2011-08-01

To evaluate the discriminative ability of the Manchester triage system (MTS) to identify serious bacterial infections (SBIs) in children with fever in the emergency department (ED) and to study the association between predictors of SBI and discriminators of MTS urgency of care. This prospective observational study included 1255 children with fever (1 month-16 years) attending the ED of the Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands in 2008-9. Triage urgency was determined with the MTS (urgency (U) level 1-5). The relationship between triage urgency and SBI was assessed with multivariable logistic regression, including effects of age, sex and temperature. Discriminative ability was assessed by receiver operating characteristic curve analysis. SBI prevalence was 11% (n=131, 95% CI 9% to 12%). The discriminative value of the MTS for predicting SBI was 0.57 (95% CI 0.52 to 0.62), and the MTS did not contribute to a model including age, sex and temperature. The sensitivity of the MTS (U1-2 vs U3-5) to detect SBI was 0.42 (95% CI 0.33 to 0.51) and specificity was 0.69 (95% CI 0.66 to 0.72). MTS high urgency discriminators include several known predictors of SBI, such as fever, work of breathing, meningism and oxygen saturation, but apply to non-SBI children as well. The MTS has poor discriminative ability to predict the presence of SBIs in children presenting with fever to the paediatric ED. Important predictors of SBI are represented within the MTS, but are used in a different way to classify urgency.

Negative Urgency Is Associated With Heightened Negative Affect and Urge During Tobacco Abstinence in Regular Smokers

PubMed Central

Park, Annie D.; Farrahi, Layla N.; Pang, Raina D.; Guillot, Casey R.; Aguirre, Claudia G.; Leventhal, Adam M.

2016-01-01

Objective: Negative urgency—the tendency to act rashly during negative affective states—is a risk factor for regular cigarette smoking. This human laboratory study tested a novel theoretical model of the underlying mechanisms linking negative urgency and smoking motivation, which purports that smokers with high negative urgency are at increased susceptibility to abstinence-induced increases in negative affect, which, in turn, provokes the urge to smoke to suppress negative affect. Method: Smokers (N = 180, >10 cigarettes/day) attended a baseline session at which they completed self-report measures of negative urgency and other co-factors and subsequently attended two counterbalanced within-subject experimental sessions (i.e., 16 hours of smoking abstinence or smoking as usual). At both experimental sessions, self-reported tobacco withdrawal symptoms, affect, and smoking urge were assessed. Results: Negative urgency was associated with larger abstinence-induced increases in tobacco withdrawal symptoms, negative affect, and urge to smoke to alleviate negative affect, both with and without controlling for anxiety, depression, tobacco dependence, and sensation seeking (βs > .18, ps < .05). The association between negative urgency and abstinence-induced increases in urge to smoke to alleviate negative affect was mediated by greater abstinence-induced increases in negative affect (βs > .062, ps = .01). Conclusions: These results provide initial support of this model by providing evidence that smokers with higher (vs. lower) negative urgency may be more prone to greater negative affect during withdrawal, which in turn may promote urge to smoke to suppress negative emotion. Research extending this model to other settings, measures, and methodological approaches may be fruitful. PMID:27588535

Parent perspectives and reasons for lower urgency paediatric presentations to emergency departments.

PubMed

Freed, Gary L; Allen, Amy R; Turbitt, Erin; Nicolas, Caroline; Oakley, Ed

2016-04-01

The age band with, by far, the greatest number of ED presentations is children 0-4 years, with other paediatric age bands also among the highest. As the majority of these presentations are for lower urgency conditions, we sought to determine why parents seek ED care for their child for lower urgency conditions. A survey study of 1150 parents or guardians of children with lower urgency conditions (triage category 4 or 5) presenting to the EDs of three public general and one paediatric specialty hospital in metropolitan Melbourne. Fewer than half of parents (43%) attempted to make an appointment with a general practitioner (GP) for their child prior to presenting to the ED. Two-thirds of those who did contact a GP were instructed by their GP to go to the ED for their lower urgency condition. Few attempted to contact a nurse telephone triage service or after-hours GP service. The current magnitude and the growth of lower urgency paediatric ED presentations is a strain on the health care system. Efforts to educate parents regarding the suitability and availability of GP appointments can be the cornerstone of an initial strategy to address this issue. However, efforts to address the high rates of GP referral to EDs for low urgency presentations will be more vexing to develop, yet no less important. They will require addressing fundamental issues in both current GP care for children and the training of GP registrars. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Alcohol Use, Depressive Symptoms, and Impulsivity as Risk Factors for Suicide Proneness among College Students

PubMed Central

Dvorak, Robert D.; Lamis, Dorian A.; Malone, Patrick S.

2013-01-01

BACKGROUND Alcohol use, depression, and suicide are significant public health problems, particularly among college students. Impulsivity is associated with all of these factors. Additionally, impulsivity increases the effects of negative mood and alcohol use on maladaptive behavior. METHODS The current cross-sectional study examined the association between the four-factor model of impulsivity (urgency, (lack of) perseverance, (lack of) premeditation, and sensation seeking), depressive symptoms, and alcohol use as predictors of suicide proneness among college students. Participants (n =1100) completed online assessments of demographics, impulsivity, depressive symptoms, and suicide proneness. RESULTS All predictors were positively related to suicide proneness. The relation between depressive symptoms and suicide proneness was moderated by (lack of) perseverance, alcohol use, and joint interactions of urgency × alcohol use and sensation seeking × alcohol use. Despite some paradoxical findings regarding the depressive symptoms-suicide proneness relation when only one risk factor was elevated, the average level of suicide proneness increased as risk factors increased. LIMITATIONS This cross-sectional self-report data comes from a non-clinical sample of college students from a homogeneous background, limiting generalizability and causal predictions. CONCLUSIONS Overall, these findings indicate that the association between depressive symptoms and suicide proneness varies considerably by different facets of impulsivity and alcohol use. The results suggest that clinical risk-assessments should weigh two forms of impulsivity (urgency and sensation seeking) as particularly vital in the presence of heavy alcohol use. These findings highlight the importance of considering and exploring moderators of the mood-suicide relationship. PMID:23474093

Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students.

PubMed

Dvorak, Robert D; Lamis, Dorian A; Malone, Patrick S

2013-07-01

Alcohol use, depression, and suicide are significant public health problems, particularly among college students. Impulsivity is associated with all of these factors. Additionally, impulsivity increases the effects of negative mood and alcohol use on maladaptive behavior. The current cross-sectional study examined the association between the four-factor model of impulsivity (urgency, (lack of) perseverance, (lack of) premeditation, and sensation seeking), depressive symptoms, and alcohol use as predictors of suicide proneness among college students. Participants (n=1100) completed online assessments of demographics, impulsivity, depressive symptoms, and suicide proneness. All predictors were positively related to suicide proneness. The relation between depressive symptoms and suicide proneness was moderated by (lack of) perseverance, alcohol use, and joint interactions of urgency×alcohol use and sensation seeking×alcohol use. Despite some paradoxical findings regarding the depressive symptoms-suicide proneness relation when only one risk factor was elevated, the average level of suicide proneness increased as risk factors increased. This cross-sectional self-report data comes from a non-clinical sample of college students from a homogeneous background, limiting generalizability and causal predictions. Overall, these findings indicate that the association between depressive symptoms and suicide proneness varies considerably by different facets of impulsivity and alcohol use. The results suggest that clinical risk-assessments should weigh two forms of impulsivity (urgency and sensation seeking) as particularly vital in the presence of heavy alcohol use. These findings highlight the importance of considering and exploring moderators of the mood-suicide relationship. Copyright © 2013 Elsevier B.V. All rights reserved.

Preventive HIV/AIDS education through physical education: reflections from Zambia.

PubMed

Njelesani, Donald

2011-01-01

Governments, UN agencies and international and local NGOs have mounted a concerted effort to remobilise sport as a vehicle for broad, sustainable social development. This resonates with the call for sport to be a key component in national and international development objectives. Missing in these efforts is an explicit focus on physical education within state schools, which still enroll most children in the global South. This article focuses on research into one of the few instances where physical education within the national curriculum is being revitalised as part of the growing interest in leveraging the appeal of sport and play as means to address social development challenges such as HIV/AIDS. It examines the response to the Zambian government's 2006 Declaration of Mandatory Physical Education (with a preventive education focus on HIV/AIDS) by personnel charged with its implementation and illustrates weaknesses within the education sector. The use of policy instruments such as decrees/mandates helps ensure the mainstreaming of physical education in development. However, the urgency required to respond to new mandates, particularly those sanctioned by the highest levels of government, can result in critical pieces of the puzzle being ignored, thereby undermining the potential of physical education (and sport) within development.

The Role of Communication in Post-disaster Research Coordination: Communicating the research moratorium after the 22 February 2011 Mw 6 Christchurch Earthquake in New Zealand.

NASA Astrophysics Data System (ADS)

Beaven, S.

2015-12-01

Disasters stimulate research activity by creating comparatively rare post-disaster data, while also increasing the urgency of agency demand for scientific evidence. In the wake of the 2011 Christchurch Earthquake disaster, New Zealand, post-disaster research activity was coordinated by a national Natural Hazards Research Platform, in collaboration with response agencies. The focus was on research support for responding agencies, with an emphasis on creating high quality scientific outcomes. This coordinated research effort did not include independent research activity, which escalated steeply in the weeks after the event. The risks this increased research pressure posed to response operations and impacted populations informed the declaration of a moratorium on research not deemed relevant to the needs of response agencies. This presentation summarizes communication issues that made it difficult to disseminate the moratorium, and to establish the relevance of this decision where it might have been most effective in diminishing these risks: within national and international natural hazard and disaster research communities, other national research communities, across responding agencies and organisations, and among impacted organizations and communities.

78 FR 45548 - South Dakota; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance...; 97.048, Disaster Housing Assistance to [[Page 45549

Methylphenidate produces selective enhancement of declarative memory consolidation in healthy volunteers.

PubMed

Linssen, A M W; Vuurman, E F P M; Sambeth, A; Riedel, W J

2012-06-01

Methylphenidate inhibits the reuptake of dopamine and noradrenaline and is used to treat children with attention deficit hyperactivity disorder (ADHD). Besides reducing behavioral symptoms, it improves their cognitive function. There are also observations of methylphenidate-induced cognition enhancement in healthy adults, although studies in this area are relatively sparse. We assessed the possible memory-enhancing properties of methylphenidate. In the current study, the possible enhancing effects of three doses of methylphenidate on declarative and working memory, attention, response inhibition and planning were investigated in healthy volunteers. In a double blind placebo-controlled crossover study, 19 healthy young male volunteers were tested after a single dose of placebo or 10, 20 or 40 mg of methylphenidate. Cognitive performance testing included a word learning test as a measure of declarative memory, a spatial working memory test, a set-shifting test, a stop signal test and a computerized version of the Tower of London planning test. Declarative memory consolidation was significantly improved relative to placebo after 20 and 40 mg of methylphenidate. Methylphenidate also improved set shifting and stopped signal task performance but did not affect spatial working memory or planning. To the best of our knowledge, this is the first study reporting enhanced declarative memory consolidation after methylphenidate in a dose-related fashion over a dose range that is presumed to reflect a wide range of dopamine reuptake inhibition.

Characteristics Associated With Treatment Response in Women Undergoing OnabotulinumtoxinA and Sacral Neuromodulation for Refractory Urgency Urinary Incontinence

PubMed Central

Richter, HE; Amundsen, CL; Erickson, SW; Jelovsek, JE; Komesu, Y; Chermansky, C; Harvie, H; Albo, M; Myers, D; Gregory, WT; Wallace, D

2017-01-01

Purpose To identify clinical and demographic characteristics associated with onabotulinumtoxinA and sacral neuromodulation treatment response in women with refractory urgency urinary incontinence. Material and Methods Data were analyzed from the Refractory Overactive Bladder: Sacral Neuromodulation vs Botulinum Toxin Assessment trial. Baseline participant characteristics and clinical variables associated with two definitions of treatment response: 1) reduction in mean daily urgency incontinence episodes over 6 months 2) ≥50% decrease in urgency incontinence episodes across 6 months were identified. Linear and logistic regression models were fit to estimate mean reductions in incontinence episodes and adjusted odds ratios for incidence of ≥50% decrease with 95% confidence intervals, respectively. Results For both treatments, a greater reduction in mean daily urgency incontinence episodes was associated with higher Health Utility Index scores (P=0.002) and higher baseline incontinence episodes (P<0.001). Increased age was associated with less reduction in incontinence episodes (P<0.001). Increasing body mass index (aOR 0.82 per 5 points, 95% CI 0.70, 0.96) was associated with reduced achievement of ≥50% decrease in incontinence episodes after both treatments. Greater age (aOR 0.44 per 10 years, 95% CI 0.30, 0.65) and higher functional comorbidity index (aOR 0.84 per point, 95% CI 0.71, 0.99) were associated with reduced achievement of ≥50% decrease in urgency incontinence episodes in the onabotulinuntoxinA group only (P=0.016; P=0.031, respectively). Conclusion Increasing age, body mass index, and functional comorbidity are negatively associated with treatment response while greater incontinence frequency and health utility is associated with a greater response to third line treatments for refractory urgency incontinence. PMID:28501541

Men's preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment.

PubMed

Mankowski, Colette; Ikenwilo, Divine; Heidenreich, Sebastian; Ryan, Mandy; Nazir, Jameel; Newman, Cathy; Watson, Verity

2016-01-01

To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment. Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes. In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm). To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.

[Urgenturia, a logical improvement in order to better caracterize a keyword irritative symptom].

PubMed

Grise, Philippe; Caremel, Romain; Cherif, Mohamed; Sibert, Louis

2007-09-01

Multiple medical terms are used in the french medical literature to caracterize an urgency. However, it is a corner stone symptom of bladder overactivity, different from a normal physiological sensation. Specific tools have been designed to measure urgency but there is an essential need to give a specific and clear medical word according to other medical terms for urinary signs or symptoms. This leads to propose urgenturia as the specific medical term for urgency.

Reliability and normal ranges for the Patient's Perception of Intensity of Urgency Scale in asymptomatic women.

PubMed

Cartwright, Rufus; Panayi, Demetri; Cardozo, Linda; Khullar, Vik

2010-03-01

Symptom prevalence (prospective cohort). 1b. To measure the test-retest reliability of a 7-day bladder diary incorporating the Patient's Perception of Intensity of Urgency Scale (PPIUS), and to establish the normal values of the scale in a population of asymptomatic women. Women volunteers, aged > or =18 years, were screened with the International Consultation on Incontinence Modular Questionnaire - Female Lower Urinary Tract Symptoms Long Form, to exclude those with bothersome lower urinary tract symptoms. Participants completed two separate 7-day bladder diaries with a 1-week interval between. Reliability was assessed using intraclass correlation, Spearman's correlation, and Student's t-test. Forty volunteers were recruited. Most (67.5%) reported no urgency episodes. Convenience voids accounted for 26.8% of all voids. There was a significant positive effect of age (r = 0.34, P = 0.034) on urgency episodes, but no effect on mean urge scores (r = -0.03, P = 0.843). The reliability of assessment of frequency (0.86), nocturia (0.84), and the mean urge scores (0.85), were better than the reliability of assessment of urgency episodes (0.56), which occurred infrequently. The 95th centile for daily urinary frequency was 7.27 and for weekly urgency episodes was 2.00. The PPIUS is a reliable tool for assessing urinary urge sensation in women. Inclusion of this measure in bladder diaries does not compromise the recording of other variables.

Integrating eating disorder-specific risk factors into the acquired preparedness model of dysregulated eating: A moderated mediation analysis.

PubMed

Racine, Sarah E; Martin, Shelby J

2017-01-01

Tests of the acquired preparedness model demonstrate that the personality trait of negative urgency (i.e., the tendency to act impulsively when distressed) predicts the expectation that eating alleviates negative affect, and this eating expectancy subsequently predicts dysregulated eating. Although recent data indicate that eating disorder-specific risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) strengthen negative urgency-dysregulated eating associations, it is unclear whether these risk factors impact associations directly or indirectly (i.e., through eating expectancies). The current study used latent moderated structural equation modeling to test moderated mediation hypotheses in a sample of 313 female college students. Eating expectancies mediated the association between negative urgency and dysregulated eating, and the indirect effect of negative urgency on dysregulated eating through eating expectancies was conditional on level of each eating disorder risk factor. Appearance pressures, thin-ideal internalization, body dissatisfaction, and dietary restraint significantly moderated the association between eating expectancies and dysregulated eating, while only dietary restraint moderated the direct effect of negative urgency on dysregulated eating. Findings suggest that the development of high-risk eating expectancies among individuals with negative urgency, combined with sociocultural pressures for thinness and their consequences, is associated with the greatest risk for dysregulated eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room.

PubMed

Maloberti, Alessandro; Cassano, Giulio; Capsoni, Nicolò; Gheda, Silvia; Magni, Gloria; Azin, Giulia Maria; Zacchino, Massimo; Rossi, Adriano; Campanella, Carlo; Beretta, Andrea Luigi Roberto; Bellone, Andrea; Giannattasio, Cristina

2018-05-18

Hypertensive urgencies-emergencies are important and common events. They are defined as a severe elevation in BP, higher than 180/120 mmHg, associated or not with the evidence of new or worsening organ damage for emergencies and urgencies respectively. Anamnestic information, physical examination and instrumental evaluation determine the following management that could need oral (for urgencies) or intravenous (for emergencies) anti-hypertensives drugs. The choice of the specific drugs depend on the underlying causes of the crisis, patient's demographics, cardiovascular risk and comorbidities. For emergencies a maximum BP reduction of 20-25% within the first hour and then to 160/110-100 over next 2-6 h, is considered appropriate with a further gradual decrease over the next 24-48 h to reach normal BP levels. In the case of hypertensive urgencies, a gradual lowering of BP over 24-48 h with an oral medication is the best approach and an aggressive BP lowering should be avoided. Subsequent management with particular attention on chronic BP values control is important as the right treatment of the acute phase.

77 FR 69489 - Pennsylvania; Emergency and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... for required emergency measures, authorized under Title V of the Stafford Act, to save lives and to... Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared Disaster Areas; 97.049, Presidentially Declared Disaster Assistance--Disaster Housing...

Frequent or urgent urination

MedlinePlus

Urgent urination; Urinary frequency or urgency; Urgency-frequency syndrome; Overactive bladder (OAB) syndrome; Urge syndrome ... Medicines such as water pills (diuretics) Overactive bladder syndrome Radiation therapy to the pelvis, which is used ...

Interstitial Cystitis

MedlinePlus

... IC) is a condition that causes discomfort or pain in the bladder and a need to urinate ... from person to person. Some people may have pain without urgency or frequency. Others have urgency and ...

Impulsive Personality Traits and Alcohol Use: Does Sleeping Help with Thinking?

PubMed Central

Miller, Mary Beth; DiBello, Angelo M.; Lust, Sarah A.; Meisel, Matthew K.; Carey, Kate B.

2016-01-01

Objective Both impulsivity and sleep disturbance have been associated with heavy alcohol use among young adults; yet studies to date have not examined their interactive effects. The current study aimed to determine if adequate sleep moderates the association between impulsive personality traits and alcohol use among young adults. Method College students (N = 568) who had been mandated to alcohol treatment following violation of campus alcohol policy provided information regarding alcohol use and related consequences, impulsive personality traits (measured using the UPPS Impulsive Behavior Scale), and perception of sleep adequacy as part of a larger intervention trial. Results Higher urgency, lower premeditation, and higher sensation-seeking predicted greater levels of alcohol consumption, while higher urgency predicted more alcohol-related consequences. As hypothesized, there was a significant interaction between premeditation and sleep adequacy in the prediction of drinks per week; in contrast to hypotheses, however, premeditation was associated with drinking only among those reporting adequate (rather than inadequate) sleep. Specifically, the tendency to premeditate was associated with less drinking among those who reported adequate sleep and was not associated with drinking among those reporting inadequate sleep. Conclusion Sensation-seeking and urgency are associated with greater alcohol involvement among young adults, regardless of sleep adequacy. Conversely, the ability to plan ahead and anticipate the consequences of one’s behaviors (premeditation) is only protective against heavy drinking among individuals receiving adequate sleep. With replication, these findings may inform alcohol prevention and intervention efforts. PMID:28094998

Correlation of thermocouple data with voiding function after prostate cryoablation.

PubMed

Levy, David A

2010-02-01

To identify possible correlations of thermocouple recorded data with altered postoperative voiding function after prostate cryosurgery. A retrospective analysis of the records of 58 patients treated with prostate cryoablation from October 2005 through April 2009 was conducted. Multivariate analysis of patient age, presenting prostate-specific antigen level, Gleason score, clinical T stage, prostate volume, maximum low temperature thermocouple recordings, history of radiation and or hormonal therapy, were studied as possible correlative factors for altered postoperative voiding function. Of 58 patients, 22 (37.9%) manifested postcryoablation urgency and frequency (n = 13) requiring medical therapy or retention (n = 9). On multivariate analysis, age (P = .037) and an external sphincter temperature < or = 23 degrees C (P = .012) were associated with voiding frequency, urgency, or retention (odds ratio = 6.26, 95% CI: 1.62-24.16), whereas anterior rectal wall temperature (Denon) was weakly associated (P = .079). Thermocouple data provide an objective means of assessing cryosurgical outcomes. This is the first report of a correlation of such data to post-treatment voiding function. A total of 37.9% of patients experienced urgency and/or frequency or urinary retention after cryoablation of the prostate for localized disease. Older age and external sphincter temperature < or = 23 degrees C were statistically significant predictors of these events. The data suggest that limiting the degree of freezing at the external sphincter may decrease procedure related morbidity. Further study is warranted to better delineate temperature-related data on treatment outcomes. 2010 Elsevier Inc. All rights reserved.

The different faces of impulsivity as links between childhood maltreatment and young adult crime.

PubMed

Shin, Sunny H; Cook, Amy K; Morris, Nancy A; McDougle, Robyn; Groves, Lauren Peasley

2016-07-01

Crime is a major public health and safety threat. Many studies have suggested that early exposure to child maltreatment increases an individual's risk for persistent serious crime in adulthood. Despite these findings about the connection between child maltreatment and criminal behavior, there is a paucity of empirically-based knowledge about the processes or pathways that link child maltreatment to later involvement in crime. Using a community sample of 337 young adults (ages 18-25) in a U.S. metropolitan area, the present study examined the role of various facets of impulsivity in linking child maltreatment to crime. A series of factor analyses identified three types of crime including property crime, violent crime, and fraud. Structural equation modelings were conducted to examine the associations among childhood maltreatment, four facets of impulsivity, and criminal behavior, controlling for sociodemographic information, family income and psychological symptoms. The present study found that child emotional abuse was indirectly related to property crime and fraud through urgency while a lack of premeditation mediates the relationship between child neglect and property crime. Child physical abuse was directly related to all three types of crime. Personality traits of urgency and lack of premeditation may play a significant role in the maltreatment-crime link. Preventive interventions targeting impulsivity traits such as urgency and a lack of premeditation might have promising impacts in curbing criminal behavior among maltreatment victims. Copyright © 2016 Elsevier Inc. All rights reserved.

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation.

PubMed

Manasse, Stephanie M; Espel, Hallie M; Schumacher, Leah M; Kerrigan, Stephanie G; Zhang, Fengqing; Forman, Evan M; Juarascio, Adrienne S

2016-10-01

Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition - both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n = 17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impulsive personality traits and alcohol use: Does sleeping help with thinking?

PubMed

Miller, Mary Beth; DiBello, Angelo M; Lust, Sarah A; Meisel, Matthew K; Carey, Kate B

2017-02-01

Both impulsivity and sleep disturbance have been associated with heavy alcohol use among young adults; yet studies to date have not examined their interactive effects. The current study aimed to determine if adequate sleep moderates the association between impulsive personality traits and alcohol use among young adults. College students (N = 568) who had been mandated to alcohol treatment following violation of campus alcohol policy provided information regarding alcohol use and related consequences, impulsive personality traits (measured using the UPPS Impulsive Behavior Scale), and perception of sleep adequacy as part of a larger intervention trial. Higher urgency, lower premeditation, and higher sensation-seeking predicted greater levels of alcohol consumption, while higher urgency predicted more alcohol-related consequences. As hypothesized, there was a significant interaction between premeditation and sleep adequacy in the prediction of drinks per week; in contrast to hypotheses, however, premeditation was associated with drinking only among those reporting adequate (rather than inadequate) sleep. Specifically, the tendency to premeditate was associated with less drinking among those who reported adequate sleep and was not associated with drinking among those reporting inadequate sleep. Sensation-seeking and urgency are associated with greater alcohol involvement among young adults, regardless of sleep adequacy. Conversely, the ability to plan ahead and anticipate the consequences of one's behaviors (premeditation) is only protective against heavy drinking among individuals receiving adequate sleep. With replication, these findings may inform alcohol prevention and intervention efforts. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Ability, Competency, Learning/Study Outcome, Qualification and Competence: Theoretical Dimension

ERIC Educational Resources Information Center

Pukelis, Kestutis

2009-01-01

The concepts important for creation of the common European higher education ("The Bologna declaration", 1999) and vocational education and training ("The Copenhagen declaration", 2002) areas and their relation are discussed in the article. The structure of ability, competency, learning/study outcome, qualification and…

78 FR 36557 - Iowa; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance....046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

76 FR 44031 - Arkansas; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance....046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

78 FR 45549 - Iowa; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42... Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially...

PANDAS with Catatonia: A Case Report

ERIC Educational Resources Information Center

Elia, Josephine; Dell, Mary Lynn; Friedman, David F.; Zimmerman, Robert A.; Balamuth, Naomi; Ahmed, Asim A.; Pati, Susmita

2005-01-01

This is a report of an 11-year-old, prepubertal boy with acute-onset urinary urgency and frequency, obsessions and compulsions related to urination, severe mood lability, inattention, impulsivity, hyperactivity, and intermittent periods of immobilization. Fever, cough, otitis, and sinusitis preceded neuropsychiatric symptoms. Antistreptolysin O…

Effects of dividing attention on memory for declarative and procedural aspects of tool use.

PubMed

Roy, Shumita; Park, Norman W

2016-07-01

Tool-related knowledge and skills are supported by a complex set of memory processes that are not well understood. Some aspects of tools are mediated by either declarative or procedural memory, while other aspects may rely on an interaction of both systems. Although motor skill learning is believed to be primarily supported by procedural memory, there is debate in the current literature regarding the role of declarative memory. Growing evidence suggests that declarative memory may be involved during early stages of motor skill learning, although findings have been mixed. In the current experiment, healthy, younger adults were trained to use a set of novel complex tools and were tested on their memory for various aspects of the tools. Declarative memory encoding was interrupted by dividing attention during training. Findings showed that dividing attention during training was detrimental for subsequent memory for tool attributes as well as accurate demonstration of tool use and tool grasping. However, dividing attention did not interfere with motor skill learning, suggesting that declarative memory is not essential for skill learning associated with tools.

Diabetes, glycemic control, and urinary incontinence in women

PubMed Central

Wang, Rui; Lefevre, Roger; Hacker, Michele R.; Golen, Toni H.

2015-01-01

OBJECTIVES To estimate the association between urinary incontinence and glycemic control in women ages 20 to 85. METHODS We included 7,270 women from the 2005–2010 National Health and Nutrition Examination Survey, stratified into three groups of glycemic control defined by hemoglobin A1c (HbA1c): i) those below the diagnostic threshold (HbA1c<6.5%), ii) those with relatively controlled diabetes (HbA1c 6.5–8.5%), and iii) those with poorly controlled diabetes (HbA1c>8.5%) to allow for a different relationship between glycemic control and urinary incontinence within each group. The primary outcomes were the presence of any, only stress, only urgency, and mixed urinary incontinence. We calculated adjusted risk ratios using Poisson regressions with robust variance estimates. RESULTS The survey-weighted prevalence was 52.9% for any, 27.2% for only stress, 9.9% for only urgency, and 15.8% for mixed urinary incontinence. Among women with relatively controlled diabetes, each one-unit increase in HbA1c was associated with a 13% (95% CI: 1.03–1.25) increase for any urinary incontinence and a 34% (95% CI 1.06–1.69) increase in risk for only stress incontinence but was not significantly associated with only urgency and mixed incontinence. Other risk factors included body mass index, hormone replacement therapy, smoking, and physical activity. CONCLUSIONS Worsening glycemic control is associated with an increased risk for stress incontinence for women with relatively controlled diabetes. For those either below the diagnostic threshold or with poorly controlled diabetes, the risk may be driven by other factors. Further prospective investigation of HbA1c as a modifiable risk factor may motivate measures to improve continence in women with diabetes. PMID:26313496

The explicit and implicit dance in psychoanalytic change.

PubMed

Fosshage, James L

2004-02-01

How the implicit/non-declarative and explicit/declarative cognitive domains interact is centrally important in the consideration of effecting change within the psychoanalytic arena. Stern et al. (1998) declare that long-lasting change occurs in the domain of implicit relational knowledge. In the view of this author, the implicit and explicit domains are intricately intertwined in an interactive dance within a psychoanalytic process. The author views that a spirit of inquiry (Lichtenberg, Lachmann & Fosshage 2002) serves as the foundation of the psychoanalytic process. Analyst and patient strive to explore, understand and communicate and, thereby, create a 'spirit' of interaction that contributes, through gradual incremental learning, to new implicit relational knowledge. This spirit, as part of the implicit relational interaction, is a cornerstone of the analytic relationship. The 'inquiry' more directly brings explicit/declarative processing to the foreground in the joint attempt to explore and understand. The spirit of inquiry in the psychoanalytic arena highlights both the autobiographical scenarios of the explicit memory system and the mental models of the implicit memory system as each contributes to a sense of self, other, and self with other. This process facilitates the extrication and suspension of the old models, so that new models based on current relational experience can be gradually integrated into both memory systems for lasting change.

78 FR 2443 - Criminal Justice Interview Room Recording System (IRRS) Standard, Supplier's Declaration of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1612] Criminal Justice Interview Room Recording System (IRRS) Standard, Supplier's Declaration of Conformity Requirements, and... three draft documents related to Interview Room Recording Systems (IRRS) used by criminal justice...

76 FR 33775 - Tennessee; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... and magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and....046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

76 FR 34090 - Missouri; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance... (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

78 FR 36556 - Oklahoma; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42... Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

78 FR 51200 - Florida; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

.... Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. (the ``Stafford Act''), as... warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance... Grant; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared...

78 FR 45547 - North Dakota; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42... Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

77 FR 20043 - Indiana; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... and magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and... Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

75 FR 30419 - Kentucky; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency....046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

Testing the Relations Between Impulsivity-Related Traits, Suicidality, and Nonsuicidal Self-Injury: A Test of the Incremental Validity of the UPPS Model

PubMed Central

Lynam, Donald R.; Miller, Joshua D.; Miller, Drew J.; Bornovalova, Marina A.; Lejuez, C. W.

2011-01-01

Borderline personality disorder (BPD) has received significant attention as a predictor of suicidal behavior (SB) and nonsuicidal self-injury (NSSI). Despite significant promise, trait impulsivity has received less attention. Understanding the relations between impulsivity and SB and NSSI is confounded, unfortunately, by the heterogeneous nature of impulsivity. This study examined the relations among 4 personality pathways to impulsive behavior studied via the UPPS model of impulsivity and SB and NSSI in a residential sample of drug abusers (N = 76). In this study, we tested whether these 4 impulsivity-related traits (i.e., Negative Urgency, Sensation Seeking, Lack of Premeditation, and Lack of Perseverance) provide incremental validity in the statistical prediction of SB and NSSI above and beyond BPD; they do. We also tested whether BPD symptoms provide incremental validity in the prediction of SB and NSSI above and beyond these impulsivity-related traits; they do not. In addition to the main effects of Lack of Premeditation and Negative Urgency, we found evidence of a robust interaction between these 2 personality traits. The current results argue strongly for the consideration of these 2 impulsivity-related domains—alone and in interaction—when attempting to understand and predict SB and NSSI. PMID:21833346

Testing the relations between impulsivity-related traits, suicidality, and nonsuicidal self-injury: a test of the incremental validity of the UPPS model.

PubMed

Lynam, Donald R; Miller, Joshua D; Miller, Drew J; Bornovalova, Marina A; Lejuez, C W

2011-04-01

Borderline personality disorder (BPD) has received significant attention as a predictor of suicidal behavior (SB) and nonsuicidal self-injury (NSSI). Despite significant promise, trait impulsivity has received less attention. Understanding the relations between impulsivity and SB and NSSI is confounded, unfortunately, by the heterogeneous nature of impulsivity. This study examined the relations among 4 personality pathways to impulsive behavior studied via the UPPS model of impulsivity and SB and NSSI in a residential sample of drug abusers (N = 76). In this study, we tested whether these 4 impulsivity-related traits (i.e., Negative Urgency, Sensation Seeking, Lack of Premeditation, and Lack of Perseverance) provide incremental validity in the statistical prediction of SB and NSSI above and beyond BPD; they do. We also tested whether BPD symptoms provide incremental validity in the prediction of SB and NSSI above and beyond these impulsivity-related traits; they do not. In addition to the main effects of Lack of Premeditation and Negative Urgency, we found evidence of a robust interaction between these 2 personality traits. The current results argue strongly for the consideration of these 2 impulsivity-related domains--alone and in interaction--when attempting to understand and predict SB and NSSI.

Emotionally up and down, behaviorally to and fro: Drinking motives mediate the synergistic effects of urgency and emotional instability on alcohol outcomes

PubMed Central

Dvorak, Robert D.; Kuvaas, Nicholas J.; Lamis, Dorian A.; Pearson, Matthew R.; Stevenson, Brittany L.

2017-01-01

Emotional and behavioral regulation has been linked to coping and enhancement motives and associated with different patterns of alcohol use and problems. The current studies examined emotional instability, urgency, and internal drinking motives as predictors of alcohol dependence symptoms and DSM-5 Alcohol Use Disorder. In Study 1, college drinkers (n = 621) completed alcohol involvement and behavioral/emotional functioning assessments. There was an indirect association between emotional instability and dependence symptoms via both coping and enhancement drinking motives which was potentiated by trait urgency. In Study 2, college drinkers (n = 510) completed alcohol involvement, behavioral/emotional functioning, and AUD criteria assessments. A significant indirect effect from emotional instability to the likelihood of meeting AUD criteria, via drinking to cope was found, again potentiated by urgency. PMID:27075609

Negative urgency mediates the relationship between childhood maltreatment and problems with alcohol and cannabis in late adolescence

PubMed Central

Wardell, Jeffrey D.; Strang, Nicole M.; Hendershot, Christian S.

2017-01-01

Background Childhood maltreatment is an important risk factor for problems with alcohol and other drugs such as cannabis. Although this link has been well established, the mechanisms in this association require further study. High levels of impulsivity and difficulties with emotion regulation are often associated with childhood maltreatment. Negative urgency – an emotion-based facet of impulsivity – is a strong predictor of substance use problems and may be a particularly relevant facet of impulsivity in the link between childhood maltreatment and alcohol and cannabis outcomes. However, few studies have examined the specific mediational pathway from childhood maltreatment to alcohol and cannabis problems through negative urgency. Objectives We tested the hypothesis that the associations between history of childhood maltreatment and current alcohol and cannabis problems would be mediated by negative urgency, but not other facets of impulsivity. Methods Participants (N=232), who were in late adolescence (mean age=19.75), completed self-report measures of different facets of impulsivity, past childhood maltreatment, and current alcohol and cannabis use and problems. Results In analyses including several facets of impulsivity as simultaneous mediators, negative urgency was the only facet to mediate the associations of childhood maltreatment severity with alcohol and cannabis problems. Conclusions These findings provide support for negative urgency as a unique mediator of the association between childhood maltreatment and both alcohol and cannabis problems, suggesting that future work on mechanisms in this association should focus on mood-based impulsivity. PMID:26774820

Similarities in human visual and declared measures of preference for opposite-sex faces.

PubMed

Griffey, Jack A F; Little, Anthony C

2014-01-01

Facial appearance in humans is associated with attraction and mate choice. Numerous studies have identified that adults display directional preferences for certain facial traits including symmetry, averageness, and sexually dimorphic traits. Typically, studies measuring human preference for these traits examine declared (e.g., choice or ratings of attractiveness) or visual preferences (e.g., looking time) of participants. However, the extent to which visual and declared preferences correspond remains relatively untested. In order to evaluate the relationship between these measures we examined visual and declared preferences displayed by men and women for opposite-sex faces manipulated across three dimensions (symmetry, averageness, and masculinity) and compared preferences from each method. Results indicated that participants displayed significant visual and declared preferences for symmetrical, average, and appropriately sexually dimorphic faces. We also found that declared and visual preferences correlated weakly but significantly. These data indicate that visual and declared preferences for manipulated facial stimuli produce similar directional preferences across participants and are also correlated with one another within participants. Both methods therefore may be considered appropriate to measure human preferences. However, while both methods appear likely to generate similar patterns of preference at the sample level, the weak nature of the correlation between visual and declared preferences in our data suggests some caution in assuming visual preferences are the same as declared preferences at the individual level. Because there are positive and negative factors in both methods for measuring preference, we suggest that a combined approach is most useful in outlining population level preferences for traits.

[Self-referrals at Emergency Care Access Points and triage by General Practitioner Cooperatives].

PubMed

Smits, M; Rutten, M; Schepers, L; Giesen, P

2017-01-01

There is a trend for General Practitioner Cooperatives (GPCs) to co-locate with emergency departments (EDs) of hospitals at Emergency Care Access Points (ECAPs), where the GPCs generally conduct triage and treat a large part of self-referrals who would have gone to the ED by themselves in the past. We have examined patient and care characteristics of self-referrals at ECAPs where triage was conducted by GPCs, also to determine the percentage of self-referrals being referred to the ED. Retrospective cross-sectional observational study. Descriptive analyses of routine registration data from self-referrals of five ECAPs (n = 20.451). Patient age, gender, arrival time, urgency, diagnosis and referral were analysed. Of the self-referrals, 57.9% was male and the mean age was 32.7 years. The number of self-referrals per hour was highest during weekends, particularly between 11 a.m. and 5 p.m. On weekdays, there was a peak between 5 and 9 p.m. Self-referrals were mostly assigned a low-urgency grade (35.7% - U4 or U5) or a mid-urgency grade (49% - U3). Almost half of the self-referrals had trauma of the locomotor system (28%) or the skin (27.3%). In total, 23% of the patients was referred to the ED. Self-referred patients at GPCs are typically young, male and have low- to mid-urgency trauma-related problems. Many self-referrals present themselves on weekend days or early weekday evenings. Over three quarters of these patients can be treated by the GPCs, without referral to the ED. This reduces the workload at the ED.

Primary hip and knee replacement surgery: Ontario criteria for case selection and surgical priority.

PubMed Central

Naylor, C D; Williams, J I

1996-01-01

OBJECTIVES--To develop, from simple clinical factors, criteria to identify appropriate patients for referral to a surgeon for consideration for arthroplasty, and to rank them in the queue once surgery is agreed. DESIGN--Delphi process, with a panel including orthopaedic surgeons, rheumatologists, general practitioners, epidemiologists, and physiotherapists, who rated 120 case scenarios for appropriateness and 42 for waiting list priority. Scenarios incorporated combinations of relevant clinical factors. It was assumed that queues should be organised not simply by chronology but by clinical and social impact of delayed surgery. The panel focused on information obtained from clinical histories, to ensure the utility of the guidelines in practice. Relevant high quality research evidence was limited. SETTING--Ontario, Canada. MAIN MEASURES--Appropriateness ratings on a 7-point scale, and urgency rankings on a 4-point scale keyed to specific waiting times. RESULTS--Despite incomplete evidence panellists agreed on ratings in 92.5% of appropriateness and 73.8% of urgency scenarios versus 15% and 18% agreement expected by chance, respectively. Statistically validated algorithms in decision tree form, which should permit rapid estimation of urgency or appropriateness in practice, were compiled by recursive partitioning. Rating patterns and algorithms were also used to make brief written guidelines on how clinical factors affect appropriateness and urgency of surgery. A summary score was provided for each case scenario; scenarios could then be matched to chart audit results, with scoring for quality management. CONCLUSIONS--These algorithms and criteria can be used by managers or practitioners to assess appropriateness of referral for hip or knee replacement and relative rankings of patients in the queue for surgery. PMID:10157268

A Non-Invasive Bladder Sensory Test Supports a Role for Dysmenorrhea Increasing Bladder Noxious Mechanosensitivity

PubMed Central

TU, Frank F.; EPSTEIN, Aliza E.; POZOLO, Kristen E.; SEXTON, Debra L.; MELNYK, Alexandra I.; HELLMAN, Kevin M.

2012-01-01

Objective Catheterization to measure bladder sensitivity is aversive and hinders human participation in visceral sensory research. Therefore, we sought to characterize the reliability of sonographically-estimated female bladder sensory thresholds. To demonstrate this technique’s usefulness, we examined the effects of self-reported dysmenorrhea on bladder pain thresholds. Methods Bladder sensory threshold volumes were determined during provoked natural diuresis in 49 healthy women (mean age 24 ± 8) using three-dimensional ultrasound. Cystometric thresholds (Vfs – first sensation, Vfu – first urge, Vmt – maximum tolerance) were quantified and related to bladder urgency and pain. We estimated reliability (one-week retest and interrater). Self-reported menstrual pain was examined in relationship to bladder pain, urgency and volume thresholds. Results Average bladder sensory thresholds (mLs) were Vfs (160±100), Vfu (310±130), and Vmt (500±180). Interrater reliability ranged from 0.97–0.99. One-week retest reliability was Vmt = 0.76 (95% CI 0.64–0.88), Vfs = 0.62 (95% CI 0.44–0.80), and Vfu = 0.63, (95% CI 0.47–0.80). Bladder filling rate correlated with all thresholds (r = 0.53–0.64, p < 0.0001). Women with moderate to severe dysmenorrhea pain had increased bladder pain and urgency at Vfs and increased pain at Vfu (p’s < 0.05). In contrast, dysmenorrhea pain was unrelated to bladder capacity. Discussion Sonographic estimates of bladder sensory thresholds were reproducible and reliable. In these healthy volunteers, dysmenorrhea was associated with increased bladder pain and urgency during filling but unrelated to capacity. Plausibly, dysmenorrhea sufferers may exhibit enhanced visceral mechanosensitivity, increasing their risk to develop chronic bladder pain syndromes. PMID:23370073

The changing nature and scope of public health emergencies in response to annual flu.

PubMed

Hodge, James G

2013-06-01

The rapid spread of influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts. The legal effects of these types of declarations are profound. Public and private actors are given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health.

Do Persian Native Speakers Prosodically Mark Wh-in-situ Questions?

PubMed

Shiamizadeh, Zohreh; Caspers, Johanneke; Schiller, Niels O

2018-02-01

It has been shown that prosody contributes to the contrast between declarativity and interrogativity, notably in interrogative utterances lacking lexico-syntactic features of interrogativity. Accordingly, it may be proposed that prosody plays a role in marking wh-in-situ questions in which the interrogativity feature (the wh-phrase) does not move to sentence-initial position, as, for example, in Persian. This paper examines whether prosody distinguishes Persian wh-in-situ questions from declaratives in the absence of the interrogativity feature in the sentence-initial position. To answer this question, a production experiment was designed in which wh-questions and declaratives were elicited from Persian native speakers. On the basis of the results of previous studies, we hypothesize that prosodic features mark wh-in-situ questions as opposed to declaratives at both the local (pre- and post-wh part) and global level (complete sentence). The results of the current study confirm our hypothesis that prosodic correlates mark the pre-wh part as well as the complete sentence in wh-in-situ questions. The results support theoretical concepts such as the frequency code, the universal dichotomous association between relaxation and declarativity on the one hand and tension and interrogativity on the other, the relation between prosody and pragmatics, and the relation between prosody and encoding and decoding of sentence type.

Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)?

PubMed

Elzinga, B M; Bremner, J D

2002-06-01

A model for the posttraumatic stress disorder (PTSD) as a disorder of memory is presented drawing both on psychological and neurobiological data. Evidence on intrusive memories and deficits in declarative memory function in PTSD-patients is reviewed in relation to three brain areas that are involved in memory functioning and the stress response: the hippocampus, amygdala, and the prefrontal cortex. Neurobiological studies have shown that the noradrenergic stress-system is involved in enhanced encoding of emotional memories, sensitization, and fear conditioning, by way of its effects on the amygdala. Chronic stress also affects the hippocampus, a brain area involved in declarative memories, suggesting that hippocampal dysfunction may partly account for the deficits in declarative memory in PTSD-patients. Deficits in the medial prefrontal cortex, a structure that normally inhibits the amygdala, may further enhance the effects of the amygdala, thereby increasing the frequency and intensity of the traumatic memories. Thus, by way of its influence on these brain structures, exposure to severe stress may simultaneously result in strong emotional reactions and in difficulties to recall the emotional event. This model is also relevant for understanding the distinction between declarative and non-declarative memory-functions in processing trauma-related information in PTSD. Implications of our model are reviewed.

Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)?

PubMed Central

Elzinga, B.M.; Bremner, J.D.

2017-01-01

A model for the posttraumatic stress disorder (PTSD) as a disorder of memory is presented drawing both on psychological and neurobiological data. Evidence on intrusive memories and deficits in declarative memory function in PTSD-patients is reviewed in relation to three brain areas that are involved in memory functioning and the stress response: the hippocampus, amygdala, and the prefrontal cortex. Neurobiological studies have shown that the noradrenergic stress-system is involved in enhanced encoding of emotional memories, sensitization, and fear conditioning, by way of its effects on the amygdala. Chronic stress also affects the hippocampus, a brain area involved in declarative memories, suggesting that hippocampal dysfunction may partly account for the deficits in declarative memory in PTSD-patients. Deficits in the medial prefrontal cortex, a structure that normally inhibits the amygdala, may further enhance the effects of the amygdala, thereby increasing the frequency and intensity of the traumatic memories. Thus, by way of its influence on these brain structures, exposure to severe stress may simultaneously result in strong emotional reactions and in difficulties to recall the emotional event. This model is also relevant for understanding the distinction between declarative and non-declarative memory-functions in processing trauma-related information in PTSD. Implications of our model are reviewed. PMID:12113915

Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men.

PubMed

Smith, Benjamin J; Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

2018-01-01

HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making. © The Author (2017). Published by Oxford University Press.

32 CFR 516.26 - Unsworn declarations under penalty of perjury.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Unsworn declarations under penalty of perjury. 516.26 Section 516.26 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.26 Unsworn...

15 CFR 712.9 - Deadlines for submission of Schedule 1 declarations, reports, advance notifications, and amendments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.9... notifications, and amendments include: (a) Annual declaration on past activities (Schedule 1 chemical production...

15 CFR 711.7 - Where to submit declarations, reports and advance notifications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Where to submit declarations, reports and advance notifications. 711.7 Section 711.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL...

15 CFR 711.1 - Overviews of declaration, reporting, and advance notification requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Overviews of declaration, reporting, and advance notification requirements. 711.1 Section 711.1 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE...

20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

Code of Federal Regulations, 2014 CFR

2014-04-01

... the year. (c) Applications for national emergency grants to respond to a declared emergency or natural disaster as described in § 671.110(e), cannot be considered until FEMA has declared that the affected area is eligible for disaster-related public assistance. ...

20 CFR 671.130 - When should applications for national emergency grants be submitted to the Department?

Code of Federal Regulations, 2013 CFR

2013-04-01

... the year. (c) Applications for national emergency grants to respond to a declared emergency or natural disaster as described in § 671.110(e), cannot be considered until FEMA has declared that the affected area is eligible for disaster-related public assistance. ...

32 CFR 516.26 - Unsworn declarations under penalty of perjury.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Unsworn declarations under penalty of perjury. 516.26 Section 516.26 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.26 Unsworn...

78 FR 51203 - Iowa; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

76 FR 32984 - Arkansas; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-07

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency... (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

76 FR 61730 - Texas; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

.... Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. (the ``Stafford Act''), as... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C..., Disaster Housing Assistance to Individuals and Households in Presidentially Declared Disaster Areas; 97.049...

78 FR 45548 - Montana; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. Sec. Sec... Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households in...

78 FR 32415 - South Dakota; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

78 FR 38728 - Michigan; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

77 FR 54601 - Oklahoma; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. (the ``Stafford Act''), as follows: I... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C... Grant; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared...

78 FR 36557 - North Dakota; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households In...

78 FR 51204 - Colorado; Major Disaster and Related Determinations

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2013-08-20

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

75 FR 45144 - Kentucky; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. (the ``Stafford Act''), as follows: I... magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief and Emergency..., Disaster Housing Assistance to Individuals and Households In Presidentially Declared Disaster Areas; 97.049...

78 FR 38727 - Vermont; Major Disaster and Related Determinations

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2013-06-27

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households In...

78 FR 32415 - Iowa; Major Disaster and Related Determinations

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2013-05-30

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and Households In...

78 FR 32416 - Minnesota; Major Disaster and Related Determinations

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2013-05-30

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C..., Disaster Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing...

75 FR 30419 - Mississippi; Major Disaster and Related Determinations

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2010-06-01

... major disaster declaration under the authority of the Robert T. Stafford Disaster Relief and Emergency... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...

76 FR 44031 - Vermont; Major Disaster and Related Determinations

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2011-07-22

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq..., Disaster Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing...

75 FR 65500 - North Carolina; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... severity and magnitude to warrant a major disaster declaration under the Robert T. Stafford Disaster Relief... Grant; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared...

77 FR 44648 - Florida; Major Disaster and Related Determinations

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2012-07-30

... President issued a major disaster declaration under the authority of the Robert T. Stafford Disaster Relief... disaster declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C... Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to...

Report Summary--Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015.

PubMed

Stankiewicz, A; Herel, M; DesMeules, M

2015-09-01

In 2012, Canada and other United Nations (UN) Member States endorsed the "Rio Political Declaration on Social Determinants of Health" (Rio Declaration), a non-binding pledge which calls on World Health Organization (WHO) Member States to improve/influence the working and living conditions that affect health and well-being. The Rio Declaration sets out actions to address health inequities in five themes: to adopt better governance for health and development; to promote participation in policy making and implementation; to further reorient the health sector towards reducing health inequities; to strengthen global governance and collaboration; and to monitor and increase accountability. In 2013, following the endorsement of the Rio Declaration, the Government of Canada released a report to begin to document Canadian actions related to its five themes. Building on this first report, and in anticipation of WHO reporting on Member State implementation of the Rio Declaration at the May 2015 World Health Assembly, the Government of Canada developed the report, Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015, which showcases Canada's recent actions since 2013 contributing to the advancement of the five Rio Declaration themes. The report provides a current picture of the diverse spectrum of activities undertaken across levels of government and sectors to advance health equity and address social determinants of health in Canada, and intends to stimulate global and domestic exchange and uptake of promising practices to advance health equity.

Negative urgency and ventromedial prefrontal cortex responses to alcohol cues: FMRI evidence of emotion-based impulsivity.

PubMed

Cyders, Melissa A; Dzemidzic, Mario; Eiler, William J; Coskunpinar, Ayca; Karyadi, Kenny; Kareken, David A

2014-02-01

Recent research has highlighted the role of emotion-based impulsivity (negative and positive urgency personality traits) for alcohol use and abuse, but has yet to examine how these personality traits interact with the brain's motivational systems. Using functional magnetic resonance imaging (fMRI), we tested whether urgency traits and mood induction affected medial prefrontal responses to alcohol odors (AcO). Twenty-seven social drinkers (mean age = 25.2, 14 males) had 6 fMRI scans while viewing negative, neutral, or positive mood images (3 mood conditions) during intermittent exposure to AcO and appetitive control (AppCo) aromas. Voxel-wise analyses (p < 0.001) confirmed [AcO > AppCo] activation throughout medial prefrontal cortex (mPFC) and ventromedial PFC (vmPFC) regions. Extracted from a priori mPFC and vmPFC regions and analyzed in Odor (AcO, AppCo) × Mood factorial models, AcO activation was greater than AppCo in left vmPFC (p < 0.001), left mPFC (p = 0.002), and right vmPFC (p = 0.01) regions. Mood did not interact significantly with activation, but the covariate of trait negative urgency accounted for significant variance in left vmPFC (p = 0.01) and right vmPFC (p = 0.01) [AcO > AppCo] activation. Negative urgency also mediated the relationship between vmPFC activation and both (i) subjective craving and (ii) problematic drinking. The trait of negative urgency is associated with neural responses to alcohol cues in the vmPFC, a region involved in reward value and emotion-guided decision-making. This suggests that negative urgency might alter subjective craving and brain regions involved in coding reward value. Copyright © 2013 by the Research Society on Alcoholism.

Rectal distensibility and symptoms after stapled and Milligan-Morgan operation for hemorrhoids.

PubMed

Corsetti, Maura; De Nardi, Paola; Di Pietro, Salvatore; Passaretti, Sandro; Testoni, Pier Alberto; Staudacher, Carlo

2009-12-01

In a previous uncontrolled study, a reduction of rectal distensibility and volume thresholds for sensations have been related to the occurrence of fecal urgency and/or increased stool frequency after stapled hemorrhoidopexy. The aim of this study was to compare rectal symptoms and sensory-motor function after stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy. The clinical records of 12 (four women) and ten patients (four women) with third- and fourth-degree hemorrhoids, respectively, who underwent stapled hemorrhoidopexy or Milligan-Morgan's hemorrhoidectomy, were evaluated. One week before and 6 months after surgery, rectal motor and sensory response to distension was assessed by an electronic barostat, and bowel and rectal symptoms were recorded by means of a 7-day diary and Bristol Index scale and psychological symptoms with SCL-90 questionnaire. Rectal distensibility and volume thresholds for sensations were significantly lower after surgery (P < 0.02) in the stapled group. Increased stool frequency and/or fecal urgency arose in 41% of patients in the stapled group and associated with altered rectal distensibility. No difference within and between groups could be demonstrated in SCL-90 score. Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.

Impulsivity and the sexes: measurement and structural invariance of the UPPS-P Impulsive Behavior Scale.

PubMed

Cyders, Melissa A

2013-02-01

Before it is possible to test whether men and women differ in impulsivity, it is necessary to evaluate whether impulsivity measures are invariant across sex. The UPPS-P Impulsive Behavior Scale (negative urgency, lack of premeditation, lack of perseverance, and sensation seeking, with added subscale of positive urgency) is one measure of five dispositions toward rash action that has shown to have robust and clinically useful relationships among risk-taking outcomes. In the current research, the author examined (a) the psychometric measurement invariance of the UPPS-P across sex, (b) the scale's structural invariance across sex, and (c) whether the five impulsivity traits differentially relate to risk outcomes as a function of sex. In a sample of 1,372 undergraduates, the author found evidence for measurement and invariance across sex: Thus, comparisons of men and women on the UPPS-P can be considered valid. Additionally, although males tend to report higher levels of sensation seeking and positive urgency (and possibly lack of perseverance), the relationships between the UPPS-P traits and risk outcomes were generally invariant across sex. The UPPS-P appears to function comparably across males and females, and mean differences on this scale between the sexes can be thought to reflect trait-level differences.

The urgency-gating model can explain the effects of early evidence.

PubMed

Carland, Matthew A; Thura, David; Cisek, Paul

2015-12-01

In a recent report, Winkel, Keuken, van Maanen, Wagenmakers & Forstmann (Psychonomics Bulletin and Review 21(3): 777-784, 2014) show that during a random-dot motion discrimination task, early differences in motion evidence can influence reaction times (RTs) and error rates in human subjects. They use this as an argument in favor of the drift-diffusion model and against the urgency-gating model. However, their implementation of the urgency-gating model is incomplete, as it lacks the low-pass filter that is necessary to deal with noisy input such as the motion signal used in their experimental task. Furthermore, by focusing analyses solely on comparison of mean RTs they overestimate how long early information influences individual trials. Here, we show that if the urgency-gating model is correctly implemented, including a low-pass filter with a 250 ms time constant, it can successfully reproduce the results of the Winkel et al. experiment.

Childhood drinking and depressive symptom level predict harmful personality change

PubMed Central

Riley, Elizabeth N.; Smith, Gregory T.

2016-01-01

Personality traits in children predict numerous life outcomes. Although traits are generally stable, if there is personality change in youth, it could affect subsequent behavior in important ways. We found that the trait of urgency, the tendency to act impulsively when highly emotional, increases for some youth in early adolescence. This increase can be predicted from the behavior of young children: alcohol consumption and depressive symptom level in elementary school children (5th grade) predicted increases in urgency 18 months later. Urgency, in turn, predicted increases in a wide range of maladaptive behaviors another 30 months later, at the end of the first year of high school. The mechanism by which early drinking behavior and depressive symptoms predict personality is not yet clear and merits future research; notably, the findings are consistent with mechanisms proposed by personality change theory and urgency theory. PMID:28392979

Under Pressure: Response Urgency Modulates Striatal and Insula Activity during Decision-Making under Risk

PubMed Central

Jones, Catherine L.; Minati, Ludovico; Harrison, Neil A.; Ward, Jamie; Critchley, Hugo D.

2011-01-01

When deciding whether to bet in situations that involve potential monetary loss or gain (mixed gambles), a subjective sense of pressure can influence the evaluation of the expected utility associated with each choice option. Here, we explored how gambling decisions, their psychophysiological and neural counterparts are modulated by an induced sense of urgency to respond. Urgency influenced decision times and evoked heart rate responses, interacting with the expected value of each gamble. Using functional MRI, we observed that this interaction was associated with changes in the activity of the striatum, a critical region for both reward and choice selection, and within the insula, a region implicated as the substrate of affective feelings arising from interoceptive signals which influence motivational behavior. Our findings bridge current psychophysiological and neurobiological models of value representation and action-programming, identifying the striatum and insular cortex as the key substrates of decision-making under risk and urgency. PMID:21677769

Under pressure: response urgency modulates striatal and insula activity during decision-making under risk.

PubMed

Jones, Catherine L; Minati, Ludovico; Harrison, Neil A; Ward, Jamie; Critchley, Hugo D

2011-01-01

When deciding whether to bet in situations that involve potential monetary loss or gain (mixed gambles), a subjective sense of pressure can influence the evaluation of the expected utility associated with each choice option. Here, we explored how gambling decisions, their psychophysiological and neural counterparts are modulated by an induced sense of urgency to respond. Urgency influenced decision times and evoked heart rate responses, interacting with the expected value of each gamble. Using functional MRI, we observed that this interaction was associated with changes in the activity of the striatum, a critical region for both reward and choice selection, and within the insula, a region implicated as the substrate of affective feelings arising from interoceptive signals which influence motivational behavior. Our findings bridge current psychophysiological and neurobiological models of value representation and action-programming, identifying the striatum and insular cortex as the key substrates of decision-making under risk and urgency.

Monoamine Oxidase A (MAOA) Genotype Predicts Greater Aggression Through Impulsive Reactivity to Negative Affect

PubMed Central

Chester, David S.; DeWall, C. Nathan; Derefinko, Karen J.; Estus, Steven; Peters, Jessica R.; Lynam, Donald R.; Jiang, Yang

2015-01-01

Low functioning MAOA genotypes have been reliably linked to increased reactive aggression, yet the psychological mechanisms of this effect remain largely unknown. The low functioning MAOA genotype’s established link to diminished inhibition and greater reactivity to conditions of negative affect suggest that negative urgency, the tendency to act impulsively in the context of negative affect, may fill this mediating role. Such MAOA carriers may have higher negative urgency, which may in turn predict greater aggressive responses to provocation. To test these hypotheses, 277 female and male participants were genotyped for an MAOA SNP yet to be linked to aggression (rs1465108), and then reported their negative urgency and past aggressive behavior. We replicated the effect of the low functioning MAOA genotype on heightened aggression, which was mediated by greater negative urgency. These results suggest that disrupted serotonergic systems predispose individuals towards aggressive behavior by increasing impulsive reactivity to negative affect. PMID:25637908

Alkalinized lidocaine and heparin provide immediate relief of pain and urgency in patients with interstitial cystitis.

PubMed

Parsons, C Lowell; Zupkas, Paul; Proctor, Jeffrey; Koziol, James; Franklin, Amie; Giesing, Dennis; Davis, Edward; Lakin, Charles M; Kahn, Bruce S; Garner, William J

2012-01-01

It has been reported in an open-label study that the combination of alkalinized lidocaine and heparin can immediately relieve the symptoms of urinary urgency, frequency, and pain associated with interstitial cystitis (IC). This combination has also been reported to relieve pain associated with sex in patients with IC. The aim of this study was to corroborate these findings in a multicenter setting. The study design was a multicenter prospective, double-blind, crossover, placebo-controlled trial. Each participant met all of the clinical National Institute of Diabetes and Digestive and Kidney Diseases criteria (excluding cystoscopy) for IC. Each patient received drug and control, in random order, within 48 hours of enrolling in the study. The primary outcome measure was percent change in pain score (11-point analog pain scale) 12 hours after receiving the drug or control. Secondary measures were the global assessment response (GAR) of symptoms and 12-hour average urgency reduction determined from 11-point urgency scales. Eighteen (18) patients completed the trial. The average reduction of pain over 12 hours was 21% for control and 42% for active drug (P = 0.0363). GAR was 13% for control and 50% for drug (P = 0.0137). Average urgency reduction was 13% for control and 35% for drug (P = 0.0328). The combination of alkalinized lidocaine and heparin provides up to 12 hours of relief from urgency and pain associated with IC. This combination provides significant immediate relief of symptoms for patients with IC. © 2011 International Society for Sexual Medicine.

Visuospatial declarative learning despite profound verbal declarative amnesia in Korsakoff's syndrome.

PubMed

Oudman, Erik; Postma, Albert; Nijboer, Tanja C W; Wijnia, Jan W; Van der Stigchel, Stefan

2017-03-20

Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterised by severe amnesia. Although the presence of impairments in memory has long been acknowledged, there is a lack of knowledge about the precise characteristics of declarative memory capacities in order to implement memory rehabilitation. In this study, we investigated the extent to which patients diagnosed with KS have preserved declarative memory capacities in working memory, long-term memory encoding or long-term memory recall operations, and whether these capacities are most preserved for verbal or visuospatial content. The results of this study demonstrate that patients with KS have compromised declarative memory functioning on all memory indices. Performance was lowest for the encoding operation compared to the working memory and delayed recall operation. With respect to the content, visuospatial memory was relatively better preserved than verbal memory. All memory operations functioned suboptimally, although the most pronounced disturbance was found in verbal memory encoding. Based on the preserved declarative memory capacities in patients, visuospatial memory can form a more promising target for compensatory memory rehabilitation than verbal memory. It is therefore relevant to increase the number of spatial cues in memory rehabilitation for KS patients.

Management of Patients With Hypertensive Urgencies and Emergencies

PubMed Central

Cherney, David; Straus, Sharon

2002-01-01

BACKGROUND Hypertensive urgencies and emergencies are common clinical occurrences in hypertensive patients. Treatment practices vary considerably to because of the lack of evidence supporting the use of one therapeutic agent over another. This paper was designed to review the evidence for various pharmacotherapeutic regimens in the management of hypertensive urgencies and emergencies, in terms of the agents' abilities to reach predetermined “safe” goal blood pressures (BPs), and to prevent adverse events. METHODS medline was searched from 1966 to 2001, and the reference lists of all the articles were retrieved and searched for relevant references, and experts in the field were contacted to identify other relevant studies. The Cochrane Library was also searched. Studies that were eligible for inclusion in this review were systematic reviews of randomized control trials (RCTs) and individual RCTs, all-or-none studies, systematic reviews of cohort studies and individual cohort studies, and outcomes research. No language restrictions were used. RESULTS None of the trials included in this review identified an optimal rate of BP lowering in hypertensive emergencies and urgencies. The definitions of hypertensive emergencies and urgencies were not consistent, but emergencies always involved target end-organ damage, and urgencies were without such damage. Measures of outcome were not uniform between studies. The 4 hypertensive emergency and 15 hypertensive urgency studies represented 236 and 1,074 patients, respectively. The evidence indicated a nonsignificant trend toward increased efficacy with urapidil compared to nitroprusside for hypertensive emergencies (number needed to treat [NNT] for urapidil to achieve target BP, 12; 95% confidence interval [95% CI], number of patients needed to harm [NNH], 5 to NNT, 40 compared to nitroprusside). Several medications were efficacious in treating hypertensive urgencies, including: nicardipine (NNT for nicardipine compared to plabebo, 2 in one study [95% CI, 1 to 5] and 1 in another [95% CI, 1 to 1]); lacidipine (NNT, 2; 95% CI, 1 to 8 for lacidipine vs nifedipine) or urapidil (NNT for urapidil compared to enalaprilat and nifedipine, 4; 95% CI, 3 to 6); and nitroprusside and fenoldopam (all patients reached target BP in 2 studies). The studies reported 2 cases of cerebral ischemia secondary to nifedipine. CONCLUSIONS Many effective agents exist for the treatment of hypertensive crises. Because of the lack of large randomized controlled trials, many questions remain unanswered, such as follow-up times and whether any of the studied agents have mortality benefit. PMID:12472930

76 FR 64958 - New Jersey; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-19

...: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: This is a notice of the Presidential declaration of a major disaster for the State of New Jersey (FEMA-4033-DR), dated September 15, 2011, and..., in a letter dated September 15, 2011, the President issued a major disaster declaration under the...

77 FR 37915 - Kansas; Major Disaster Declaration and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... to apply for assistance under the Hazard Mitigation Grant Program. The following Catalog of Federal... Presidential declaration of a major disaster for the State of Kansas (FEMA-4063-DR), dated May 24, 2012, and... have determined that the damage in certain areas of the State of Kansas resulting from severe storms...

The Right to Education in a Globalized World

ERIC Educational Resources Information Center

Lindahl, Ronald

2006-01-01

This article explores the fundamental issues related to education as a human right, particularly in the context of rapid globalization. The 1948 Universal Declaration of Human Rights, the United Nations' 1959 Convention on the Rights of the Child, and the UN International Covenant on Economic, Social, and Cultural Rights all declare education to…

31 CFR 362.1 - Declaration of “valuables”.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Declaration of âvaluablesâ. 362.1 Section 362.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... “valuables” within the meaning of the act. (a) Money of the United States and foreign countries. Currency...

77 FR 68801 - Utah; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. (the ``Stafford Act''), as follows: I... declaration under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq... Grant; 97.048, Disaster Housing Assistance to Individuals and Households in Presidentially Declared...

New European initiatives in colorectal cancer screening: Budapest Declaration. Official appeal during the Hungarian Presidency of the Council of the European Union under the Auspices of the United European Gastroenterology Federation, the European Association for Gastroenterology and Endoscopy and the Hungarian Society of Gastroenterology.

PubMed

Wittmann, Tibor; Stockbrugger, Reinhold; Herszényi, László; Jonkers, Daisy; Molnár, Béla; Saurin, Jean-Christophe; Regula, Jaroslaw; Malesci, Alberto; Laghi, Luigi; Pintér, Tamás; Teleky, Béla; Dítě, Petr; Tulassay, Zsolt

2012-01-01

Colorectal cancer (CRC) is the second most common newly diagnosed cancer and the second most common cause of death in the European Union (EU). CRC is an enormous health and economic burden. Early detection and prevention have the possibility of reducing this burden significantly. Many cancer-associated deaths can be avoided through early detection by high-quality colorectal screening programs followed by appropriate treatment. Under the auspices of the United European Gastroenterology Federation (UEGF), the European Association for Gastroenterology and Endoscopy, the Hungarian Society of Gastroenterology and the Hungarian College of Gastroenterology, the 'Budapest Declaration' (2011) was an accepted official scientific program during the Hungarian Presidency of the Council of the European Union. The Budapest Declaration follows the Munich Declaration (2001), the Brussels Declaration (2007), the Transatlantic Declaration (2009), the Barcelona Declaration (2010), the written declaration of CRC screening, a joint initiative with European Parliamentarians coordinated by the UEGF, and finally, the 'European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis'. The 'Budapest Declaration' together with previous declarations aims to urge the national and supranational healthcare decision makers to launch new Europe-wide initiatives to establish high-quality CRC programs to achieve optimal efficiency in CRC screening. In case of implementation of the proposals, actions and conditions recommended, we can achieve that one of the basic principles of the EU - the chance of equal access - be realized in member states with respect to the prevention of CRC and reduction of cancer-related mortality. To better achieve this goal, we propose to establish an UEGF joint committee, with one participant representing each EU member state to coordinate and supervise the implementation of CRC screening. Copyright © 2012 S. Karger AG, Basel.

RESPECT, ENGAGEMENT, RESPONSIBILITY.

ERIC Educational Resources Information Center

HOWE, HAROLD, II

THIS ADDRESS STRESSES THE URGENCY OF INVOLVING PARENTS, COMMUNITIES, TEACHERS, AND STUDENTS IN THE POWER STRUCTURE OF THE SCHOOLS. THESE GROUPS MUST NOW BE ACTIVELY INCLUDED IN DECISION MAKING AND IN THE CONTROL OF THEIR ENVIRONMENTS. AMONG THE ISSUES DISCUSSED IN RELATION TO THE POWER STRUGGLE ARE THE COMPATABILITY OF THE GOALS OF RACIAL…

Fun & Fitness with Balloons

ERIC Educational Resources Information Center

Farrell, Anne; Faigenbaum, Avery; Radler, Tracy

2010-01-01

The urgency to improve fitness levels and decrease the rate of childhood obesity has been at the forefront of physical education philosophy and praxis. Few would dispute that school-age youth need to participate regularly in physical activities that enhance and maintain both skill- and health-related physical fitness. Regular physical activity…

Pedagogical Conditions of Interethnic Relations Correction in Educational Environment

ERIC Educational Resources Information Center

Shibankova, Lyutsia A.; Dolganovskaya, Natalia V.; Ishmuradova, Alfiya M.; Matveeva, Elena S.; Vlasova, Tatiana; Chistyakov, Alexey A.

2016-01-01

The research urgency is conditioned by the strengthening of the role of educational institutions in the process of interaction between representatives of different cultures and religions, by the creation of favorable socio-psychological climate. Within the study of the educational environment, the authors identify its properties, conditioning the…

Relations Between Trait Impulsivity, Behavioral Impulsivity, Physiological Arousal, and Risky Sexual Behavior among Young Men

PubMed Central

Derefinko, Karen J.; Peters, Jessica R.; Eisenlohr-Moul, Tory A.; Walsh, Erin C.; Adams, Zachary W.; Lynam, Donald R.

2014-01-01

The current study examined how impulsivity-related traits (negative urgency, sensation seeking, and positive urgency), behavioral measures of risk taking and reward seeking, and physiological reactivity related to three different risky sexual behaviors in sexually active undergraduate men (N = 135). Regression analyses indicated that sensation seeking and behavioral risk-taking predicted unique variance in number of sexual partners. These findings suggest that, for young men, acquisition of new partners is associated with need for excitement and reward and willingness to take risks to meet those needs. Sensation seeking, behavioral risk-taking, and skin conductance reactivity to arousing stimuli was related to ever having engaged in sex with a stranger, indicating that, for men, willingness to have sex with a stranger is related not only to the need for excitement and risk-taking but also with innate responsiveness to arousing environmental triggers. In contrast, regression analyses indicated that young men who were impulsive in the context of negative emotions were less likely to use condoms, suggesting that emotion-based impulsivity may be an important factor in negligent prophylactic use. This study adds to the current understanding of the divergence between the correlates of risky sexual behaviors and may lend utility to the development of individualized HIV prevention programming. PMID:24958252

Impulsivity and temporal frame: Reducing frequency of snacking by highlighting immediate health benefits.

PubMed

Pavey, Louisa; Churchill, Sue

2017-08-01

The current study aimed to examine the effect of giving temporally framed health information regarding either the immediate or long-term health consequences of consuming high-calorie snacks, for people with high Negative Urgency (a dimension of impulsivity), and for those primed with impulsivity. We expected that for participants with high Negative Urgency, and those primed with impulsivity, information which detailed the immediate health benefits of avoiding snack consumption would be more effective than information which detailed long-term health benefits. Participants (N=110) completed a measure of Negative Urgency, reported their snacking frequency over the previous seven days, and completed either an impulsivity or neutral prime task. Following this, they read information detailing either the immediate or long-term health benefits of avoiding high-calorie snacks. High-calorie snack consumption was reported 7days later. The results showed a significant three-way interaction between Negative Urgency, prime task, and temporal frame. Participants who were primed with impulsivity and those high in Negative Urgency showed a greater reduction in snacking frequency after being given information about the immediate vs. long-term health benefits of snacking. The results suggest that the immediacy of health consequences should be considered when designing health information to reduce impulsive snacking behaviour. Copyright © 2017. Published by Elsevier Ltd.

[Hypertensive crisis: urgency and hypertensive emergency].

PubMed

Sobrino Martínez, Javier; Doménech Feria-Carot, Mónica; Morales Salinas, Alberto; Coca Payeras, Antonia

2016-11-18

Hypertensive crises lumped several clinical situations with different seriousness and prognosis. The differences between hypertensive urgency and hypertensive emergency depends on if this situation involves a vital risk for the patient. This risk is defined more by the severity of the organ damage than for the higher values of blood pressure. The hypertensive urgency not involves an immediately risk for the patient, for these reason, the treatment can be completed after discharged. Otherwise, the hypertensive emergency is a critical clinical condition that requires hospital assistance. Faced with a patient, with severe hypertension, asymptomatic or with unspecific symptoms we must be careful. First, we need to confirm the values of blood pressure, with several measures of blood pressure and investigate and treat factors, which triggered this situation. The objective of medical treatment for hypertensive urgency is to reduce blood pressure values (at least 20% of baseline values) but to avoid sudden reduction of these values. In hypertensive urgencies rapid acting drug should not be used because of the risk of ischemic stroke and use drugs with longer half-life. The cardiovascular risk of these patients is higher than that do not suffer hypertensive crisis. The treatment must be personalized in each hypertensive emergency and intravenous it’s the best route to treat these patients.

Overactive bladder (OAB): A symptom in search of a disease - Its relationship to specific lower urinary tract symptoms and conditions.

PubMed

Van Batavia, Jason P; Combs, Andrew J; Fast, Angela M; Glassberg, Kenneth I

2017-06-01

The ICCS defines OAB by the subjective symptom of urgency; detrusor overactivity (DO) is only implied. While no other symptom is required, OAB can also be associated with urinary frequency, decreased functional bladder capacity, and incontinence. We sought to determine how often these associated findings occur in OAB and what if any uroflow/EMG-defined conditions are found to be associated with it. The charts of 548 children (231M, 318F; mean age 9.0 years, range 3-20) who presented sequentially with urgency (OAB), over a period of 2 years, were reviewed paying particular attention to whether or not there was a history of frequency and/or daytime incontinence in addition to the urgency. All patients had been previously diagnosed with one of the following four lower urinary tract (LUT) conditions based on specific uroflow/EMG findings: 1. dysfunctional voiding (DV; active pelvic floor EMG during voiding); 2. idiopathic detrusor overactivity disorder (IDOD; OAB with a short EMG lag time (<2 s), and quiet pelvic floor EMG during voiding); 3. detrusor underutilization disorder (DUD; willful infrequent voiding with %EBC >125%, quiet EMG during voiding); and 4. primary bladder neck dysfunction (PBND; prolonged EMG lag time (>6 s), quiet EMG during voiding, and depressed uroflow curve). Mean %EBC was compared between patients with urgency alone and those with urgency plus other symptoms. Any association with gender was analyzed. Urgency was accompanied by either frequency or daytime incontinence in 91% of the children (summary Table). Daytime incontinence was reported in 398 (72.6%) and frequency in 268 (48.9%). Mean %EBC was 80.9. Females were more likely to report daytime incontinence (76.7% vs. 66.7%, p = 0.02) and frequency was found more often in males (63.6% vs. 38.1%, p < 0.001). %EBC was less in males (70.0 vs. 88.8, p < 0.001). The majority of patients with urgency were diagnosed with IDOD (62%), while 15% had DV, 5% PBND, 3% DUD, and in 15%, the uroflow/EMG was not diagnostic. %EBC was usually normal or mildly increased in OAB when urgency is the only symptom but significantly decreases with each additional LUTS. OAB is more common in girls and they tend to have a lower incidence of frequency, more incontinence, and >%EBC than boys. Because urgency in an anatomically and neurologically normal child is the only required criterion for diagnosing OAB, it must be realized that OAB can be associated with any of a number of objectively defined LUT conditions. Thus OAB appears to be a symptom, not a condition, that is often associated with other symptoms. Copyright © 2017. Published by Elsevier Ltd.

Saul: Towards Declarative Learning Based Programming

PubMed Central

Kordjamshidi, Parisa; Roth, Dan; Wu, Hao

2015-01-01

We present Saul, a new probabilistic programming language designed to address some of the shortcomings of programming languages that aim at advancing and simplifying the development of AI systems. Such languages need to interact with messy, naturally occurring data, to allow a programmer to specify what needs to be done at an appropriate level of abstraction rather than at the data level, to be developed on a solid theory that supports moving to and reasoning at this level of abstraction and, finally, to support flexible integration of these learning and inference models within an application program. Saul is an object-functional programming language written in Scala that facilitates these by (1) allowing a programmer to learn, name and manipulate named abstractions over relational data; (2) supporting seamless incorporation of trainable (probabilistic or discriminative) components into the program, and (3) providing a level of inference over trainable models to support composition and make decisions that respect domain and application constraints. Saul is developed over a declaratively defined relational data model, can use piecewise learned factor graphs with declaratively specified learning and inference objectives, and it supports inference over probabilistic models augmented with declarative knowledge-based constraints. We describe the key constructs of Saul and exemplify its use in developing applications that require relational feature engineering and structured output prediction. PMID:26635465

Saul: Towards Declarative Learning Based Programming.

PubMed

Kordjamshidi, Parisa; Roth, Dan; Wu, Hao

2015-07-01

We present Saul , a new probabilistic programming language designed to address some of the shortcomings of programming languages that aim at advancing and simplifying the development of AI systems. Such languages need to interact with messy, naturally occurring data, to allow a programmer to specify what needs to be done at an appropriate level of abstraction rather than at the data level, to be developed on a solid theory that supports moving to and reasoning at this level of abstraction and, finally, to support flexible integration of these learning and inference models within an application program. Saul is an object-functional programming language written in Scala that facilitates these by (1) allowing a programmer to learn, name and manipulate named abstractions over relational data; (2) supporting seamless incorporation of trainable (probabilistic or discriminative) components into the program, and (3) providing a level of inference over trainable models to support composition and make decisions that respect domain and application constraints. Saul is developed over a declaratively defined relational data model, can use piecewise learned factor graphs with declaratively specified learning and inference objectives, and it supports inference over probabilistic models augmented with declarative knowledge-based constraints. We describe the key constructs of Saul and exemplify its use in developing applications that require relational feature engineering and structured output prediction.

Developmental Course of Impulsivity and Capability from Age 10 to Age 25 as Related to Trajectory of Suicide Attempt in a Community Cohort

ERIC Educational Resources Information Center

Kasen, Stephanie; Cohen, Patricia; Chen, Henian

2011-01-01

Hierarchical linear models were used to examine trajectories of impulsivity and capability between ages 10 and 25 in relation to suicide attempt in 770 youths followed longitudinally: intercepts were set at age 17. The impulsivity measure assessed features of urgency (e.g., poor control, quick provocation, and disregard for external constraints);…

15 CFR Supplement No. 2 to Part 714 - Deadlines for Submission of Schedule 3 Declarations, Reports, and Amendments

Code of Federal Regulations, 2010 CFR

2010-01-01

... Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS Pt. 714, Supp. 2... Schedule 3 chemical exceeded the declaration threshold in § 714.1(a)(1)(i) of the CWCR. Annual Report on...

15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

Code of Federal Regulations, 2013 CFR

2013-01-01

...) You plan to increase the production, processing, or consumption of a Schedule 2 chemical by a plant... production, processing, or consumption of a Schedule 2 chemical by a declared plant site by 20 percent or... multipurpose activities; (v) Changes to the plant site's status relating to domestic transfer of the chemical...

15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

Code of Federal Regulations, 2014 CFR

2014-01-01

...) You plan to increase the production, processing, or consumption of a Schedule 2 chemical by a plant... production, processing, or consumption of a Schedule 2 chemical by a declared plant site by 20 percent or... multipurpose activities; (v) Changes to the plant site's status relating to domestic transfer of the chemical...

15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

Code of Federal Regulations, 2012 CFR

2012-01-01

...) You plan to increase the production, processing, or consumption of a Schedule 2 chemical by a plant... production, processing, or consumption of a Schedule 2 chemical by a declared plant site by 20 percent or... multipurpose activities; (v) Changes to the plant site's status relating to domestic transfer of the chemical...

The Universal Declaration of Human Rights

ERIC Educational Resources Information Center

Landorf, Hilary

2012-01-01

A study of human rights prepares students for their role as global citizens and their study of practices in the world's countries that relate to the rights of human beings. Today, when one talks of human rights it is usually with reference to the 1948 Universal Declaration of Human Rights (UDHR). It is the task of teachers to give students the…

15 CFR 758.1 - The Shipper's Export Declaration (SED) or Automated Export System (AES) record.

Code of Federal Regulations, 2010 CFR

2010-01-01

... that relate to EAR License Exceptions: (1) License Exception Baggage (BAG), as set forth in § 740.14 of.... See 15 CFR 30.53 of the FTSR; (5) License Exception Technology and Software Under Restriction (TSR... entered on the loading document (e.g., Cargo Declaration, manifest, bill of lading, (master) air waybill...

15 CFR 758.1 - The Shipper's Export Declaration (SED) or Automated Export System (AES) record.

Code of Federal Regulations, 2011 CFR

2011-01-01

... that relate to EAR License Exceptions: (1) License Exception Baggage (BAG), as set forth in § 740.14 of.... See 15 CFR 30.53 of the FTSR; (5) License Exception Technology and Software Under Restriction (TSR... entered on the loading document (e.g., Cargo Declaration, manifest, bill of lading, (master) air waybill...

Examining the role of emotion in suicidality: negative urgency as an amplifier of the relationship between components of the interpersonal-psychological theory of suicidal behavior and lifetime number of suicide attempts.

PubMed

Anestis, Michael D; Joiner, Thomas E

2011-03-01

Joiner's (2005) interpersonal-psychological theory of suicidal behavior posits that an individual must exhibit elevations on three variables--perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide--in order to enact lethal self-harm. Thus far, however, no research has examined the role of emotion in this process or whether the interaction of these three variables is more problematic for certain populations than for others. We sought to address these voids by examining the role of negative urgency as an amplifier of the relationship between the components of the theory and lifetime number of suicide attempts. Results indicated that the four-way interaction of negative urgency and the three components of the theory predicted lifetime number of suicide attempts, controlling for depression symptoms and sex. Additionally, the three-way interaction of the theory components significantly predicted lifetime number of suicide attempts in the full sample. Furthermore, for individuals with negative urgency scores at or above the median, the three-way interaction of the theory components significantly predicted lifetime number of suicide attempts whereas, for individuals with negative urgency scores below the median, the interaction was non-significant. These findings indicate that, although elevations on the three components of the theory may be dangerous for anyone, this is particularly true for individuals exhibiting high levels of negative urgency, as they might be more likely to quickly develop suicidal ideation and resort to painful self-harming behaviors while experiencing negative affective states. Copyright © 2010 Elsevier B.V. All rights reserved.

Impact of convenience void in a bladder diary with urinary perception grade to assess overactive bladder symptoms: a community-based study.

PubMed

Honjo, Hisashi; Kawauchi, Akihiro; Nakao, Masahiro; Ukimura, Osamu; Kitakoji, Hiroshi; Miki, Tsuneharu

2010-09-01

Bladder diaries including bladder perception grade were analyzed to assess convenience void (CV) in community-dwelling women 40 years of age or older. A total of 310 women completed a 3-day bladder diary with a grade for bladder perception. The grade was defined on scores 0-5 as follows: 0 = No bladder sensation, 1 = Sensation of bladder filling without desire to void, 2 = Desire to void, 3 = Strong desire to void, 4 = Urgency without urge urinary incontinence (UUI), and 5 = Urge incontinence episode. CV was defined as void without desire to void: when the grade was 0, CV in a narrow sense, and when 0 or 1, CV in a broad sense. The incidence of CV in the broad sense significantly decreased with age. Of the 310 women, 48 (15.5%) had overactive bladder (OAB) symptoms on the medical interview, including 37 (11.9%) without UUI (OAB-Dry) and 11 (3.5%) with UUI (OAB-Wet). Of the remaining 262 women, 111 (35.8%), who had urgency but a urinary frequency of 7 or less, and another 141 (48.7%) were classified into the Normal with Urgency and Normal without Urgency groups, respectively. The incidence of CV in a broad sense in the Normal without Urgency group was significantly greater than that in the Normal with Urgency and OAB-Wet groups. The mean voided volumes of CV in the broad sense in the OAB-Wet group were significantly smaller than those in the other three groups. The evaluation of CV may be a new tool in assessing storage condition and voiding dysfunction. © 2010 Wiley-Liss, Inc.

The female urinary microbiome in urgency urinary incontinence.

PubMed

Pearce, Meghan M; Zilliox, Michael J; Rosenfeld, Amy B; Thomas-White, Krystal J; Richter, Holly E; Nager, Charles W; Visco, Anthony G; Nygaard, Ingrid E; Barber, Matthew D; Schaffer, Joseph; Moalli, Pamela; Sung, Vivian W; Smith, Ariana L; Rogers, Rebecca; Nolen, Tracy L; Wallace, Dennis; Meikle, Susan F; Gai, Xiaowu; Wolfe, Alan J; Brubaker, Linda

2015-09-01

The purpose of this study was to characterize the urinary microbiota in women who are planning treatment for urgency urinary incontinence and to describe clinical associations with urinary symptoms, urinary tract infection, and treatment outcomes. Catheterized urine samples were collected from multisite randomized trial participants who had no clinical evidence of urinary tract infection; 16S ribosomal RNA gene sequencing was used to dichotomize participants as either DNA sequence-positive or sequence-negative. Associations with demographics, urinary symptoms, urinary tract infection risk, and treatment outcomes were determined. In sequence-positive samples, microbiotas were characterized on the basis of their dominant microorganisms. More than one-half (51.1%; 93/182) of the participants' urine samples were sequence-positive. Sequence-positive participants were younger (55.8 vs 61.3 years old; P = .0007), had a higher body mass index (33.7 vs 30.1 kg/m(2); P = .0009), had a higher mean baseline daily urgency urinary incontinence episodes (5.7 vs 4.2 episodes; P < .0001), responded better to treatment (decrease in urgency urinary incontinence episodes, -4.4 vs -3.3; P = .0013), and were less likely to experience urinary tract infection (9% vs 27%; P = .0011). In sequence-positive samples, 8 major bacterial clusters were identified; 7 clusters were dominated not only by a single genus, most commonly Lactobacillus (45%) or Gardnerella (17%), but also by other taxa (25%). The remaining cluster had no dominant genus (13%). DNA sequencing confirmed urinary bacterial DNA in many women with urgency urinary incontinence who had no signs of infection. Sequence status was associated with baseline urgency urinary incontinence episodes, treatment response, and posttreatment urinary tract infection risk. Copyright © 2015 Elsevier Inc. All rights reserved.

47 CFR 80.369 - Distress, urgency, safety, call and reply frequencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... assignable to maritime stations for distress, urgency, safety, call and reply radiotelephony communications... by Alaska private fixed stations for calling and listening, but only for establishing communication... public coast stations for call and reply communications. The paired ship frequencies are available for...

Emotionally Up and Down, Behaviorally To and Fro: Drinking Motives Mediate the Synergistic Effects of Urgency and Emotional Instability on Alcohol Outcomes.

PubMed

Dvorak, Robert D; Kuvaas, Nicholas J; Lamis, Dorian A; Pearson, Matthew R; Stevenson, Brittany L

2015-01-01

Emotional and behavioral regulation has been linked to coping and enhancement motives and associated with different patterns of alcohol use and problems. The current studies examined emotional instability, urgency, and internal drinking motives as predictors of alcohol dependence symptoms as well as the likelihood and severity of Diagnostic and Statistical Manual of Mental Disorders-5th editionAlcohol Use Disorder (AUD). In Study 1, college drinkers (n = 621) completed alcohol involvement and behavioral/emotional functioning assessments. There was an indirect association between emotional instability and dependence symptoms via both coping and enhancement drinking motives which was potentiated by trait urgency. In Study 2, college drinkers (n = 510) completed alcohol involvement, behavioral/emotional functioning, and AUD criteria assessments. A significant indirect effect from emotional instability to the likelihood of meeting AUD criteria, via drinking to cope was found, again potentiated by urgency. © The Author(s) 2016.

Mediation-moderation analysis of problematic alcohol use: the roles of urgency, drinking motives, and risk/benefit perception.

PubMed

Coskunpinar, Ayca; Cyders, Melissa A

2012-07-01

The goal of the current study is to examine how urgency, drinking motives, and risk/benefit perception concurrently influence problematic alcohol consumption in young adults. Participants were 281 young adults enrolled in large, public US mid-western university. The mean age of the sample was 19.81 (SD=1.82) and 79.7% of the sample was female and 84.7% of the sample was Caucasian. A series of moderated-mediation analyses indicated the following: The relationship between negative urgency and alcohol use was mediated through coping motives, and this relationship between coping motives and alcohol use was moderated by benefit perception. The relationship between positive urgency and alcohol use was mediated through enhancement motives, and this relationship between enhancement motives and alcohol use was moderated by benefit perception. This study suggests that modifying perceptions about the benefits of alcohol and drinking motives could be viable prevention and/or treatment strategy in this population, especially among those who exhibit urgent behaviors. Published by Elsevier Ltd.

Epidural steroid injections in the management of a patient with spinal stenosis and urinary urgency.

PubMed

Mitra, Raj; Huang, Lawrence; Payne, Christopher

2009-02-01

A 79-year-old woman with a history of chronic back pain and urinary urgency presented to a spine center for treatment and evaluation for axial low back pain. The patient described the back pain as severe with intermittent radiation into the right leg; her pain intensity was 7 out of 10 on a visual analog scale. She described her sense of urgency as severe, and could delay urination for 10 min or less. She described her bladder control as 6 out of 10 on the urgency perception score (with 0 being perfect control). Physical examination, including manual muscle testing, test for sensation to fine touch, reflex assessment and assessment of gait pattern, and MRI of the lumbar spine. Overactive bladder associated with severe central-canal stenosis at L4-5, in the setting of anterolisthesis. Fluoroscopically guided caudal epidural steroid injection; 60 mg of triamcinolone, 3 ml of 1% lidocaine hydrochloride and 3 ml of normal saline, injected in increments.

Êtes-vous prêt pour un code bleu en cabinet?

PubMed Central

Moore, Simon

2015-01-01

Résumé Problème traité Les urgences médicales sont fréquentes dans le cabinet des médecins de famille, mais nombreux sont ceux qui ne sont pas préparés à répondre aux urgences. Une vidéo éducative en ligne traitant des urgences en cabinet pourrait améliorer la réponse des médecins et de leur personnel aux urgences. Un outil comme celui-là n’a jamais été décrit auparavant. Objectif du programme Utiliser les pratiques fondées sur les données probantes pour produire une vidéo éducative expliquant comment se préparer à parer à une urgence dans un cabinet médical, disséminer la vidéo en ligne et évaluer l’attitude des médecins et de leur personnel à l’égard de la vidéo. Description du programme Une vidéo de 6 minutes a été produite en s’appuyant sur une revue de la littérature récente et des politiques des organismes réglementaires canadiens. La vidéo décrit l’équipement d’urgence recommandé, l’amélioration de la réponse à l’urgence et la formation du personnel en cabinet. Les médecins et leur personnel ont été invités à visualiser la vidéo en ligne à www.OfficeEmergencies.ca. L’opinion de l’auditoire sur le format de la vidéo et son contenu a été évaluée par l’entremise d’un sondage (N = 275). Conclusion Les résultats du sondage indiquent que la vidéo était pertinente et bien présentée, et le format en ligne était pratique et satisfaisant. Les participants s’inscriraient à d’autres formations ayant recours à cette technologie et étaient d’accord pour dire que ce programme améliorerait les soins aux patients.

Two types of urgency.

PubMed

Blaivas, Jerry G; Panagopoulos, Georgia; Weiss, Jeffrey P; Somaroo, Chandra

2009-01-01

To determine whether urinary urgency, as defined by the International Continence Society, is an intensification of the normal sensation that occurs when micturition must be delayed once the urge to void is felt (Type 1 urgency) or a discrete, pathologic symptom different from the normal urge (Type 2 urgency). Forty-eight consecutive patients who complained of urinary urgency completed two different questionnaires designed to answer the question posed above. The patients were divided into two groups of 24. For the test-retest, group 1 completed questionnaire 1 twice within 3-10 days and group 2 did the same with questionnaire 2. On the second administration of the questionnaire, each subject crossed over and answered the other questionnaire. For the test-retest, since the data set is dichotomous (yes/no), the degree of agreement between the two sets of data was assessed by calculating the kappa coefficient. There were 37 women and 11 men ranging in age from 54 to 87 years. There was no difference in age and sex between the two groups (P = 0.19). There was excellent agreement in the test-retest responses for both questionnaires (kappa = 1.0, P < 0.001). For questionnaire 1, the urge sensation was an intensification of the normal sensation in 33 (68.8%) and it was a different sensation in 15 (31.3%). Similarly, for questionnaire 2, it was an intensification of the normal urge in 34 (70.8%) and different in 14 (29.2%). The differences in patient responses between the two groups were not significant. In the crossover section, only 1 of 48 subjects changed their response, resulting in a very high degree of agreement (kappa = .95, p < .001). Combining the two groups, urgency was perceived as an intensification of the normal urge to void in 33/48 patients (69%), a different sensation in 14/48 (29%) and 1/48 (2%) was not sure. Urgency is comprised of at least two different sensations. One is an intensification of the normal urge to void and the other is a different sensation. The implications of this distinction are important insofar as they may have different etiologies and respond differently to treatment.

A Population-based Survey of the Prevalence, Potential Risk Factors, and Symptom-specific Bother of Lower Urinary Tract Symptoms in Adult Chinese Women.

PubMed

Zhang, Lei; Zhu, Lan; Xu, Tao; Lang, Jinghe; Li, Zhaoai; Gong, Jian; Liu, Qing; Liu, Xiaochun

2015-07-01

Epidemiological studies of lower urinary tract symptoms (LUTS) are few in China, and none has been conducted nationwide. To estimate the prevalence and potential risk factors of LUTS and the bother they impose on adult women in China. This is the second analysis of a population-based cross-sectional survey on urinary incontinence conducted between February and July 2006 in six regions of China. Cluster samples were randomly selected for interviews. No intervention was implemented. A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. The participants were asked about the presence of individual LUTS and rated their symptom bother. Descriptive statistics, χ(2) tests, receiver operating characteristic curves, and multivariate logistic regressions were used for data analysis. A total of 18 992 respondents (94.96%) were included. The prevalence of any LUTS, storage symptoms, or voiding symptoms was 55.5%, 53.9%, and 12.9%, respectively, and increased with age. Nocturia was the most common symptom (23.4%), followed by urgency (23.3%) and stress urinary incontinence (SUI; 18.9%). Nocturia was most frequently rated as bothersome (93.0%) but was generally minor (80.5%). Urgency and urgency urinary incontinence (UUI) were most frequently reported as severe (11.5% and 10.8%) or moderate (18.5% and 16.8%) bothers. Any LUTS were more prevalent in urban women (57.1% vs 53.9%). Multiple factors increased the odds of bother and individual LUTS, and older age and coexisting pelvic organ prolapse were strong predictors (p<0.05). This survey was conducted 8 yr ago and did not assess all LUTS. Half of adult women suffered with LUTS; nocturia, urgency, and SUI were more prevalent. Urgency and UUI were most frequently reported as severe or moderate bothers. Multiple factors influenced bother and individual LUTS. The prevalence of lower urinary tract symptoms is high and increases with age in adult women in China. Urgency and urgency urinary incontinence were most frequently regarded as severe or moderate bothers and should be targeted for medical intervention. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Event-related potential correlates of declarative and non-declarative sequence knowledge.

PubMed

Ferdinand, Nicola K; Rünger, Dennis; Frensch, Peter A; Mecklinger, Axel

2010-07-01

The goal of the present study was to demonstrate that declarative and non-declarative knowledge acquired in an incidental sequence learning task contributes differentially to memory retrieval and leads to dissociable ERP signatures in a recognition memory task. For this purpose, participants performed a sequence learning task and were classified as verbalizers, partial verbalizers, or nonverbalizers according to their ability to verbally report the systematic response sequence. Thereafter, ERPs were recorded in a recognition memory task time-locked to sequence triplets that were either part of the previously learned sequence or not. Although all three groups executed old sequence triplets faster than new triplets in the recognition memory task, qualitatively distinct ERP patterns were found for participants with and without reportable knowledge. Verbalizers and, to a lesser extent, partial verbalizers showed an ERP correlate of recollection for parts of the incidentally learned sequence. In contrast, nonverbalizers showed a different ERP effect with a reverse polarity that might reflect priming. This indicates that an ensemble of qualitatively different processes is at work when declarative and non-declarative sequence knowledge is retrieved. By this, our findings favor a multiple-systems view postulating that explicit and implicit learning are supported by different and functionally independent systems. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

The Relative Humidity of the Atmosphere in the Encasements Containing the Declaration of Independence, the US Constitution (Pages 1 and 4), and the Bill of Rights

NASA Technical Reports Server (NTRS)

West, James W.; Burkett, Cecil G.; Levine, Joel S.

2002-01-01

In 1951, the four pages of the US Constitution, the Letter of Transmittal, the Bill of Rights and the Declaration of Independence, collectively called the 'Charters of Freedom,' were hermetically sealed individually in glass encasements. The atmosphere in the encasements consisted of a mixture of helium with water vapor at a relative humidity between 25 and 35% at room temperature. In 1998, Margaret Kelly of the National Archives and Records Administration (NARA), contacted Dr. Joel S. Levine at NASA Langley Research Center (LaRC) to request assistance in determining the chemical composition of the atmosphere inside the encasements. Several different Langley learns were assembled to address that request. each using a different measurement technique. This report describes the method and results of one team's relative humidity measurements on encasements containing pages 1 and 4 of the US Constitution, the Bill of Rights, and the Declaration of Independence performed at NARA, College Park. Maryland, on July 23, 2001.

Declarative memory deficits and schizophrenia: problems and prospects.

PubMed

Stone, William S; Hsi, Xiaolu

2011-11-01

Cognitive deficits are among the most important factors leading to poor functional outcomes in schizophrenia, with deficits in declarative memory among the largest and most robust of these. Thus far, attempts to enhance cognition in schizophrenia have shown only modest success, which underlies increasing efforts to develop effective treatment strategies. This review is divided into three main parts. The first section delineates the nature and extent of the deficits in both patients with schizophrenia and in their adult, non-psychotic relatives. The second part focuses on structural and functional abnormalities in the hippocampus, both in people with schizophrenia and in animal studies that model relevant features of the illness. The third section views problems in declarative memory and hippocampal function from the perspective of elevated rates of common medical disorders in schizophrenia, with a focus on insulin insensitivity/diabetes. The likelihood that poor glucose regulation/availability contribute to declarative memory deficits and hippocampal abnormalities is considered, along with the possibility that schizophrenia and poor glucose regulation share common etiologic elements, and with clinical implications of this perspective for enhancing declarative memory. Copyright © 2011 Elsevier Inc. All rights reserved.

Another Look at Impulsivity: A Meta- Analytic Review Comparing Specific Dispositions to Rash Action in their Relationship to Bulimic Symptoms

PubMed Central

Fischer, Sarah; Smith, Gregory T.; Cyders, Melissa A.

2008-01-01

Recent advances in personality theory indicate that there are distinct constructs that dispose individuals to rash action and risky behavior, as opposed to one broad trait of impulsivity. Two are emotion based, two represent deficits in conscientiousness, and one is sensation seeking. Previous studies of impulsivity and its relationship to bulimia nervosa have yielded mixed findings. The authors applied this advance in personality theory to the study of bulimia nervosa (BN) to test the hypothesis that the emotion-based disposition of negative urgency (the tendency to act rashly when distressed) relates most strongly to BN symptoms. A meta analysis of 50 articles indicated the following. Negative urgency had by far the largest effect size (weighted r = .38), followed by sensation seeking (weighted r = .16); lack of planning (weighted r = .16) and lack of persistence (weighted r = .08). Methodological moderators of the effect of distinct traits on BN symptoms were the use of scales that precisely measured one construct as opposed to general impulsivity scales that measured several constructs, clinical vs. non-clinical samples, and whether or not the personality scale was translated from its original language or not. Negative urgency appears especially important for BN; more broadly, researchers should consider the role of emotion-based dispositions to rash acts in their risk theories. PMID:18848741

Another look at impulsivity: a meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms.

PubMed

Fischer, Sarah; Smith, Gregory T; Cyders, Melissa A

2008-12-01

Recent advances in personality theory indicate that there are distinct constructs that dispose individuals to rash action and risky behavior, as opposed to one broad trait of impulsivity. Two are emotion based, two represent deficits in conscientiousness, and one is sensation seeking. Previous studies of impulsivity and its relationship to bulimia nervosa have yielded mixed findings. The authors applied this advance in personality theory to the study of bulimia nervosa (BN) to test the hypothesis that the emotion-based disposition of negative urgency (the tendency to act rashly when distressed) relates most strongly to BN symptoms. A meta-analysis of 50 articles indicated the following. Negative urgency had by far the largest effect size (weighted r=.38), followed by sensation seeking (weighted r=.16); lack of planning (weighted r=.16) and lack of persistence (weighted r=.08). Methodological moderators of the effect of distinct traits on BN symptoms were the use of scales that precisely measured one construct as opposed to general impulsivity scales that measured several constructs, clinical vs. non-clinical samples, and whether or not the personality scale was translated from its original language or not. Negative urgency appears especially important for BN; more broadly, researchers should consider the role of emotion-based dispositions to rash acts in their risk theories.

Integrating Global Poverty into Mainstream Business Classrooms

ERIC Educational Resources Information Center

Paton, Bruce; Harris-Boundy, Jason; Melhus, Peter

2012-01-01

Most of the products and services discussed in business curricula serve a small portion of humanity. But the great majority of economic growth over the next few decades is expected to occur in emerging and frontier markets. This emerging reality increases the urgency for including topics related to global poverty, unmet human needs, and emergence…

Turning around Maple Shade Middle School: A Principal's Initial Reform Efforts

ERIC Educational Resources Information Center

Salmonowicz, Michael J.; Levy, Melissa K.

2009-01-01

This case was written for use in courses dealing with school administration, specifically those related to organizational change, school improvement/turnaround, and the principalship. It explores a veteran principal's first year as a "turnaround specialist" in a low-performing middle school, where she works with a sense of urgency to achieve an…

44 CFR 59.23 - Priorities for the sale of flood insurance under the regular program.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-related erosion prone communities are placed on a register of areas eligible for ratemaking studies and then selected from this register for ratemaking studies on the basis of the following considerations— (a) Recommendations of State officials; (b) Location of community and urgency of need for flood...

44 CFR 59.23 - Priorities for the sale of flood insurance under the regular program.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-related erosion prone communities are placed on a register of areas eligible for ratemaking studies and then selected from this register for ratemaking studies on the basis of the following considerations— (a) Recommendations of State officials; (b) Location of community and urgency of need for flood...

VOCATIONAL-TECHNICAL TEACHER EDUCATION--NATIONAL SEMINAR PROCEEDINGS (SEPTEMBER 24-29, 1967). LEADERSHIP 15.

ERIC Educational Resources Information Center

VIVIAN, NEAL E.; HOFFMAN, KENNETH E.

APPROXIMATELY 300 TEACHER-EDUCATORS AND NATIONAL LEADERS AND EXPERTS IN EDUCATION AND RELATED DISCIPLINES FROM 46 STATES, TWO TERRITORIES, AND TWO CANADIAN PROVINCES PARTICIPATED IN A SEMINAR TO IDENTIFY ALTERNATIVE APPROACHES FOR IMPROVING PROGRAMS IN PREPARING AND UPGRADING VOCATIONAL TEACHERS. MAJOR SPEECHES INCLUDED--(1) "URGENCY OF THE DEMAND…

Quality Assurance and Qualifications Frameworks: Exchanging Good Practice. ENQA Workshop Report 21

ERIC Educational Resources Information Center

Blomqvist, Carita; Donohoe, Tony; Kelo, Maria; Linde, Karin Jarplid; Llavori, Rafael; Maguire, Bryan; Metz, David; Sanchez, Teresa

2012-01-01

The theme of qualifications frameworks and their relation to quality assurance is gaining urgency in the European scene as more and more countries are completing their national qualifications frameworks and quality assurance agencies need to take important decisions on how to implement them. Some of the key features of the qualifications…

45 CFR 612.5 - Timing of responses to requests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Timing of responses to requests. 612.5 Section 612.5 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION... expected to pose an imminent threat to the life or physical safety of an individual; or (B) An urgency to...

Attachment and physiological reactivity to infant crying in young adulthood: dissociation between experiential and physiological arousal in insecure adoptees.

PubMed

Schoenmaker, Christie; Huffmeijer, Renske; van IJzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; van den Dries, Linda; Linting, Mariëlle; van der Voort, Anja; Juffer, Femmie

2015-02-01

The associations between attachment representations of adopted young adults and their experiential and physiological arousal to infant crying were examined. Attachment representations were assessed with the Attachment Script Assessment (ASA), and the young adults listened to infant cries, during which ratings of cry perception were collected and physiological reactivity was measured. Secure adoptees showed a well-integrated response to infant distress: heart-rate increases and respiratory sinus arrhythmia (RSA) withdrawal were coupled with heightened perception of urgency in these individuals. In insecure adoptees RSA withdrawal was absent, and a combination of lowered perceived urgency and heightened sympathetic arousal was found, reflecting a deactivating style of emotional reactivity. Overall, our findings support the idea that internal working models of attachment explain individual differences in the way attachment-related information is processed. Copyright © 2014 Elsevier Inc. All rights reserved.

Psychological Factors and Alcohol Use in Problematic Mobile Phone Use in the Spanish Population

PubMed Central

De-Sola, José; Talledo, Hernán; Rubio, Gabriel; de Fonseca, Fernando Rodríguez

2017-01-01

This research aims to study the existing relationships among the factors of state anxiety, depression, impulsivity, and alcohol consumption regarding problematic mobile phone use, as assessed by the Mobile Phone Problem Use Scale. The study was conducted among 1,126 participants recruited among the general Spanish population, aged 16–65 years, by assessing the predictive value of these variables regarding this problematic use. Initially tobacco use was also considered being subsequently refused because of the low internal consistency of the scale used. In general terms, the results show that this problematic use is mainly related to state anxiety and impulsivity, through the dimensions of Positive and Negative Urgency. Considering its predictive value, multiple regression analysis reveals that state anxiety, positive and negative urgency, and alcohol consumption may predict problematic mobile phone use, ruling out the influence of depression. PMID:28217101

Psychological Factors and Alcohol Use in Problematic Mobile Phone Use in the Spanish Population.

PubMed

De-Sola, José; Talledo, Hernán; Rubio, Gabriel; de Fonseca, Fernando Rodríguez

2017-01-01

This research aims to study the existing relationships among the factors of state anxiety, depression, impulsivity, and alcohol consumption regarding problematic mobile phone use, as assessed by the Mobile Phone Problem Use Scale. The study was conducted among 1,126 participants recruited among the general Spanish population, aged 16-65 years, by assessing the predictive value of these variables regarding this problematic use. Initially tobacco use was also considered being subsequently refused because of the low internal consistency of the scale used. In general terms, the results show that this problematic use is mainly related to state anxiety and impulsivity, through the dimensions of Positive and Negative Urgency. Considering its predictive value, multiple regression analysis reveals that state anxiety, positive and negative urgency, and alcohol consumption may predict problematic mobile phone use, ruling out the influence of depression.

Transcutaneous tibial nerve stimulation in the treatment of lower urinary tract symptoms and its impact on health-related quality of life in patients with Parkinson disease: a randomized controlled trial.

PubMed

Perissinotto, Maria Carolina; DʼAncona, Carlos Arturo Levi; Lucio, Adélia; Campos, Renata Martins; Abreu, Anelyssa

2015-01-01

A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS). Randomized controlled trial. Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes. Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation. Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group. These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF.

37 CFR 7.36 - Affidavit or declaration of use in commerce or excusable nonuse required to avoid cancellation of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Affidavit or declaration of... the United States. 7.36 Section 7.36 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN FILINGS PURSUANT TO THE PROTOCOL RELATING TO...

Who Will Declare a STEM Major? The Role of Achievement and Interests. ACT Research Report Series 2017-4

ERIC Educational Resources Information Center

Radunzel, Justine; Mattern, Krista; Westrick, Paul

2017-01-01

As new initiatives and programs are being increasingly implemented to promote STEM (Science, Technology, Engineering, and Mathematics) interest and participation among U.S. students, the percentage of students who declare a STEM-related major in college continues to lag behind what would be expected based on students' intentions. Such findings…

Differential effects of non-REM and REM sleep on memory consolidation?

PubMed

Ackermann, Sandra; Rasch, Björn

2014-02-01

Sleep benefits memory consolidation. Previous theoretical accounts have proposed a differential role of slow-wave sleep (SWS), rapid-eye-movement (REM) sleep, and stage N2 sleep for different types of memories. For example the dual process hypothesis proposes that SWS is beneficial for declarative memories, whereas REM sleep is important for consolidation of non-declarative, procedural and emotional memories. In fact, numerous recent studies do provide further support for the crucial role of SWS (or non-REM sleep) in declarative memory consolidation. However, recent evidence for the benefit of REM sleep for non-declarative memories is rather scarce. In contrast, several recent studies have related consolidation of procedural memories (and some also emotional memories) to SWS (or non-REM sleep)-dependent consolidation processes. We will review this recent evidence, and propose future research questions to advance our understanding of the role of different sleep stages for memory consolidation.

Development of an approach to facilitate optimal equipment replacement : technical summary.

DOT National Transportation Integrated Search

1999-10-01

The objective of the study was to determine a way or ways to assign an urgency rating to equipment that was currently in service but in need of replacement. This urgency rating must in some manner took into account the various costs associated with r...

Residents' numeric inputting error in computerized physician order entry prescription.

PubMed

Wu, Xue; Wu, Changxu; Zhang, Kan; Wei, Dong

2016-04-01

Computerized physician order entry (CPOE) system with embedded clinical decision support (CDS) can significantly reduce certain types of prescription error. However, prescription errors still occur. Various factors such as the numeric inputting methods in human computer interaction (HCI) produce different error rates and types, but has received relatively little attention. This study aimed to examine the effects of numeric inputting methods and urgency levels on numeric inputting errors of prescription, as well as categorize the types of errors. Thirty residents participated in four prescribing tasks in which two factors were manipulated: numeric inputting methods (numeric row in the main keyboard vs. numeric keypad) and urgency levels (urgent situation vs. non-urgent situation). Multiple aspects of participants' prescribing behavior were measured in sober prescribing situations. The results revealed that in urgent situations, participants were prone to make mistakes when using the numeric row in the main keyboard. With control of performance in the sober prescribing situation, the effects of the input methods disappeared, and urgency was found to play a significant role in the generalized linear model. Most errors were either omission or substitution types, but the proportion of transposition and intrusion error types were significantly higher than that of the previous research. Among numbers 3, 8, and 9, which were the less common digits used in prescription, the error rate was higher, which was a great risk to patient safety. Urgency played a more important role in CPOE numeric typing error-making than typing skills and typing habits. It was recommended that inputting with the numeric keypad had lower error rates in urgent situation. An alternative design could consider increasing the sensitivity of the keys with lower frequency of occurrence and decimals. To improve the usability of CPOE, numeric keyboard design and error detection could benefit from spatial incidence of errors found in this study. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Declaration of patent applications as financial interests: a survey of practice among authors of papers on molecular biology in Nature.

PubMed

Mayer, S

2006-11-01

To determine whether authors of scientific publications in molecular biology declare patents and other potential financial interests. Survey of a 6-month sample of papers related to molecular biology in Nature. The esp@cenet worldwide patent search engine was used to search for patents applied for by the authors of scientific papers in Nature that were related to molecular biology and genetics, between January and June 2005. Of the 79 papers considered, four had declared that certain authors had competing financial interests. Seven papers in which no financial interests were declared had authors with patent applications that were based on the research in the paper or were closely related to it. Another paper had two authors with connections to biotechnology companies that were not disclosed. Two thirds of the papers in which authors had patent applications or company affiliations that might be considered to be competing financial interests did not disclose them. Failure to disclose such information may have negative implications on the perception of science in society and on its quality if the possible bias is hidden. Journals should make greater efforts to ensure full disclosure, and scientific institutions should consider failure to disclose financial interests as an example of scientific malpractice. Establishing a register of interests for scientists is one way to increase transparency and openness.

Declaration of patent applications as financial interests: a survey of practice among authors of papers on molecular biology in Nature

PubMed Central

Mayer, S

2006-01-01

Objectives To determine whether authors of scientific publications in molecular biology declare patents and other potential financial interests. Design Survey of a 6‐month sample of papers related to molecular biology in Nature. Methods The esp@cenet worldwide patent search engine was used to search for patents applied for by the authors of scientific papers in Nature that were related to molecular biology and genetics, between January and June 2005. Results Of the 79 papers considered, four had declared that certain authors had competing financial interests. Seven papers in which no financial interests were declared had authors with patent applications that were based on the research in the paper or were closely related to it. Another paper had two authors with connections to biotechnology companies that were not disclosed. Conclusion Two thirds of the papers in which authors had patent applications or company affiliations that might be considered to be competing financial interests did not disclose them. Failure to disclose such information may have negative implications on the perception of science in society and on its quality if the possible bias is hidden. Journals should make greater efforts to ensure full disclosure, and scientific institutions should consider failure to disclose financial interests as an example of scientific malpractice. Establishing a register of interests for scientists is one way to increase transparency and openness. PMID:17074824

Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy.

PubMed

Mavroidis, Panayiotis; Pearlstein, Kevin A; Dooley, John; Sun, Jasmine; Saripalli, Srinivas; Das, Shiva K; Wang, Andrew Z; Chen, Ronald C

2018-02-02

To estimate the radiobiological parameters of three popular normal tissue complication probability (NTCP) models, which describe the dose-response relations of bladder regarding different acute urinary symptoms during post-prostatectomy radiotherapy (RT). To evaluate the goodness-of-fit and the correlation of those models with those symptoms. Ninety-three consecutive patients treated from 2010 to 2015 with post-prostatectomy image-guided intensity modulated radiotherapy (IMRT) were included in this study. Patient-reported urinary symptoms were collected pre-RT and weekly during treatment using the validated Prostate Cancer Symptom Indices (PCSI). The assessed symptoms were flow, dysuria, urgency, incontinence, frequency and nocturia using a Likert scale of 1 to 4 or 5. For this analysis, an increase by ≥2 levels in a symptom at any time during treatment compared to baseline was considered clinically significant. The dose volume histograms of the bladder were calculated. The Lyman-Kutcher-Burman (LKB), Relative Seriality (RS) and Logit NTCP models were used to fit the clinical data. The fitting of the different models was assessed through the area under the receiver operating characteristic curve (AUC), Akaike information criterion (AIC) and Odds Ratio methods. For the symptoms of urinary urgency, leakage, frequency and nocturia, the derived LKB model parameters were: 1) D 50  = 64.2Gy, m = 0.50, n = 1.0; 2) D 50  = 95.0Gy, m = 0.45, n = 0.50; 3) D 50  = 83.1Gy, m = 0.56, n = 1.00; and 4) D 50  = 85.4Gy, m = 0.60, n = 1.00, respectively. The AUC values for those symptoms were 0.66, 0.58, 0.64 and 0.64, respectively. The differences in AIC between the different models were less than 2 and ranged within 0.1 and 1.3. Different dose metrics were correlated with the symptoms of urgency, incontinence, frequency and nocturia. The symptoms of urinary flow and dysuria were poorly associated with dose. The values of the parameters of three NTCP models were determined for bladder regarding four acute urinary symptoms. All the models could fit the clinical data equally well. The NTCP predictions of urgency showed the best correlation with the patient reported outcomes.

Hypertensive Crisis: A Review of Pathophysiology and Treatment.

PubMed

Taylor, Deborah A

2015-12-01

Hypertensive crisis presents as hypertensive urgency or hypertensive emergency, the differences being the presence or absence of target organ damage (TOD) and the type of treatment the patient will receive. Patients with hypertensive urgency do not express TOD, which is seen only in hypertensive emergencies and can involve the heart, kidneys, or brain. Recognition of hypertensive crisis at initial assessment is crucial. An important first step is to obtain a full medical and medication history to be used as a guide for treatment. Proper and effective treatment of hypertensive urgency or emergency involves appropriate use of specific agents based on knowledge of any comorbid disease state. Copyright © 2015 Elsevier Inc. All rights reserved.

Math Anxiety and How It Affects High School Students.

ERIC Educational Resources Information Center

Murr, Kathleen A.

2001-01-01

Studies the role that math anxiety played in the poor performance of students, what promoted such feelings, and what teachers can do to lessen this anxiety. Students and adults sense the urgency to understand the mathematical material, and that urgency often leads to anxiety when they cannot arrive at a solution. (ASK)

Evaluating Warning Sound Urgency with Reaction Times

ERIC Educational Resources Information Center

Suied, Clara; Susini, Patrick; McAdams, Stephen

2008-01-01

It is well-established that subjective judgments of perceived urgency of alarm sounds can be affected by acoustic parameters. In this study, the authors investigated an objective measurement, the reaction time (RT), to test the effectiveness of temporal parameters of sounds in the context of warning sounds. Three experiments were performed using a…

Predictors of Urgency of Out-of-Home Placement Needs.

ERIC Educational Resources Information Center

Kobe, Frank H.; And Others

1991-01-01

Interviews with 137 primary caregivers with developmentally disabled family members (ages 2-62) on waiting lists for out-of-home placement found that caregiver stress was a significant predictor of the urgency of placement need. Behavior problems of the disabled person were almost as important. Lack of support services was correlated with…

Gain Modulation by an Urgency Signal Controls the Speed–Accuracy Trade-Off in a Network Model of a Cortical Decision Circuit

PubMed Central

Standage, Dominic; You, Hongzhi; Wang, Da-Hui; Dorris, Michael C.

2011-01-01

The speed–accuracy trade-off (SAT) is ubiquitous in decision tasks. While the neural mechanisms underlying decisions are generally well characterized, the application of decision-theoretic methods to the SAT has been difficult to reconcile with experimental data suggesting that decision thresholds are inflexible. Using a network model of a cortical decision circuit, we demonstrate the SAT in a manner consistent with neural and behavioral data and with mathematical models that optimize speed and accuracy with respect to one another. In simulations of a reaction time task, we modulate the gain of the network with a signal encoding the urgency to respond. As the urgency signal builds up, the network progresses through a series of processing stages supporting noise filtering, integration of evidence, amplification of integrated evidence, and choice selection. Analysis of the network's dynamics formally characterizes this progression. Slower buildup of urgency increases accuracy by slowing down the progression. Faster buildup has the opposite effect. Because the network always progresses through the same stages, decision-selective firing rates are stereotyped at decision time. PMID:21415911

Gain modulation by an urgency signal controls the speed-accuracy trade-off in a network model of a cortical decision circuit.

PubMed

Standage, Dominic; You, Hongzhi; Wang, Da-Hui; Dorris, Michael C

2011-01-01

The speed-accuracy trade-off (SAT) is ubiquitous in decision tasks. While the neural mechanisms underlying decisions are generally well characterized, the application of decision-theoretic methods to the SAT has been difficult to reconcile with experimental data suggesting that decision thresholds are inflexible. Using a network model of a cortical decision circuit, we demonstrate the SAT in a manner consistent with neural and behavioral data and with mathematical models that optimize speed and accuracy with respect to one another. In simulations of a reaction time task, we modulate the gain of the network with a signal encoding the urgency to respond. As the urgency signal builds up, the network progresses through a series of processing stages supporting noise filtering, integration of evidence, amplification of integrated evidence, and choice selection. Analysis of the network's dynamics formally characterizes this progression. Slower buildup of urgency increases accuracy by slowing down the progression. Faster buildup has the opposite effect. Because the network always progresses through the same stages, decision-selective firing rates are stereotyped at decision time.

A urodynamic study of surface neuromodulation versus sham in detrusor instability and sensory urgency.

PubMed

Bower, W F; Moore, K H; Adams, R D; Shepherd, R

1998-12-01

We studied the effect of surface neuromodulation on cystometric pressure and volume parameters in women with detrusor instability or sensory urgency. Electrical current was delivered to the suprapubic region and third sacral foramina via a transcutaneous electrical nerve stimulator with sham neuromodulation control. A consecutive series of women with proved detrusor instability or sensory urgency were randomized to 3 surface neuromodulation groups. Volume and pressure parameters were the main outcomes of transcutaneous electrical nerve stimulation applied during second cystometric fill. Sham transcutaneous electrical nerve stimulation did not alter the outcome measures. However, neuromodulation delivered across the suprapubic and sacral skin effected a reduction in mean maximum height of detrusor contraction. A current which inhibits motor activity was not superior to that which inhibits sensory perception in reducing detrusor pressure. Response in sensory urgency was poor. Results from our sham controlled study suggest that short-term surface neuromodulation via transcutaneous electrical nerve stimulation may have a role in the treatment of detrusor instability. Future studies must examine the clinical effect of long-term surface neuromodulation.

Problematic Drinking Mediates the Association Between Urgency and Intimate Partner Aggression During Acute Intoxication.

PubMed

Subramani, Olivia S; Parrott, Dominic J; Eckhardt, Christopher I

2017-09-01

This study tested a moderated-mediation model whereby dimensions of impulsivity (i.e., negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance) differentially predict perpetration of physical intimate partner aggression (IPA) through problematic drinking in intoxicated and nonintoxicated heavy drinkers. Participants were 249 heavy drinkers (148 men and 101 women) with a recent history of psychological and/or physical IPA perpetration toward their current partner recruited from 2 metropolitan U.S. cities. Participants completed questionnaires that assessed impulsivity and problematic drinking, consumed an Alcohol or No-Alcohol Control beverage, and completed a shock-based aggression task in which they were ostensibly provoked by their intimate partner. Results indicated an indirect effect of urgency on IPA through problematic drinking that was significantly more positive in intoxicated individuals. These findings implicate a tendency to act rashly in response to emotions as the specific dimension of impulsivity associated with problematic drinking, which in turn exacerbates risk for IPA perpetration. Results also suggest acute effects of alcohol are key in facilitating this mechanism. Copyright © 2017 by the Research Society on Alcoholism.

Education of Tolerant Personality of a Future Specialist as the Social-Pedagogical Phenomenon

ERIC Educational Resources Information Center

Kaztaevna, Tokkulinova Gulnar; Omarovna, Assylova Raushan; Askerkhanovna, Tleuzhanova Kuralay; Zhanarbekovna, Burkitbaeva Anar; Erezhepovna, Kazhieva Nurgul

2015-01-01

The article raises the problem of education of tolerance in students as a social and pedagogical phenomenon and stresses the importance and urgency of this problem at the present stage of society development. The author examines the theoretical basis and the possibility of development of tolerant relations in vocational education as a special…

Student Safety and the Reauthorization of No Child Left Behind

ERIC Educational Resources Information Center

Gastic, Billie

2010-01-01

The reauthorization of the No Child Left Behind Act of 2001 (NCLB) is 3 years overdue, and the Obama administration, through Secretary of Education Arne Duncan, has explained the urgency of revising and reauthorizing the law. Attention has been focused most acutely on the provisions that directly relate to academic performance and accountability.…

Nano Futures: shaping the nanoscience landscape

NASA Astrophysics Data System (ADS)

Demming, Anna; Reed, Mark

2017-06-01

Nano Futures™ is a new journal, dedicated to bringing together the latest and most important results and perspectives from across nanoscience and related technologies. Highly selective, the journal's primary aim is to become the home for high urgency work that will define the future direction of new and emerging fields across nanoscience, with the expectation for lasting scientific and technological impact.

Scheduling unplanned surgery: a tool for improving dialogue about queue position on emergency theatre lists.

PubMed

Fitzgerald, Janna; Lum, Martin; Dadich, Ann

2006-05-01

Theatre use is heavily influenced by the presentation and scheduling of emergency cases for unplanned surgery. This research guided the development of a triage standard for scheduling emergency surgery in New South Wales public hospitals and aimed to contribute to a better understanding of decision-making practices. An emergency-surgery survey asked questions about urgency of a set of clinical conditions and appropriate time frames for patients to receive surgical treatment for these conditions. Surveys were distributed via 71 NSW public hospitals. A total of 198 decision makers responded: surgeons (42.8%), anaesthetists (24.7%), and nurses (32.5%). Principal component analysis was applied to reduce the data to three urgency classifications, and analysis of variance was used to assess variance of opinions between professional groups. The data suggested that the parameters that distinguish the codes (1, very urgent; 2, semi-urgent; 3, least urgent) were not unequivocally apparent. Although there was a consistent approach to the "urgency 1" and "urgency 3" categories, there were significant differences between responses when determining "urgency 2". The data indicated that when making decisions, anaesthetists act as intermediaries between surgeons and nurses. There was significant disparity between individuals when respondents were asked to state an ideal time for the commencement of surgery and the maximum length of time that the surgery could wait. This presented a need for a risk assessment tool to be incorporated when developing a dynamic prototype triage instrument.

Objective measurement of bladder sensation: use of a new patient-activated device and response to neuromodulation.

PubMed

Craggs, Michael D

2005-09-01

Detrusor overactivity is the primary objective focus of most investigations into the diagnosis and management of patients with urgency incontinence. Patients with an overactive bladder are characteristically troubled by subjective sensations of bladder fullness and urinary urgency, and frequently void at low bladder volumes attained before noticeable detrusor overactivity occurs. Bladder sensations are therefore crucial to understanding voiding patterns and symptoms, but little progress has been made in objectively describing the range of these sensations, and adequate information is lacking about their response to neuromodulation. Towards this end, a keypad 'urge score' device was designed to measure sensations during bladder filling. This patient-activated device gathers information about patient perceptions of bladder filling and the successive stages of increasing bladder sensation, without prompting or intervention by the investigator. The accuracy of the 'urge keypad' during filling cystometrography was validated in patients with urgency incontinence, and compared with data abstracted from patient voiding diaries. The device provides reliable and repeatable measures of different bladder sensations, with excellent, statistically significant consistency between bladder volumes and corresponding levels of sensation. Subsequently, it was shown that the sensation of urgency can be suppressed by neuromodulation in most patients tested; this suppression occurs with improvements in bladder capacity and voided volumes. It is therefore suggested that urodynamics with concurrent sensory evaluation may offer a more useful assessment tool for selecting those patients for therapies such as neuromodulation who present predominantly with the symptom of urgency.

The role of negative urgency and expectancies in problem drinking and disordered eating: testing a model of comorbidity in pathological and at-risk samples.

PubMed

Fischer, Sarah; Settles, Regan; Collins, Brittany; Gunn, Rachel; Smith, Gregory T

2012-03-01

The aim of this study was to test hypotheses derived from a model that explains both the comorbidity of problem drinking and eating disorder symptoms and the difference in risk process between the two disorders. In Study One, the authors examined four personality constructs typically associated with rash action (sensation seeking, lack of planning, lack of persistence, and negative urgency) and disorder-specific expectancies in samples of women with eating disorders, substance dependence disorders, comorbid conditions, and no symptoms (N = 104). Negative urgency, the tendency to act rashly when distressed, differentiated the disordered groups from the control group. In contrast, learned expectancies differentiated among clinical groups. Women with eating disorders endorsed high levels of eating and dieting expectancies and women with substance use disorders endorsed high levels of alcohol expectancies, while comorbid women endorsed high levels of both. In Study Two, this pattern of findings was replicated in a sample of fifth grade girls (N = 905). Girls who had engaged in binge eating, alcohol use, or both had higher levels of negative urgency than asymptomatic girls, and the pattern of outcome expectancy endorsement was disorder specific. Negative urgency may represent a general, personality influence on both eating disordered behaviors and symptoms of alcohol dependence, which, when combined with learned, behavior-specific expectancies, leads to specific addictive behavior patterns. PsycINFO Database Record (c) 2012 APA, all rights reserved.

[Lower urinary tract symptoms in women and impact on quality of life. Results of the application of the King's Health Questionnaire].

PubMed

Espuña Pons, M; Puig Clota, M

2006-01-01

The self-assessment of quality of life (QoL) of women with urinary symptoms may help in selecting the best treatment in each case. Epidemiologic, observational, cross-sectional and multicentric study of 674 women who underwent to a gynecology unit with symptoms suggesting Overactive Bladder, with or without urinary incontinence (UI). All women fill out the King's Health Questionnaire. Sociodemographic data and a complete register of urinary symptoms and the degree of afectation which caused, were also collected. Most frequent symptoms were "frequency" (612 women-90.8%), followed by "urgency" (562-83.4%), "nocturia" (543-80.6%) and "stres UI" (535-79.4%). Symptoms of "frecuency", "nocturia", "urgency" and "urgency UI" were more frequent in women aged 65 or under 65 years and that of "stress UI", in women over 65 years (79.8% vs 77.9%). 210 women did not fill out all the KHQ dimensions, mainly "Personal Limitations", "Personal Relationship", "Social limitations" and "Incontinence Impact". Global KHQ score was38.3 (SD=19.2). Higher scores (worse QoL) corresponded to "Incontinence Impact", "Severity Measures", "Personal Limitations" and "Role Limitations". Variables associated to global KHQ score were (multiple linear regression): age, BMI, urgency UI, UI in sexual intercourse, frequent urinary infections. QoL impact in women with urinary symptoms is important. The symptoms with higher association with QoL are: UI in sexual intercourse, urgency UI and frequent urinary infections.

Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study.

PubMed

Cameron, Anne P; Lewicky-Gaupp, Christina; Smith, Abigail R; Helfand, Brian T; Gore, John L; Clemens, J Quentin; Yang, Claire C; Siddiqui, Nazema Y; Lai, H Henry; Griffith, James W; Andreev, Victor P; Liu, Gang; Weinfurt, Kevin; Amundsen, Cindy L; Bradley, Catherine S; Kusek, John W; Kirkali, Ziya

2018-04-01

We described and compared the frequency and type of lower urinary tract symptoms reported by men and women at the time that they were recruited from urology and urogynecology clinics into the Symptoms of Lower Urinary Tract Dysfunction Research Network multicenter, prospective, observational cohort study. At 6 research sites treatment seeking men and women were enrolled who reported any lower urinary tract symptoms at a frequency more than rarely during the last month on the LUTS (Lower Urinary Tract Symptoms) Tool. At baseline the study participants underwent a standardized clinical evaluation and completed validated questionnaires. Urological tests were performed, including pelvic/rectal examination, post-void residual urine measurement and urinalysis. A total of 545 women and 519 men were enrolled in the study. Mean ± SD age was 58.8 ± 14.1 years. At baseline nocturia, frequency and a sensation of incomplete emptying were similar in men and women but men experienced more voiding symptoms (90% vs 85%, p = 0.007) and women reported more urgency (85% vs 66%, p <0.001). Women also reported more of any type of urinary incontinence than men (82% vs 51% p <0.001), which was mixed incontinence in 57%. Only 1% of men reported stress incontinence but they had other urinary incontinence, including post-void dribbling in 44% and urgency incontinence in 46%. Older participants had higher odds of reporting symptoms of nocturia and urgency. In this large, treatment seeking cohort of men and women lower urinary tract symptoms varied widely by gender and age. Men reported more voiding symptoms and nonstress or urgency urinary incontinence while women reported more incontinence overall and urgency. Older participants had greater odds of urgency and nocturia. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Lower Urinary Tract Symptoms and Incident Falls in Community Dwelling Older Men: The Concord Health and Ageing in Men Project.

PubMed

Noguchi, Naomi; Chan, Lewis; Cumming, Robert G; Blyth, Fiona M; Handelsman, David J; Seibel, Markus J; Waite, Louise M; Le Couteur, David G; Naganathan, Vasi

2016-12-01

We sought to determine which lower urinary tract symptoms are associated with incident falls in community dwelling older men. The Concord Health and Ageing in Men Project involves a representative sample of community dwelling men 70 years old or older in a defined geographic region in Sydney, New South Wales, Australia. Included in analysis were 1,090 men without neurological diseases, poor mobility or dementia at baseline. Lower urinary tract symptoms were assessed using I-PSS (International Prostate Symptom Score) and incontinence was assessed using ICIQ (International Consultation on Incontinence Questionnaire) at baseline. I-PSS subscores were calculated for storage and voiding symptoms. Incident falls in 1 year were determined by telephone followup every 4 months. I-PSS storage and voiding subscores were associated with falls. Urgency incontinence was associated with falls (adjusted incidence rate ratio 2.57, 95% CI 1.54-4.30). In addition, intermediate to high I-PSS storage subscores without urgency incontinence were associated with falls (adjusted incidence rate ratio 1.72, 95% CI 1.24-2.38). Other types of incontinence and urgency alone without urgency incontinence were not associated with falls. Lower urinary tract storage and voiding symptoms were associated with falls in community dwelling older men. Of the symptoms of overactive bladder urgency incontinence carried a high risk of falls. Storage symptoms also contributed to the fall risk independently of urgency incontinence. Circumstances of falls among men with lower urinary tract symptoms should be explored to understand how lower urinary tract symptoms increase the fall risk and generate hypotheses regarding potential interventions. Furthermore, trials to treat lower urinary tract symptoms in older men should include falls as an end point. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Evaluating Self-declared Ancestry of U.S. Americans with Autosomal, Y-chromosomal and Mitochondrial DNA

PubMed Central

Lao, Oscar; Vallone, Peter M; Coble, Michael D; Diegoli, Toni M; van Oven, Mannis; van der Gaag, Kristiaan J; Pijpe, Jeroen; de Knijff, Peter; Kayser, Manfred

2010-01-01

The current U.S. population represents an amalgam of individuals originating mainly from four continental regions (Africa, Europe, Asia and America). To study the genetic ancestry and compare with self-declared ancestry we have analyzed paternally, maternally and bi-parentally inherited DNA markers sensitive for indicating continental genetic ancestry in all four major U.S. American groups. We found that self-declared U.S. Hispanics and U.S. African Americans tend to show variable degrees of continental genetic admixture among the three genetic systems, with evidence for a marked sex-biased admixture history. Moreover, for these two groups we observed significant regional variation across the country in genetic admixture. In contrast, self-declared U.S. European and U.S. Asian Americans were genetically more homogeneous at the continental ancestry level. Two autosomal ancestry-sensitive markers located in skin pigmentation candidate genes showed significant differences in self-declared U.S. African Americans or U.S. European Americans, relative to their assumed parental populations from Africa or Europe. This provides genetic support for the importance of skin color in the complex process of ancestry identification. © 2010 Wiley-Liss, Inc. PMID:20886636

Is sensory urgency part of the same spectrum of bladder dysfunction as detrusor overactivity?

PubMed

Haylen, Bernard T; Chetty, Naven; Logan, Vanessa; Schulz, Serena; Verity, Louise; Law, Matthew; Zhou, Jialun

2007-02-01

It has been suggested that the urogynecological diagnosis of sensory urgency is an early form of detrusor overactivity and may be just earlier in the spectrum of disease. The former term is generally defined as increased perceived bladder sensation during filling, a low first desire to void and low bladder capacity in the absence of recorded urinary tract infection (UTI) or detrusor overactivity. The aims of this study are to determine the prevalence and associations of sensory urgency in comparison with detrusor overactivity, and whether sensory urgency is shown to be in the same spectrum of bladder dysfunction as detrusor overactivity. Five hundred and ninety-two women attending for an initial urogynecological/urodynamic assessment took part in this prospective study. In addition to a full clinical assessment, all women underwent free uroflowmetry, residual urine volume measurement (by vaginal ultrasound) and multichannel filling and voiding cystometry. Data were separated into those having (1) sensory urgency or (2) detrusor overactivity. Apart from prevalence figures, comparative associations were sought for (3) age; (4) parity; (5) presenting symptoms; (6) presence of at least one (medically) documented UTI in the previous 12 months; (7) two or more (recurrent) documented UTIs in the previous 12 months; (8) prior hysterectomy; (9) prior continence surgery; (10) menopause; (11) menopause and HRT use; (12) sign of clinical stress leakage; (13) retroverted uterus; (14) anterior vaginal wall prolapse; (15) uterine prolapse; (16) posterior vaginal wall prolapse; (17) apical vaginal prolapse; (18, 19) maximum, average urine flow rate (MUFR, AUFR) centiles, Liverpool Nomograms; (20) median residual urine volume (RUV) in milliliters; (21, 22) voiding difficulty: VD1,VD2 (MUFR, AUFR under 10th centile Liverpool Nomogram and/or RUV >30 ml); (23) diagnosis of urodynamic stress incontinence and (24) diagnosis of uterine and/or vaginal prolapse (grade >0). The prevalence of sensory urgency was 13%. The only differences in the clinical and urodynamic profiles of it and detrusor overactivity were (1) significantly increased prevalence of the symptom of urge incontinence and (2) (by definition) abnormal detrusor contractions during filling cystometry in women with detrusor overactivity. Overall, sensory urgency and detrusor overactivity appear to be part of the same spectrum of bladder dysfunction.

Outlooks on Children and Media: Child Rights, Media Trends, Media Research, Media Literacy, Child Participation, Declarations. Children and Media Violence Yearbook, 2001.

ERIC Educational Resources Information Center

von Feilitzen, Cecilia; Bucht, Catharina

Focusing on media literacy, this yearbook compiles information on recent and current trends in media effects, including research on children and media, declarations related to the area, and a selection of relevant organizations and Web sites. The report first delineates children's rights as stipulated in the U.N. Convention on the Rights of the…

Relation between lifespan polytrauma typologies and post-trauma mental health.

PubMed

Contractor, Ateka A; Brown, Lily A; Weiss, Nicole H

2018-01-01

Most individuals experience more than one trauma. Hence, it is important to consider the count and types of traumas (polytraumatization) in relation to post-trauma mental health. The current study examined the relation of polytraumatization patterns to PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]), depression, and impulsivity facets (lack of perseverance, lack of premeditation, negative urgency, sensation seeking) using a web-based sample of 346 participants. Age, gender, race, and ethnicity were covariates. Results of latent class analyses indicated a three-class solution: Low Experience, Moderate Experience - Predominent Threat/Indirect PTEs (Moderate Experience), and High Experience - Predominant Interpersonal PTEs (High/Interpersonal). Multinomial logistic regression results indicated that ethnicity and gender were significant covariates in predicting Low versus High/Interpersonal Class, and Moderate Experience versus High/Interpersonal Class membership, respectively. The High/Interpersonal Class had higher scores on most PTSD clusters, depression, and the impulsivity facets of lack of perseverance and negative urgency compared to the other classes. The Low and Moderate Experience Classes differed on PTSD's avoidance and AAR clusters (lower in the former). Individuals exposed to multiple PTE types, particularly interpersonal traumas, may be at risk for more severe post-trauma symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

Connotative Meaning of Military Chat Communications

DTIC Science & Technology

2009-09-01

humans recognize connotative cues expressing uncertainty, perception of personal threat, and urgency; formulate linguistic and non-linguistic means for...built a matrix of speech “cues” representative of uncertainty, perception of personal threat, and urgency, but also applied maximum entropy analysis...results. This project proposed to: (1) conduct a study of how humans recognize connotative cues expressing uncertainty, perception of personal

The TUPA Scale: A Self-Report Measure for the Type A Subcomponent of Time Urgency and Perpetual Activation.

ERIC Educational Resources Information Center

Wright, Logan; And Others

1992-01-01

A self-report measure for the Type A subcomponent of time urgency and perpetual activation (TUPA) was developed using 10 coronary heart disease (CHD) patients and validated with another 48 CHD patients. The internal consistency and test-retest reliabilities indicate that the instrument has clinical and research applications. (SLD)

75 FR 13416 - Federal Acquisition Regulation; FAR Case 2008-006, Enhanced Competition for Task- and Delivery...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

.... ``Unusual and Compelling Urgency.'' In the event of a FAR subpart 6.3 exception for a single contract award over $100 million including an unusual and compelling urgency exception, the commenter expresses... work. In those situations, it does not make sense in terms of costs and efficiency to require the...

Democracy is a historical urgency

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2014-03-01

Survival of human society on this planet depends heavily on coping with advanced nuclear technological development. Democracy is a historical urgency, in the age of intercontinental nuclear missiles, computerized on a push-button, conceivably controllable by a miscalculating, suicidal and very powerful dictator, producing a global nuclear holocaust, on our entire planet. Diplomacy should help humanity to approach the contemporary situation.

Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study.

PubMed

Lutri, Vittorio; Soldini, Emiliano; Ronzitti, Silvia; Smith, Neil; Clerici, Massimo; Blaszczynski, Alex; Bowden-Jones, Henrietta

2018-03-03

Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes-rather than high-stakes-gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.

Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients with Detrusor Hyperactivity and Impaired Contractility

PubMed Central

Wang, Chung-Cheng; Lee, Cheng-Ling; Kuo, Hann-Chorng

2016-01-01

We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE) at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ± 4.8 months in DHIC patients and 7.2 ± 3.3 months in OAB patients (p = 0.03). We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC. PMID:26999209

Descriptors of sensation confirm the multidimensional nature of desire to void.

PubMed

Das, Rebekah; Buckley, Jonathan D; Williams, Marie T

2015-02-01

To collect and categorize descriptors of "desire to void" sensation, determine the reliability of descriptor categories and assess whether descriptor categories discriminate between people with and without symptoms of overactive bladder. This observational, repeated measures study involved 64 Australian volunteers (47 female), aged 50 years or more, with and without symptoms of overactive bladder. Descriptors of desire to void sensation were derived from a structured interview (conducted on two occasions, 1 week apart). Descriptors were recorded verbatim and categorized in a three-stage process. Overactive bladder status was determined by the Overactive Bladder Awareness Tool and the Overactive Bladder Symptom Score. McNemar's test assessed the reliability of descriptors volunteered between two occasions and Partial Least Squares Regression determined whether language categories discriminated according to overactive bladder status. Post hoc Chi squared analysis and relative risk calculation determined the size and direction of overactive bladder prediction. Thirteen language categories (Urgency, Fullness, Pressure, Tickle/tingle, Pain/ache, Heavy, Normal, Intense, Sudden, Annoying, Uncomfortable, Anxiety, and Unique somatic) encapsulated 344 descriptors of sensation. Descriptor categories were stable between two interviews. The categories "Urgency" and "Fullness" predicted overactive bladder status. Participants who volunteered "Urgency" descriptors were twice as likely to have overactive bladder and participants who volunteered "Fullness" descriptors were almost three times as likely not to have overactive bladder. The sensation of desire to void is reliably described over sessions separated by a week, the language used reflects multiple dimensions of sensation, and can predict overactive bladder status. © 2013 Wiley Periodicals, Inc.

[Physiotherapy and neurogenic lower urinary tract dysfunction in multiple sclerosis patients: a randomized controlled trial].

PubMed

Gaspard, L; Tombal, B; Opsomer, R-J; Castille, Y; Van Pesch, V; Detrembleur, C

2014-09-01

This randomized controlled trial compare the efficacy of pelvic floor muscle training vs. transcutaneous posterior tibial nerve stimulation. Inclusion criteria were EDSS score<7 and presence of lower urinary tract symptoms. Exclusion criteria were multiple sclerosis relapse during the study, active urinary tract infection and pregnancy. The primary outcome was quality of life (SF-Qualiveen questionnaire). Secondary outcomes included overactive bladder (USP questionnaire) score and frequency of urgency episodes (3-day bladder diary). Sample size was calculated after 18 patients were included. Data analysis was blinded. Each patient received 9 sessions of 30 minutes weekly. Patients were randomized in pelvic floor muscles exercises with biofeedback group (muscle endurance and relaxation) or transcutaneous posterior tibial nerve stimulation group (rectangular alternative biphasic current with low frequency). A total of 31 patients were included. No difference appeared between groups for quality of life, overactive bladder and frequency of urgency episodes (respectively P=0.197, P=0.532 et P=0.788). These parameters were significantly improved in pelvic floor muscle training group (n=16) (respectively P=0.004, P=0.002 et P=0.006) and in transcutaneous posterior tibial nerve stimulation group (n=15) (respectively P=0.001, P=0.001 et P=0.031). Pelvic floor muscle training and transcutaneous posterior tibial nerve stimulation improved in the same way symptoms related to urgency in MS patients with mild disability. 2. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Dutch guideline for the management of hypertensive crisis -- 2010 revision.

PubMed

van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

2011-05-01

Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

Declarative memory.

PubMed

Riedel, Wim J; Blokland, Arjan

2015-01-01

Declarative Memory consists of memory for events (episodic memory) and facts (semantic memory). Methods to test declarative memory are key in investigating effects of potential cognition-enhancing substances--medicinal drugs or nutrients. A number of cognitive performance tests assessing declarative episodic memory tapping verbal learning, logical memory, pattern recognition memory, and paired associates learning are described. These tests have been used as outcome variables in 34 studies in humans that have been described in the literature in the past 10 years. Also, the use of episodic tests in animal research is discussed also in relation to the drug effects in these tasks. The results show that nutritional supplementation of polyunsaturated fatty acids has been investigated most abundantly and, in a number of cases, but not all, show indications of positive effects on declarative memory, more so in elderly than in young subjects. Studies investigating effects of registered anti-Alzheimer drugs, cholinesterase inhibitors in mild cognitive impairment, show positive and negative effects on declarative memory. Studies mainly carried out in healthy volunteers investigating the effects of acute dopamine stimulation indicate enhanced memory consolidation as manifested specifically by better delayed recall, especially at time points long after learning and more so when drug is administered after learning and if word lists are longer. The animal studies reveal a different picture with respect to the effects of different drugs on memory performance. This suggests that at least for episodic memory tasks, the translational value is rather poor. For the human studies, detailed parameters of the compositions of word lists for declarative memory tests are discussed and it is concluded that tailored adaptations of tests to fit the hypothesis under study, rather than "off-the-shelf" use of existing tests, are recommended.

Hazards associated with the recreational drug 'ecstasy'.

PubMed

O'Connor, B

The amphetamine analogue 'ecstasy' is a popular 'designer' drug and is perceived by its users to be relatively harmless. However, it has been associated with several fatalities through a disorder of thermoregulation, and severe reactions have been reported across many disciplines. This article emphasises the hazardous nature of the drug and highlights the urgency and nature of treatment in the acutely toxic state.

Knowledge that Counts in a Global Community: Exploring the Contribution of Integrated Curriculum

ERIC Educational Resources Information Center

Rennie, Leonie J.; Venville, Grady; Wallace, John

2011-01-01

As the third millennium progresses, we are faced with increasing pressures relating to climate change and the sustainability of life on Earth. Concerned citizens are realizing that the responsibility to respond is both local and global. There is an increasing sense of urgency about the need to reform the processes of schooling and curriculum to…

Personal Meanings of Learning in the Process of Formation of Students' Subjectivity

ERIC Educational Resources Information Center

Kalatskaya, Natalia N.; Selivanova, Olga G.; Ilesanmi, Ruth A.

2016-01-01

The urgency of the presented study is stipulated by the current situation in the education system: learning has lost its meaning for a significant number of students; knowledge is external in relation to their real life. However, a lot of specialists view education as a source of personal development of a student, finding for himself, disclosure…

The Explosion of Real Time and the Structural Conditions of Temporality in a Society of Control: Durations and Urgencies of Academic Research

ERIC Educational Resources Information Center

Lapping, Claudia

2017-01-01

In the context of ongoing debates about the distinctive temporalities associated with contemporary regulative regimes, this paper explores the interpretive trajectories initiated in contrasting conceptualisations of the politics of time. This exploration is developed through analysis of interview data from a study of unconscious relations in…

Validation of the urinary sensation scale (USS).

PubMed

Coyne, Karin S; Margolis, Mary Kay; Hsieh, Ray; Vats, Vasudha; Chapple, Christopher R

2011-03-01

The purpose of this study was to assess the validity of the Urinary Sensation Scale (USS) in men with overactive bladder and voiding symptoms (OAB-LUTS) and women with overactive bladder (OAB). Data from two OAB clinical trials of tolterodine were used. The USS, a 5-point scale, assesses the amount of urinary urgency associated with each urination. Three methods to calculate the USS are: mean urgency (Mean USS); mode urgency (Mode USS); and sum urgency (sum USS). The validity and responsiveness of the scoring methods was assessed using Spearman's correlations, general linear models, and effect sizes. Data from 650 men (Study 1) and 413 women (Study 2) were analyzed. Mean age was 65.2 (men) and 47.8 (women); 70% were Caucasian in both studies. Correlations of USS scores with bladder diary variables were small to moderate and higher among Sum USS than Mean USS (r=0.02-0.64). Correlations among the USS and patient-reported outcomes (PROs) were again small to moderate and higher with Sum USS (r=0.05-0.41). Both the Mean USS and Sum USS significantly discriminated (all P<0.001) among all bladder diary variables (except nocturia and UUI in men) when grouped as improved/not improved as well as by the PROs. Effect sizes for men and women, respectively, were -0.52 and -1.09 for Mean USS and -0.72 and -1.36 for Sum USS. The USS is a valid and highly responsive measure of urinary urgency in men with OAB-LUTS and women with OAB. Copyright © 2011 Wiley-Liss, Inc.

Urgency severity scale could predict urodynamic detrusor overactivity in patients with overactive bladder syndrome.

PubMed

Chung, Shiu-Dong; Liao, Chun-Hou; Chen, Yi-Chou; Kuo, Hann-Chorng

2011-09-01

To evaluate the correlation between an urgency severity scale (USS) based on a voiding diary with detrusor overactivity (DO) in a videourodynamic study in patients with an overactive bladder (OAB). We prospectively enrolled 190 consecutive patients with OAB. All patients were assessed using a USS and completed a 3-day voiding diary that recorded urgency and urgency urinary incontinence (UUI) episodes and the degree of urgency severity. The highest recorded USS score in the voiding diary was considered as the USS score. A videourodynamic study was performed, and the presence of increased bladder sensation (IBS) or DO was recorded. These clinical findings and videourodynamic data were analyzed. This study enrolled 65 men and 125 women. The mean patient age was 66.4 years (21-88). Among them, 82.6% had urodynamic DO, 7.9% had IBS, and 9.5% had normal urodynamic findings. The prevalence of DO was 50%, 76%, and 94% in patients with a USS = 2, 3, and 4, respectively. Multivariate analysis indicated that OAB wet, high USS and UUI were significantly associated with the presence of DO. Urodynamic DO was present in most patients with OAB wet (94.1%) or USS = 4 (95.5%); however, only 63.9% of OAB dry patients had DO. In the OAB dry patients, 11/25 (44%) with USS = 2, 30/42 (71%) with USS = 3, and 5/5 (100%) with USS = 4 had DO. A high USS recorded in conjunction with a voiding diary and OAB wet were strongly associated with urodynamic DO. Copyright © 2011 Wiley-Liss, Inc.

Internal Delorme's Procedure for Treating ODS Associated With Impaired Anal Continence.

PubMed

Liu, Weicheng; Sturiale, Alessandro; Fabiani, Bernardina; Giani, Iacopo; Menconi, Claudia; Naldini, Gabriele

2017-12-01

The aim of this study was to evaluate the medium-term outcomes of internal Delorme's procedure for treating obstructed defecation syndrome (ODS) patients with impaired anal continence. In a retrospective study, 41 ODS patients who underwent internal Delorme's procedure between 2011 and 2015 were divided into 3 subgroups according to their associated symptoms of impaired continence, as urgency, passive fecal incontinence and both, before study. Then the patients' preoperative statuses, perioperative complications, and postoperative outcomes were investigated and collected from standardized questionnaires, including Altomare ODS score, Fecal Incontinence Severity Index (FISI), Patient Assessment of Constipation-Quality of Life Questionnaire (PAC-QoL), and Fecal Incontinence Quality of Life Scale (FIQLS). All results with a 2-tailed P < .05 were considered statistically significant. At an average 2.8 years of follow-up, there were significant improvements ( P < .01) in Altomare ODS score, FISI, PAC-QoL, and FIQLS in all patients when comparing scores from before the operation with those at the final follow-up. Similar results were also observed in both the urgency subgroup and passive fecal incontinence subgroup, but there were no statistically significant improvements ( P > .05) in Altomare ODS score, FISI, PAC-QoL, or FIQLS in the urgency and passive fecal incontinence subgroups. Anorectal manometry showed the mean value of anal resting pressure increased 20%. Additionally, no major complications occurred. Internal Delorme's procedure is effective without major morbidity for treating ODS associated with urgency or passive fecal incontinence, but it may be less effective for treating ODS associated with both urgency and passive fecal incontinence.

Effects of acute psychological stress on placebo and nocebo responses in a clinically relevant model of visceroception.

PubMed

Roderigo, Till; Benson, Sven; Schöls, Margarita; Hetkamp, Madeleine; Schedlowski, Manfred; Enck, Paul; Elsenbruch, Sigrid

2017-08-01

There is evidence to suggest a role of emotions in placebo and nocebo effects, but whether acute psychological stress changes the magnitude of placebo or nocebo responses has not been tested. In a clinically relevant model of visceroception, we assessed effects of acute psychological stress on changes in urgency and pain in response to positive or negative treatment suggestions. In 120 healthy volunteers, perceived urge-to-defecate and pain in response to individually calibrated rectal distensions were measured with visual analogue scales during a BASELINE. Participants then underwent the Trier Social Stress Test (N = 60) or a simple cognitive task (control, N = 60) and were randomized to positive (placebo), negative (nocebo), or neutral treatment information regarding intravenous administration of saline. The series of distensions was repeated, and changes in visual analogue scales from BASELINE to TEST were compared between groups using analysis of covariance and planned post hoc tests. Treatment information emerged as a main factor (P <0.001), supporting treatment information effects for both urgency and pain. Effects for urgency were modulated by stress (interaction effect: P <0.05): Positive information reduced urgency (P = 0.025), while negative information increased urgency (P = 0.026) only in stressed groups. For pain, effects of stress emerged for nocebo responses, which were only evident in stressed groups (P = 0.009). This is the first experimental study supporting effects of acute psychological stress on placebo and nocebo responses in visceroception. Results call for mechanistic as well as patient studies to assess how psychological stress shapes patients' treatment expectations and thereby affects health outcomes.

Developmental trends in alcohol use initiation and escalation from early- to middle-adolescence: Prediction by urgency and trait affect

PubMed Central

Spillane, Nichea S.; Merrill, Jennifer E.; Jackson, Kristina M.

2016-01-01

Studies on adolescent drinking have not always been able to distinguish between initiation and escalation of drinking, because many studies include samples in which initiation has already occurred; hence initiation and escalation are often confounded. The present study draws from a dual-process theoretical framework to investigate: if changes in the likelihood of drinking initiation and escalation are predicted by a tendency towards rash action when experiencing positive and negative emotions (positive and negative urgency); and whether trait positive and negative affect moderate such effects. Alcohol naïve adolescents (n=944; age: M=12.16, SD=.96; 52% female) completed 6 semi-annual assessments of trait urgency and affect (wave-1) and alcohol use (waves 2–6). A two-part random-effects model was used to estimate changes in the likelihood of any alcohol use vs. escalation in the volume of use amongst initiators. Main effects suggest a significant association between positive affect and change in level of alcohol use amongst initiators, such that lower positive affect predicted increased alcohol involvement. This main effect was qualified by a significant interaction between positive urgency and positive affect predicting changes in the escalation of drinking, such that the effect of positive urgency was augmented for those high on trait positive affect, though only at extremely high levels of positive affect. Results suggest risk factors in the development of drinking depend on whether initiation or escalation is investigated. A more nuanced understanding of the early developmental phases of alcohol involvement can inform prevention and intervention efforts. PMID:27031086

Assessment of the urgency and deferability of transfusion to inform emergency blood planning and triage: the Bloodhound prospective audit of red blood cell use.

PubMed

Shortt, Jake; Polizzotto, Mark N; Waters, Neil; Borosak, Marija; Moran, Martine; Comande, Mary; Devine, Alexandra; Jolley, Damien J; Wood, Erica M

2009-11-01

Careful planning is essential to ensure blood availability during shortages. Triaging supply is one proposed strategy; however, few data concerning the urgency of transfusion are available to inform planning. This study sought to determine the proportion of red blood cells (RBCs) used for clinically urgent indications. A total of 5132 RBC units were randomly selected at point of production and distributed into general statewide inventory over a 9-month period. These selected units carried case report forms, for completion at the point of hospital issue for transfusion. Completed forms were returned to the blood service for collation and analysis, capturing information on indication and clinical urgency of supply, including use for potentially deferrable elective surgery. Data from 5052 RBC units indicated that 95.6% were transfused. Approximately one-third of transfused units were used to support surgery, one-third for hematology/oncology, and one-third for other medical and miscellaneous indications. Where used for surgery, 25.7% (95% confidence interval [CI], 23.4%-28.0%) were for elective procedures, although urgency of surgery was unknown in 17.1% (95% CI, 15.2%-19.2%) of cases. Supply for nonurgent medical indications and elective surgery only accounted for 9.8% (95% CI, 9.0%-10.6%) of use, with 53.4% (95% CI, 52.0%-54.8%) of RBCs required within 24 hours. The majority of RBCs are transfused with a high degree of clinical urgency, with only a minor proportion required to support elective surgery.

DUNDRUM-2: Prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a forensic mental health hospital

PubMed Central

2011-01-01

Background The criteria for deciding who should be admitted first from a waiting list to a forensic secure hospital are not necessarily the same as those for assessing need. Criteria were drafted qualitatively and tested in a prospective 'real life' observational study over a 6-month period. Methods A researcher rated all those presented at the weekly referrals meeting using the DUNDRUM-1 triage security scale and the DUNDRUM-2 triage urgency scale. The key outcome measure was whether or not the individual was admitted. Results Inter-rater reliability and internal consistency for the DUNDRUM-2 were acceptable. The DUNDRUM-1 triage security score and the DUNDRUM-2 triage urgency score correlated r = 0.663. At the time of admission, after a mean of 23.9 (SD35.9) days on the waiting list, those admitted had higher scores on the DUNDRUM-2 triage urgency scale than those not admitted, with no significant difference between locations (remand or sentenced prisoners, less secure hospitals) at the time of admission. Those admitted also had higher DUNDRUM-1 triage security scores. At baseline the receiver operating characteristic area under the curve for a combined score was the best predictor of admission while at the time of admission the DUNDRUM-2 triage urgency score had the largest AUC (0.912, 95% CI 0.838 to 0.986). Conclusions The triage urgency items and scale add predictive power to the decision to admit. This is particularly true in maintaining equitability between those referred from different locations. PMID:21722397

The effect of prolapse repair on urinary flow rates and the relationship to changes in the ultrasound appearance of the bladder neck.

PubMed

Duckett, Jonathan; Chakani, Dorothy

2013-12-01

To assess whether specific changes in bladder neck morphology, caused by an anterior repair operation, are associated with resolution of overactive bladder and improved urinary flow rates. Sixty-four women with urgency documented on the urgency perception scale (UPS) underwent an anterior repair. Their preoperative flow studies were compared to those 8 weeks postoperatively. Flow rates were compared in those women who reported improved or cured urgency to those who reported no effect. Resolution of urgency was correlated with the change in bladder neck angulation (posterior urethrovesical angle-PUA). 55% (35/64) women reported no urgency after the anterior repair. A further 19% (12/64) were improved and 26% (17/64) were no better. Patients who were cured or improved showed a significant increase in their flow rates after surgery (mean flow=15 before and 17.6 ml/s after) (Mann-Whitney p=0.04). There was a significant change (increase in the PUA angle/straightening of the angle between the bladder and urethra) from a mean value of 123 degrees (SD 49.3) preoperatively to a mean value of 146.8 (SD 29.2) post operatively (p<0.001). Despite an increase in PUA, this was not correlated with an increase in the maximum flow rate centile (p=0.45, r=0.10). An anterior repair results in increased maximum urinary flow rates but this does not correlate to changes in the appearance of the bladder neck. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Bigger is better! Hippocampal volume and declarative memory performance in healthy young men.

PubMed

Pohlack, Sebastian T; Meyer, Patric; Cacciaglia, Raffaele; Liebscher, Claudia; Ridder, Stephanie; Flor, Herta

2014-01-01

The importance of the hippocampus for declarative memory processes is firmly established. Nevertheless, the issue of a correlation between declarative memory performance and hippocampal volume in healthy subjects still remains controversial. The aim of the present study was to investigate this relationship in more detail. For this purpose, 50 healthy young male participants performed the California Verbal Learning Test. Hippocampal volume was assessed by manual segmentation of high-resolution 3D magnetic resonance images. We found a significant positive correlation between putatively hippocampus-dependent memory measures like short-delay retention, long-delay retention and discriminability and percent hippocampal volume. No significant correlation with measures related to executive processes was found. In addition, percent amygdala volume was not related to any of these measures. Our data advance previous findings reported in studies of brain-damaged individuals in a large and homogeneous young healthy sample and are important for theories on the neural basis of episodic memory.

Emotionally Up and Down, Behaviorally to and fro: Drinking Motives Mediate the Synergistic Effects of Urgency and Emotional Instability on Alcohol Outcomes

ERIC Educational Resources Information Center

Dvorak, Robert D.; Kuvaas, Nicholas J.; Lamis, Dorian A.; Pearson, Matthew R.; Stevenson, Brittany L.

2015-01-01

Emotional and behavioral regulation has been linked to coping and enhancement motives and associated with different patterns of alcohol use and problems. The current studies examined emotional instability, urgency, and internal drinking motives as predictors of alcohol dependence symptoms as well as the likelihood and severity of "Diagnostic…

Impulsivity and the Sexes: Measurement and Structural Invariance of the UPPS-P Impulsive Behavior Scale

ERIC Educational Resources Information Center

Cyders, Melissa A.

2013-01-01

Before it is possible to test whether men and women differ in impulsivity, it is necessary to evaluate whether impulsivity measures are invariant across sex. The UPPS-P Impulsive Behavior Scale (negative urgency, lack of premeditation, lack of perseverance, and sensation seeking, with added subscale of positive urgency) is one measure of five…

Dorsolateral prefrontal γ-aminobutyric acid in men predicts individual differences in rash impulsivity.

PubMed

Boy, Frederic; Evans, C John; Edden, Richard A E; Lawrence, Andrew D; Singh, Krish D; Husain, Masud; Sumner, Petroc

2011-11-01

Impulsivity is a multifaceted personality construct associated with numerous psychiatric disorders. Recent research has characterized four facets of impulsivity: "urgency" (the tendency to act rashly especially in the context of distress or cravings); "lack of premeditation" (not envisaging the consequences of actions); "lack of perseverance" (not staying focused on a task); and "sensation seeking" (engaging in exciting activities). Urgency is particularly associated with clinical populations and problematic disinhibited behavior. We used magnetic resonance spectroscopy to measure concentration of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the dorsolateral prefrontal cortex (DLPFC) in two cohorts of 12 and 13 participants. We find that variation in trait urgency in healthy men correlates with GABA concentration in the DLPFC. The result was replicated in an independent cohort. More GABA predicted lower urgency scores, consistent with a role in self-control for GABA-mediated inhibitory mechanisms in DLPFC. These findings help account for individual differences in self-control and thus clarify the relationship between GABA and a wide range of psychiatric disorders associated with impaired self-control. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Brain structure correlates of emotion-based rash impulsivity

PubMed Central

Muhlert, N.; Lawrence, A.D.

2015-01-01

Negative urgency (the tendency to engage in rash, ill-considered action in response to intense negative emotions), is a personality trait that has been linked to problematic involvement in several risky and impulsive behaviours, and to various forms of disinhibitory psychopathology, but its neurobiological correlates are poorly understood. Here, we explored whether inter-individual variation in levels of trait negative urgency was associated with inter-individual variation in regional grey matter volumes. Using voxel-based morphometry (VBM) in a sample (n = 152) of healthy participants, we found that smaller volumes of the dorsomedial prefrontal cortex and right temporal pole, regions previously linked to emotion appraisal, emotion regulation and emotion-based decision-making, were associated with higher levels of trait negative urgency. When controlling for other impulsivity linked personality traits (sensation seeking, lack of planning/perseverance) and negative emotionality per se (neuroticism), these associations remained, and an additional relationship was found between higher levels of trait negative urgency and smaller volumes of the left ventral striatum. This latter finding mirrors recent VBM findings in an animal model of impulsivity. Our findings offer novel insight into the brain structure correlates of one key source of inter-individual differences in impulsivity. PMID:25957991

The prospective effects of impulsivity on alcohol and tobacco use in a college sample.

PubMed

Doran, Neal; Trim, Ryan S

2013-01-01

Alcohol and tobacco use are strongly associated, particularly in younger populations, and concurrent use may encourage progression toward dependence on both substances. Impulsivity has been linked to the use of alcohol and tobacco individually, but has not been studied in terms of its association with use of both. This study tested the hypothesis that the effects of impulsivity (sensation seeking and negative urgency) on smoking initiation in a sample of college students (n = 400) would be mediated by alcohol consumption. We also predicted that sensation seeking and negative urgency would predict alcohol and cigarette use and overlap among initiators. Sensation seeking and negative urgency both predicted smoking initiation, but only the former effect was mediated by alcohol use. Among initiators, sensation seeking was associated with more frequent alcohol use as well as more frequent overlap between alcohol and tobacco use but not with smoking frequency. Higher negative urgency was associated with more frequent smoking, but not with alcohol use or alcohol/tobacco overlap. Findings are consistent with previous research in college samples and suggest the existence of multiple pathways to alcohol and tobacco use and co-use in college students.

Editorial: Should We Develop a Sense of Urgency in Science and Technology Development?

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

Kintner-Meyer, Michael CW

2011-07-01

In his book A Sense of Urgency, John P. Kotter describes how organizations must develop the right sense of urgency as an enabler for organizational changes necessary to compete in today’s global economy. A surfeit of complacency promotes institutional inertia that solely relies on past accomplishments, people *hoping* that the tomorrow will be an extrapolation of the today. However, the reality is that the marketplace around us changes drastically at an ever-increasing rate of change. Only x number of Fortune 500 companies are still on the list who were there five years ago . Transferring the sense of urgency frommore » a business setting to the nation’s energy and energy security area is critical, Peter Ogden et al. wrote in a 2008 article in the journal Issues Online in Science and Technology. In the article, Ending the Inertia on Energy Policy. A new Strategy to Spur Energy Innovation, he writes, the United States must undergo an innovation revolution. The rate at which the United States is able to develop and deploy new energy technologies will, to a great extent, determine the ultimate speed and cost of the economic transformation« less

Error rate information in attention allocation pilot models

NASA Technical Reports Server (NTRS)

Faulkner, W. H.; Onstott, E. D.

1977-01-01

The Northrop urgency decision pilot model was used in a command tracking task to compare the optimized performance of multiaxis attention allocation pilot models whose urgency functions were (1) based on tracking error alone, and (2) based on both tracking error and error rate. A matrix of system dynamics and command inputs was employed, to create both symmetric and asymmetric two axis compensatory tracking tasks. All tasks were single loop on each axis. Analysis showed that a model that allocates control attention through nonlinear urgency functions using only error information could not achieve performance of the full model whose attention shifting algorithm included both error and error rate terms. Subsequent to this analysis, tracking performance predictions for the full model were verified by piloted flight simulation. Complete model and simulation data are presented.

Impulsivity and sexual assault in college men.

PubMed

Mouilso, Emily R; Calhoun, Karen S; Rosenbloom, Thomas G

2013-01-01

Although impulsivity has been consistently linked to perpetration of sexual aggression, results lack clarity because they do not account for the substantial heterogeneity associated with the construct. The UPPS-P model (Lynam, Smith, Whiteside, & Cyders, 2006), which was proposed to clarify the multidimensional nature of impulsivity, has yet to be applied to sexual aggression. We measured UPPS-P Impulsivity in a sample of male college students who also self-reported on perpetration of sexual aggression. As predicted, impulsivity distinguished perpetrators from nonperpetrators. Perpetrators scored higher than non-perpetrators on Negative Urgency, Positive Urgency, and lack of Premeditation. Results suggest that the impulsivity traits most relevant to sexual aggression are the tendency to act impulsively when experiencing intense emotions (Positive and Negative Urgency) and lack of forethought and planning (lack of Premeditation).

Decision making by urgency gating: theory and experimental support.

PubMed

Thura, David; Beauregard-Racine, Julie; Fradet, Charles-William; Cisek, Paul

2012-12-01

It is often suggested that decisions are made when accumulated sensory information reaches a fixed accuracy criterion. This is supported by many studies showing a gradual build up of neural activity to a threshold. However, the proposal that this build up is caused by sensory accumulation is challenged by findings that decisions are based on information from a time window much shorter than the build-up process. Here, we propose that in natural conditions where the environment can suddenly change, the policy that maximizes reward rate is to estimate evidence by accumulating only novel information and then compare the result to a decreasing accuracy criterion. We suggest that the brain approximates this policy by multiplying an estimate of sensory evidence with a motor-related urgency signal and that the latter is primarily responsible for neural activity build up. We support this hypothesis using human behavioral data from a modified random-dot motion task in which motion coherence changes during each trial.

Impact of solifenacin on quality of life, medical care use, work productivity, and health utility in the elderly: an exploratory subgroup analysis.

PubMed

Zinner, Norman; Noe, Les; Rasouliyan, Lawrence; Marshall, Thomas; Runken, M Christopher; Seifeldin, Raafat

2009-12-01

Overactive bladder (OAB) is a common problem among the elderly and a financial burden to society. The prevalence of OAB increases with age and affects > or = 25% of people aged > or = 65 years. The goal of this exploratory subgroup analysis of the VESIcare Efficacy and Research Study US (VERSUS) was to assess changes in health-related quality of life (HRQoL), medical care resource utilization, work and activity impairment, and health utility among elderly patients with OAB who continued to have urgency symptoms with tolterodine and were willing to try solifenacin. This was a 12-week, multicenter, prospective, open-label, noncomparative, flexible-dosing study designed to assess the efficacy and tolerability of solifenacin. Patients who received tolterodine 4 mg/d for > or = 4 weeks but continued to experience urgency symptoms (> or = 3 urgency episodes/24 hours) were enrolled. This exploratory analysis describes results from 2 elderly cohorts (patients 65 to 74 years and > or = 75 years of age). After a washout period of > or = 14 days, patients began treatment with solifenacin 5 mg/d with dosing adjustments allowed at week 4 (to 10 mg/d) and at week 8 (back to 5 mg/d for patients whose dose was increased to 10 mg/d at week 4). Outcomes were assessed using the OAB-q (a questionnaire specific to OAB and HRQoL), the Work Productivity and Activity Impairment-Specific Health Problem index, the Medical Care Use Index, and the Health Utilities Index Mark 2 and Mark 3 (HUI2/3), administered at the prewashout and week-12 visits. The subgroup analysis included 108 patients 65 to 74 years of age and 86 patients > or = 75 years of age. Patients in both age groups experienced significant improvement in HRQoL (P < 0.001), as well as significant reductions in nonprotocol-related office visits (P < 0.001) and activity impairment (P < 0.025). A significant reduction in the use of pads/diapers was reported for patients 65 to 74 years of age (P < 0.018), and patients in this age group who were working reported significantly less impairment related to OAB while working during solifenacin treatment than during tolterodine treatment (P < 0.042). No significant differences in HUI2/3 scores were observed in either of the elderly subgroups. Overall, solifenacin was found to improve symptom bother, HRQoL, work productivity, activity participation, and reduced medical care resource utilization in these elderly subjects with OAB who continued to have urgency symptoms with tolterodine and were willing to try solifenacin. This was an exploratory subgroup analysis of an open-label, noncomparative study; further research is needed to confirm these results. Copyright 2009 Excerpta Medica Inc. All rights reserved.

48 CFR 218.203 - Incidents of national significance, emergency declaration, or major disaster declaration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... significance, emergency declaration, or major disaster declaration. 218.203 Section 218.203 Federal Acquisition... significance, emergency declaration, or major disaster declaration. (1) Establishing or maintaining alternative... awarded by contracting officers in the conduct of emergency operations, such as responses to natural...

48 CFR 218.203 - Incidents of national significance, emergency declaration, or major disaster declaration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... significance, emergency declaration, or major disaster declaration. 218.203 Section 218.203 Federal Acquisition... significance, emergency declaration, or major disaster declaration. (1) Establishing or maintaining alternative... awarded by contracting officers in the conduct of emergency operations, such as responses to natural...

48 CFR 218.203 - Incidents of national significance, emergency declaration, or major disaster declaration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... significance, emergency declaration, or major disaster declaration. 218.203 Section 218.203 Federal Acquisition... significance, emergency declaration, or major disaster declaration. (1) Establishing or maintaining alternative... awarded by contracting officers in the conduct of emergency operations, such as responses to natural...

48 CFR 218.203 - Incidents of national significance, emergency declaration, or major disaster declaration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... significance, emergency declaration, or major disaster declaration. 218.203 Section 218.203 Federal Acquisition... significance, emergency declaration, or major disaster declaration. (1) Establishing or maintaining alternative... awarded by contracting officers in the conduct of emergency operations, such as responses to natural...

A randomized, placebo-controlled proof-of-concept, crossover trial of phenytoin for hydrocortisone-induced declarative memory changes

PubMed Central

Brown, E. Sherwood; Lu, Hanzhang; Denniston, Daren; Uh, Jinsoo; Thomas, Binu P.; Carmody, Thomas J.; Auchus, Richard J.; Diaz-Arrastia, Ramon; Tamminga, Carol

2013-01-01

Background Corticosteroid excess is associated with declarative memory impairment and hippocampal atrophy. These findings are clinically important because approximately 1% of the population receives prescription corticosteroids at any time, and major depressive disorder is associated with elevated cortisol levels and hippocampal atrophy. In animals, hippocampal changes with corticosteroids are blocked by phenytoin. The objective of the current study was to extend these preclinical findings to humans. We examined whether phenytoin attenuated the effects of hydrocortisone on declarative memory. Functional magnetic resonance imaging (fMRI) assessed task-related hippocampal activation. Methods A randomized, double-blind, placebo-controlled, within-subject crossover study was conducted in 17 healthy adult volunteers. Participants received hydrocortisone (2.5 days), phenytoin (3.5 days), both medications together, or placebo, with 21-day washouts between conditions. Differences between treatments were estimated using a mixed-effects repeated measures analysis. Results Fifteen participants had data from at least two treatment conditions and were used in the analysis. Basal cortisol levels negatively correlated with fMRI BOLD activation in the para-hippocampus with a similar trend observed in the hippocampus. Decrease in declarative memory with hydrocortisone was blocked with concomitant phenytoin administration. Relative to the placebo condition, a significant decrease in hippocampal BOLD activation was observed with hydrocortisone and phenytoin alone, and the two medications in combination. Declarative memory did not show significant correlations with hippocampal activation. Limitations The modest sample size, which limited our statistical power, was a limitation. Conclusions Findings from this pilot study suggest phenytoin attenuated effects of corticosteroids memory in humans, but potentiated the reduction in hippocampal activation. PMID:23453674

Brussels Declaration: a vehicle for the advancement of tobacco and alcohol industry interests at the science/policy interface?

PubMed

McCambridge, Jim; Daube, Mike; McKee, Martin

2018-06-25

The case for policies to be based on evidence appeared to gain a major boost with the publication of the Brussels Declaration, apparently with support from many leading scientists and institutions. Yet, as we show in this analysis, there are major concerns about how it was developed and, in particular, the extensive involvement of tobacco and alcohol industry actors. We describe how its coverage of conflicts of interest and vested interests is consistent with the perspectives of these same actors. The process of developing the Declaration successfully involved science advisors, other senior officials in governments and politicians in its preparation. Despite this, the final Declaration fails to address the need for safeguards to protect the integrity of science or policy from corporate interests, including in relation to the tobacco industry. This undermines Article 5.3 of the Framework Convention on Tobacco Control which seeks to protect public health policies from interference by the tobacco companies. More broadly, the Declaration offers potential to serve as a vehicle for advancing the vested interests of corporate sectors in public policymaking and appears to have been regarded in this way by a range of organisations related to the alcohol industry. This exercise is now being extended to the continent of Africa, which is strategically important to both the tobacco and alcohol industries. It will be important to study carefully to what extent initiatives like this form part of the global political strategies of tobacco and alcohol industry actors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Paris Declaration in practice: challenges of health sector aid coordination at the district level in Zambia

PubMed Central

Sundewall, Jesper; Forsberg, Birger C; Jönsson, Kristina; Chansa, Collins; Tomson, Göran

2009-01-01

Background The increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia. Methods The study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration. Findings While the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low. Conclusion Greater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation. PMID:19505300

19 CFR 148.14 - Family declarations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Family declarations. 148.14 Section 148.14 Customs... (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.14 Family declarations. A family group... declare orally articles acquired abroad for the personal or household use of any member of the family if...

19 CFR 148.14 - Family declarations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Family declarations. 148.14 Section 148.14 Customs... (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.14 Family declarations. A family group... declare orally articles acquired abroad for the personal or household use of any member of the family if...

19 CFR 148.14 - Family declarations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Family declarations. 148.14 Section 148.14 Customs... (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.14 Family declarations. A family group... declare orally articles acquired abroad for the personal or household use of any member of the family if...

"We Can't Let Them Fail for One More Day": School Reform Urgency and the Politics of Reformer-Community Alliances

ERIC Educational Resources Information Center

Gordon, Hava Rachel

2016-01-01

This article provides a critical examination of neoliberal urgency in education reform. While critics of neoliberal reform policies have argued that these reforms exclude low-income community participation almost entirely, I argue that in practice this exclusion is not as total or as overt as macro-analyses would suggest. These macro analyses do…

Establishing a sense of urgency for leading transformational change.

PubMed

Shirey, Maria R

2011-04-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses successful tactics for establishing a sense of urgency to facilitate organizational change.

Outlooks on Children and Media: Child Rights, Media Trends, Media Research, Media Literacy, Child Participation, Declarations. Compiled for the World Summit on Media for Children (3rd, Thessaloniki, Greece, March 23-26, 2001).

ERIC Educational Resources Information Center

von Feilitzen, Cecilia, Comp.; Bucht, Catharina, Comp.

This report compiles information on recent and current trends in media literacy, including research on children and media, declarations related to the area, and a selection of relevant organizations and Web sites. The report first delineates children's rights as stipulated in the U.N. Convention on the Rights of the Child, especially as they…

[Tuberculosis as occupational disease].

PubMed

Mendoza-Ticona, Alberto

2012-06-01

There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupational disease among health care workers, presenting the current Peruvian law related.

The cortisol awakening response and memory performance in older men and women.

PubMed

Almela, Mercedes; van der Meij, Leander; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia

2012-12-01

The activity and regulation of the hypothalamus-pituitary-adrenal axis has been related to cognitive decline during aging. This study investigated whether the cortisol awakening response (CAR) is related to memory performance among older adults. The sample was composed of 88 participants (44 men and 44 women) from 55 to 77 years old. The memory assessment consisted of two tests measuring declarative memory (a paragraph recall test and a word list learning test) and two tests measuring working memory (a spatial span test and a spatial working memory test). Among those participants who showed the CAR on two consecutive days, we found that a greater CAR was related to poorer declarative memory performance in both men and women, and to better working memory performance only in men. The results of our study suggest that the relationship between CAR and memory performance is negative in men and women when memory performance is largely dependent on hippocampal functioning (i.e. declarative memory), and positive, but only in men, when memory performance is largely dependent on prefrontal cortex functioning (i.e. working memory). Copyright © 2012 Elsevier Ltd. All rights reserved.

Theoretical and Practical Issues of Systematization of Russian Energy Legislation When Bringing It into a Coherent System

ERIC Educational Resources Information Center

Shevchenko, Lyubov' I.; Ivanova, Svetlana A.

2016-01-01

The urgency of the problems stated in the paper is conditioned by the need to develop and adopt a new concept of legislation, which would have fixed the starting positions and the principles of legal regulation of relations in the sphere of fuel and energy complex, including the forms of Russia's participation in international projects in the…

Efficiency Analysis and Productivity of Socioeconomic Activities of the Municipal Museums on the Basis of Factorial Communications

ERIC Educational Resources Information Center

Nuykina, Elena Y.; Polyanskova, Natalia V.; Snegireva, Marija V.

2016-01-01

The urgency of the problem under investigation due to the fact that in most municipal districts with a deficit of financial and other resources are troubled almost all areas of museum activity. The article focused on the study of factor socioeconomic relations of municipal museums. The leading method to the study of this problem is the correlation…

Effectiveness of Retropubic Tension-Free Vaginal Tape and Transobturator Inside-Out Tape Procedures in Women With Overactive Bladder and Stress Urinary Incontinence

PubMed Central

Han, Ji-Yeon; Choo, Myung-Soo; Lee, Young-Suk; Seo, Ju Tae; Kim, Jang Hwan; Kim, Young Ho

2013-01-01

Purpose We compared the effectiveness of the retropubic tension-free vaginal tape (TVT) and the transobturator inside-out tape (TVT-O) in treating symptoms of overactive bladder (OAB) in women with stress urinary incontinence (SUI). Methods Women with urodynamic SUI and OAB (mean urgency episodes ≥1 and frequency ≥8/24 hours on a 3-day voiding diary) were assigned to the TVT or TVT-O group. Preoperative measures were based on a urodynamic study, 3-day voiding diary, the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTSSF), and the urgency perception scale (UPS). At 12 postoperative months, the 3-day voiding diary, symptoms questionnaire, patient satisfaction, and standing stress test were assessed. The primary endpoint was change in the number of urgency episodes/24 hours from baseline to 12 months. Results In this group of 132 women, 42 received TVT and 90 received TVT-O. The mean urgency episodes/24 hours decreased from 6.3±5.5 to 1.6±3.2 in the TVT group and from 5.1±4.4 to 1.8±3.0 in the TVT-O group. The mean percent change was significantly greater after TVT than after TVT-O (73% vs. 60%, P=0.049). All subscales of BFLUTSSF and UPS were significantly improved using either method, with significantly greater improvement seen in the quality of life (QoL) domain after TVT (P=0.002). There were no significant differences in the cure and satisfaction rates between the two groups. Conclusions Intervention with the TVT or the TVT-O significantly improved symptoms of OAB in women with SUI and OAB. Urgency and QoL significantly improved after TVT compared with that after TVT-O. PMID:24143294

Increased fatigability of external anal sphincter in inflammatory bowel disease: significance in fecal urgency and incontinence.

PubMed

Papathanasopoulos, Athanasios A; Katsanos, Konstantinos H; Tatsioni, Athina; Christodoulou, Dimitrios K; Tsianos, Epameinondas V

2010-11-01

Fatigability of external anal sphincter (EAS) has not been studied in inflammatory bowel disease (IBD) patients. We evaluated EAS fatigability in IBD patients with and without fecal incontinence (FI) and urgency, and correlated fatigability with demographic and clinical factors, and EAS endosonography. Fifty-eight consecutive IBD cases and 14 healthy volunteers completed Bristol stool form and a FI severity scale. Groups I, II and III included 27 patients with urgency including 13 with concomitant FI, 31 patients without FI or urgency, and 14 controls, respectively. We performed stationary pull-through manometry with an 8-channel water-perfused catheter. Fatigue rate (FR) was calculated by linear regression during a 20-s anal squeeze, and fatigue rate index (FRI) as the ratio of squeeze pressure increment to FR. EAS thickness and deficits were evaluated with an endoanal 10-MHz probe. Patients underwent sigmoidoscopy. Group I demonstrated a higher Bristol score, more frequent defecations, and more EAS defects compared to group II. Resting, peak squeeze pressures and EAS thickness did not differ between groups. FR was increased in group I versus II, and in group II versus III; FRI was decreased in group I versus II and in group II versus III (p<0.001, adjusting for age and BMI). Gender, oral glucocorticoids, presence of proctitis, perianal disease and EAS defects did not interact with group membership on FR or FRI. IBD is associated with increased fatigue rate and decreased fatigue rate index. These differences were even more striking in patients with incontinence or urgency. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Epidemiology of Mixed, Stress & Urgency Urinary Incontinence in Mid-Aged/Older Women: Importance of Incontinence History

PubMed Central

Komesu, Yuko M.; Schrader, Ronald M.; Ketai, Loren H.; Rogers, Rebecca G.; Dunivan, Gena C.

2016-01-01

Introduction & Hypothesis Urinary incontinence (UI) is common and the relationship between its subtypes is complex. Our objective was to describe the natural history and predictors of incontinence subtypes, Stress, Urgency and Mixed, in mid-aged and older U.S. women. We hypothesized that past UI subtype history predicted future UI subtype status and sought to determine the extent to which this occurred. Methods We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women ≥50 in the 2004–2010 Health and Retirement Study database. Mixed, Stress, Urgency incontinence prevalence (2004,2006,2008,2010) and 2-year cumulative incidence and remissions (2004–6,2006–8 2008–10) were estimated. Patient characteristics and incontinence subtype status 2004–2008 were entered into a multivariable model to determine predictors for incontinence subtype occurrence in 2010. Results Prevalence of each subtype in this population (median age 63–66) was 2.6%–8.9%. Subtype incidence equaled 2.1–3.5% and remissions for each varied between 22.3–48.7%. Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, functional limitations. Compared to White women, Black women had decreased odds of incident Stress Incontinence, Hispanic women had increased odds of Stress Incontinence remission. Age 80–90 and severe obesity predicted incident Mixed Incontinence. Functional limitations predicted Mixed and Urgency Incontinence. The strongest predictor of incontinence subtypes was incontinence subtype history. Presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence [Odds Ratio (OR) Stress Incontinence=30.7, Urgency OR=47.4, Mixed OR=42.1]. Conclusions Although remissions were high, prior history of incontinence subtypes predicted recurrence. Incontinence status is dynamic but tends to recur over the longer term. PMID:26670573

Painful Bladder Filling and Painful Urgency Are Distinct Characteristics in Men and Women with Urologic Chronic Pelvic Pain Syndromes – A MAPP Research Network Study

PubMed Central

Lai, H. Henry; Krieger, John N.; Pontari, Michel A.; Buchwald, Dedra; Hou, Xiaoling; Landis, J. Richard

2015-01-01

Purpose To describe bladder-associated symptoms in patients with urologic chronic pelvic pain syndromes (UCPPS) and to correlate these symptoms with urologic, non-urologic, psychosocial, and quality of life measures. Methods Participants were 233 women and 191 men with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome in a multi-center study. They completed a battery of measures, including items asking if their pain worsened with bladder filling (“painful filling”) or if their urge to urinate was due to pain, pressure, or discomfort (“painful urgency”). Participants were categorized into 3 groups: 1) “both” painful filling and painful urgency, 2) “either” painful filling or painful urgency, or 3) “neither.” Results Seventy-five percent of men and 88% of women were categorized as “both” or “either.” These bladder characteristics were associated with more severe urologic symptoms (increased pain, frequency, urgency), higher somatic symptom burden, depression, and worse quality of life (all p<0.01, 3-group trend test). A gradient effect was observed across groups (both > either > neither). Compared to those in the “neither” group, men categorized as “both” or “either” reported more frequent UCPPS symptom flares, catastrophizing, and irritable bowel syndrome, and women categorized as “both” or “either” were more likely to have negative affect and chronic fatigue syndrome. Conclusions Men and women with bladder symptoms characterized as painful filling or painful urgency had more severe urologic symptoms, more generalized symptoms, and worse quality of life than participants who reported neither characteristic, suggesting that these symptom characteristics might represent important subsets of UCPPS patients. PMID:26192257

Communicating the Urgency and Challenge of Global Climate Change: Lessons Learned and New Strategies

NASA Astrophysics Data System (ADS)

Dilling, L.; Moser, S. C.

2004-12-01

Climate change can sometimes be characterized as a "creeping environmental problem"--it is complex and long-term, involves long system lags, lacks the immediacy of everyday experience and thus is hard to perceive, and feels overwhelming to most individuals. Climate change thus does not typically attain the status of an urgent concern, taking priority over other matters for individuals, organizations or in the policy arena. We review the major reasons behind this lack of urgency, and document the observed consequences of previous communication strategies, including lack of public understanding, indifference, confusion, fear and uncertainty. We find that certain emotional motivators such as fear and guilt, while oft-employed, do not actually result in improved recognition of the urgency of the issue, nor do they typically result in action. Rather, positive and engaging approaches may be more likely to achieve this goal. We propose seven strategies to improve the communication of climate change and its urgency: 1) Abide by basic communication rules and heed the warnings of communication experts; 2) Address the emotional and the temporal components of "urgency"; 3) Increase the persuasiveness of the message; 4) Use trusted messengers-broaden the circle; 5) Use opportunities well; 6) Tap into individual and cultural strengths and values; and 7) Unite and Conquer. The multi-faceted nature of the proposed strategies reflects the unique challenges of the climate change issue as well as the need to engage all levels and sectors of societies in the solution, from individuals, to businesses, to governments. These strategies and results emerged from a multi-disciplinary, academic/practitioner workshop on the topic held at NCAR in summer 2004.

Do emotion regulation difficulties when upset influence the association between dietary restraint and weight gain among college students?

PubMed

Hunt, Tyler K; Forbush, Kelsie T; Hagan, Kelsey E; Chapa, Danielle A N

2017-07-01

Obesity is a significant public health concern that affects more than one-fifth of adolescents aged 12-19 in the United States. Theoretical models suggest that prolonged dietary restraint leads to binge-eating behaviors, which in turn increases individuals' risk for weight gain or obesity. Results from the literature indicate a potential role for negative urgency (the tendency to act rashly when distressed) as a mediating variable that explains the link between dietary restraint and binge-eating episodes. The current study tested short-term, prospective longitudinal associations among dietary restraint, binge eating, negative urgency, and weight gain among college students - a population at increased risk for the development of overweight and obesity. We hypothesized that dietary restraint and weight gain would be mediated by negative urgency and binge eating, but only among participants with overweight and obesity. College students (N = 227) completed the Eating Pathology Symptoms Inventory, UPPS-P Impulsivity Scale, and self-reported weight and height to calculate body mass index. Results showed that the association between dietary restraint and weight gain was mediated by negative urgency and binge eating, but only among participants with overweight and obesity. Our findings indicated that negative urgency might represent a mechanism that explains why dietary restraint leads to future binge-eating episodes and weight gain among college students with overweight and obesity. Results suggest that future treatment and prevention programs for overweight and obesity may benefit from incorporating strategies to improve emotion regulation as a way to reduce binge eating and to prevent additional weight gain among 'at-risk' populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Climate Change and Professional Responsibility: A Declaration of Helsinki for Engineers.

PubMed

Lawlor, Rob; Morley, Helen

2017-10-01

In this paper, we argue that the professional engineering institutions ought to develop a Declaration of Climate Action. Climate change is a serious global problem, and the majority of greenhouse gas emissions come from industries that are enabled by engineers and represented by the engineering professional institutions. If the professional institutions take seriously the claim that a profession should be self-regulating, with codes of ethics that go beyond mere obedience to the law, and if they take their own ethical codes seriously, recognising their responsibility to the public and to future generations (and also recognising a duty of "responsible leadership"), the professional institutions ought to develop a declaration for engineers, addressing climate change. Our argument here is largely inspired by the history of the Declaration of Helsinki. The Declaration of Helsinki was created by the medical profession for the profession, and it held physicians to a higher standard of ethical conduct than was found in the legal framework of individual countries. Although it was not originally a legal document, the influence of the Declaration can be seen in the fact that it is now enshrined in law in a number of different countries. Thus, we argue that the engineering profession could, and should, play a significant role in the abatement of climate change by making changes within the profession. If the engineering profession sets strict standards for professional engineers, with sanctions for those who refuse to comply, this could have a significant impact in relation to our efforts to develop a coordinated response to climate change.

Impulsivity and Aggression in Schizophrenia: A Neural Circuitry Perspective with Implications for Treatment

PubMed Central

Hoptman, Matthew J.

2015-01-01

Elevations of impulsive behavior have been observed in a number of serious mental illnesses. These phenomena can lead to harmful behaviors, including violence, and thus represent a serious public health concern. Such violence is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Despite the attention paid to violence, little is understood about its neural basis in schizophrenia. On a psychological level, aggression in schizophrenia has been primarily attributed to psychotic symptoms, desires for instrumental gain, or impulsive responses to perceived personal slights. Often multiple attributions can coexist during a single aggressive incident. In this review, I will discuss the neural circuitry associated with impulsivity and aggression in schizophrenia, with an emphasis on implications for treatment. Impulsivity appears to account for a great deal of aggression in schizophrenia, especially in inpatient settings. Urgency, defined as impulsivity in the context of strong emotion, is the primary focus of this article. It is elevated in several psychiatric disorders, and in schizophrenia, it has been related to aggression. Many studies have implicated dysfunctional frontotemporal circuitry in impulsivity and aggression in schizophrenia, and pharmacological treatments may act via that circuitry to reduce urgency and aggressive behaviors, but more mechanistic studies are critically needed. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. It is hoped that these approaches will improve treatment efficacy. PMID:25900066

Formation and maintenance of the territorial balance in the conditions of high-rise construction in the city

NASA Astrophysics Data System (ADS)

Kisel, Tatiana

2018-03-01

High-rise construction results in the need of planning of infrastructure facilities, taking into account the increase in loading, as high-rise construction allows to place considerably bigger number of residents in the limited territory. For this purpose it is necessary to estimate the required and actual level of providing the population with each particular type of the facilities of social infrastructure. The compliance of required and actual level of providing can be characterized as the territorial balance, while the discrepancy acts as the territorial imbalance. The article is devoted to the development of such instruments of planning of urban development, which will allow to create the qualitative urban environment, founded on the territorial balances. Namely, it is devoted to the calculation of level of providing the population with the facilities of social infrastructure, to the determination of level of the imbalance in absolute and relative units and also to the ranging of imbalances on urgency of their elimination. The size of the imbalance is of great importance for planning and realization of managerial influences from the executive authorities, operating the city development. In order to determine the urgency of realization of actions for the construction of facilities of social infrastructure it is offered to range the imbalances according to their size, having determined the deviation size from balance, which is so insignificant that it does not demand any managerial influences (it can be characterized as balance) and also the groups of the imbalances, differing in urgency of managerial influences, directed to the decrease and elimination of the revealed imbalance.

Nocturia in men is a chaotic condition dominated by nocturnal polyuria.

PubMed

Fujimura, Tetsuya; Yamada, Yuta; Sugihara, Toru; Azuma, Takeshi; Suzuki, Motofumi; Fukuhara, Hiroshi; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

2015-05-01

To characterize nocturia in men based on frequency volume chart data and symptom profiles assessed using the Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires. The Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires were administered to 299 consecutive treatment naïve men with nocturia (≥one time per night). Frequency volume chart data were recorded for 2 days. Correlations between nocturia and clinical characteristics including symptom scores, clinical diagnosis, Charlson Comorbidity Index, estimated glomerular filtration rate, uroflowmetry and prostate volume were analyzed. Patients were divided into five groups: one time (n = 36), two times (n = 65), three times (n = 85), four times (n = 78) and five times (n = 34) of nocturia. Age, prevalence or severity of chronic kidney disease, hyperlipidemia, low bladder capacity, nocturnal polyuria, urgency, bladder pain and sleep disorders were significantly correlated with the severity of nocturia. The Spearman correlation analysis identified eight possible independent factors for nocturia: age, estimated glomerular filtration rate, urgency, bladder pain, sleep quality, sleepiness during the day, average voided volume and nocturnal volume divided by body weight. Logistic regression analysis showed that nocturnal volume divided by body weight was the strongest factor of nocturia, and ≥7, 9 and 9.7 mL/kg were practical cut-off values of three, four and five times per night of nocturia, respectively. Nocturia in men is a chaotic condition dominated by nocturnal polyuria, and related to multiple factors including age, renal function, urgency, bladder pain, insomnia and bladder volume. © 2015 The Japanese Urological Association.

Relation of Bowel Habits to Fecal Incontinence in Women

PubMed Central

Bharucha, Adil E.; Seide, Barbara M.; Zinsmeister, Alan R.; Melton, L. Joseph

2008-01-01

BACKGROUND Though most women with fecal incontinence (FI) have anorectal dysfunctions, a majority have intermittent symptoms. Variations in bowel habits and daily routine may partly explain this. AIM To compare bowel habits and daily routine between controls and FI, and between continent and incontinent stools among women with FI. METHOD Using a mailed questionnaire, we identified 507 women with FI among 5,300 women in Olmsted County, MN. Bowel habits were compared among 127 randomly selected controls and 154 women with self-reported FI, who did (“active” FI, N = 106) or did not (“inactive” FI, N = 48) have an incontinent episode during a 2-wk bowel diary period. RESULTS Independent risk factors for FI were: rectal urgency (odds ratio [OR] for inactive FI vs controls 5.6, 95% confidence interval [CI] 2.3–13.3; and OR for active FI vs inactive FI 2.0, 95% CI 0.9–4.3) and a sense of incomplete evacuation (OR for inactive FI vs controls 3.5, 95% CI 1.4–8.8; and OR for active FI vs inactive FI 2.2, 95% CI 1.1–4.9). Similar results were found for stool frequency and form. Among incontinent women, incontinent stools (versus continent stools) were less formed, more likely to occur at work, and to be preceded by rectal urgency. CONCLUSIONS Bowel patterns, rectal urgency, and daily routine influence the occurrence of FI. Stool characteristics explained 46% of the likelihood for incontinence episodes, emphasizing that anorectal sensorimotor dysfunctions must also contribute to FI in women. PMID:18510612

Short-term results of changes in existing and de novo lower urinary tract symptoms after robot-assisted laparoscopic uterosacral ligament suspension and sacrocolpopexy.

PubMed

Kurdoglu, Mertihan; Unlu, Serdar; Antonetti-Elford, Megan; Kurdoglu, Zehra; Kilic, Gokhan S

2018-03-06

This study presents short-term outcomes related to changes in existing and de novo lower urinary tract symptoms (LUTS), pelvic pain, and bowel function following robot-assisted laparoscopic uterosacral ligament suspension (RALUSLS) and sacrocolpopexy (RALSC). Observational data for RALUSLS (n = 23) and RALSC (n = 25) collected between August 2014 and March 2016 from a single institute (The University of Texas Medical Branch) were evaluated retrospectively. Patient characteristics, concomitant procedures, and the occurrence of lower urinary tract, pelvic pain, and bowel symptoms were compared between patients undergoing RALUSLS and RALSC. There was no significant difference in background characteristics between the 2 groups, except for parity, which was high in the RALUSLS group. In the RALUSLS group, patients experienced significant resolution of urinary urgency (P < .001) and frequency, urge and mixed incontinence, and pelvic pain (P < .05). In the RALSC group, there was significant resolution of nocturia, mixed incontinence, pelvic pain, and dyspareunia (P < .05). There was no significant difference in the occurrence of de novo symptoms in the RALUSLS and RALSC groups (P > .05), although newly appearing urinary urgency or frequency and stress or urge incontinence were more common after RALSC. Mixed incontinence and pelvic pain improved significantly in patients after RALUSLS or RALSC. In RALUSLS patients, urgency, frequency, and urge incontinence also improved, whereas additional improvement in nocturia and dyspareunia was evident only in RALSC patients. De novo LUTS developing after these procedures, especially after RALSC, necessitate careful patient consultation prior to surgery. © 2018 John Wiley & Sons Australia, Ltd.

Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture.

PubMed

Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens; Jangö, Hanna

2017-06-01

To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women randomly identified, 763 were eligible and received a questionnaire. Maternal and obstetric data were retrieved from the national registry. The response rate was 58.3%. In total, 394 women were included for analysis after reviewing responses according to previously defined exclusion criteria. Median follow-up time was 9.8 years after the first delivery and 6.4 years after the second. The prevalence of flatal incontinence, fecal incontinence and fecal urgency were 11.7, 4.1, and 12.3%, respectively. Overall, 20.1% had any degree of anal incontinence and/or fecal urgency. In 6.3% these symptoms affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal deliveries without OASIS at long-term follow-up. Episiotomy or vacuum extraction did not alter the risk of long-term anal incontinence.

Agreement on urgency assessment between secretaries and general practitioners: an observational study in out-of-hours general practice service in Belgium.

PubMed

Philips, H; Van Bergen, J; Huibers, L; Colliers, A; Bartholomeeusen, S; Coenen, S; Remmen, R

2015-10-01

In some European countries telephone triage (TT) during out-of-hours primary care showed to be safe and effective. Other countries, such as Belgium, may not have trained auxiliary personnel while their national health services want to establish TT. To compare urgency levels assessed by secretaries and general practitioners in one general practice cooperative in Belgium. Percentage of correct-, under-, and over-triage were calculated in total and per reason for encounter. Inter-rater agreement was investigated. The secretaries correctly triaged (same urgency level) 77% of the telephone calls, under-triaged 10% and over-triaged 13%.'Shortness of breath', 'skin cuts', 'chest pain', 'feeling unwell' and 'syncope' were often under-triaged. Before introducing TT, auxiliary staff should be trained and protocols should be used.

Contextualizing individual differences in error monitoring: Links with impulsivity, negative affect, and conscientiousness.

PubMed

Hill, Kaylin E; Samuel, Douglas B; Foti, Dan

2016-08-01

The error-related negativity (ERN) is a neural measure of error processing that has been implicated as a neurobehavioral trait and has transdiagnostic links with psychopathology. Few studies, however, have contextualized this traitlike component with regard to dimensions of personality that, as intermediate constructs, may aid in contextualizing links with psychopathology. Accordingly, the aim of this study was to examine the interrelationships between error monitoring and dimensions of personality within a large adult sample (N = 208). Building on previous research, we found that the ERN relates to a combination of negative affect, impulsivity, and conscientiousness. At low levels of conscientiousness, negative urgency (i.e., impulsivity in the context of negative affect) predicted an increased ERN; at high levels of conscientiousness, the effect of negative urgency was not significant. This relationship was driven specifically by the conscientiousness facets of competence, order, and deliberation. Links between personality measures and error positivity amplitude were weaker and nonsignificant. Post-error slowing was also related to conscientiousness, as well as a different facet of impulsivity: lack of perseverance. These findings suggest that, in the general population, error processing is modulated by the joint combination of negative affect, impulsivity, and conscientiousness (i.e., the profile across traits), perhaps more so than any one dimension alone. This work may inform future research concerning aberrant error processing in clinical populations. © 2016 Society for Psychophysiological Research.

Investigating the Mediational Role of Negative Urgency in the Anxiety Sensitivity Pathway to Cannabis Problems and Dependence Symptoms among Postsecondary Students

ERIC Educational Resources Information Center

Keough, Matthew T.; Hendershot, Christian S.; Wardell, Jeffrey D.; Bagby, R. Michael

2018-01-01

Objectives: Anxiety sensitivity (AS) is associated with cannabis use. People high in AS may use cannabis to cope with elevated anxiety. This association is consistently supported in the literature. However, we have much to learn about the mechanisms of the AS pathway to cannabis use. We aimed to examine negative urgency--the tendency to act…

Sacral neuromodulation for lower urinary tract dysfunction.

PubMed

Van Kerrebroeck, Philip E V; Marcelissen, Tom A T

2012-08-01

To review the technique, indications, results and working mechanisms of sacral neuromodulation (SNM) for lower urinary tract dysfunction. The available literature on SNM for lower urinary tract dysfunction was searched. Based on the information available in the literature and also based on personal experience, the urological indications, technique, mechanisms of action and results of SNM are presented and discussed. SNM for lower urinary tract dysfunction involves stimulation of the 3rd sacral nerve with an electrode implanted in the sacral foramen and connected to a pulse generator. The technique is accepted by the FDA since 1997. Currently, SNM for lower urinary tract dysfunction has been successfully used in about 26,000 patients with various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. The actual procedure of SNM consists of a minimal invasive technique and is effective in about 70% of the patients who have been implanted with a permanent system. Also, in pelvic pain, interesting results have been described. SNM modulates the micturition reflexes at different levels in the central nervous system. Sacral neuromodulation is a safe and effective therapy for various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. It should be the first choice after failure of maximal conservative therapy.

Hippocampal declarative memory supports gesture production: Evidence from amnesia

PubMed Central

Hilliard, Caitlin; Cook, Susan Wagner; Duff, Melissa C.

2016-01-01

Spontaneous co-speech hand gestures provide a visuospatial representation of what is being communicated in spoken language. Although it is clear that gestures emerge from representations in memory for what is being communicated (De Ruiter, 1998; Wesp, Hesse, Keutmann, & Wheaton, 2001), the mechanism supporting the relationship between gesture and memory is unknown. Current theories of gesture production posit that action – supported by motor areas of the brain – is key in determining whether gestures are produced. We propose that when and how gestures are produced is determined in part by hippocampally-mediated declarative memory. We examined the speech and gesture of healthy older adults and of memory-impaired patients with hippocampal amnesia during four discourse tasks that required accessing episodes and information from the remote past. Consistent with previous reports of impoverished spoken language in patients with hippocampal amnesia, we predicted that these patients, who have difficulty generating multifaceted declarative memory representations, may in turn have impoverished gesture production. We found that patients gestured less overall relative to healthy comparison participants, and that this was particularly evident in tasks that may rely more heavily on declarative memory. Thus, gestures do not just emerge from the motor representation activated for speaking, but are also sensitive to the representation available in hippocampal declarative memory, suggesting a direct link between memory and gesture production. PMID:27810497

Non-Declarative Sequence Learning does not Show Savings in Relearning

PubMed Central

Keisler, Aysha; Willingham, Daniel T.

2007-01-01

Researchers have utilized the savings in relearning paradigm in a variety of settings since Ebbinghaus developed the tool over a century ago. In spite of its widespread use, we do not yet understand what type(s) of memory are measurable by savings. Specifically, can savings measure both declarative and non-declarative memories? The lack of conscious recollection of the encoded material in some studies indicates that non-declarative memories may show savings effects, but as all studies to date have used declarative tasks, we cannot be certain. Here, we administer a non-declarative task and then measure savings in relearning the material declaratively. Our results show that while material outside of awareness may show savings effects, non-declarative sequence memory does not. These data highlight the important distinction between memory without awareness and non-declarative memory. PMID:17343944

Non-declarative sequence learning does not show savings in relearning.

PubMed

Keisler, Aysha; Willingham, Daniel T

2007-04-01

Researchers have utilized the savings in relearning paradigm in a variety of settings since Ebbinghaus developed the tool over a century ago. In spite of its widespread use, we do not yet understand what type(s) of memory are measurable by savings. Specifically, can savings measure both declarative and non-declarative memories? The lack of conscious recollection of the encoded material in some studies indicates that non-declarative memories may show savings effects, but as all studies to date have used declarative tasks, we cannot be certain. Here, we administer a non-declarative task and then measure savings in relearning the material declaratively. Our results show that while material outside of awareness may show savings effects, non-declarative sequence memory does not. These data highlight the important distinction between memory without awareness and non-declarative memory.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics.

PubMed

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-11-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

PubMed Central

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the ‘can't intubate, can't oxygenate’ situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training. PMID:26449292

Selective sex differences in declarative memory.

PubMed

Maitland, Scott B; Herlitz, Agneta; Nyberg, Lars; Bäckman, Lars; Nilsson, Lars-Göran

2004-10-01

Sex invariance of a six-factor, higher order model of declarative memory (two second-order factors: episodic and semantic memory; and four first-order factors: recall, recognition, fluency, and knowledge) was established for 1,796 participants (35-85 years). Metric invariance of first- and second-order factor loadings across sex was demonstrated. At the second-order level, a female advantage was observed for both episodic and semantic memory. At the first-order level, sex differences in episodic memory were apparent for both recall and recognition, whereas the differences in semantic memory were driven by a female superiority in fluency. Additional tests of sex differences in three age groups (35-50, 55-65, and 70-85 years of age) indicated that the female superiority in declarative memory diminished with advancing age. The factor-specific sex differences are discussed in relation to sex differences in hippocampal function.

The neural basis of novelty and appropriateness in processing of creative chunk decomposition.

PubMed

Huang, Furong; Fan, Jin; Luo, Jing

2015-06-01

Novelty and appropriateness have been recognized as the fundamental features of creative thinking. However, the brain mechanisms underlying these features remain largely unknown. In this study, we used event-related functional magnetic resonance imaging (fMRI) to dissociate these mechanisms in a revised creative chunk decomposition task in which participants were required to perform different types of chunk decomposition that systematically varied in novelty and appropriateness. We found that novelty processing involved functional areas for procedural memory (caudate), mental rewarding (substantia nigra, SN), and visual-spatial processing, whereas appropriateness processing was mediated by areas for declarative memory (hippocampus), emotional arousal (amygdala), and orthography recognition. These results indicate that non-declarative and declarative memory systems may jointly contribute to the two fundamental features of creative thinking. Copyright © 2015 Elsevier Inc. All rights reserved.

Waiting for coronary angiography: is there a clinically ordered queue?

PubMed

Hemingway, H; Crook, A M; Feder, G; Dawson, J R; Timmis, A

2000-03-18

Among over 3000 patients undergoing coronary angiography in the absence of a formal queue-management system, we found that a-priori urgency scores were strongly associated with waiting times, prevalence of coronary-artery disease, rate of revascularisation, and mortality. These data challenge the widely held assumption that such waiting lists are not clinically ordered; however, the wide variation in waiting times within urgency categories suggests the need for further improvements in clinical queueing.

Integrative pathway knowledge bases as a tool for systems molecular medicine.

PubMed

Liang, Mingyu

2007-08-20

There exists a sense of urgency to begin to generate a cohesive assembly of biomedical knowledge as the pace of knowledge accumulation accelerates. The urgency is in part driven by the emergence of systems molecular medicine that emphasizes the combination of systems analysis and molecular dissection in the future of medical practice and research. A potentially powerful approach is to build integrative pathway knowledge bases that link organ systems function with molecules.

Delirium following fesoterodine treatment for urgency incontinence in an 89-year old man.

PubMed

Charbonneau, Jeannie Medeiros; Bisset, Rania; Nguyen, Patrick Viet-Quoc

2016-01-01

We describe the case of an 89-year-old man who developed delirium following the introduction of fesoterodine to treat his urgency incontinence. The patient started experiencing visual hallucinations approximately five days after starting fesoterodine 4 mg once daily. Delirium resolved after fesoterodine was stopped. Despite the apparent safe cognitive profile due to its pharmacodynamic properties, fesoterodine should be used with caution in the elderly, frail population.

The 9/11 Commission Report

DTIC Science & Technology

2004-07-17

athletic, skilled as a horseman, runner, climber, and soccer player. He had attended Abdul Aziz University in Saudi Arabia. By some accounts, he had been...High Probability of Near-Term “Spectacular”Attacks Threat reports surged in June and July, reaching an even higher peak of urgency . The summer...which the chief on the 23rd floor may have heard as well). He subsequently acted with a sense of urgency , and some firefighters heard the evacuation

Waiting lists and elective surgery: ordering the queue.

PubMed

Curtis, Andrea J; Russell, Colin O H; Stoelwinder, Johannes U; McNeil, John J

2010-02-15

In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed-upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high-demand procedures in other areas of health care.

Classification of hospital admissions into emergency and elective care: a machine learning approach.

PubMed

Krämer, Jonas; Schreyögg, Jonas; Busse, Reinhard

2017-11-25

Rising admissions from emergency departments (EDs) to hospitals are a primary concern for many healthcare systems. The issue of how to differentiate urgent admissions from non-urgent or even elective admissions is crucial. We aim to develop a model for classifying inpatient admissions based on a patient's primary diagnosis as either emergency care or elective care and predicting urgency as a numerical value. We use supervised machine learning techniques and train the model with physician-expert judgments. Our model is accurate (96%) and has a high area under the ROC curve (>.99). We provide the first comprehensive classification and urgency categorization for inpatient emergency and elective care. This model assigns urgency values to every relevant diagnosis in the ICD catalog, and these values are easily applicable to existing hospital data. Our findings may provide a basis for policy makers to create incentives for hospitals to reduce the number of inappropriate ED admissions.

Negative Urgency Accounts for the Association Between Borderline Personality Features and Intimate Partner Violence in Young Men

PubMed Central

Peters, Jessica R.; Derefinko, Karen J.; Lynam, Donald R.

2016-01-01

Many studies have demonstrated that borderline personality disorder (BPD) is associated with aggression and, in particular, intimate partner violence; however, the mechanisms underlying this association have been less clearly identified. The present study examines the hypothesis that negative urgency (impulsive behavior in response to intense, negative emotions) may explain the specific association between BPD and intimate partner violence. Cross-sectional self-report measures of BPD, violent behavior, and multiple dimensions of impulsivity were administered to 193 undergraduate men. BPD profile scores were associated with both general violence behaviors and intimate partner violence; however, an indirect path via negative urgency existed only with intimate partner violence. No indirect paths from BPD scores were demonstrated via any other factors of impulsivity, although sensation seeking was an independent predictor of general violence. Clinical implications and directions for future research are discussed. PMID:26845532

Negative Urgency Accounts for the Association Between Borderline Personality Features and Intimate Partner Violence in Young Men.

PubMed

Peters, Jessica R; Derefinko, Karen J; Lynam, Donald R

2017-02-01

Many studies have demonstrated that borderline personality disorder (BPD) is associated with aggression and, in particular, intimate partner violence; however, the mechanisms underlying this association have been less clearly identified. The present study examines the hypothesis that negative urgency (impulsive behavior in response to intense, negative emotions) may explain the specific association between BPD and intimate partner violence. Cross-sectional self-report measures of BPD, violent behavior, and multiple dimensions of impulsivity were administered to 193 undergraduate men. BPD profile scores were associated with both general violence behaviors and intimate partner violence; however, an indirect path via negative urgency existed only with intimate partner violence. No indirect paths from BPD scores were demonstrated via any other factors of impulsivity, although sensation seeking was an independent predictor of general violence. Clinical implications and directions for future research are discussed.

[Hypertensive crisis and posterior reversible encephalopathy syndrome (PRES)].

PubMed

Eberhardt, Olaf

2018-05-01

The urgency and intensity of therapeutic response to a hypertensive crisis are governed by the presence or absence of acute end-organ damage, which define hypertensive emergency and hypertensive urgency, respectively. In case of hypertensive urgency a slow and moderate lowering of blood pressure by oral antihypertensive agents seems adequate, while the approach to hypertensive emergency has to be tailored to the specific type of organ failure. Optimal blood pressure management in the context of neurovascular emergencies is made difficult by contradictory data from observational and interventional studies. It might prove advantageous to individualize treatment according to characteristics such as the location of persistent vessel occlusion or the presence of collaterals. Reversible posterior encephalopathy may present with atypical features that might make diagnosis difficult. Clevidipine might be a welcome supplement to current intravenous antihypertensive agents in neurological disease. Georg Thieme Verlag KG Stuttgart · New York.

The Work of Power and the Power of Work: Teaching for Class Consciousness in the Neo-Liberal Age

ERIC Educational Resources Information Center

Weiner, Eric J.

2004-01-01

As workers throughout the globe struggle to gain control over the conditions in which they labor as well as the means by which capital is produced, the importance of understanding class struggle, class formation and class consciousness as they relate to education and schooling takes on a new urgency. In the early part of the twenty-first century,…

An Examination of the Impact That Selected School Characteristics Have on the Academic Achievement of Students Attending High Schools in South Carolina

ERIC Educational Resources Information Center

McCord, Gregory A.

2014-01-01

The impact of school locale, size and poverty levels (SES) on student achievement has been of great interest in school research for more than the last five decades. The increasing public demand to hold schools accountable for their effects on student outcomes lends urgency to the task of exploring variables related to student achievement that are…

The Historical Significance of the Universal Declaration.

ERIC Educational Resources Information Center

Eide, Asbjorn

1998-01-01

Explains the historical significance of the Universal Declaration of Human Rights. Focuses on the initiative for the Declaration and its elaboration, the precursors to modern human rights, the foundation of the Declaration, the rights contained in the Universal Declaration, three modes of human rights analysis, and global governance and human…

19 CFR 148.18 - Failure to declare.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

19 CFR 148.18 - Failure to declare.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

19 CFR 148.18 - Failure to declare.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

19 CFR 148.18 - Failure to declare.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

19 CFR 148.18 - Failure to declare.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

Normal-range verbal-declarative memory in schizophrenia.

PubMed

Heinrichs, R Walter; Parlar, Melissa; Pinnock, Farena

2017-10-01

Cognitive impairment is prevalent and related to functional outcome in schizophrenia, but a significant minority of the patient population overlaps with healthy controls on many performance measures, including declarative-verbal-memory tasks. In this study, we assessed the validity, clinical, and functional implications of normal-range (NR), verbal-declarative memory in schizophrenia. Performance normality was defined using normative data for 8 basic California Verbal Learning Test (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000) recall and recognition trials. Schizophrenia patients (n = 155) and healthy control participants (n = 74) were assessed for performance normality, defined as scores within 1 SD of the normative mean on all 8 trials, and assigned to normal- and below-NR memory groups. NR schizophrenia patients (n = 26) and control participants (n = 51) did not differ in general verbal ability, on a reading-based estimate of premorbid ability, across all 8 CVLT-II-score comparisons or in terms of intrusion and false-positive errors and auditory working memory. NR memory patients did not differ from memory-impaired patients (n = 129) in symptom severity, and both patient groups were significantly and similarly disabled in terms of functional status in the community. These results confirm a subpopulation of schizophrenia patients with normal, verbal-declarative-memory performance and no evidence of decline from higher premorbid ability levels. However, NR patients did not experience less severe psychopathology, nor did they show advantage in community adjustment relative to impaired patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Probing the DPRK nuclear test-site to low magnitude using seismic pattern detectors

NASA Astrophysics Data System (ADS)

Kvaerna, T.; Gibbons, S. J.; Mykkeltveit, S.

2017-12-01

Six declared nuclear explosions at North Korea's Punggye-ri test-site between October 2006 and September 2017 were detected seismically both at regional and teleseismic distances. The similarity of body-wave signals from explosion to explosion allows us to locate these events relative to each other with high accuracy. Greater uncertainty in the relative time measurements for the most recent test on 3 September 2017 results in a greater uncertainty in the relative location estimate for this event, although it appears to have taken place below optimal overburden close to the peak of Mount Mantap. A number of smaller events, detected mainly at regional distances, have been identified as being at, or very close to, the test site. Due to waveform differences and available station coverage, a simple double-difference relative location is often not possible. In addition to the apparent collapse event some 8 minutes after the declared nuclear test, small seismic events have been detected on 25 May 2014, 11 September 2016, 23 September 2017, and 12 October 2017. The signals from these events differ significantly from those from the declared nuclear tests with far weaker Pn and far stronger Lg phases. Multi-channel correlation analysis and empirical matched field processing allow us to categorize these weaker seismic events with far greater confidence than classical waveform analysis allows.

37 CFR 1.69 - Foreign language oaths and declarations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Foreign language oaths and... Declaration § 1.69 Foreign language oaths and declarations. (a) Whenever an individual making an oath or declaration cannot understand English, the oath or declaration must be in a language that such individual can...

A shared resource between declarative memory and motor memory

PubMed Central

Keisler, Aysha; Shadmehr, Reza

2010-01-01

The neural systems that support motor adaptation in humans are thought to be distinct from those that support the declarative system. Yet, during motor adaptation changes in motor commands are supported by a fast adaptive process that has important properties (rapid learning, fast decay) that are usually associated with the declarative system. The fast process can be contrasted to a slow adaptive process that also supports motor memory, but learns gradually and shows resistance to forgetting. Here we show that after people stop performing a motor task, the fast motor memory can be disrupted by a task that engages declarative memory, but the slow motor memory is immune from this interference. Furthermore, we find that the fast/declarative component plays a major role in the consolidation of the slow motor memory. Because of the competitive nature of declarative and non-declarative memory during consolidation, impairment of the fast/declarative component leads to improvements in the slow/non-declarative component. Therefore, the fast process that supports formation of motor memory is not only neurally distinct from the slow process, but it shares critical resources with the declarative memory system. PMID:21048140

The hippocampus and memory for orderly stimulus relations

PubMed Central

Dusek, Jeffery A.; Eichenbaum, Howard

1997-01-01

Human declarative memory involves a systematic organization of information that supports generalizations and inferences from acquired knowledge. This kind of memory depends on the hippocampal region in humans, but the extent to which animals also have declarative memory, and whether inferential expression of memory depends on the hippocampus in animals, remains a major challenge in cognitive neuroscience. To examine these issues, we used a test of transitive inference pioneered by Piaget to assess capacities for systematic organization of knowledge and logical inference in children. In our adaptation of the test, rats were trained on a set of four overlapping odor discrimination problems that could be encoded either separately or as a single representation of orderly relations among the odor stimuli. Normal rats learned the problems and demonstrated the relational memory organization through appropriate transitive inferences about items not presented together during training. By contrast, after disconnection of the hippocampus from either its cortical or subcortical pathway, rats succeeded in acquiring the separate discrimination problems but did not demonstrate transitive inference, indicating that they had failed to develop or could not inferentially express the orderly organization of the stimulus elements. These findings strongly support the view that the hippocampus mediates a general declarative memory capacity in animals, as it does in humans. PMID:9192700

Strain Specific Phage Treatment for Staphylococcus aureus Infection Is Influenced by Host Immunity and Site of Infection.

PubMed

Pincus, Nathan B; Reckhow, Jensen D; Saleem, Danial; Jammeh, Momodou L; Datta, Sandip K; Myles, Ian A

2015-01-01

The response to multi-drug resistant bacterial infections must be a global priority. While mounting resistance threatens to create what the World Health Organization has termed a "post-antibiotic era", the recent discovery that antibiotic use may adversely impact the microbiome adds further urgency to the need for new developmental approaches for anti-pathogen treatments. Methicillin-resistant Staphylococcus aureus (MRSA), in particular, has declared itself a serious threat within the United States and abroad. A potential solution to the problem of antibiotic resistance may not entail looking to the future for completely novel treatments, but instead looking into our history of bacteriophage therapy. This study aimed to test the efficacy, safety, and commercial viability of the use of phages to treat Staphylococcus aureus infections using the commercially available phage SATA-8505. We found that SATA-8505 effectively controls S. aureus growth and reduces bacterial viability both in vitro and in a skin infection mouse model. However, this killing effect was not observed when phage was cultured in the presence of human whole blood. SATA-8505 did not induce inflammatory responses in peripheral blood mononuclear cultures. However, phage did induce IFN gamma production in primary human keratinocyte cultures and induced inflammatory responses in our mouse models, particularly in a mouse model of chronic granulomatous disease. Our findings support the potential efficacy of phage therapy, although regulatory and market factors may limit its wider investigation and use.

Outsmarting cancer: an international brainstorm in Guangzhou.

PubMed

Qian, Chao-Nan; Zhang, Wei

2011-08-01

Cancer is the most deadly disease in the United States. In developing countries such as China, cancer is increasingly prevalent as a cause of death. The "war against cancer" that was initially declared in the United States has become a global war that requires an alliance of world-wide cancer researchers. As part of such an effort, the Second Guangzhou International Symposium on Oncology was held on May 20-22, 2011, in Guangzhou, China. The symposium was jointly organized by the Guangdong Anti-Cancer Association, the US Chinese Anti-Cancer Association (USCACA), the Chinese Journal of Cancer, and the Sun Yat-sen University Cancer Center. More than 1000 cancer researchers attended, including speakers from China, the USA, Finland, England, Japan, and Spain. The presentations covered most cancer types and both basic and clinical research. Recurring themes of the presentations were that cancer is "smart", cancer is complex, and cancer cells communicate actively. Outsmarting cancer is clearly a challenging task that needs multipronged attacks on multiple targets and on the communication systems among cancer cells. Presenters and attendees left the conference with a sense of urgency in the need for more communication among cancer researchers in fighting this disease. In this article, we summarize highlights from a number of presentations. Many of the presenters have published or will publish reviews and research articles in the Chinese Journal of Cancer, which has become an important international forum in disseminating exciting cancer research progress.

Mid-term follow-up of the TVT-Secur midurethral sling for primary stress incontinence.

PubMed

Angleitner-Flotzinger, Johannes; Aigmueller, Thomas

2014-09-01

The TVT-Secur was introduced in 2006 as a less invasive alternative to retropubic and transobturator suburethral slings. This retrospective cohort study evaluated objective and subjective results in a series of 158 consecutive patients as well as complications and the reoperation rate after TVT-Secur procedure. Between November 2006 and June 2010 a total of 158 patients underwent a TVT-Secur procedure at a single institution. All patients underwent preoperative urodynamic testing. All patients were invited for follow-up including physical examination, urodynamic studies and subjective evaluation. A total of 96 patients (61%) were available for follow-up with a mean follow-up of 29.8 months (range 5-50, median 30). At follow-up, eight (8%) of 96 patients had reoperations for stress incontinence. There were no reoperations for bleeding/hematoma, tape erosions or obstructed micturition and there were no tape erosions or exposures. 29 patients (30%) had a negative cough stress test and 44 patients (46%) subjectively considered themselves "cured". Nine of 43 patients (21%) without urgency symptoms preoperatively developed de novo urgency; 24 of 35 patients (69%) with preoperative urgency complaints were free of urgency symptoms. At 2.4 years, the TVT-Secur appears to have a low adverse events profile but inferior results compared with traditional midurethral slings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Discriminating evidence accumulation from urgency signals in speeded decision making.

PubMed

Hawkins, Guy E; Wagenmakers, Eric-Jan; Ratcliff, Roger; Brown, Scott D

2015-07-01

The dominant theoretical paradigm in explaining decision making throughout both neuroscience and cognitive science is known as “evidence accumulation”--The core idea being that decisions are reached by a gradual accumulation of noisy information. Although this notion has been supported by hundreds of experiments over decades of study, a recent theory proposes that the fundamental assumption of evidence accumulation requires revision. The "urgency gating" model assumes decisions are made without accumulating evidence, using only moment-by-moment information. Under this assumption, the successful history of evidence accumulation models is explained by asserting that the two models are mathematically identical in standard experimental procedures. We demonstrate that this proof of equivalence is incorrect, and that the models are not identical, even when both models are augmented with realistic extra assumptions. We also demonstrate that the two models can be perfectly distinguished in realistic simulated experimental designs, and in two real data sets; the evidence accumulation model provided the best account for one data set, and the urgency gating model for the other. A positive outcome is that the opposing modeling approaches can be fruitfully investigated without wholesale change to the standard experimental paradigms. We conclude that future research must establish whether the urgency gating model enjoys the same empirical support in the standard experimental paradigms that evidence accumulation models have gathered over decades of study. Copyright © 2015 the American Physiological Society.

An investigation of two dimensions of impulsivity as predictors of loss-of-control eating severity and frequency.

PubMed

Espel, Hallie M; Muratore, Alexandra F; Lowe, Michael R

2017-10-01

Loss-of-control (LOC) eating episodes represent one form of dysregulated eating common to full- and sub-threshold eating disorders. Extensive evidence suggests that impulsivity, particularly in the context of negative affect and/or depression, may play an important etiological role in the development and maintenance of LOC eating. However, most prior studies have considered LOC eating as a dichotomous rather than dimensional construct, and few studies have considered the interaction of multiple dimensions of impulsivity while also accounting for the role of depressive symptoms. The present study examined the independent and interacting effects of two facets of impulsivity-response inhibition and negative urgency-on LOC eating episode severity and frequency among college women (N = 102). Depressive symptom severity was included as a covariate. Results indicated that greater negative urgency was associated with greater LOC severity; this effect was moderated by response inhibition, such that the effect of urgency was particularly pronounced for individuals with higher response inhibition capacity. Negative urgency was the only significant predictor of LOC frequency. Depression had no significant effect on either LOC severity or frequency (ps ≥ 0.16). Results support the importance of considering multiple facets of impulsivity in predicting LOC eating behavior, and further indicate that factors influencing subjective severity and frequency of LOC may be distinct. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Meta-analysis of clinical efficacy of TVT-S versus TVT-O/TOT in the treatment of stress urinary incontinence].

PubMed

Zhou, Quan; Song, Yan-feng; Chen, Jie; Qiu, Lin-lin; Yuan, Xiao-dong

2012-10-09

To assess the current evidence of effectiveness and safety of Single-incision mini-slings (TVT-S) versus transobturator tension-free vaginal tapes (TVT-O/TOT) in the management of female stress urinary incontinence (SUI). Literature searches were conducted for all randomized controlled trials (RCTs) comparing TVT-S and TVT-O/TOT from CNKI, CBM, VIP, MEDLINE, OVID, FMJS and Cochrane Library between November 1996 and November 2011. The Revman 5.1.0 software was used for Meta-analysis according to Cochrane system evaluation method. A total of 1545 females in 7 RCTs were included. Meta-analysis showed that no statistical differences existed in the rate of postoperative voiding dysfunction and dyspareunia between TVT-S and TVT-O/TOT (P > 0.05). But the rate of objective cure, re-operation, inner thigh and groin pain and de novo urgency were statistically significant (P < 0.05). As compared with TVT-O/TOT, TVT-S procedure is associated with less postoperative inner thigh and groin pain, but a lower objective cure rate and relatively higher rates of de novo urgency and re-operation.

Emotionally laden impulsivity interacts with affect in predicting addictive use of online sexual activity in men.

PubMed

Wéry, Aline; Deleuze, Jory; Canale, Natale; Billieux, Joël

2018-01-01

The interest in studying addictive use of online sexual activities (OSA) has grown sharply over the last decade. Despite the burgeoning number of studies conceptualizing the excessive use of OSA as an addictive disorder, few have tested its relations to impulsivity, which is known to constitute a hallmark of addictive behaviors. To address this missing gap in the literature, we tested the relationships between addictive OSA use, impulsivity traits, and affect among a convenience sample of men (N=182; age, M=29.17, SD = 9.34), building upon a theoretically driven model that distinguishes the various facets of impulsivity. Results showed that negative urgency (an impulsivity trait reflecting the tendency to act rashly in negative emotional states) and negative affect interact in predicting addictive OSA use. These results highlight the pivotal role played by negative urgency and negative affect in addictive OSA use, supporting the relevance of psychological interventions that focus on improving emotional regulation (e.g., to reduce negative affect and learn healthier coping strategies) to mitigate excessive use of OSA. Copyright © 2017 Elsevier Inc. All rights reserved.

26 CFR 301.6316-6 - Declarations of estimated tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Declarations of estimated tax. 301.6316-6... Declarations of estimated tax. (a) Filing of declaration. A declaration of estimated tax in respect of amounts on which the tax is to be paid in foreign currency under the provisions of § 301.6316-1 shall be...