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Sample records for conversion disorder

  1. Postoperative conversion disorder.

    Science.gov (United States)

    Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

    2016-05-01

    Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Paradoxical therapy in conversion disorder

    OpenAIRE

    ATAOĞLU, Ahmet

    1998-01-01

    Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour, such as performing complusive ritual or bringing on a conversion attack. In this study paradoxical intention (PI) was used with to half of the patients with conversion disorders, while the other half were treated with diazepam in order to examine the efficiency of the PI versus diazepam in conversion disorder. Patients treated with PI appeared to have a greater improvement r...

  3. [Neuropsychological assessment in conversion disorder].

    Science.gov (United States)

    Demır, Süleyman; Çelıkel, Feryal Çam; Taycan, Serap Erdoğan; Etıkan, İlker

    2013-01-01

    Conversion disorder is characterized by functional impairment in motor, sensory, or neurovegetative systems that cannot be explained by a general medical condition. Diagnostic systems emphasize the absence of an organic basis for the dysfunction observed in conversion disorder. Nevertheless, there is a growing body of data on the specific functional brain correlates of conversion symptoms, particularly those obtained via neuroimaging and neurophysiological assessment. The present study aimed to determine if there are differences in measures of cognitive functioning between patients with conversion disorder and healthy controls. The hypothesis of the study was that the patients with conversion disorder would have poorer neurocognitive performance than the controls. The patient group included 43 patients diagnosed as conversion disorder and other psychiatric comorbidities according to DSM-IV-TR. Control group 1 included 44 patients diagnosed with similar psychiatric comorbidities, but not conversion diosorder, and control group 2 included 43 healthy individuals. All participants completed a sociodemographic questionnaire and were administered the SCID-I and a neuropsychological test battery of 6 tests, including the Serial Digit Learning Test (SDLT), Auditory Verbal Learning Test (AVLT), Wechsler Memory Scale, Stroop Color Word Interference Test, Benton Judgment of Line Orientation Test (BJLOT), and Cancellation Test. The patient group had significantly poorer performance on the SDLT, AVLT, Stroop Color Word Interference Test, and BJLOT than both control groups. The present findings highlight the differences between the groups in learning and memory, executive and visuospatial functions, and attention, which seemed to be specific to conversion disorder.

  4. Progress in understanding conversion disorder

    Science.gov (United States)

    Allin, Matthew; Streeruwitz, Anna; Curtis, Vivienne

    2005-01-01

    Conversion disorder has a history that may reach back into antiquity, and it continues to present a clinical challenge to both psychiatrists and neurologists. This article reviews the current state of knowledge surrounding the prevalence, etiology, and neurobiology of conversion disorder. There have been improvements in the accuracy of diagnosis that are possibly related to improved technologies such as neuroimaging. Once the diagnosis is made, it is important to develop a therapeutic alliance between the patient and the medical team, and where comorbid psychiatric diagnoses have been made, these need to be adequately treated. While there have been no formal trials of medication or psychoanalytic treatments in this disorder, case reports suggest that a combination of antidepressants, psychotherapy, and a multidisciplinary approach to rehabilitation may be beneficial. PMID:18568070

  5. Conversion disorder: a problematic diagnosis.

    Science.gov (United States)

    Nicholson, Timothy R J; Stone, Jon; Kanaan, Richard A A

    2011-11-01

    The diagnosis of conversion disorder is problematic. Since doctors have conceptually and practically differentiated the symptoms from neurological ('organic') disease it has been presumed to be a psychological disorder, but the psychological mechanism, and how this differs from feigning (conscious simulation), has remained elusive. Although misdiagnosis of neurological disease as conversion disorder is uncommon, it remains a concern for clinicians, particularly for psychiatrists who may be unaware of the positive ways in which neurologists can exclude organic disease. The diagnosis is anomalous in psychiatry in that current diagnostic systems require that feigning is excluded and that the symptoms can be explained psychologically. In practice, feigning is very difficult to either disprove or prove, and a psychological explanation cannot always be found. Studies of childhood and adult psychological precipitants have tended to support the relevance of stressful life events prior to symptom onset at the group level but they are not found in a substantial proportion of cases. These problems highlight serious theoretical and practical issues not just for the current diagnostic systems but for the concept of the disorder itself. Psychology, physiology and functional imaging techniques have been used in attempts to elucidate the neurobiology of conversion disorder and to differentiate it from feigning, but while intriguing results are emerging they can only be considered preliminary. Such work looks to a future that could refine our understanding of the disorder. However, until that time, the formal diagnostic requirement for associated psychological stressors and the exclusion of feigning are of limited clinical value. Simplified criteria are suggested which will also encourage cooperation between neurology and psychiatry in the management of these patients.

  6. Valproate in Conversion Disorder: A Case Report

    OpenAIRE

    Messina, Antonino; Fogliani, Anna Maria

    2010-01-01

    Few data are in literature about the pharmacological treatment of conversion disorder and there are not any studies about the use of Valproate extended release (ER) in treating conversion disorder. In this article, we are reporting a case of an Italian woman with a diagnosis of conversion disorder treated effectively and quickly by Valproate ER.

  7. Interrogative suggestibility in patients with conversion disorders.

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    Foong, J; Lucas, P A; Ron, M A

    1997-09-01

    We tested the hypothesis that increased interrogative suggestibility may contribute to the shaping and maintaining of conversions symptoms. Interrogative suggestibility was measured in 12 patients with conversion disorder and 10 control patients with confirmed neurological disease matched for age, premorbid intelligence, and as closely as possible in terms of their neurological symptoms to the patients with conversion disorder. Our observations do not support the contention that individual differences in interrogative suggestibility are of importance in the etiology of conversion disorders.

  8. Conversion Disorder in Stroke: A Case Report

    Directory of Open Access Journals (Sweden)

    Hsien-Yeh Chou

    2006-11-01

    Full Text Available Conversion disorder is caused by previous severe stress, emotional conflict, or an associated psychiatric disorder, and usually presents with one or more neurologic symptoms. Clinically, it is challenging to diagnose diseases such as transient ischemia attack, stroke, brain tumor, spinal cord injury, and neuropathy. In this case report, we present a male stroke patient who had a typical conversion disorder.

  9. Conversion Disorder Presenting As Neuritic Leprosy

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    Sayal SK

    2000-01-01

    Full Text Available Conversion disorder is not normally listed amongst the conditions in differential diagnosis of leprosy neuropathy. A case conversion reaction who was initially diagnosed as neuritic leprosy is reported. Patient responded to narcosuggestion and psychotherapy.

  10. [Conversion disorder : functional neuroimaging and neurobiological mechanisms].

    Science.gov (United States)

    Lejeune, J; Piette, C; Salmon, E; Scantamburlo, G

    2017-04-01

    Conversion disorder is a psychiatric disorder often encountered in neurology services. This condition without organic lesions was and still is sometimes referred as an imaginary illness or feigning. However, the absence of organic lesions does not exclude the possibility of cerebral dysfunction. The etiologic mechanisms underlying this disorder remain uncertain even today.The advent of cognitive and functional imaging opens up a field of exploration for psychiatry in understanding the neurobiological mechanisms underlying mental disorders and especially the conversion disorder. This article reports several neuroimaging studies of conversion disorder and attempts to generate hypotheses about neurobiological mechanisms.

  11. [Neurology of hysteria (conversion disorder)].

    Science.gov (United States)

    Sonoo, Masahiro

    2014-07-01

    Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

  12. Conversion Disorder in Australian Pediatric Practice

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    Kozlowska, Kasia; Nunn, Kenneth P.; Rose, Donna; Morris, Anne; Ouvrier, Robert A.; Varghese, John

    2007-01-01

    Objectives: To describe the incidence and clinical features of children presenting to Australian child health specialists with conversion disorder. Method: Active, national surveillance of conversion disorder in children younger than 16 years of age during 2002 and 2003. Results: A total of 194 children were reported on. The average age was 11.8…

  13. [Management of patients with conversion disorder].

    Science.gov (United States)

    Vermeulen, Marinus; Hoekstra, Jan; Kuipers-van Kooten, Mariëtte J; van der Linden, Els A M

    2014-01-01

    The symptoms of conversion disorder are not due to conscious simulation. There should be no doubt that the symptoms of conversion disorder are genuine, even if scans do not reveal any abnormalities. The management of patients with conversion disorder starts with an explanation of the diagnosis. The essence of this explanation is that patients first hear about what the diagnosis actually means and only after this about what they do not have. When explaining the diagnosis it is a good idea to use metaphors. The treatment of patients with conversion disorder is carried out together with a physical therapist. The collaboration of healthcare professionals who are involved in the treatment of a patient with conversion disorder should preferably be coordinated by the patient's general practitioner.

  14. Neurologists' understanding and management of conversion disorder.

    Science.gov (United States)

    Kanaan, Richard A; Armstrong, David; Wessely, Simon Charles

    2011-09-01

    Conversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients. A postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists. 349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past. Neurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients.

  15. Conversion Disorder- Mind versus Body: A Review.

    Science.gov (United States)

    Ali, Shahid; Jabeen, Shagufta; Pate, Rebecca J; Shahid, Marwah; Chinala, Sandhya; Nathani, Milankumar; Shah, Rida

    2015-01-01

    In this article, the authors accentuate the signs and symptoms of conversion disorder and the significance of clinical judgment and expertise in order to reach the right diagnosis. The authors review the literature and provide information on the etiology, prevalence, diagnostic criteria, and the treatment methods currently employed in the management of conversion disorder. Of note, the advancements of neuropsychology and brain imaging have led to emergence of a relatively sophisticated picture of the neuroscientific psychopathology of complex mental illnesses, including conversion disorder. The available evidence suggests new methods with which to test hypotheses about the neural circuits underlying conversion symptoms. In context of this, the authors also explore the neurobiological understanding of conversion disorder.

  16. Childhood abuse in patients with conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Keijsers, G.P.J.; Hoogduin, C.A.L.; Näring, G.W.B.; Moene, F.C.

    2002-01-01

    OBJECTIVE: Despite the fact that the assumption of a relationship between conversion disorder and childhood traumatization has a long history, there is little empirical evidence to support this premise. The present study examined this relation and investigated whether hypnotic susceptibility

  17. Emotional stimuli and motor conversion disorder

    NARCIS (Netherlands)

    Voon, V.; Brezing, C.; Gallea, C.; Ameli, R.; Roelofs, K.; LaFrance, W.C.; Hallett, M.

    2010-01-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli,

  18. Hypnotic susceptibility in patients with conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Hoogduin, C.A.L.; Keijsers, G.P.J.; Näring, G.W.B.; Moene, F.C.; Sandijck, P.

    2002-01-01

    Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however. little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50

  19. Neuroimaging in patients with conversion disorder

    NARCIS (Netherlands)

    Noort, P.D.

    2013-01-01

    Background: Medically unexplained symptoms are not uncommon in the clinical setting. Conversion disorder is a psychological disorder in which there is no neurological explanation for patients’ physical symptoms. These physical symptoms can be both positive or negative, e.g. tremor or paresis. This

  20. Case Study: Camptocormia, a Rare Conversion Disorder.

    Science.gov (United States)

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

    Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

  1. Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.

    Science.gov (United States)

    Debadatta, Mohapatra; Mishra, Ajay K

    2013-07-01

    Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent.

  2. Alexithymia in patients with conversion disorder.

    Science.gov (United States)

    Gulpek, Demet; Kelemence Kaplan, Figen; Kesebir, Sermin; Bora, Ozlem

    2014-07-01

    In the recent years, it has been observed that alexithymia is not specified for the psychosomatic disorders. It is known that alexithymia is observed frequently in various psychiatric disorders especially in the somatoform disorders. The aim of this study is to evaluate alexithymia in the patients with the conversion disorder. The study was performed in the Psychiatry Outpatients Clinics of the Izmir Atatürk Training and Research Hospital and Erenköy Psychiatry Education and Research Hospital. A total of 93 cases-47 outpatients who were diagnosed with conversion disorder according to the DSM-IV criteria and 46 age, gender and educational level matched healthy controls-were included in the study. All the cases were assessed by a Structured Clinical Interview for DSM-IV and were evaluated with a questionnaire (which included demographics and clinical data), the Toronto Alexithymia Scale and the Somatosensory Amplification Scale. When the two groups were compared, the Toronto Alexithymia Scale scores (except "externally oriented thinking" subscale) and the Somatosensory Amplification Scale score of the conversion disorder group were statistically significantly higher than the control group. The number of the alexithymic cases of the patient group was significantly higher than the control group's. The level of alexithymia in conversion disorder patients, without any other psychiatric disorder, is higher than that of the healthy controls. During the evaluation of the psychological state of patients with conversion disorder, it could be useful to keep in mind the probability of them having alexithymia to determine the type of suitable therapy.

  3. Response inhibition in motor conversion disorder.

    Science.gov (United States)

    Voon, Valerie; Ekanayake, Vindhya; Wiggs, Edythe; Kranick, Sarah; Ameli, Rezvan; Harrison, Neil A; Hallett, Mark

    2013-05-01

    Conversion disorders (CDs) are unexplained neurological symptoms presumed to be related to a psychological issue. Studies focusing on conversion paralysis have suggested potential impairments in motor initiation or execution. Here we studied CD patients with aberrant or excessive motor movements and focused on motor response inhibition. We also assessed cognitive measures in multiple domains. We compared 30 CD patients and 30 age-, sex-, and education-matched healthy volunteers on a motor response inhibition task (go/no go), along with verbal motor response inhibition (color-word interference) and measures of attention, sustained attention, processing speed, language, memory, visuospatial processing, and executive function including planning and verbal fluency. CD patients had greater impairments in commission errors on the go/no go task (P conversion. Patients with nonepileptic seizures, a different form of conversion disorder, are commonly reported to have lower IQ and multiple cognitive deficits. Our results point toward potential differences between conversion disorder subgroups. © 2013 Movement Disorder Society. Copyright © 2013 Movement Disorder Society.

  4. Postoperative conversion disorder in a pediatric patient.

    Science.gov (United States)

    Judge, Amy; Spielman, Fred

    2010-11-01

    According to the Diagnostic and Statistical Manual IV (DSM IV), conversion disorder is classified as a somatoform illness and defined as an alteration or loss of physical function because of the expression of an underlying psychological ailment. This condition, previously known as hysteria, hysterical neurosis, or conversion hysteria occurs rarely, with an incidence of 11-300 cases per 100,000 people (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edn. Washington, DC: American Psychiatric Association, 1994). Presentation after an anesthetic is exceptional. After thorough review of the literature, fewer than 20 cases have been documented, with only two instances in patients younger than 18 years of age after general anesthesia; both were mild in nature. We present a severe case of postoperative conversion disorder that developed upon emergence from anesthesia in a previously healthy 16-year-old girl following direct laryngoscopy with vocal fold injection. © 2010 Blackwell Publishing Ltd.

  5. Emotional Stimuli and Motor Conversion Disorder

    Science.gov (United States)

    Voon, Valerie; Brezing, Christina; Gallea, Cecile; Ameli, Rezvan; Roelofs, Karin; LaFrance, W. Curt, Jr.; Hallett, Mark

    2010-01-01

    Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to…

  6. [Conversion Disorder in Children and Adolescents].

    Science.gov (United States)

    Duque, Paula Andrea; Vásquez, Rafael; Cote, Miguel

    2015-01-01

    Conversion disorder is diagnosed late, by exclusion and with a high risk of complications. There is a wide experience in adults that is not extrapolated to paediatric patients. According to the literature, the prognosis is better in children, but this changes when other variables such are included, such as comorbidities, late diagnosis and a very convincing social image of the neurological disease. To review the medical literature on the clinical features, diagnosis, comorbidities and treatment of this disorder. A literature research was performed on Medline and Pubmed, the terms used were "conversion disorder", pseudoseizures, treatment, clinic, children ("conversion disorder" OR hysteria OR hysterical) (child OR children OR childhood OR pediatric OR paediatric). The most relevant material found is included in this review. Conversion disorder is often an imprecise diagnosis in high complexity paediatric services. No consensus was found in the literature search on how to treat patients after the initial diagnosis. The evidence that it becomes chronic is not strong enough, just as the evidence is not convincing enough to argue that comorbidity factors are those maintained over time. Clearly, there is no medical experience of the natural history of this disorder in children and adolescents. It is only known is that it is a complex condition, on which there is experience only in the diagnosis and treatment of the acute state, but not so in the long-term care. It is proposed that each patient is studied in detail in order to define the psychiatric diagnosis and its treatment. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  7. Conversion disorder: towards a neurobiological understanding

    Science.gov (United States)

    Harvey, Samuel B; Stanton, Biba R; David, Anthony S

    2006-01-01

    Conversion disorders are a common cause of neurological disability, but the diagnosis remains controversial and the mechanism by which psychological stress can result in physical symptoms “unconsciously” is poorly understood. This review summarises research examining conversion disorder from a neurobiological perspective. Early observations suggesting a role for hemispheric specialization have not been replicated consistently. Patients with sensory conversion symptoms have normal evoked responses in primary and secondary somatosensory cortex but a reduction in the P300 potential, which is thought to reflect a lack of conscious processing of sensory stimuli. The emergence of functional imaging has provided the greatest opportunity for understanding the neural basis of conversion symptoms. Studies have been limited by small patient numbers and failure to control for confounding variables. The evidence available would suggest a broad hypothesis that frontal cortical and limbic activation associated with emotional stress may act via inhibitory basal ganglia–thalamocortical circuits to produce a deficit of conscious sensory or motor processing. The conceptual difficulties that have limited progress in this area are discussed. A better neuropsychiatric understanding of the mechanisms of conversion symptoms may improve our understanding of normal attention and volition and reduce the controversy surrounding this diagnosis. PMID:19412442

  8. Prosopagnosia as a Type of Conversion Disorder

    Directory of Open Access Journals (Sweden)

    Clodagh Power

    2018-01-01

    Full Text Available Background. Conversion disorder is a common and debilitating condition that remains poorly understood. We present a previously undescribed form of conversion disorder to highlight the complexity of the condition and consider the interplay of factors that produce conversion symptoms. Case. A 50-year-old male presented with acquired prosopagnosia and language impairment. Neuropsychological testing indicated right temporal lobe dysfunction. Extensive work-up outruled an organic aetiology. Reactivation of childhood trauma coincided with the onset of his symptoms. Childhood trauma is known to have adverse effects on the developing brain which may affect an individual’s emotional behaviour and coping style. Functional neuroimaging techniques suggest that conversion symptoms may be linked to the disruption of higher order neural circuitry involved in the integration of emotional processing and cortical functioning. Conclusions. We propose that our patient’s adverse childhood experiences led to the development of a particular personality and coping style that “primed” him for a later abnormal emotional and behavioural response when confronted with reminders of his traumatic background. Further interdisciplinary studies are required to further elucidate the neurobiological basis for this condition.

  9. Prosopagnosia as a Type of Conversion Disorder.

    Science.gov (United States)

    Power, Clodagh; Hannigan, Oisin; Coen, Robert; Bruce, Irene; Gibb, Matthew; McCarthy, Marie; Robinson, David; Lawlor, Brian A

    2018-01-01

    Conversion disorder is a common and debilitating condition that remains poorly understood. We present a previously undescribed form of conversion disorder to highlight the complexity of the condition and consider the interplay of factors that produce conversion symptoms. A 50-year-old male presented with acquired prosopagnosia and language impairment. Neuropsychological testing indicated right temporal lobe dysfunction. Extensive work-up outruled an organic aetiology. Reactivation of childhood trauma coincided with the onset of his symptoms. Childhood trauma is known to have adverse effects on the developing brain which may affect an individual's emotional behaviour and coping style. Functional neuroimaging techniques suggest that conversion symptoms may be linked to the disruption of higher order neural circuitry involved in the integration of emotional processing and cortical functioning. We propose that our patient's adverse childhood experiences led to the development of a particular personality and coping style that "primed" him for a later abnormal emotional and behavioural response when confronted with reminders of his traumatic background. Further interdisciplinary studies are required to further elucidate the neurobiological basis for this condition.

  10. Psychosocial Factors in Children and Adolescents with Conversion Disorder

    Science.gov (United States)

    Sharma, I.; Giri, D.; Dutta, Anna; Mazumder, P.

    2005-01-01

    Introduction: In view of the limited studies on the psychosocial environment of children presenting with conversion disorders, the present study was carried out to study the psychosocial factors in children with conversion disorders. Method: 40 patients of Conversion Disorder, who presented with "pseudo seizures" and were diagnosed…

  11. Conversion disorders: psychiatric and psychotherapeutic aspects.

    Science.gov (United States)

    Cottencin, O

    2014-10-01

    Hysteria is still stigmatized and frequently associated with lying or malingering. However, conversion disorder is not malingering, nor factitious disorder. The first step for the clinician faced with suspected conversion disorder is to make a positive diagnosis, which is in fact an integral part of treatment. In the emergency situation, it is important to look for an underlying somatic disorder. Although no specific treatment exists, there is a consensus in favor of a positive role of psychotherapy. First of all, the main problem is to explain to patients that their physical complaint has a psychological cause. In order to deliver the diagnosis in the most appropriate and useful manner, physicians have to first convince themselves before trying to convince patients. Combined consultation (medicine and psychiatry) is a useful tool to help patients. With or without combined consultation, this approach requires patience and open-mindedness to motivate patients to recognize the value of psychotherapy. Coordination between specialists and general practitioners is an important part of this treatment, which frequently requires long-term intervention. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Conversion Disorder Comorbidity and Childhood Trauma.

    Science.gov (United States)

    Akyüz, Fatma; Gökalp, Peykan G; Erdiman, Sezgin; Oflaz, Serap; Karşidağ, Çağatay

    2017-03-01

    The aim of this study is to examine the socio-demographic and clinical characteristics, the presence of comorbidity, and the link with childhood traumatic experiences in patients with conversion disorder (CD) in a psychiatric outpatient clinic. A total of 60 literate, female patients between 18 and 65 years of age who were referred to the general psychiatry outpatient clinic and who were diagnosed with conversion disorder according to the DSM-IV diagnostic criteria were included in the study. A questionnaire on sociodemographic and clinical characteristics, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Events Scale (DES) were used to assess the cases. The mean age of the participants was 36.27±11.18 years. 72% of the patients were married and 63% were primary school graduates. The most common symptoms were asthenia (100%), aphasia (96.7%), and crying-convulsions (93%). The most common co-morbidities were depression (50%) and dissociative disorders (48.3%). Among the patients, 53.3% reported a history of exposure to physical violence and 25% reported a history of sexual assault in childhood. Assessment of the Childhood Traumatic Questionnaire revealed a significant positive relation between emotional, physical, and sexual abuse scores and DES score. CD has not yet been fully analyzed in detail in health institutions; co-existence of another mental disorder and the presence of traumatic experiences in the past further complicate the issue. Consideration of these factors during treatment will have a positive impact on the course and prognosis of the disorder.

  13. Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder).

    Science.gov (United States)

    Voon, Valerie; Cavanna, Andrea E; Coburn, Kerry; Sampson, Shirlene; Reeve, Alya; LaFrance, W Curt

    2016-01-01

    Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes.

  14. Neurophysiology of conversion disorders: a historical perspective.

    Science.gov (United States)

    Crommelinck, M

    2014-10-01

    The aim of this paper is to present a short historical perspective on the neurophysiological approach to hysteria and conversion disorders. The body of this paper will be constituted of three main parts. In the first part, we will present the significant progress due to some pioneers of neurology/psychiatry during the XIXth century. As we shall see, this period was particularly rich in personalities whose work gradually laid the foundations to a true medical approach to hysteria. In the first half of the XXth century, different factors have led to a long eclipse of the neurological approach to hysteria. In the second part, we will show how, by the 1960's-1970's, the conceptual and methodological advances in neurophysiology, as well as the turning point of cognitive sciences (and cognitive psychology in particular) allowed a gradual reinstatement of hysteria within the fields of neurology and clinical neurophysiology. Finally, and this is the third part of this paper, we will show how over the past three decades, an entirely new neurophysiological approach to hysteria and conversion disorders has emerged. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. An atypical presentation of visual conversion disorder.

    Science.gov (United States)

    Foutch, Brian K

    2015-01-01

    Nonorganic vision loss accounts for up to 5% of patients and presents in two forms, malingering and visual conversion disorder (VCD). It is described a case of VCD in a new mother struggling both with her husband being deployed overseas and the recent death of her father. In addition, she had been evaluated for a concussion secondary to a motor vehicle accident three months prior. An inexpensive series of clinical tests were performed to rule out organic disease and obtained equivocal results. Some tests revealed intact vision in the affected eye while others supported a neurological cause for the vision loss. However, the patient quickly recovered normal visual acuity when encouraged to discuss situations that have been causing emotional stress. This almost immediate recovery of vision confirmed the diagnosis of VCD. This report should make primary eye care professionals more aware of visual conversion disorder and its clinical evaluation. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  16. Childhood Trauma and Alexithymia in Patients with Conversion Disorder.

    Science.gov (United States)

    Farooq, Anum; Yousaf, Aasma

    2016-07-01

    To determine the relationship between childhood trauma (physical, sexual, emotional abuse and neglect) and alexithymia in patients with conversion disorder, and to identify it as a predictor of alexithymia in conversion disorder. An analytical study. Multiple public sector hospitals in Lahore, from September 2012 to July 2013. Eighty women with conversion disorder were recruited on the basis of DSM IV-TR diagnostic criteria checklist to screen conversion disorder. Childhood abuse interview to measure childhood trauma and Bermond Vorst Alexithymia Questionnaire, DSM-IV TR Dianostic Criteria Checklist, and Childhood Abuse Interview to assess alexithymia were used, respectively. The mean age of the sample was 18 ±2.2 years. Thirty-six cases had a history of childhood trauma, physical abuse was the most reported trauma (f = 19, 23.8%) in their childhood. Patients with conversion disorder has a significant association with alexithymia (p conversion disorder. Strategies should be devised to reduce this disorder among women in Pakistani society.

  17. TEMPERAMENT CHARACTERISTICS OF CHILDREN WITH CONDUCT AND CONVERSION DISORDERS

    OpenAIRE

    Malhotra, Savita

    1989-01-01

    SUMMARY In a comparative study of temperament profiles of groups of 30 children each diagnosed as conduct disorders, conversion disorder, emotional disorders (according to DSM-III) and normal control, it was found that the children diagnosed as conduct disorders showed high activity and intensity of emotional response as well as negative mood, those diagnosed as conversion disorder exhibited low distractibility. The significance of various temperament variables in differing clinical outcomes ...

  18. Proinflammatory cytokine levels in patients with conversion disorder.

    Science.gov (United States)

    Tiyekli, Utkan; Calıyurt, Okan; Tiyekli, Nimet Dilek

    2013-06-01

    It was aimed to evaluate the relationship between proinflammatory cytokine levels and conversion disorder both commonly known as stress regulated. Baseline proinflammatory cytokine levels-[Tumour necrosis factor alpha (TNF-α), Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6)]-were evaluated with enzyme-linked immunosorbent assay in 35 conversion disorder patients and 30 healthy controls. Possible changes in proinflammatory cytokine levels were evaluated again, after their acute phase in conversion disorder patients. Statistically significant decreased serum TNF-α levels were obtained in acute phase of conversion disorder. Those levels increased after acute conversion phase. There were no statistically significant difference observed between groups in serum IL-1β and (IL-6) levels. Stress associated with conversion disorder may suppress immune function in acute conversion phase and may have diagnostic and therapeutic value.

  19. Conversion Disorder in an Appalachian Community.

    Science.gov (United States)

    Slocum, Sarah; Holroyd, Suzanne

    2016-08-01

    Conversion disorder (CD) is believed to be the manifestation of physical and/or neurological symptoms for primary gain without an identifiable organic cause. Although it is believed to be more common in rural areas, the literature examining this claim is sparse. To our knowledge, no study has been published evaluating the prevalence of CD in a rural Appalachian population. The aim of this study was to characterize and determine the prevalence of CD per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria in a rural Appalachian psychiatric consultation service and to compare this population with control patients from the same service. We performed a retrospective chart review of all patients diagnosed as having CD per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria on a psychiatric consultation service at a rural Appalachian academic medical center during a 13-month time period. For each case, two consecutive control patients were selected from the same service and time span. There were 21 cases and 42 controls in this study, with a CD prevalence rate of 6.0% (N = 21/351). Sociodemographic, comorbidity, and recent symptomatology data were obtained. Compared with controls, cases were significantly younger and were more likely to have a history of sexual abuse, seizure disorder, antiepileptic use, neurologic referral, electroencephalogram, magnetic resonance imaging of the brain, and history of CD. We found it interesting that fewer cases reported alcohol and drug use. The observed prevalence of 6.0% does not support the historical theory that CD is more prevalent in rural or lower socioeconomic populations. Our data add to the characterization of the Appalachian CD population.

  20. Psychometric properties of Conversion Disorder Scale- Revised (CDS) for children.

    Science.gov (United States)

    Ijaz, Tazvin; Nasir, Attikah; Sarfraz, Naema; Ijaz, Shirmeen

    2017-05-01

    To revise conversion disorder scale and to establish the psychometric properties of the revised scale. This case-control study was conducted from February to June, 2014, at the Government College University, Lahore, Pakistan, and comprised schoolchildren and children with conversion disorder. In order to generate items for revised version of conversion disorder scale, seven practising mental health professionals were consulted. A list of 42 items was finalised for expert ratings. After empirical validation, a scale of 40 items was administered on the participants and factor analysis was conducted. Of the240 participants, 120(50%) were schoolchildren (controls group) and 120(50%)were children with conversion disorder (clinical group).The results of factor analysis revealed five factors (swallowing and speech symptoms, motor symptoms, sensory symptoms, weakness and fatigue, and mixed symptoms) and retention of all 40 items of revised version of conversion disorder scale. Concurrent validity of the revised scale was found to be 0.81 which was significantly high. Similarly, discriminant validity of the scale was also high as both clinical and control groups had significant difference (pconversion disorder scale was 76% sensitive to predicting conversion disorder while specificity showed that the scale was 73% accurate in specifying participants of the control group. The revised version of conversion disorder scale was a reliable and valid tool to be used for screening of children with conversion disorder.

  1. Culture and conversion disorder: implications for DSM-5.

    Science.gov (United States)

    Brown, Richard J; Lewis-Fernández, Roberto

    2011-01-01

    The diagnostic criteria and related features of conversion disorder are under revision for DSM-5, including the requirement that psychological factors accompany the symptoms or deficits in question (Criterion B) and whether conversion disorder should be re-labeled as a dissociative, rather than a somatoform, condition. We examined the cross-cultural evidence on the prevalence, characteristics, and associated features of pseudoneurological symptoms more generally, and conversion disorder in particular, in order to inform the ongoing re-evaluation of the conversion disorder category. We also examined the relationship between these constructs and dissociative symptoms and disorders across cultural groups. Searches were conducted of the mental health literature, particularly since 1994, regarding culture, race, or ethnicity factors related to conversion disorder. Many proposed DSM-5 revisions were supported, such as the elimination of Criterion B. We also found cross-cultural variability in predominant symptoms, disorder prevalence, and relationship with cultural syndromes. Additional information that may contribute to DSM-5 includes the elevated rates across cultures of traumatic exposure and psychiatric comorbidity in conversion disorder. Cross-culturally, conversion disorder is associated strongly with both dissociative and somatoform presentations, revealing no clear basis on which to locate the disorder in DSM-5. Careful consideration should be given to the possible alternatives.

  2. METACOGNITION OF VISUOMOTOR DECISIONS IN CONVERSION DISORDER.

    Science.gov (United States)

    Sinanaj, Indrit; Blakemore, Rebekah; Klug, Julian; Cojan, Yann; Galli, Silvio; Berney, Alexandre; Aybek, Selma; Vuilleumier, Patrik

    2018-04-23

    Motor conversion disorder (CD) entails genuine disturbances in the subjective experience of patients who maintain they are unable to perform a motor function, despite lack of apparent neurological damage. Abilities by which individuals assess their own capacities during performance in a task are called metacognitive, and distinctive impairment of such abilities is observed in several disorders of self-awareness such as blindsight and anosognosia. In CD, previous research has focused on the recruitment of motor and emotional brain systems, generally linking symptoms to altered limbic-motor interactions; however, metacognitive function has not been studied to our knowledge. Here we tested ten CD patients and ten age-gender matched controls during a visually-guided motor paradigm, previously employed in healthy controls (HC), allowing us to probe for motor awareness and metacognition. Participants had to draw straight trajectories towards a visual target while, unbeknownst to them, deviations were occasionally introduced in the reaching trajectory seen on the screen. Participants then reported both awareness of deviations and confidence in their response. Activity in premotor and cingulate cortex distinguished between conscious and unconscious movement corrections in controls better than patients. Critically, whereas controls engaged the left superior precuneus and middle temporal region during confidence judgments, CD patients recruited bilateral parahippocampal and amygdalo-hippocampal regions instead. These results reveal that distinct brain regions subserve metacognitive monitoring for HC and CD, pointing to different mechanisms and sources of information used to monitor and form confidence judgments of motor performance. While brain systems involved in sensory-motor integration and vision are more engaged in controls, CD patients may preferentially rely on memory and contextual associative processing, possibly accounting for how affect and memories can imbue

  3. Rate and predictors of conversion from unipolar to bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Willer, Inge; Andersen, Per Kragh

    2017-01-01

    OBJECTIVES: For the first time to present a systematic review and meta-analysis of the conversion rate and predictors of conversion from unipolar disorder to bipolar disorder. METHODS: A systematic literature search up to October 2016 was performed. For the meta-analysis, we only included studies...... that used survival analysis to estimate the conversion rate. RESULTS: A total of 31 studies were identified, among which 11 used survival analyses, including two register-based studies. The yearly rate of conversion to bipolar disorder decreased with time from 3.9% in the first year after study entry...... with a diagnosis of unipolar disorder to 3.1% in years 1-2, 1.0% in years 2-5 and 0.8% in years 5-10. A total of eight risk factors were evaluated comprising gender, age at onset of unipolar disorder, number of depressive episodes, treatment resistance to antidepressants, family history of bipolar disorder...

  4. Conversion disorder and mass psychogenic illness in child neurology.

    Science.gov (United States)

    Mink, Jonathan W

    2013-11-01

    A common problem faced by neurologists is the existence of disorders that present with neurological symptoms but do not have identifiable neurological bases. Conversion disorder is the most common of these disorders. In some situations, members of a cohesive social group will develop the same or similar symptoms. This review discusses conversion disorder in children, with an emphasis on function movement disorders. It also reviews a recent occurrence of mass psychogenic illness in New York State with discussion of the key features of mass psychogenic illness. © 2013 New York Academy of Sciences.

  5. MULTIPLE PERSONALITY DISORDER FOLLOWING CONVERSION AND DISSOCIATIVE DISORDER NOS : A CASE REPORT

    OpenAIRE

    Jhingan, Harsh Prem; Aggarwal, Neeruj; Saxena, Shekhar; Gupta, Dhanesh K.

    2000-01-01

    A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed.

  6. Life events and escape in conversion disorder.

    Science.gov (United States)

    Nicholson, T R; Aybek, S; Craig, T; Harris, T; Wojcik, W; David, A S; Kanaan, R A

    2016-09-01

    Psychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged. Forty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel 'escape' rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of 'secondary gain'. CD patients had significantly more severe life events and 'escape' events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients - significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56-13.70] and healthy controls (OR 5.81, 95% CI 1.86-18.2). In the same time period 53% of CD patients had at least one 'high escape' event - again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05-23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events. Evidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.

  7. The question of symptom lateralization in conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Näring, G.W.B.; Moene, F.C.; Hoogduin, C.A.L.

    2000-01-01

    Objective: The purpose of this study was to determine whether or not conversion symptoms are lateralized. Studies have shown a predominant left-oriented manifestation of symptoms for most somatoform disorders. The reports in the literature on the lateralization of conversion symptoms, however, are

  8. Abreaction for conversion disorder: systematic review with meta-analysis.

    Science.gov (United States)

    Poole, Norman A; Wuerz, Axel; Agrawal, Niruj

    2010-08-01

    The value of drug interviews in the treatment of conversion disorder is at present unknown. To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.

  9. Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment.

    Science.gov (United States)

    Tsui, Patricia; Deptula, Andrew; Yuan, Derek Y

    2017-06-01

    This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

  10. Operant procedures applied to a conversion disorder

    NARCIS (Netherlands)

    Kop, P.F.M.; Heijden, H.P. van der; Hoogduin, K.A.L.; Schaap, C.P.D.R.

    1995-01-01

    Conversion symptoms, as identified by the existing classification systems, do not form a single unitary class. It is therefore difficult to find an adequate treatment that closely connects to the basic characteristics of the disease. Instead, we designed a treatment method that closely relates to

  11. Pituitary volumes are changed in patients with conversion disorder.

    Science.gov (United States)

    Atmaca, Murad; Baykara, Sema; Mermi, Osman; Yildirim, Hanefi; Akaslan, Unsal

    2016-03-01

    Our study group previously measured pituitary volumes and found a relationship between somatoform disoders and pituitary volumes. Therefore, in conversion disorder, another somatoform disorder, we hypothesized that pituitary gland volumes would be reduced. Twenty female patients and healthy controls were recruited to the present investigation. The volumes of the pituitary gland were determined by using a 1.5 Tesla magnetic resonance scanner. We found that the pituitary gland volumes of the patients with conversion disorder were significantly smaller than those of healthy control subjects. In the patients with conversion disorder but not in the healthy control group, a significant negative correlation between the duration of illness and pituitary gland volume was determined. In summary, in the present study, we suggest that the patients with conversion disorder have smaller pituitary volumes compared to those of healthy control subjects. Further studies should confirm our data and ascertain whether volumetric alterations determined in the patients with conversion disorder can be changed with treatment or if they change over time.

  12. Conversion disorder: current problems and potential solutions for DSM-5.

    Science.gov (United States)

    Stone, Jon; LaFrance, W Curt; Brown, Richard; Spiegel, David; Levenson, James L; Sharpe, Michael

    2011-12-01

    Conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes neurological symptoms, including weakness, numbness and events resembling epilepsy or syncope, which can be positively identified as not being due to recognised neurological disease. This review combines perspectives from psychiatry, psychology and neurology to identify and discuss key problems with the current diagnostic DSM-IV criteria for conversion disorder and to make the following proposals for DSM-5: (a) abandoning the label "conversion disorder" and replacing it with an alternative term that is both theoretically neutral and potentially more acceptable to patients and practitioners; (b) relegating the requirements for "association of psychological factors" and the "exclusion of feigning" to the accompanying text; (c) adding a criterion requiring clinical findings of internal inconsistency or incongruity with recognised neurological or medical disease and altering the current 'disease exclusion' criteria to one in which the symptom must not be 'better explained' by a disease if present, (d) adding a 'cognitive symptoms' subtype. We also discuss whether conversion symptoms are better classified with other somatic symptom disorders or with dissociative disorders and how we might address the potential heterogeneity of conversion symptoms in classification. 2011 Elsevier Inc. All rights reserved.

  13. Motor and somatosensory conversion disorder: a functional unawareness syndrome?

    Science.gov (United States)

    Perez, David L; Barsky, Arthur J; Daffner, Kirk; Silbersweig, David A

    2012-01-01

    Although conversion disorder is closely connected to the origins of neurology and psychiatry, it remains poorly understood. In this article, the authors discuss neural and clinical parallels between lesional unawareness disorders and unilateral motor and somatosensory conversion disorder, emphasizing functional neuroimaging/disease correlates. Authors suggest that a functional-unawareness neurobiological framework, mediated by right hemisphere-lateralized, large-scale brain network dysfunction, may play a significant role in the neurobiology of conversion disorder. The perigenual anterior cingulate and the posterior parietal cortices are detailed as important in disease pathophysiology. Further investigations will refine the functional-unawareness concept, clarify the role of affective circuits, and delineate the process through which functional neurologic symptoms emerge.

  14. Neuroanatomy of conversion disorder: towards a network approach.

    Science.gov (United States)

    Conejero, Ismael; Thouvenot, Eric; Abbar, Mocrane; Mouchabac, Stéphane; Courtet, Philippe; Olié, Emilie

    2018-06-27

    The pathophysiology of conversion disorder is not well understood, although studies using functional brain imaging in patients with motor and sensory symptoms are progressively increasing. We conducted a systematic review of the literature with the aim of summarising the available data on the neuroanatomical features of this disorder. We also propose a general model of the neurobiological disturbance in motor conversion disorder. We systematically searched articles in Medline using the Medical Subject Headings terms '(conversion disorder or hysterical motor disorder) and (neuropsychology or cognition) or (functional magnetic resonance imaging or positron emission tomography or neuroimaging) or (genetics or polymorphisms or epigenetics) or (biomarkers or biology)', following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two authors independently reviewed the retrieved records and abstracts, assessed the exhaustiveness of data abstraction, and confirmed the quality rating. Analysis of the available literature data shows that multiple specialised brain networks (self-agency, action monitoring, salience system, and memory suppression) influence action selection and modulate supplementary motor area activation. Some findings suggest that conceptualisation of movement and motor intention is preserved in patients with limb weakness. More studies are needed to fully understand the brain alterations in conversion disorders and pave the way for the development of effective therapeutic strategies.

  15. Postoperative Conversion Disorder in Elderly Oral Cancer Patient.

    Science.gov (United States)

    Yakushiji, Takashi; Hayashi, Kamichika; Morikawa, Takamichi; Migita, Masashi; Ogane, Satoru; Muramatsu, Kyotaro; Kamio, Takashi; Shibahara, Takahiko; Takano, Nobuo

    2016-01-01

    Conversion disorder is a condition in which psychological stress in response to difficult situations manifests as physical symptoms. Here, we report a case of postoperative coma due to conversion disorder in an elderly oral cancer patient. An 82-year-old woman was referred to Tokyo Dental College Chiba Hospital with a mass lesion on the tongue. A biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment was performed for the tongue carcinoma and tracheotomy for management of the airway. On postoperative day 5, the patient exhibited loss of consciousness (Glasgow Coma Scale: E1, VT, M1; Japan Coma Scale: III-300). The patient's vital signs were all normal, as were the results of a full blood count, brain-CT, MRI, and MRA. Only the arm dropping test was positive. Therefore, the cause of the coma was diagnosed as conversion disorder. Seven hours later, the patient showed a complete recovery.

  16. Functional neuroimaging of conversion disorder: the role of ancillary activation.

    Science.gov (United States)

    Burke, Matthew J; Ghaffar, Omar; Staines, W Richard; Downar, Jonathan; Feinstein, Anthony

    2014-01-01

    Previous functional neuroimaging studies investigating the neuroanatomy of conversion disorder have yielded inconsistent results that may be attributed to small sample sizes and disparate methodologies. The objective of this study was to better define the functional neuroanatomical correlates of conversion disorder. Ten subjects meeting clinical criteria for unilateral sensory conversion disorder underwent fMRI during which a vibrotactile stimulus was applied to anesthetic and sensate areas. A block design was used with 4 s of stimulation followed by 26 s of rest, the pattern repeated 10 times. Event-related group averages of the BOLD response were compared between conditions. All subjects were right-handed females, with a mean age of 41. Group analyses revealed 10 areas that had significantly greater activation (p conversion symptoms are associated with a pattern of abnormal cerebral activation comprising neural networks implicated in emotional processing and sensory integration. Further study of the roles and potential interplay of these networks may provide a basis for an underlying psychobiological mechanism of conversion disorder.

  17. Association of Substance Use Disorders With Conversion From Schizotypal Disorder to Schizophrenia.

    Science.gov (United States)

    Hjorthøj, Carsten; Albert, Nikolai; Nordentoft, Merete

    2018-04-25

    Understanding the role of substance use disorders in conversion from schizotypal disorder to schizophrenia may provide physicians and psychiatrists with important tools for prevention or early detection of schizophrenia. To investigate whether substance use disorders, in particular cannabis use disorder, are associated with conversion to schizophrenia in individuals with schizotypal disorder. This prospective cohort study included a population-based sample of all individuals born in Denmark from January 1, 1981, through August 10, 2014, with an incident diagnosis of schizotypal disorder and without a previous diagnosis of schizophrenia. Follow-up was completed on August 10, 2014, and data were analyzed from March 10, 2017, through February 15, 2018. Information on substance use disorders combined from 5 different registers. Cox proportional hazards regression using time-varying information on substance use disorders and receipt of antipsychotics and adjusted for parental history of mental disorders, sex, birth year, and calendar year were used to estimate hazard ratios (HRs) and 95% CIs for conversion to schizophrenia. A total of 2539 participants with incident schizotypal disorder were identified (1448 men [57.0%] and 1091 women [43.0%]; mean [SD] age, 20.9 [4.4] years). After 2 years, 16.3% (95% CI, 14.8%-17.8%) experienced conversion to schizophrenia. After 20 years, the conversion rate was 33.1% (95% CI, 29.3%-37.3%) overall and 58.2% (95% CI, 44.8%-72.2%) among those with cannabis use disorders. In fully adjusted models, any substance use disorder was associated with conversion to schizophrenia (HR, 1.34; 95% CI, 1.11-1.63). When data were stratified by substance, cannabis use disorders (HR, 1.30; 95% CI, 1.01-1.68), amphetamine use disorders (HR, 1.90; 95% CI, 1.14-3.17), and opioid use disorders (HR, 2.74; 95% CI, 1.38-5.45) were associated with conversion to schizophrenia. These associations were not explained by concurrent use of antipsychotics, functional

  18. Stiff person case misdiagnosed as conversion disorder: A case report.

    Science.gov (United States)

    Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

    2017-01-01

    Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.

  19. Trauma and dissociation in conversion disorder and chronic pelvic pain

    NARCIS (Netherlands)

    Spinhoven, P.; Roelofs, K.; Moene, F.C.; Kuyk, J.; Nijenhuis, E.R.S.; Hoogduin, C.A.L.; Dyck, R. van

    2004-01-01

    Objective: The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology. Method: This report examines data from

  20. Knowledge of conversion disorder in children by pediatricians in a ...

    African Journals Online (AJOL)

    Introduction: Conversion disorder (CD) in children presents the clinician with a diagnostic and treatment dilemma. Mistaking a physical condition for CD carries serious consequences for the child while continued investigation in line with physical disease in a child with CD also may expose the child to serious harm.

  1. Conversion disorder in a neurological emergency department: Restrospective series

    Directory of Open Access Journals (Sweden)

    Alejandro Cardozo

    2017-01-01

    Full Text Available Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we reviewed 94 patients that arrived a neurological emergency room in a 3 year period.Results: 72 patients were females (76%, and the initial presumptive diagnosis were: neurovascular syndrome in 36 patients (38.3%, convulsive disorder in 20 patients (21.28%, and conversive disorder in 8 patients (8.51%. 82 patients had motor symptoms and 61 sensitive symptoms. 88 patients (93% required neuroimaging studies, 77 (81% patients underwent through basic biochemical panels. Other tests performed were: electroencephalogram in 12 patients (12.77%, electromyography in 11 patients (11.7%, lumbar punction in 8 patients (8.04% and regarding the medical consult in the care of these patients 11 were evaluated by 1 specialists, 35 (37.2% by 2 different specialties, 42 (44.63% patients required evaluation by 3, and 6 patients (6.38% required evaluation by 4 different specialties.Conclusions: Based on this data, we conclude that conversion disorders require a lot of resources in the emergency room and that the similarities with neurological diseases demands a complete workup including expensive diagnostic tools. However, this patients can be discharged safely without requiring hospitalization.

  2. Conversion (dissociative) symptoms as a presenting feature in early onset bipolar disorder: a case series

    OpenAIRE

    Ghosal, Malay Kumar; Guha, Prathama; Sinha, Mausumi; Majumdar, Debabrata; Sengupta, Payel

    2009-01-01

    We present three cases of early onset bipolar disorder where dissociative (conversion) symptoms preceded the onset of mania. This case series underscores the significance of dissociative/conversion symptoms as an early atypical presentation in juvenile bipolar disorder.

  3. Conversion Disorder; an Unusual Etiology of Unilateral Foot Drop.

    Science.gov (United States)

    Ayaz, Saeed Bin; Matee, Sumeera; Malik, Riffat; Ahmad, Khalil

    2015-06-01

    Foot drop is generally a consequence of common peroneal or sciatic nerve injury or L5 radiculopathy but rarely, it can be a manifestation of conversion disorder. A 24-year-old male presented with a foot drop on left side that developed overnight. He had difficulty walking with a trunk tilt towards right side and numbness in left leg up to mid-thigh. The initial diagnosis by the general practitioner was common peroneal nerve injury, which was not supported by the subsequent detailed examination in the physiatry department. Routine laboratory investigations, computed tomographic scan of brain and electrophysiological evaluation were normal. In a multidisciplinary team evaluation involving a psychiatrist, he was diagnosed to be suffering from conversion disorder and was advised gait retraining, cognitive and behavioral therapy and tablet venlafaxine. By sixth day of treatment, the patient was able to walk independently with a normal gait pattern and reported complete recovery of his symptoms. In the absence of an identifiable organic cause of foot drop in a patient, conversion disorder may be considered necessitating early intervention by a psychiatrist.

  4. Conversational behaviour of children with Asperger syndrome and conduct disorder.

    Science.gov (United States)

    Adams, Catherine; Green, Jonathan; Gilchrist, Anne; Cox, Anthony

    2002-07-01

    Social communication problems in individuals who have Asperger syndrome constitute one of the most significant problems in the syndrome. This study makes a systematic analysis of the difficulties demonstrated with the use of language (pragmatics) in adolescents who have Asperger syndrome. Recent advances in discourse analysis were applied to conversational samples from a group of children with Asperger syndrome and a matched control group of children with severe conduct disorder. Two types of conversation were sampled from each group, differing in emotional content. The results showed that in these contexts children with Asperger syndrome were no more verbose as a group than controls, though they showed a tendency to talk more in more emotion-based conversations. Children with Asperger syndrome, as a group, performed similarly to control subjects in ability to respond to questions and comments. However, they were more likely to show responses which were problematic in both types of conversation. In addition, individuals with Asperger syndrome showed more problems in general conversation than during more emotionally and socially loaded topics. The group with Asperger syndrome was found to contain a small number of individuals with extreme verbosity but this was not a reliable characteristic of the group as a whole.

  5. Conversion disorder: A systematic review of current terminology.

    Science.gov (United States)

    Ding, Juen Mei; Kanaan, Richard Antony Alexander

    It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from conversion disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these. Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted. Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "non-epileptic/organic" was relatively popular with both groups. "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms - however the views of neither psychiatrists nor actual patients with the disorder were considered. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. ['Histrionic personality disorder with regression and conversion': a meningioma].

    Science.gov (United States)

    Oude Elberink, A M L; Oudijn, M S; Kwa, V I H; Van, H L

    2011-01-01

    A 47-year-old woman, who was believed to be suffering from histrionic personality disorder with regression and conversion, was finally diagnosed with a frontal meningioma. Patients with meningiomas can present with a variety of psychiatric symptoms, sometimes even before neurological symptoms occur. The diagnosis is often delayed because the symptoms are misleading and it is difficult to modify a psychiatric diagnosis once this has been made. Discussion focuses on the characteristic signs of a meningioma, the reasons for delays in diagnosis and the indications for brain-imaging on psychiatric patients.

  7. Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder.

    Science.gov (United States)

    Boeckle, Markus; Liegl, Gregor; Jank, Robert; Pieh, Christoph

    2016-06-10

    Conversion Disorders (CD) are prevalent functional disorders. Although the pathogenesis is still not completely understood, an interaction of genetic, neurobiological, and psychosocial factors is quite likely. The aim of this study is to provide a systematic overview on imaging studies on CDs and investigate neuronal areas involved in Motor Conversion Disorders (MCD). A systematic literature search was conducted on CD. Subsequently a meta-analysis of functional neuroimaging studies on MCD was implemented using an Activation Likelihood Estimation (ALE). We calculated differences between patients and healthy controls as well as between affected versus unaffected sides in addition to an overall analysis in order to identify neuronal areas related to MCD. Patients with MCD differ from healthy controls in the amygdala, superior temporal lobe, retrosplenial area, primary motor cortex, insula, red nucleus, thalamus, anterior as well as dorsolateral prefrontal and frontal cortex. When comparing affected versus unaffected sides, temporal cortex, dorsal anterior cingulate cortex, supramarginal gyrus, dorsal temporal lobe, anterior insula, primary somatosensory cortex, superior frontal gyrus and anterior prefrontal as well as frontal cortex show significant differences. Neuronal areas seem to be involved in the pathogenesis, maintenance or as a result of MCD. Areas that are important for motor-planning, motor-selection or autonomic response seem to be especially relevant. Our results support the emotional unawareness theory but also underline the need of more support by conduction imaging studies on both CD and MCD.

  8. Monetary conversion factors for economic evaluations of substance use disorders.

    Science.gov (United States)

    McCollister, Kathryn; Yang, Xuan; Sayed, Bisma; French, Michael T; Leff, Jared A; Schackman, Bruce R

    2017-10-01

    Estimating the economic consequences of substance use disorders (SUDs) is important for evaluating existing programs and new interventions. Policy makers in particular must weigh program effectiveness with scalability and sustainability considerations in deciding which programs to fund with limited resources. This study provides a comprehensive list of monetary conversion factors for a broad range of consequences, services, and outcomes, which can be used in economic evaluations of SUD interventions (primarily in the United States), including common co-occurring conditions such as HCV and HIV. Economic measures were selected from standardized clinical assessment instruments that are used in randomized clinical trials and other research studies (e.g., quasi-experimental community-based projects) to evaluate the impact of SUD interventions. National datasets were also reviewed for additional SUD-related consequences, services, and outcomes. Monetary conversion factors were identified through a comprehensive literature review of published articles as well as targeted searches of other sources such as government reports. Eight service/consequence/outcome domains were identified containing more than sixty monetizable measures of medical and behavioral health services, laboratory services, SUD treatment, social services, productivity outcomes, disability outcomes, criminal activity and criminal justice services, and infectious diseases consequences. Unit-specific monetary conversion factors are reported, along with upper and lower bound estimates, whenever possible. Having an updated and standardized source of monetary conversion factors will facilitate and improve future economic evaluations of interventions targeting SUDs and other risky behaviors. This exercise should be repeated periodically as new sources of data become available to maintain the timeliness, comprehensiveness, and quality of these estimates. Copyright © 2017 The Authors. Published by Elsevier Inc

  9. [Dissociation (conversion) - malingering - antisocial personality disorder: differential diagnostic reflection on the basis of a case study].

    Science.gov (United States)

    Rothuber, Helfried; Mitterauer, Bernhard

    2011-01-01

    In this case report we refer to the big challenge of making a diagnosis in a deliberate malingering in the field of mental disorders. We specifically describe the difficulty regarding the differentiation between a conversion disorder and malingering of a serial delinquent. For such a person avoiding criminal persecution is one of the most frequent reason to deceitfully simulate a mental illness. In this field, symptoms of conversion disorders exceed the average; furthermore, a great number of organic-neurological illnesses may appear to be very similar to a conversion disorder or in many cases a neurological disorder can actually be detected in the course of a somatic examination. A further obstacle for the differential diagnosis can be seen in the difficulty to discern it from factitious disorders. However, it is quite possible to discern the deliberate malingering of a mental disorder from a conversion disorder by means of the diligent diagnosis of a competent and experienced doctor/assessor who specialises.

  10. Subtypes of dissociative (conversion) disorder in two tertiary hospitals in Bangladesh.

    Science.gov (United States)

    Ahsan, M S; Mullick, S I; Sobhan, M A; Khanam, M; Nahar, J S; Salam, M A; Ali, R; Islam, M; Kabir, M S

    2010-01-01

    Dissociative (conversion) disorders are common among the patients attending in and out patients of Psychiatry Department of tertiary hospitals in Bangladesh. This study was done to see the subtypes of dissociative (conversion) disorder according to International Classification of Diseases, Tenth Revision (ICD-10). This is a descriptive, cross sectional study done on 100 consecutive patients from the Departments of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH). Study period was July 2005 to June 2006. Among the patients of dissociative (conversion) disorder, mixed dissociative (conversion) disorder was found highest 34%, followed by dissociative convulsion 33%, dissociative motor disorders 19%, dissociative anaesthesia and sensory loss 5%, dissociative amnesia 4%, dissociative fugue 3%. However, the researcher did not find any multiple personality disorder which is relatively common in North America. This finding reflected that there are differences in prevalence of sub types of dissociative disorders in Bangladesh and Western countries.

  11. Hospital revisit rate after a diagnosis of conversion disorder.

    Science.gov (United States)

    Merkler, Alexander E; Parikh, Neal S; Chaudhry, Simriti; Chait, Alanna; Allen, Nicole C; Navi, Babak B; Kamel, Hooman

    2016-04-01

    To estimate the hospital revisit rate of patients diagnosed with conversion disorder (CD). Using administrative data, we identified all patients discharged from California, Florida and New York emergency departments (EDs) and acute care hospitals between 2005 and 2011 with a primary discharge diagnosis of CD. Patients discharged with a primary diagnosis of seizure or transient global amnesia (TGA) served as control groups. Our primary outcome was the rate of repeat ED visits and hospital admissions after initial presentation. Poisson regression was used to compare rates between diagnosis groups while adjusting for demographic characteristics. We identified 7946 patients discharged with a primary diagnosis of CD. During a mean follow-up of 3.0 (±1.6) years, patients with CD had a median of three (IQR, 1-9) ED or inpatient revisits, compared with 0 (IQR, 0-2) in patients with TGA and 3 (IQR, 1-7) in those with seizures. Revisit rates were 18.25 (95% CI, 18.10 to 18.40) visits per 100 patients per month in those with CD, 3.90 (95% CI, 3.84 to 3.95) in those with TGA and 17.78 (95% CI, 17.75 to 17.81) in those with seizures. As compared to CD, the incidence rate ratio for repeat ED visits or hospitalisations was 0.89 (95% CI, 0.86 to 0.93) for seizure disorder and 0.32 (95% CI 0.31 to 0.34) for TGA. CD is associated with a substantial hospital revisit rate. Our findings suggest that CD is not an acute, time-limited response to stress, but rather that CD is a manifestation of a broader pattern of chronic neuropsychiatric disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder.

    Science.gov (United States)

    Blakemore, Rebekah L; Sinanaj, Indrit; Galli, Silvio; Aybek, Selma; Vuilleumier, Patrik

    2016-12-01

    Conversion disorder or functional neurological symptom disorder (FND) can affect the voluntary motor system, without an organic cause. Functional symptoms are thought to be generated unconsciously, arising from underlying psychological stressors. However, attempts to demonstrate a direct relationship between the limbic system and disrupted motor function in FND are lacking. We tested whether negative affect would exacerbate alterations of motor control and corresponding brain activations in individuals with FND. Ten patients and ten healthy controls produced an isometric precision-grip contraction at 10% of maximum force while either viewing visual feedback of their force output, or unpleasant or pleasant emotional images (without feedback). Force magnitude was continuously recorded together with change in brain activity using fMRI. For controls, force output decayed from the target level while viewing pleasant and unpleasant images. Patients however, maintained force at the target level without decay while viewing unpleasant images, indicating a pronounced effect of negative affect on force output in FND. This emotional modulation of force control was associated with different brain activation patterns between groups. Contrasting the unpleasant with the pleasant condition, controls showed increased activity in the inferior frontal cortex and pre-supplementary motor area, whereas patients had greater activity in the cerebellum (vermis), posterior cingulate cortex, and hippocampus. Engagement of a cerebellar-limbic network in patients is consistent with heightened processing of emotional salience, and supports the role of the cerebellum in freezing responses in the presence of aversive events. These data highlight a possible neural circuit through which psychological stressors elicit defensive behaviour and modulate motor function in FND. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Emotion-motion interactions in conversion disorder: an FMRI study.

    Science.gov (United States)

    Aybek, Selma; Nicholson, Timothy R; O'Daly, Owen; Zelaya, Fernando; Kanaan, Richard A; David, Anthony S

    2015-01-01

    To evaluate the neural correlates of implicit processing of negative emotions in motor conversion disorder (CD) patients. An event related fMRI task was completed by 12 motor CD patients and 14 matched healthy controls using standardised stimuli of faces with fearful and sad emotional expressions in comparison to faces with neutral expressions. Temporal changes in the sensitivity to stimuli were also modelled and tested in the two groups. We found increased amygdala activation to negative emotions in CD compared to healthy controls in region of interest analyses, which persisted over time consistent with previous findings using emotional paradigms. Furthermore during whole brain analyses we found significantly increased activation in CD patients in areas involved in the 'freeze response' to fear (periaqueductal grey matter), and areas involved in self-awareness and motor control (cingulate gyrus and supplementary motor area). In contrast to healthy controls, CD patients exhibited increased response amplitude to fearful stimuli over time, suggesting abnormal emotional regulation (failure of habituation / sensitization). Patients with CD also activated midbrain and frontal structures that could reflect an abnormal behavioral-motor response to negative including threatening stimuli. This suggests a mechanism linking emotions to motor dysfunction in CD.

  14. Uncovering the etiology of conversion disorder: insights from functional neuroimaging

    Science.gov (United States)

    Ejareh dar, Maryam; Kanaan, Richard AA

    2016-01-01

    Conversion disorder (CD) is a syndrome of neurological symptoms arising without organic cause, arguably in response to emotional stress, but the exact neural substrates of these symptoms and the underlying mechanisms remain poorly understood with the hunt for a biological basis afoot for centuries. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from CDs in both motor and nonmotor domains. This review summarizes recent functional neuroimaging studies including functional magnetic resonance imaging (fMRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET) to see whether they bring us closer to understanding the etiology of CD. Convergent functional neuroimaging findings suggest alterations in brain circuits that could point to different mechanisms for manifesting functional neurological symptoms, in contrast with feigning or healthy controls. Abnormalities in emotion processing and in emotion-motor processing suggest a diathesis, while differential reactions to certain stressors implicate a specific response to trauma. No comprehensive theory emerges from these clues, and all results remain preliminary, but functional neuroimaging has at least given grounds for hope that a model for CD may soon be found. PMID:26834476

  15. The classification of conversion disorder (functional neurologic symptom disorder) in ICD and DSM.

    Science.gov (United States)

    Levenson, J L; Sharpe, M

    2016-01-01

    The name given to functional neurologic symptoms has evolved over time in the different editions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), reflecting a gradual move away from an etiologic conception rooted in hysterical conversion to an empiric phenomenologic one, emphasizing the central role of the neurologic examination and testing in demonstrating that the symptoms are incompatible with recognized neurologic disease pathophysiology, or are internally inconsistent. © 2016 Elsevier B.V. All rights reserved.

  16. A randomized controlled clinical trial of a hypnosis-based treatment for patients with conversion disorder, motor type

    NARCIS (Netherlands)

    Moene, F.C.; Spinhoven, P.; Hoogduin, C.A.L.; Dyck, R. van

    2003-01-01

    This study tested whether a hypnosis-based intervention showed promise as a treatment for patients with conversion disorder, motor type. Forty-four outpatients with conversion disorder, motor type, or somatization disorder with motor conversion symptoms, were randomly assigned to a hypnosis or a

  17. Conversion, Factitious Disorder and Malingering: A Distinct Pattern or a Continuum?

    Science.gov (United States)

    Galli, Silvio; Tatu, Laurent; Bogousslavsky, Julien; Aybek, Selma

    2018-01-01

    This chapter is aimed at highlighting the recent findings concerning physiopathology, diagnosis, and management of conversion, factitious disorder, and malingering. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist's consultation. The first challenge is to detect them, and recent studies have confirmed the importance of "positive" clinical bedside signs based on incoherence and discordance, such as the Hoover's sign for the diagnosis of conversion disorder. Functional neuroimaging has allowed a better understanding of the pathophysiology, and highlighted abnormal cerebral activation patterns in conversion disorder in relation to motor, emotional, and limbic networks, different from feigners. This supports the theory evoked by Charcot of a "psychodynamic lesion," which is also reflected by the new term introduced in the DSM-5: functional neurological disorder. Multidisciplinary therapy is recommended with behavioral cognitive therapy, antidepressant to treat frequent comorbid anxiety or depression, and physiotherapy. Factitious disorder and malingering should be clearly delineated from conversion disorder. Factitious disorder should be considered as a mental illness and more research on its physiopathology and treatment is needed, when malingering is a non-medical condition encountered in medico-legal cases. © 2018 S. Karger AG, Basel.

  18. Sex Distribution and Psychiatric Features of Child and Adolescent Conversion Disorder Across 2 Decades

    Directory of Open Access Journals (Sweden)

    Kai-Lin Huang

    2009-09-01

    Conclusion: The sex distribution in conversion disorder might have significantly changed over the past 2 decades. There is an increasing need for screening and interventions for psychiatric comorbidity and experiences of being abused in children and adolescents with conversion disorder. Because of the small sample size of our study, further studies that include multiple study sites and a larger number of patients are needed before a firm conclusion can be drawn.

  19. Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis

    DEFF Research Database (Denmark)

    Starzer, Marie Stefanie Kejser; Nordentoft, Merete; Hjorthøj, Carsten

    2017-01-01

    . Self-harm after a substance-induced psychosis was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder. Half the cases of conversion to schizophrenia occurred within 3.1 years after a substance-induced psychosis, and half the cases of conversion to bipolar...

  20. Childhood trauma and dissociation in women with pseudoseizure-type conversion disorder.

    Science.gov (United States)

    Ozcetin, Adnan; Belli, Hasan; Ertem, Umit; Bahcebasi, Talat; Ataoglu, Ahmet; Canan, Fatih

    2009-11-01

    Conversion disorder is thought to be associated with psychological factors because of the presence of conflict and other stressors prior to the condition. The aim of this study is to compare adult patients with pseudoseizure-type conversion disorder with healthy control group in terms of childhood trauma, dissociative disorder and family history of psychiatric disorders. 56 female patients were admitted to the general psychiatry hospital outpatient clinic between January and July 2005. All patients had a negative experience about their families just before having the conversion. Diagnosis was made according to the DSM-IV criteria. A control group consisting of similar patient demographics of the disease group has been selected. Socio-demographic information forms, the Childhood Trauma Questionnaire (CTQ) and Dissociation Questionnaire (DIS-Q), were completed on the patients. CTQ total (t=12.12, Pconversion group. DIS-Q mean points were statistically higher in the conversion group (t=11.05, Pconversion disorder) should be included within dissociative disorders in DSM system as in ICD. It is usually uncommon for the patient to tell about childhood trauma without being specially questioned about this issue. Thus, it would be helpful to uncover these experiences by using related scales in conversion disorder patients.

  1. The relationship between temperament and character in conversion disorder and comorbid depression.

    Science.gov (United States)

    Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

    2013-05-01

    The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (Pconversion disorder patients had high self-transcendence (PConversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Temperament and character traits in patients with conversion disorder and their relations with dissociation.

    Science.gov (United States)

    Sarisoy, Gökhan; Kaçar, Ö Mer Faruk; Öztürk, Arif; Yilman, Tuba; Mor, Sema; Özturan, Deniz Deniz; Yazici, Neslihan; Gümüş, Kübra

    2015-12-01

    The purpose of this study was to investigate temperament and character traits in patients with conversion disorder and the relation of these traits with dissociative symptoms. Sixty patients (60) diagnosed with conversion disorder according to DSM-IV-TR and 60 healthy volunteers were included in the study. All participants' temperament and character traits were determined using Cloninger's Temperament and Character Inventory (TCI). Patients with conversion disorder were divided into two subgroups using the Dissociative Experiences Scale (DES), dissociative (n=30, 50%) and non-dissociative (n=30, 50%). The two conversion disorder subgroups were compared with the control group in terms of temperament and character traits. Correlation analysis was also performed between TCI and DES scores in the entire conversion group. Novelty seeking (NS) scores were lower in both the dissociative and non-dissociative groups compared to the control group. Harm avoidance (HA) scores were higher in the dissociative group than in the control group. Reward dependence (RD) scores were lower in the dissociative group than in the non-dissociative and control group. Self-directedness (SD) scores were lower in the dissociative group than in the control group. Self-transcendence (ST) scores were higher in the dissociative group than in the non-dissociative group. DES scores were negatively correlated with RD and SD scores in the entire conversion group and positively correlated with ST scores. Low NS temperament traits may be associated with conversion disorder. High HA and low RD temperament traits and low SD and high ST character traits may be associated with pathological dissociation in patients with conversion disorder.

  3. The role of psychiatrists in diagnosing conversion disorder: a mixed-methods analysis

    Directory of Open Access Journals (Sweden)

    Kanaan RA

    2016-05-01

    Full Text Available Richard A Kanaan,1,2 David Armstrong,3 Simon Wessely2 1Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, VIC, Australia; 2Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Weston Education Centre, Denmark Hill, 3Department of General Practice, King’s College London, Capital House, London, UK Objective: Since DSM-5 removed the requirement for a psychosocial formulation, neurologists have been able to make the diagnosis of conversion disorder without psychiatric input. We sought to examine whether neurologists and specialist psychiatrists concurred with this approach.Design: We used mixed methods, first surveying all the neurologists in the UK and then interviewing the neuropsychiatrists in a large UK region on the role of psychiatrists in diagnosing conversion disorder.Results: Of the surveyed neurologists, 76% did not think that psychiatrists were essential for the diagnosis and 71% thought that psychiatrists did not even consider conversion disorder when referred a case. The neuropsychiatrists who were interviewed held complex models of conversion disorder. They believed all cases could be explained psychosocially in theory, but the nature of the diagnostic encounter often prevented it in practice; all felt that psychosocial formulation could be very helpful and some felt that it was essential to diagnosis.Conclusion: Although neurologists do not think psychiatrists are required for diagnosing conversion disorder, specialist psychiatrists disagree, at least in some cases. Keywords: functional neurological disorders, classification, qualitative research, survey, psychiatric formulation

  4. The impact of early trauma and recent life-events on symptom severity in patients with conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Spinhoven, P.; Sandijck, P.; Moene, F.C.; Hoogduin, C.A.L.

    2005-01-01

    Although the presence of psychological stress factors in the evolution of conversion symptoms forms an important criterion for the DSM-IV diagnosis of conversion disorder, little is known about the nature and timing of these stress factors. Fifty-four patients with conversion disorder and 50 control

  5. Psychiatric comorbidity in patients with conversion disorder and prevalence of dissociative symptoms.

    Science.gov (United States)

    Yayla, Sinan; Bakım, Bahadır; Tankaya, Onur; Ozer, Omer Akil; Karamustafalioglu, Oguz; Ertekin, Hulya; Tekin, Atilla

    2015-01-01

    The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

  6. Participant characteristics and observed support in conversations involving people with communication disorders.

    Science.gov (United States)

    Eriksson, Karin; Hartelius, Lena; Saldert, Charlotta

    2016-10-01

    Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored. Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson's disease along with 10 significant others and two enrolled nurses. Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses. Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.

  7. Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia: A case study

    Directory of Open Access Journals (Sweden)

    Hamid Nasiri

    2015-01-01

    Full Text Available Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

  8. Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia): A case study.

    Science.gov (United States)

    Nasiri, Hamid; Ebrahimi, Amrollah; Zahed, Arash; Arab, Mostafa; Samouei, Rahele

    2015-05-01

    Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia) was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

  9. A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

    Science.gov (United States)

    Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

    2015-03-15

    The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Symptom-specific amygdala hyperactivity modulates motor control network in conversion disorder

    Directory of Open Access Journals (Sweden)

    Thomas Hassa

    2017-01-01

    Full Text Available Initial historical accounts as well as recent data suggest that emotion processing is dysfunctional in conversion disorder patients and that this alteration may be the pathomechanistic neurocognitive basis for symptoms in conversion disorder. However, to date evidence of direct interaction of altered negative emotion processing with motor control networks in conversion disorder is still lacking. To specifically study the neural correlates of emotion processing interacting with motor networks we used a task combining emotional and sensorimotor stimuli both separately as well as simultaneously during functional magnetic resonance imaging in a well characterized group of 13 conversion disorder patients with functional hemiparesis and 19 demographically matched healthy controls. We performed voxelwise statistical parametrical mapping for a priori regions of interest within emotion processing and motor control networks. Psychophysiological interaction (PPI was used to test altered functional connectivity of emotion and motor control networks. Only during simultaneous emotional stimulation and passive movement of the affected hand patients displayed left amygdala hyperactivity. PPI revealed increased functional connectivity in patients between the left amygdala and the (pre-supplemental motor area and the subthalamic nucleus, key regions within the motor control network. These findings suggest a novel mechanistic direct link between dysregulated emotion processing and motor control circuitry in conversion disorder.

  11. The role of psychiatrists in diagnosing conversion disorder: a mixed-methods analysis.

    Science.gov (United States)

    Kanaan, Richard A; Armstrong, David; Wessely, Simon

    2016-01-01

    Since DSM-5 removed the requirement for a psychosocial formulation, neurologists have been able to make the diagnosis of conversion disorder without psychiatric input. We sought to examine whether neurologists and specialist psychiatrists concurred with this approach. We used mixed methods, first surveying all the neurologists in the UK and then interviewing the neuropsychiatrists in a large UK region on the role of psychiatrists in diagnosing conversion disorder. Of the surveyed neurologists, 76% did not think that psychiatrists were essential for the diagnosis and 71% thought that psychiatrists did not even consider conversion disorder when referred a case. The neuropsychiatrists who were interviewed held complex models of conversion disorder. They believed all cases could be explained psychosocially in theory, but the nature of the diagnostic encounter often prevented it in practice; all felt that psychosocial formulation could be very helpful and some felt that it was essential to diagnosis. Although neurologists do not think psychiatrists are required for diagnosing conversion disorder, specialist psychiatrists disagree, at least in some cases.

  12. Symptom-specific amygdala hyperactivity modulates motor control network in conversion disorder.

    Science.gov (United States)

    Hassa, Thomas; Sebastian, Alexandra; Liepert, Joachim; Weiller, Cornelius; Schmidt, Roger; Tüscher, Oliver

    2017-01-01

    Initial historical accounts as well as recent data suggest that emotion processing is dysfunctional in conversion disorder patients and that this alteration may be the pathomechanistic neurocognitive basis for symptoms in conversion disorder. However, to date evidence of direct interaction of altered negative emotion processing with motor control networks in conversion disorder is still lacking. To specifically study the neural correlates of emotion processing interacting with motor networks we used a task combining emotional and sensorimotor stimuli both separately as well as simultaneously during functional magnetic resonance imaging in a well characterized group of 13 conversion disorder patients with functional hemiparesis and 19 demographically matched healthy controls. We performed voxelwise statistical parametrical mapping for a priori regions of interest within emotion processing and motor control networks. Psychophysiological interaction (PPI) was used to test altered functional connectivity of emotion and motor control networks. Only during simultaneous emotional stimulation and passive movement of the affected hand patients displayed left amygdala hyperactivity. PPI revealed increased functional connectivity in patients between the left amygdala and the (pre-)supplemental motor area and the subthalamic nucleus, key regions within the motor control network. These findings suggest a novel mechanistic direct link between dysregulated emotion processing and motor control circuitry in conversion disorder.

  13. Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis.

    Science.gov (United States)

    Starzer, Marie Stefanie Kejser; Nordentoft, Merete; Hjorthøj, Carsten

    2018-04-01

    The authors investigated the rates of conversion to schizophrenia and bipolar disorder after a substance-induced psychosis, as well as risk factors for conversion. All patient information was extracted from the Danish Civil Registration System and the Psychiatric Central Research Register. The study population included all persons who received a diagnosis of substance-induced psychosis between 1994 and 2014 (N=6,788); patients were followed until first occurrence of schizophrenia or bipolar disorder or until death, emigration, or August 2014. The Kaplan-Meier method was used to obtain cumulative probabilities for the conversion from a substance-induced psychosis to schizophrenia or bipolar disorder. Cox proportional hazards regression models were used to calculate hazard ratios for all covariates. Overall, 32.2% (95% CI=29.7-34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI=42.7-52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm after a substance-induced psychosis was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder. Half the cases of conversion to schizophrenia occurred within 3.1 years after a substance-induced psychosis, and half the cases of conversion to bipolar disorder occurred within 4.4 years. Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases.

  14. Huntington's Disease in a Patient Misdiagnosed as Conversion Disorder.

    Science.gov (United States)

    Nogueira, João Machado; Franco, Ana Margarida; Mendes, Susana; Valadas, Anabela; Semedo, Cristina; Jesus, Gustavo

    2018-01-01

    Huntington's disease (HD) is an inherited, progressive, and neurodegenerative neuropsychiatric disorder caused by the expansion of cytosine-adenine-guanine (CAG) trinucleotide in Interested Transcript (IT) 15 gene on chromosome 4. This pathology typically presents in individuals aged between 30 and 50 years and the age of onset is inversely correlated with the length of the CAG repeat expansion. It is characterized by chorea, cognitive deficits, and psychiatric symptoms. Usually the psychiatric disorders precede motor and cognitive impairment, Major Depressive Disorder and anxiety disorders being the most common presentations. We present a clinical case of a 65-year-old woman admitted to our Psychiatric Acute Unit. During the 6 years preceding the admission, the patient had clinical assessments made several times by different specialties that focused only on isolated symptoms, disregarding the syndrome as a whole. In the course of her last admission, the patient was referred to our Neuropsychiatric Team, which made the provisional diagnosis of late-onset Huntington's disease, later confirmed by genetic testing. This clinical vignette highlights the importance of a multidisciplinary approach to atypical clinical presentations and raises awareness for the relevance of investigating carefully motor symptoms in psychiatric patients.

  15. Chronic subjective dizziness versus conversion disorder: discussion of clinical findings and rehabilitation.

    Science.gov (United States)

    Honaker, Julie A; Gilbert, Jane M; Staab, Jeffrey P

    2010-06-01

    Audiologists frequently encounter patients who complain of chronic dizziness or imbalance, in the absence of active vestibular or neurological deficits. Knowledge about conditions that cause this clinical presentation will allow audiologists to make important contributions to accurate diagnosis and effective management of these patients. This article reviews 2 such conditions, chronic subjective dizziness (CSD) and conversion disorder. A case of CSD and another of conversion disorder are presented, with a literature review of their clinical presentations, key diagnostic features, and treatment strategies. The role of the audiologist in assessing patients with these conditions and facilitating appropriate treatment referrals is discussed. The audiologist is in a key position to identify individuals with CSD and conversion disorder, 2 conditions that can be effectively managed if properly recognized. The authors demonstrate an effective team approach program that includes the audiologist's contribution to differential diagnosis, education of patients and other clinicians about these conditions, and development of recommendations for neurological, psychiatric, otologic, and physical therapy referrals.

  16. Is physiotherapy effective in the management of child and adolescent conversion disorder? A systematic review.

    Science.gov (United States)

    FitzGerald, Tara L; Southby, Alesha K; Haines, Terrence P; Hough, Janet P; Skinner, Elizabeth H

    2015-02-01

    Child and adolescent conversion disorder has the potential to impart significant burden on health-care services and affect quality of life. Clinically, physiotherapists are involved in conversion disorder management; however, no systematic reviews have examined physiotherapy effectiveness in its management. The aim of this review is to identify the efficacy of physiotherapy management of child and adolescent conversion disorder. A search of multiple databases (Medline, CINAHL, Embase, PsychINFO, PEDro and the Cochrane Library) was completed along with manual searching of relevant reference lists to identify articles including children 0-18 years with a diagnosis of conversion disorder who received physical management. Two independent reviewers screened titles and abstracts using criteria. Data were extracted regarding study characteristics, functional outcome measures, length of stay, physiotherapy service duration and resolution of conversion symptoms. Methodological quality was assessed using a tool designed for observational studies. Twelve observational studies were included. No functional outcome measures were used to assess the effectiveness of the treatment protocols in the case studies. Resolution of symptoms occurred in all but two cases, with conversion symptoms still present at 11 months and at 2 years. Length of stay varied from 3 days to 16 weeks, with similar variation evident in length of physiotherapy service provision (2.5 weeks to 16 weeks). There was limited and poor quality evidence to establish the efficacy of physiotherapy management of child and adolescent conversion disorders. More rigorous study designs with consistent use of reliable, valid and sensitive functional outcome measures are needed in this area. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  17. [Conversion disorder in an internal medicine department: A series of 37 cases].

    Science.gov (United States)

    Régny, P; Cathébras, P

    2016-04-01

    To describe the clinical characteristics of a series of patients presenting conversion disorder in a general internal medicine ward and outpatient clinic, the arguments retained by the physicians in favour of the diagnosis, the somatic and psychiatric co-morbidities, the management and the outcome of the disorder. We report the study of 37 patients diagnosed with conversion disorder in an internal medicine department of a French university hospital over a period of 14 years. We retrospectively reviewed the charts of the patients and contacted their primary care physicians to obtain follow-up data. No structured instrument was used for the diagnosis of conversion disorder or for the assessment of psychiatric comorbidities. As expected, patients were mostly young females, although a great variety of age, gender, and socio-cultural background was observed. Motor symptoms predominated (62%). A relevant psychogenic factor was explicitly mentioned in only 43% of the cases. In many cases, organic disease was also present, and an organic cause for the symptom initially considered as conversion was suspected in 3 cases. Depressive and anxious disorders were present respectively in 38% and 35% of cases. A pain complaint was associated in half of the cases. Among patients for whom follow-up data is available, conversion symptoms persisted or recurred in 70% of cases and were associated with a poor quality of life. This case series confirms that the DSM-IV-TR criterion of "psychogenicity" (later abandoned in DSM-5) is highly problematic in clinical practice. It suggests a close relationship between conversion disorder and unexplained chronic pain. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  18. [Conversion disorder: from DSM IV to DSM 5 or from a psychiatric to a neurological diagnosis].

    Science.gov (United States)

    Vermeulen, M; Willems, M H A

    2015-01-01

    According to one of the diagnostic criteria of the dsm iv for conversion disorder there has to be a temporal relationship between psychological factors and the onset, or the worsening, of the symptoms. This criterion has been omitted in the dsm-5. Another criterion, namely that the symptoms are not produced intentionally, has also been abandoned. A new recommendation is that therapists should look for neurological symptoms that support the diagnosis. To investigate whether studies support the changes in the criteria. We searched literature using PubMed. When the symptoms first appear, trauma or stress in 37% of patients is of a physical rather than a psychological nature. Different forms of stress were found in equal proportions (20%) in patients with or without conversion disorder. There are no specific stressors, except possibly in patients with dysphonia. The percentages of childhood abuse vary widely, namely from 0 to 85%. The characteristic phenomenon of 'la belle indifference' occurs in only 3% of patients with conversion disorder versus only 2% of controls. Most of the 'positive' clinical tests for partial paralysis and sensory and gait disorders are highly specific. There are no reliable tests for distinguishing conversion disorder from simulation. The changes of the criteria are supported by recent studies.

  19. Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders.

    Science.gov (United States)

    Jones, Danielle; Drew, Paul; Elsey, Christopher; Blackburn, Daniel; Wakefield, Sarah; Harkness, Kirsty; Reuber, Markus

    2016-01-01

    In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on 'timely diagnosis' aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints. This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group. Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences. The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

  20. Cognitive rehabilitation treatment for mental slowness in conversion disorder : A case report

    NARCIS (Netherlands)

    De Vroege, L.; Khasho, D.; Foruz, A.; Van Der Feltz-cornelis, C.M.; Walla, P.

    2017-01-01

    Cognitive rehabilitation treatment (CRT) has been described in patients with brain injury, but it has not been attempted in cases of cognitive dysfunction without organic cause. This case report describes CRT of neurocognitive impairment in a 54-year-old female patient with conversion disorder (CD).

  1. Increased activation in cingulate cortex in conversion disorder : What does it mean?

    NARCIS (Netherlands)

    van Beilen, M.; Vogt, B. A.; Leenders, K. L.

    2010-01-01

    Conversion disorder is one of the terms used to describe various psychosomatic neurological symptoms that are thought to originate from a psychological conflict Psychological stressors can usually be identified but appear to be almost similar to the severity of psychological stress in

  2. Specific biases for identifying facial expression of emotion in children and adolescents with conversion disorders.

    Science.gov (United States)

    Kozlowska, Kasia; Brown, Kerri J; Palmer, Donna M; Williams, Lea M

    2013-04-01

    This study aimed to assess how children and adolescents with conversion disorders identify universal facial expressions of emotion and to determine whether identification of emotion in faces relates to subjective emotional distress. Fifty-seven participants (41 girls and 16 boys) aged 8.5 to 18 years with conversion disorders and 57 age- and sex-matched healthy controls completed a computerized task in which their accuracy and reaction times for identifying facial expressions were recorded. To isolate the effect of individual emotional expressions, participants' reaction times for each emotion (fear, anger, sadness, disgust, and happiness) were subtracted from their reaction times for the neutral control face. Participants also completed self-report measures of subjective emotional distress. Children/Adolescents with conversion disorders showed faster reaction times for identifying expressions of sadness (t(112) = -2.2, p = .03; 444 [609] versus 713 [695], p = .03) and slower reactions times for happy expressions (t(99.3) = 2.28, p ≤ .024; -33 [35] versus 174 [51], p = .024), compared with controls (F(33.75, 419.81) = 3.76, p .018). There were also no differences in identification accuracy for any emotion (p > .82). The observation of faster reaction times to sad faces in children and adolescents with conversion disorders suggests increased vigilance and motor readiness to emotional signals that are potential threats to self or to close others. These effects may occur before conscious processing.

  3. Using Self-Management to Improve the Reciprocal Social Conversation of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Koegel, Lynn Kern; Park, Mi N.; Koegel, Robert L.

    2014-01-01

    Individuals with autism spectrum disorders often exhibit difficulties with reciprocal social conversation, engaging in limited verbal exchanges, even when language structures are intact. This study employed a multiple baseline design to examine the effectiveness of a self-management intervention targeting (1) on-topic responsiveness to a…

  4. Behavioral Treatment of Conversion Disorder in Adolescence: A Case Example of Globus Hystericus.

    Science.gov (United States)

    Donohue, Brad; Thevenin, Deborah M.; Runyon, Melissa K.

    1997-01-01

    Using a case study, evaluates the efficacy of a cognitive-behavioral intervention for the treatment of a patient diagnosed with a conversion disorder characterized by a perceived lump in the throat and subsequent weight loss. Results indicate that the behavioral therapy procedures contributed to increased weight and improved eating behavior. (RJM)

  5. Spin-charge conversion in disordered two-dimensional electron gases lacking inversion symmetry

    Science.gov (United States)

    Huang, Chunli; Milletarı, Mirco; Cazalilla, Miguel A.

    2017-11-01

    We study the spin-charge conversion mechanisms in a two-dimensional gas of electrons moving in a smooth disorder potential by accounting for both Rashba-type and Mott's skew scattering contributions. We find that the quantum interference effects between spin-flip and skew scattering give rise to anisotropic spin precession scattering (ASP), a direct spin-charge conversion mechanism that was discovered in an earlier study of graphene decorated with adatoms [Huang et al., Phys. Rev. B 94, 085414 (2016), 10.1103/PhysRevB.94.085414]. Our findings suggest that, together with other spin-charge conversion mechanisms such as the inverse galvanic effect, ASP is a fairly universal phenomenon that should be present in disordered two-dimensional systems lacking inversion symmetry.

  6. Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder.

    Science.gov (United States)

    Yılmaz, Savaş; Bilgiç, Ayhan; Akça, Ömer Faruk; Türkoğlu, Serhat; Hergüner, Sabri

    2016-01-01

    This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Fifty outpatients, aged 8-18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.

  7. Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder

    Science.gov (United States)

    Voon, V; Brezing, C; Gallea, C; Hallett, M

    2014-01-01

    Background Conversion disorder is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self-monitoring, limbic processing or top-down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that conversion disorder with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amgydala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Methods Subjects performed either an internally or externally generated two-button action selection task in a functional MRI study. Results Eleven conversion disorder patients without major depression and 11 age- and gender-matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. Conclusion We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system which is both hypoactive and functionally disconnected from prefrontal top-down regulation. PMID:21935985

  8. Functional networks of motor inhibition in conversion disorder patients and feigning subjects

    Directory of Open Access Journals (Sweden)

    Thomas Hassa

    2016-01-01

    Full Text Available The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG, with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

  9. Functional networks of motor inhibition in conversion disorder patients and feigning subjects.

    Science.gov (United States)

    Hassa, Thomas; de Jel, Esther; Tuescher, Oliver; Schmidt, Roger; Schoenfeld, Mircea Ariel

    2016-01-01

    The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG), with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

  10. "Hunger Hurts, but Starving Works". The Moral Conversion to Eating Disorders.

    Science.gov (United States)

    Orsini, Gisella

    2017-03-01

    This article aims to shed light on the self-perceptions of people with eating disorders in Malta and Italy through a deep understanding of their narratives. In contrast to the biomedical perception of the phenomenon and in opposition with the prevalent feminist theories on the subject, I consider eating disorders as the result of self-transformative processes. I suggest that anorexics, bulimics and binge eaters are actively and deliberately engaged in a project of moral self-transformation that is culturally defined. The moral transformations of women with eating disorders in Malta and Italy, the two considered contexts of this research, reflect the social expectations of women in these societies. The drastic changes in personal attitudes towards both food and the body that characterise eating disorders are the result of a complete dedication to the moral values embodied in thinness, namely the control of bodily needs and pleasure. The self-transformative process of people with eating disorders can be understood as a form of moral conversion along a continuum of increasing control over hunger: the higher the control, the higher the level of satisfaction and the degree of moral conversion achieved. Considering the general low recovery rates of people with eating disorders, this approach helps in the understanding of why people who are diagnosed with an eating disorder accept medical definitions and treatments to different extents.

  11. A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.

    Science.gov (United States)

    Yegya-Raman, Nikhil; Aziz, Rehan; Schneider, Daniel; Tobia, Anthony; Leitch, Megan; Nwobi, Onyi

    2017-01-01

    Background . Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. Methods . PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder". Case . The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder and unspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease. Discussion . This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations.

  12. Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.

    Science.gov (United States)

    Ng, Tommy H; Burke, Taylor A; Stange, Jonathan P; Walshaw, Patricia D; Weiss, Rachel B; Urosevic, Snezana; Abramson, Lyn Y; Alloy, Lauren B

    2017-04-01

    Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p conversion to bipolar I disorder (HR = 2.51; p conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Action-effect binding is decreased in motor conversion disorder: implications for sense of agency.

    Science.gov (United States)

    Kranick, Sarah M; Moore, James W; Yusuf, Nadia; Martinez, Valeria T; LaFaver, Kathrin; Edwards, Mark J; Mehta, Arpan R; Collins, Phoebe; Harrison, Neil A; Haggard, Patrick; Hallett, Mark; Voon, Valerie

    2013-07-01

    The abnormal movements seen in motor conversion disorder are affected by distraction and entrainment, similar to voluntary movement. Unlike voluntary movement, however, patients lack a sense of control for the abnormal movements, a failure of "self-agency." The action-effect binding paradigm has been used to quantify the sense of self-agency, because subjective contraction of time between an action and its effect only occurs if the patient feels that they are the agent responsible for the action. We used this paradigm, coupled with emotional stimuli, to investigate the sense of agency with voluntary movements in patients with motor conversion disorder. Twenty patients with motor conversion disorder and 20 age-matched and sex-matched healthy volunteers used a rotating clock to judge the time of their own voluntary key presses (action) and a subsequent auditory tone (effect) after they completed conditioning blocks in which high, medium, and low tones were coupled to images of happy, fearful, and neutral faces. The results replicated those produced previously: it was reported that an effect after a voluntary action occurred earlier, and the preceding action occurred later, compared with trials that used only key presses or tones. Patients had reduced overall binding scores relative to healthy volunteers, suggesting a reduced sense of agency. There was no effect of the emotional stimuli (faces) or other interaction effects. Healthy volunteers with subclinical depressive symptoms had higher overall binding scores. We demonstrate that patients with motor conversion disorder have decreased action-effect binding for normal voluntary movements compared with healthy volunteers, consistent with the greater experience of lack of control. Copyright © 2013 Movement Disorder Society.

  14. Conversion disorder

    Science.gov (United States)

    ... Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  15. Diagnostic conversion to bipolar disorder in unipolar depressed patients participating in trials on antidepressants

    DEFF Research Database (Denmark)

    Holmskov, J; Licht, R W; Andersen, K

    2017-01-01

    OBJECTIVE: In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder. METHOD: A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.......8 years (SD=11.9) participating in three randomized trials on antidepressants conducted in the period 1985-1994. The independent effects of explanatory variables were examined by applying Cox regression analyses. RESULTS: The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years...... per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10-1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM...

  16. Functional neuroimaging of recovery from motor conversion disorder: A case report

    DEFF Research Database (Denmark)

    Dogonowski, A M; Andersen, Kasper W.; Sellebjerg, F

    2018-01-01

    A patient with motor conversion disorder presented with a functional paresis of the left hand. After exclusion of structural brain damage, she was repeatedly examined with whole-brain functional magnetic resonance imaging, while she performed visually paced finger-tapping tasks. The dorsal premotor...... cortex showed a bilateral deactivation in the acute-subacute phase. Recovery from unilateral hand paresis was associated with a gradual increase in task-based activation of the dorsal premotor cortex bilaterally. The right medial prefrontal cortex displayed the opposite pattern, showing initial task...... that an excessive 'veto' signal generated in medial prefrontal cortex along with decreased premotor activity might constitute the functional substrate of conversion disorder. This notion warrants further examination in a larger group of affected patients....

  17. Postoperative Conversion Disorder Presenting as Inspiratory Stridor and Hemiparesis in a Pediatric Patient.

    Science.gov (United States)

    Nelson, Erik J; Wu, Jennifer Y

    2017-01-17

    BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal. CONCLUSIONS After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder.

  18. Clinical Considerations Regarding Regression in Psychotherapy with Patients with Conversion Disorder.

    Science.gov (United States)

    Kaplan, Marcia

    Regression is a ubiquitous phenomenon in psychodynamic psychotherapy and psychoanalysis, typically part of a reorganization that leads to progression, at least with respect to recruiting elements in the unconscious to consciousness. Regression in patients with conversion disorder (i.e., pseudo-neurological symptoms without an organic basis) is often itself somatic/physical rather than psychic in nature. Psychotherapists working with these patients must be prepared for confusing or frightening forms of regression that should be expected as part of the therapeutic process. In conversion disorder patients with adequate character structure, this regression, when handled effectively by the psychotherapist, ultimately leads to verbalized thoughts and feelings and a gradually strengthening alternative to physically experienced psychic conflict.

  19. Rate and predictors of conversion from unipolar to bipolar disorder: A systematic review and meta-analysis.

    Science.gov (United States)

    Kessing, Lars Vedel; Willer, Inge; Andersen, Per Kragh; Bukh, Jens Drachman

    2017-08-01

    For the first time to present a systematic review and meta-analysis of the conversion rate and predictors of conversion from unipolar disorder to bipolar disorder. A systematic literature search up to October 2016 was performed. For the meta-analysis, we only included studies that used survival analysis to estimate the conversion rate. A total of 31 studies were identified, among which 11 used survival analyses, including two register-based studies. The yearly rate of conversion to bipolar disorder decreased with time from 3.9% in the first year after study entry with a diagnosis of unipolar disorder to 3.1% in years 1-2, 1.0% in years 2-5 and 0.8% in years 5-10. A total of eight risk factors were evaluated comprising gender, age at onset of unipolar disorder, number of depressive episodes, treatment resistance to antidepressants, family history of bipolar disorder, the prevalence of psychotic depression, the prevalence of chronic depression, and severity of depression. It was not possible to identify risk factors that were consistently or mainly confirmed to predict conversion across studies. The conversion rate from unipolar to bipolar disorder decreases with time. It was not possible to identify predictors of conversion that were consistently or mainly confirmed across studies, which may be due to variations in methodology across studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. When symptoms don't fit: a case series of conversion disorder in the pediatric otolaryngology practice.

    Science.gov (United States)

    Caulley, Lisa; Kohlert, Scott; Gandy, Hazen; Olds, Janet; Bromwich, Matthew

    2018-05-29

    Conversion disorder refers to functional bodily impairments that can be precipitated by high stress situations including trauma and surgery. Symptoms of conversion disorder may mimic or complicate otolaryngology diseases in the pediatric population. In this report, the authors describe 3 cases of conversion disorder that presented to a pediatric otolaryngology-head and neck surgery practice. This report highlights a unique population of patients who have not previously been investigated. The clinical presentation and management of these cases are discussed in detail. Non-organic otolaryngology symptoms of conversion disorder in the pediatric population are reviewed. In addition, we discuss the challenges faced by clinicians in appropriately identifying and treating these patients and present an approach to management of their care. In this report, the authors highlight the importance of considering psychogenic illnesses in patients with atypical clinical presentations of otolaryngology disorders.

  1. Cathecol-O-methyl transferase Val158Met genotype is not a risk factor for conversion disorder.

    Science.gov (United States)

    Armagan, E; Almacıoglu, M L; Yakut, T; Köse, A; Karkucak, M; Köksal, O; Görükmez, O

    2013-03-19

    Alterations in catechol-O-methyltransferase (COMT) activity are involved in various types of neurological disorders. We examined a possible association between the COMT Val158Met polymorphism and conversion disorder in a study of 48 patients with conversion disorder and 48 control patients. In the conversion disorder group, 31 patients were Val/Met heterozygotes, 15 patients were Val/Val homozygotes and 2 patients were Met/Met homozygotes. In the control group, 32 patients were Val/Met heterozygotes and 16 patients were Val/Val homozygotes. There was no significant difference between the groups. We conclude that the COMT Val158Met genotype is quite common in Turkey and that it is not a risk factor for conversion disorder in the Turkish population.

  2. Conversion disorder in children and adolescents: a disorder of cognitive control.

    Science.gov (United States)

    Kozlowska, Kasia; Palmer, Donna M; Brown, Kerri J; Scher, Stephen; Chudleigh, Catherine; Davies, Fiona; Williams, Leanne M

    2015-03-01

    To assess cognitive function in children and adolescents presenting with acute conversion symptoms. Fifty-seven participants aged 8.5-18 years (41 girls and 16 boys) with conversion symptoms and 57 age- and gender-matched healthy controls completed the IntegNeuro neurocognitive battery, an estimate of intelligence, and self-report measures of subjective emotional distress. Participants with conversion symptoms showed poorer performance within attention, executive function, and memory domains. Poorer performance was reflected in more errors on specific tests: Switching of Attention (t(79) = 2.17, p = .03); Verbal Interference (t(72) = 2.64, p = .01); Go/No-Go (t(73) = 2.20, p = .03); Memory Recall and Verbal Learning (interference errors for memory recall; t(61) = 3.13, p conversion symptoms have a reduced capacity to manipulate and retain information, to block interfering information, and to inhibit responses, all of which are required for effective attention, executive function, and memory. © 2014 The British Psychological Society.

  3. Afasia global sem hemiparesia: AVC ou transtorno conversivo? Global aphasia without hemiparesis: stroke or conversion disorder?

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    Daniel Philippi de Negreiros

    2007-01-01

    Full Text Available CONTEXTO: A realização de diagnóstico neurológico e psiquiátrico em ambiente de emergência hospitalar com freqüência é uma tarefa complexa e exige colaboração interdisciplinar. Um dos diagnósticos diferenciais de doenças neurológicas é o transtorno conversivo, cuja característica principal é a presença de sintomas afetando funções motoras ou sensoriais, que sugerem desordem clínica ou neurológica, porém sem doença orgânica subjacente que explique o quadro. RELATO DE CASO: Os autores relatam o caso de uma paciente de 23 anos com apresentação clínica atípica de acidente vascular cerebral, afasia global sem hemiparesia, que foi inicialmente diagnosticada como transtorno psiquiátrico pelo serviço de clínica médica de emergência. CONCLUSÃO: Certas apresentações neurológicas podem ser interpretadas como transtorno conversivo pelas similaridades clínicas entre as duas desordens, raridade do quadro clínico, pela presença de sintomatologia psiquiátrica e fatores psicossociais nos pacientes neurológicos. Mesmo com apresentações neurológicas atípicas e sintomas psiquiátricos, pacientes com quadro sugestivo de transtorno conversivo devem ser sempre investigados de forma interdisciplinar.BACKGROUND: The neurologic and psychiatric diagnosis in emergency settings are difficult tasks and require interdisciplinary effort. Conversion disorder is one of the differential diagnosis for certain neurologic disorders. The main characteristic is motor or sensory deficits suggesting neurologic or medical condition, but without organic disease that explains the symptoms. CASE REPORT: We present a 23 year-old-woman with an atypical clinical presentation of stroke: global aphasia without hemiparesis. This patient was initially diagnosed with conversion disorder by the internal medicine service in the emergency room. CONCLUSION: Some rare neurologic diseases can be interpreted as conversive disorders due to some reasons

  4. Diagnostic conversion to bipolar disorder in unipolar depressed patients participating in trials on antidepressants.

    Science.gov (United States)

    Holmskov, J; Licht, R W; Andersen, K; Bjerregaard Stage, T; Mørkeberg Nilsson, F; Bjerregaard Stage, K; Valentin, J B; Bech, P; Ernst Nielsen, R

    2017-02-01

    In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder. A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.8 years (SD=11.9) participating in three randomized trials on antidepressants conducted in the period 1985-1994. The independent effects of explanatory variables were examined by applying Cox regression analyses. The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10-1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM-D subscales included was found. The patients were followed-up through the Danish Psychiatric Central Research Register, which resulted in inherent limitations such as possible misclassification of outcome. In a sample of middle-aged hospitalized unipolar depressed patients participating in trials on antidepressants, the risk of conversion was associated with the number of previous depressive episodes. Therefore, this study emphasizes that unipolar depressed patients experiencing a relatively high number of recurrences should be followed more closely, or at least be informed about the possible increased risk of conversion. Copyright © 2016. Published by Elsevier Masson SAS.

  5. Caloric vestibular stimulation as a treatment for conversion disorder: A case report and medical hypothesis

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    Michael eNoll-Hussong

    2014-06-01

    Full Text Available Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation (CVS has been demonstrated to modulate transiently a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.

  6. Recurrence of conversion disorder symptoms in a successfully treated 16-year-old female.

    Science.gov (United States)

    Shapiro, Michael; Mehta, Anuja; Avila, Jorge; Nguyen, Mathew

    2015-01-01

    We present a case of a 16-year-old Caucasian female with a history of major depressive disorder and post-traumatic stress disorder who was admitted to an inpatient adolescent psychiatric unit with symptoms of conversion disorder, including non-epileptic seizures, an inability to speak or walk, and not eating on her own. She has a history of multiple previous medical and psychiatric hospitalizations without any significant resolution of symptoms, and extensive medical workups have all been negative. Treatment ultimately involved reassuring the patient and family that there was no underlying medical condition and emphasizing the conversion disorder diagnosis. The patient participated daily in physical therapy to improve mobility, deconditioning, and functioning. Hospital staff was instructed on the nature of the non-epileptic seizures, which continued to occur during the hospitalization. After one month, the patient was discharged home fully functional: walking, speaking, and eating on her own. One week after discharge, the patient presented with the same symptoms and was readmitted to the psychiatric facility. She subsequently never regained her previous level of functioning, and she was ultimately transferred to a residential treatment facility. We will discuss factors that led to the initial improvement and the factors that led to recurrence and persistence of symptoms. © The Author(s) 2015.

  7. The value of 'positive' clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review.

    Science.gov (United States)

    Daum, Corinna; Hubschmid, Monica; Aybek, Selma

    2014-02-01

    Experts in the field of conversion disorder have suggested for the upcoming DSM-V edition to put less weight on the associated psychological factors and to emphasise the role of clinical findings. Indeed, a critical step in reaching a diagnosis of conversion disorder is careful bedside neurological examination, aimed at excluding organic signs and identifying 'positive' signs suggestive of a functional disorder. These positive signs are well known to all trained neurologists but their validity is still not established. The aim of this study is to provide current evidence regarding their sensitivity and specificity. We conducted a systematic search on motor, sensory and gait functional signs in Embase, Medline, PsycINfo from 1965 to June 2012. Studies in English, German or French reporting objective data on more than 10 participants in a controlled design were included in a systematic review. Other relevant signs are discussed in a narrative review. Eleven controlled studies (out of 147 eligible articles) describing 14 signs (7 motor, 5 sensory, 2 gait) reported low sensitivity of 8-100% but high specificity of 92-100%. Studies were evidence class III, only two had a blinded design and none reported on inter-rater reliability of the signs. Clinical signs for functional neurological symptoms are numerous but only 14 have been validated; overall they have low sensitivity but high specificity and their use should thus be recommended, especially with the introduction of the new DSM-V criteria.

  8. Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder.

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    Voon, Valerie; Brezing, Christina; Gallea, Cecile; Hallett, Mark

    2011-11-01

    Conversion disorder (CD) is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self-monitoring, limbic processing or top-down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that CD with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amygdala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Subjects performed either an internally or externally generated 2-button action selection task in a functional MRI study. Eleven CD patients without major depression and 11 age- and gender-matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula, and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system, which is both hypoactive and functionally disconnected from prefrontal top-down regulation. Copyright © 2011 Movement Disorder Society.

  9. Risk factors for conversion from unipolar psychotic depression to bipolar disorder.

    Science.gov (United States)

    Østergaard, Søren Dinesen; Straszek, Sune; Petrides, Georgios; Skadhede, Søren; Jensen, Signe Olrik Wallenstein; Munk-Jørgensen, Povl; Nielsen, Jimmi

    2014-03-01

    Patients with unipolar psychotic depression (PD) are at high risk of developing bipolar disorder (BD). This conversion has important implications for the choice of treatment. This study, therefore, aimed to identify risk factors associated with diagnostic conversion from PD to BD. We conducted a population-based, historical prospective cohort study by merging data from Danish registers. Patients assigned an ICD-10 diagnosis of PD between 1 January 1995 and 31 December 2007 were identified in the Danish Central Psychiatric Research Register and were followed until the development of BD, death, loss to follow-up, or 31 December 2007. Potential risk factors for conversion to BD, also defined through various Danish registers, were tested in multiple logistic regression analyses with risk expressed as adjusted odds ratios (AOR). We identified 8,588 patients with PD, of whom 609 (7.1%) developed BD during follow-up. The following characteristics were significantly associated with diagnostic conversion from PD to BD: early onset of PD [AOR = 0.99 (per year of increasing age), p = 0.044], recurrent depression [AOR = 1.02 (per episode), p = 0.036], living alone (AOR = 1.29, p = 0.007), receiving a disability pension (AOR = 1.55, p conversion to BD was prevalent among patients with PD. The following characteristics were significantly associated with this conversion: early onset of PD, recurrent depression, living alone, receiving a disability pension, and the highest educational level being a technical education, short-cycle higher education, or medium-cycle higher education. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Patterns and predictors of conversion to bipolar disorder in 91 587 individuals diagnosed with unipolar depression.

    Science.gov (United States)

    Musliner, K L; Østergaard, S D

    2018-05-01

    Conversion from unipolar depression (UD) to bipolar disorder (BD) is a clinically important event that should lead to treatment modifications. Unfortunately, recognition of this transition is often delayed. Therefore, the objective of this study was to identify predictors of diagnostic conversion from UD to BD. Historical prospective cohort study based on 91 587 individuals diagnosed with UD in Danish hospital psychiatry between 1995 and 2016. The association between a series of potential predictors and the conversion from UD to BD during follow-up (702 710 person-years) was estimated by means of Cox regression with death as competing risk. During follow-up, 3910 individuals with UD developed BD. The cumulative incidence of conversion was slightly higher in females (8.7%, 95% CI: 8.2-9.3) compared to males (7.7%, 95% CI: 7.0-8.4). The strongest predictor of conversion from UD to BD was parental history of BD (adjusted hazard ratio (aHR) = 2.60, 95% CI: 2.20-3.07)). Other predictors included psychotic depression at the index UD episode (aHR = 1.73, 95% CI: 1.48-2.02), a prior/concomitant non-affective psychosis (aHR = 1.73, 95% CI: 1.51-1.99), and in-patient treatment at the index episode (aHR = 1.76, 95% CI: 1.63-1.91). Diagnostic conversion from UD to BD is predicted by severe depression requiring in-patient treatment, psychotic symptomatology, and parental history of BD. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Functional neuroimaging of recovery from motor conversion disorder: A case report.

    Science.gov (United States)

    Dogonowski, Anne-Marie; Andersen, Kasper W; Sellebjerg, Finn; Schreiber, Karen; Madsen, Kristoffer H; Siebner, Hartwig R

    2018-03-27

    A patient with motor conversion disorder presented with a functional paresis of the left hand. After exclusion of structural brain damage, she was repeatedly examined with whole-brain functional magnetic resonance imaging, while she performed visually paced finger-tapping tasks. The dorsal premotor cortex showed a bilateral deactivation in the acute-subacute phase. Recovery from unilateral hand paresis was associated with a gradual increase in task-based activation of the dorsal premotor cortex bilaterally. The right medial prefrontal cortex displayed the opposite pattern, showing initial task-based activation that gradually diminished with recovery. The inverse dynamics of premotor and medial prefrontal activity over time were found during unimanual finger-tapping with the affected and non-affected hand as well as during bimanual finger-tapping. These observations suggest that reduced premotor and increased medial prefrontal activity reflect an effector-independent cortical dysfunction in conversion paresis which gradually disappears in parallel with clinical remission of paresis. The results link the medial prefrontal and dorsal premotor areas to the generation of intentional actions. We hypothesise that an excessive 'veto' signal generated in medial prefrontal cortex along with decreased premotor activity might constitute the functional substrate of conversion disorder. This notion warrants further examination in a larger group of affected patients. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion.

    Science.gov (United States)

    Martinez, Molly S; Fristad, Mary A

    2013-06-01

    Bipolar disorder-not otherwise specified (BD-NOS) is an imprecise, heterogeneous diagnosis that is unstable in youth. This study reports rates of conversion from BD-NOS to BD-I or II in children aged 8-12, and investigates the impact of family history of bipolar disorder and depression on conversion. As part of the Multi-Family Psychoeducational Psychotherapy (MF-PEP) study, 27 children (6-12 years of age) diagnosed with BD-NOS at baseline were reassessed every 6 months over an 18-month period. Family history of bipolar disorder and depression was assessed at baseline. One-third of the sample converted from BD-NOS to BD-I or II over 18-months. Having a first-degree relative with symptoms of bipolar disorder and having a loaded pedigree for diagnosis of depression each were associated with conversion from BD-NOS to BD-I or II (odds ratio range: 1.09-3.14; relative risk range: 1.06-2.34). This study had very low power (range: 10-45) given the small sample size, precluding statistical significance of non-parametric Fisher's Exact test findings. This study replicates the previous finding of a high rate of conversion from BD-NOS to BD-I or II among youth, and suggests conversion is related to symptoms of bipolar disorder or depression diagnoses in the family history. Additional research is warranted in a larger sample with a longer follow-up period. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Functional neurological symptom disorder (conversion disorder): A role for microglial-based plasticity mechanisms?

    Science.gov (United States)

    Stephenson, Chris P; Baguley, Ian J

    2018-02-01

    Functional Neurological Symptom Disorder (FND) is a relatively common neurological condition, accounting for approximately 3-6% of neurologist referrals. FND is considered a transient disorder of neuronal function, sometimes linked to physical trauma and psychological stress. Despite this, chronic disability is common, for example, around 40% of adults with motor FND have permanent disability. Building on current theoretical models, this paper proposes that microglial dysfunction could perpetuate functional changes within acute motor FND, thus providing a pathophysiological mechanism underlying the chronic stage of the motor FND phenotypes seen clinically. Core to our argument is microglia's dual role in modulating neuroimmunity and their control of synaptic plasticity, which places them at a pathophysiological nexus wherein coincident physical trauma and psychological stress could cause long-term change in neuronal networks without producing macroscopic structural abnormality. This model proposes a range of hypotheses that are testable with current technologies. Copyright © 2017. Published by Elsevier Ltd.

  14. Differences in psychopathology and behavioral characteristics of patients affected by conversion motor disorder and organic dystonia

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    Pastore A

    2018-05-01

    Full Text Available Adriana Pastore, Grazia Pierri, Giada Fabio, Silvia Ferramosca, Angelo Gigante, Maria Superbo, Roberta Pellicciari, Francesco Margari Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy Purpose: Typically, the diagnosis of conversion motor disorder (CMD is achieved by the exclusion of a wide range of organic illnesses rather than by applying positive criteria. New diagnostic criteria are highly needed in this scenario. The main aim of this study was to explore the use of behavioral features as an inclusion criterion for CMD, taking into account the relationship of the patients with physicians, and comparing the results with those from patients affected by organic dystonia (OD. Patients and methods: Patients from the outpatient Movement Disorder Service were assigned to either the CMD or the OD group based on Fahn and Williams criteria. Differences in sociodemographics, disease history, psychopathology, and degree of satisfaction about care received were assessed. Patient–neurologist agreement about the etiological nature of the disorder was also assessed using the k-statistic. A logistic regression analysis estimated the discordance status as a predictor to case/control status. Results: In this study, 31 CMD and 31 OD patients were included. CMD patients showed a longer illness life span, involvement of more body regions, higher comorbidity with anxiety, depression, and borderline personality disorder, as well as higher negative opinions about physicians’ delivering of proper care. Contrary to our expectations, CMD disagreement with neurologists about the etiological nature of the disorder was not statistically significant. Additional analysis showed that having at least one personality disorder was statistically associated with the discordance status. Conclusion: This study suggests that CMD patients show higher conflicting behavior toward physicians. Contrary to our

  15. Distinct modulation of event-related potentials during motor preparation in patients with motor conversion disorder.

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    Rebekah L Blakemore

    Full Text Available OBJECTIVE: Conversion paresis patients and healthy people feigning weakness both exhibit weak voluntary movement without detectable neuropathology. Uniquely, conversion patients lack a sense of conscious awareness of the origin of their impairment. We investigated whether conversion paresis patients show distinct electroencephalographic (EEG markers associated with their unconscious movement deficits. METHODS: Six unilateral upper limb conversion paresis patients, 12 feigning participants asked to mimic weakness and 12 control participants performed a precued reaction time task, requiring movements of either hand, depending on precue information. Performance measures (force, reaction and movement time, and event-related EEG potentials (ERP were compared, between groups and across hands or hemisphere, using linear mixed models. RESULTS: Feigners generated the same inter-hand difference in reaction and movement time as expressed by patients, even though no specific targets were set nor feedback given on these measures. We found novel ERP signatures specific to patients. When the symptomatic hand was precued, the P3 ERP component accompanying the precue was dramatically larger in patients than in feigning participants. Additionally, in patients the earlier N1 ERP component was diminished when the precue signalled either the symptomatic or asymptomatic hand. CONCLUSIONS: These results are consistent with previous suggestions that lack of awareness of the origin of their symptoms in conversion disorder patients may result from suppression of brain activity normally related to self-agency. In patients the diminished N1 to all precues is consistent with a generalised reduction in cognitive processing of movement-related precues. The P3 enhancement in patients is unlikely to simply reflect changes required for generation of impaired movements, because it was not seen in feigners showing the same behavioural deficits. Rather, this P3 enhancement in

  16. Evaluation of oxidant, antioxidant, and S100B levels in patients with conversion disorder.

    Science.gov (United States)

    Büyükaslan, Hasan; Kandemir, Sultan Basmacı; Asoğlu, Mehmet; Kaya, Halil; Gökdemir, Mehmet Tahir; Karababa, İbrahim Fatih; Güngörmez, Fatih; Kılıçaslan, Fethiye; Şavik, Emin

    2016-01-01

    Various psychodynamic, neurobiological, genetic, and sociocultural factors are believed to be involved in the etiology of conversion disorder (CD). Oxidative metabolism has been shown to deteriorate in association with many health problems and psychiatric disorders. We evaluated oxidative metabolism and S100B levels in the context of this multifactorial disease. Thirty-seven patients with CD (25 females and 12 males) and 42 healthy volunteers (21 females and 21 males), all matched for age and sex, were included in this study. The total oxidant status, total antioxidant status, oxidative stress index, and S100B levels were compared between the two groups. The total oxidant status, oxidative stress index, and S100B levels were significantly higher in patients with CD than in the control group, whereas the total antioxidant status was significantly lower. CD is associated with deterioration of oxidative metabolism and increased neuronal damage.

  17. Systemic Lupus Erythematosus and Sjögren's Syndrome Complicated by Conversion Disorder: a Case Report.

    Science.gov (United States)

    Nakamura, Misa; Tanaka, Seiji; Inoue, Tadashi; Maeda, Yasuto; Okumiya, Kiyohito; Esaki, Takuya; Shimomura, G O; Masunaga, Kenji; Nagamitsu, Shinichiro; Yamashita, Yushiro

    2018-05-21

    Conversion disorder (CD) is sometimes accompanied by motor and sensory impairments, such as muscle weakness, paralysis, sensory hypersensitivity, and sensory loss. Sjögren's syndrome (SS) complicates 5-10% of cases of systemic lupus erythematosus (SLE). Patients with SS or SLE present with various neurological symptoms and psychiatric manifestations. When neurological symptoms are present, it is important to distinguish whether the symptoms are caused by a neurological or a mental disorder because the former requires early intensive intervention, such as methylprednisolone pulse therapy (MPT), whereas psychotherapy or antidepressant drugs are recommended for mental disorders. We noticed SS- and SLE-like symptoms just after a diagnosis of idiopathic thrombocytopenic purpura in a 14-year-old girl. At approximately the same time, paralysis started in her lower limbs and subsequently spread to her upper limbs. An examination for neurological symptoms revealed no abnormalities. Because of the conversion reaction between her neurological symptoms and her disease state, CD was suspected as the etiology of her physical symptoms. Nevertheless, because of the progressive nature of the neurological symptoms, MPT was initiated with concurrent administration of intravenous immunoglobulin, but it failed to achieve a good outcome. The patient's symptoms eventually improved after she underwent psychotherapy treatment for a few months. Because early diagnosis of the cause of neurological symptoms accompanying SS and SLE is difficult, it may be necessary to combine the two lines of treatment in the early stages. However, when a mental disorder is suspected, psychotherapy should be started early to minimize the use of unnecessary neurological treatment.

  18. First Episode of Psychosis in a Middle-Aged Patient with a 14-Year History of Conversion Disorder

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    Vaios Peritogiannis

    2014-01-01

    Full Text Available We present a case of a middle-aged male patient with a long history of conversion disorder and histrionic personality, who presented with newly onset psychotic symptoms while being engaged to treatment with a community mental health team in a primary care setting. The symptoms could not be attributed to an organic cause. After a short course of olanzapine treatment which caused adverse effects, the symptomatology responded well to low dose amisulpride. Conversion symptoms were stable throughout the psychotic episode. This case illustrates the complex interplay between disorders classified in different categories (somatoform versus psychotic disorders.

  19. Elevated left mid-frontal cortical activity prospectively predicts conversion to bipolar I disorder

    Science.gov (United States)

    Nusslock, Robin; Harmon-Jones, Eddie; Alloy, Lauren B.; Urosevic, Snezana; Goldstein, Kim; Abramson, Lyn Y.

    2013-01-01

    Bipolar disorder is characterized by a hypersensitivity to reward-relevant cues and a propensity to experience an excessive increase in approach-related affect, which may be reflected in hypo/manic symptoms. The present study examined the relationship between relative left-frontal electroencephalographic (EEG) activity, a proposed neurophysiological index of approach-system sensitivity and approach/reward-related affect, and bipolar course and state-related variables. Fifty-eight individuals with cyclothymia or bipolar II disorder and 59 healthy control participants with no affective psychopathology completed resting EEG recordings. Alpha power was obtained and asymmetry indices computed for homologous electrodes. Bipolar spectrum participants were classified as being in a major/minor depressive episode, a hypomanic episode, or a euthymic/remitted state at EEG recording. Participants were then followed prospectively for an average 4.7 year follow-up period with diagnostic interview assessments every four-months. Sixteen bipolar spectrum participants converted to bipolar I disorder during follow-up. Consistent with hypotheses, elevated relative left-frontal EEG activity at baseline 1) prospectively predicted a greater likelihood of converting from cyclothymia or bipolar II disorder to bipolar I disorder over the 4.7 year follow-up period, 2) was associated with an earlier age-of-onset of first bipolar spectrum episode, and 3) was significantly elevated in bipolar spectrum individuals in a hypomanic episode at EEG recording. This is the first study to identify a neurophysiological marker that prospectively predicts conversion to bipolar I disorder. The fact that unipolar depression is characterized by decreased relative left-frontal EEG activity suggests that unipolar depression and vulnerability to hypo/mania may be characterized by different profiles of frontal EEG asymmetry. PMID:22775582

  20. Differences in psychopathology and behavioral characteristics of patients affected by conversion motor disorder and organic dystonia.

    Science.gov (United States)

    Pastore, Adriana; Pierri, Grazia; Fabio, Giada; Ferramosca, Silvia; Gigante, Angelo; Superbo, Maria; Pellicciari, Roberta; Margari, Francesco

    2018-01-01

    Typically, the diagnosis of conversion motor disorder (CMD) is achieved by the exclusion of a wide range of organic illnesses rather than by applying positive criteria. New diagnostic criteria are highly needed in this scenario. The main aim of this study was to explore the use of behavioral features as an inclusion criterion for CMD, taking into account the relationship of the patients with physicians, and comparing the results with those from patients affected by organic dystonia (OD). Patients from the outpatient Movement Disorder Service were assigned to either the CMD or the OD group based on Fahn and Williams criteria. Differences in sociodemographics, disease history, psychopathology, and degree of satisfaction about care received were assessed. Patient-neurologist agreement about the etiological nature of the disorder was also assessed using the k -statistic. A logistic regression analysis estimated the discordance status as a predictor to case/control status. In this study, 31 CMD and 31 OD patients were included. CMD patients showed a longer illness life span, involvement of more body regions, higher comorbidity with anxiety, depression, and borderline personality disorder, as well as higher negative opinions about physicians' delivering of proper care. Contrary to our expectations, CMD disagreement with neurologists about the etiological nature of the disorder was not statistically significant. Additional analysis showed that having at least one personality disorder was statistically associated with the discordance status. This study suggests that CMD patients show higher conflicting behavior toward physicians. Contrary to our expectations, they show awareness of their psychological needs, suggesting a possible lack of recognition of psychological distress in the neurological setting.

  1. Social performance deficits in social anxiety disorder: reality during conversation and biased perception during speech.

    Science.gov (United States)

    Voncken, Marisol J; Bögels, Susan M

    2008-12-01

    Cognitive models emphasize that patients with social anxiety disorder (SAD) are mainly characterized by biased perception of their social performance. In addition, there is a growing body of evidence showing that SAD patients suffer from actual deficits in social interaction. To unravel what characterizes SAD patients the most, underestimation of social performance (defined as the discrepancy between self-perceived and observer-perceived social performance), or actual (observer-perceived) social performance, 48 patients with SAD and 27 normal control participants were observed during a speech and conversation. Consistent with the cognitive model of SAD, patients with SAD underestimated their social performance relative to control participants during the two interactions, but primarily during the speech. Actual social performance deficits were clearly apparent in the conversation but not in the speech. In conclusion, interactions that pull for more interpersonal skills, like a conversation, elicit more actual social performance deficits whereas, situations with a performance character, like a speech, bring about more cognitive distortions in patients with SAD.

  2. P-wave and QT dispersion in patients with conversion disorder

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    Izci F

    2015-03-01

    Full Text Available Filiz Izci,1 Hilal Hocagil,2 Servet Izci,3 Vedat Izci,4 Merve Iris Koc,5 Rezzan Deniz Acar3 1Department of Psychiatry, Istanbul Bilim University, Sisli Florence Nightingale Hospital; 2Department of Emergency, Faculty of Medicine Hospital Zonguldak Bulent Ecevit University, Zonguldak, Turkey; 3Department of Cardiology, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey; 4Department of Emergency, Kartal Training and Research Hospital, Istanbul, Turkey; 5Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatry, Istanbul, Turkey Objective: The aim of this study was to investigate QT dispersion (QTd, which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD.Patients and methods: A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist.Results: There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001 and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01 were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156. Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416

  3. Postoperative visual loss due to conversion disorder after spine surgery: a case report

    Directory of Open Access Journals (Sweden)

    Dailson Mamede Bezerra

    Full Text Available Abstract Background and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm followed by capnography and urinary catheterization for diuresis. Maintenance with full target-controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 min, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non-organic origin,including visual component. It is noteworthy that the occurrence of this type of visual dysfunc-tion in the postoperative period of spinal surgery is a rare event and should be remembered asa differential diagnosis.

  4. [Postoperative visual loss due to conversion disorder after spine surgery: a case report].

    Science.gov (United States)

    Bezerra, Dailson Mamede; Bezerra, Eglantine Mamede; Silva Junior, Antonio Jorge; Amorim, Marco Aurélio Soares; Miranda, Denismar Borges de

    Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. A male patient, 39 years old, 71kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target-controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conversion disorders may have different signs and symptoms of non-organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Evaluation of oxidant, antioxidant, and S100B levels in patients with conversion disorder

    Directory of Open Access Journals (Sweden)

    Büyükaslan H

    2016-07-01

    Full Text Available Hasan Büyükaslan,1 Sultan Basmacı Kandemir,2 Mehmet Asoğlu,3 Halil Kaya,4 Mehmet Tahir Gökdemir,1 İbrahim Fatih Karababa,3 Fatih Güngörmez,5 Fethiye Kılıçaslan,6 Emin Şavik7 1Department of Emergency Medicine, Faculty of Medicine, Harran University, 2Department of Psychiatry, Balıklıgöl State Hospital, 3Department of Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, 4Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, 5Department of Emergency Medicine, Mehmet Akif İnan Research Hospital, 6Department of Child and Adolescent Psychiatry, 7Department of Biochemistry, Faculty of Medicine, Harran University, Sanliurfa, Turkey Introduction: Various psychodynamic, neurobiological, genetic, and sociocultural factors are believed to be involved in the etiology of conversion disorder (CD. Oxidative metabolism has been shown to deteriorate in association with many health problems and psychiatric disorders. We evaluated oxidative metabolism and S100B levels in the context of this multifactorial disease.Methods: Thirty-seven patients with CD (25 females and 12 males and 42 healthy volunteers (21 females and 21 males, all matched for age and sex, were included in this study. The total oxidant status, total antioxidant status, oxidative stress index, and S100B levels were compared between the two groups.Results: The total oxidant status, oxidative stress index, and S100B levels were significantly higher in patients with CD than in the control group, whereas the total antioxidant status was significantly lower.Conclusion: CD is associated with deterioration of oxidative metabolism and increased neuronal damage. Keywords: conversion disorder, oxidative stress, S100B

  6. Multidisciplinary Assessment and Diagnosis of Conversion Disorder in a Patient with Foreign Accent Syndrome

    Directory of Open Access Journals (Sweden)

    Harrison N. Jones

    2011-01-01

    Full Text Available Multiple reports have described patients with disordered articulation and prosody, often following acute aphasia, dysarthria, or apraxia of speech, which results in the perception by listeners of a foreign-like accent. These features led to the term foreign accent syndrome (FAS, a speech disorder with perceptual features that suggest an indistinct, non-native speaking accent. Also correctly known as psuedoforeign accent, the speech does not typically match a specific foreign accent, but is rather a constellation of speech features that result in the perception of a foreign accent by listeners. The primary etiologies of FAS are cerebrovascular accidents or traumatic brain injuries which affect cortical and subcortical regions critical to expressive speech and language production. Far fewer cases of FAS associated with psychiatric conditions have been reported. We will present the clinical history, neurological examination, neuropsychological assessment, cognitive-behavioral and biofeedback assessments, and motor speech examination of a patient with FAS without a known vascular, traumatic, or infectious precipitant. Repeated multidisciplinary examinations of this patient provided convergent evidence in support of FAS secondary to conversion disorder. We discuss these findings and their implications for evaluation and treatment of rare neurological and psychiatric conditions.

  7. [Before you diagnose a patient with a conversion disorder, perform a thorough general medical and neurological examination. Case study].

    Science.gov (United States)

    Pawełczyk, Tomasz; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta

    2012-01-01

    Dissociative and conversion disorders are classified together according to ICD-10 as states that are not confirmed by the presence of somatic diseases, which they suggest. According to the DSM-IV, both disorders are classified separately. Conversion disorders are a group of psychiatric disorders whose symptoms mimic the presence of malfunction or loss of motor or sensory function, whereas the nature and dynamics of the observed symptoms is not fully explained by the results of objective assessments and consultations, nor is the direct effect of a psychoactive substance. Impaired mental integration of different functions which normally interact simultaneously in the perception of reality and inner experience of the individual is found in dissociative disorders. The article describes the case of 25-year old man, in whom after initial suspicion of myasthenia gravis and its exclusion, a diagnosis of conversion disorder was made on the basis of the clinical picture and treatment with an SSRI antidepressant and individual psychotherapy were recommended. No improvement in mental and neurological status after six month therapy resulted in an in-depth diagnostics in a clinical setting and diagnosis of brain stem tumor (aastrocytoma fibrillare). (a) Neuroimaging is a source of important clinical data and in many cases should constitute an inherent element of a psychiatric diagnosis. (b) Diagnosis of conversion (dissociative) disorders requires a precise differential diagnosis, excluding the somatic causes of observed neurological ailments. (c) A late diagnosis of neurological or somatic causes of symptoms which arouse a suspicion of conversion (dissociative) disorders may make a radical treatment impossible or may considerably aggravate the remote prognosis and quality of the patients' life.

  8. Are psychogenic non-epileptic seizures just another symptom of conversion disorder?

    Science.gov (United States)

    Kanaan, Richard A A; Duncan, Roderick; Goldstein, Laura H; Jankovic, Joseph; Cavanna, Andrea E

    2017-05-01

    Psychogenic non-epileptic seizures (PNES) are classified with other functional neurological symptoms as 'Conversion Disorder', but there are reasons to wonder whether this symptomatology constitutes a distinct entity. We reviewed the literature comparing PNES with other functional neurological symptoms. We find eight studies that directly examined this question. Though all but one found significant differences-notably in presenting age, trauma history, and dissociation-they were divided on whether these differences represented an important distinction. We argue that the aetiological and mechanistic distinctions they support, particularly when bolstered by additional data, give reason to sustain a separation between these conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Conversion disorder as psychogenic nonepileptic seizures in suspected cancer: a case report.

    Science.gov (United States)

    Jimenez, Xavier F; Sharma, Jennifer S; Dar, Syma A

    2014-01-01

    Psychogenic nonepileptic seizures (PNES), a form of conversion disorder, are paroxysmal episodes resembling epilepsy while lacking electrographic correlation. The phenomenon has rarely been reported in elderly patients and has not been associated with a new-onset medical diagnosis. We present the case of an 81-year-old female with no past psychiatric or traumatic history who developed PNES within the context of a new, suspected cancer. To our knowledge, this is the first such reported case of a suspected cancer (or otherwise medical) diagnosis contributing directly and temporally to the development of PNES. Discussion of involved psychosocial variables follows the vignette, and a brief review of relevant literature is offered. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. P-wave and QT dispersion in patients with conversion disorder.

    Science.gov (United States)

    Izci, Filiz; Hocagil, Hilal; Izci, Servet; Izci, Vedat; Koc, Merve Iris; Acar, Rezzan Deniz

    2015-01-01

    The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD). A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist. There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, Pconversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, Pdisorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients.

  11. Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms

    Directory of Open Access Journals (Sweden)

    Barnum R

    2014-04-01

    Full Text Available Richard BarnumPrivate practice, Child and adolescent psychiatry, MA, USAAbstract: Conversion Disorder (CD is a diagnosis offered to explain signs and symptoms that do not correspond to recognized medical conditions. Pediatric patients with variable, vague, and multisystem complaints are at increased risk for being diagnosed with CD. Little is known about the impact of such a diagnosis. In making such diagnoses, it is likely that pediatric providers hope to encourage patients to access mental health care, but no basis exists to show that these diagnoses result in such access in any useful way. This article presents the case of a child with Ehlers-Danlos Syndrome, who had been previously (incorrectly diagnosed with CD and referred for mental health care. It offers commentary based on interviews with other pediatric patients with similar experiences – conducted in collaboration with the Ehlers-Danlos National Foundation. These cases indicate that CD diagnoses can seriously undermine patients’ trust in doctors, and can create such defensiveness that it may interfere with (especially patients’ abilities to engage with mental health services. Such interference is an important problem, if the diagnosis is accurate. But, in the (more likely event that it is not accurate, this defensiveness can interfere with both important mental health care and further ongoing necessary medical care.Keywords: somatoform disorders, dysautonomias, pain, collagen diseases, mitochondrial diseases, complex regional pain syndromes

  12. [When a patient falls (asleep) and can't get up: conversion disorder - paraplegia following general anesthesia].

    Science.gov (United States)

    Mason, Chawla LaToya

    This case report describes the rare occurrence of paraplegia caused by conversion disorder in a woman who received general anesthesia for breast surgery. A 46-year-old healthy woman received general anesthesia for excision of a left breast fibroepithelial lesion. In the post-anesthesia care unit, she reported bilateral loss of both sensation and motor function below the knees. Physical signs and symptoms did not correlate with any anatomical or neurological patterns; imaging revealed no abnormalities. Psychiatric consultation was performed wherein familial stressor circumstances were identified, leading to diagnosis and management of conversion disorder. Conversion disorder is characterized by alteration of physical function due to expression of an underlying psychological ailment. Its diagnosis requires thorough evaluation including appropriate workup to exclude organic causes. The meshing together of anesthesiology and psychiatry - as demonstrated by this case report - offers an opportunity to highlight important information pertaining to the definition, diagnosis, and management of conversion disorder as it may be encountered in the postanesthesia recovery period. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Clinical predictors of conversion to bipolar disorder in a prospective longitudinal familial high-risk sample: focus on depressive features.

    Science.gov (United States)

    Frankland, Andrew; Roberts, Gloria; Holmes-Preston, Ellen; Perich, Tania; Levy, Florence; Lenroot, Rhoshel; Hadzi-Pavlovic, Dusan; Breakspear, Michael; Mitchell, Philip B

    2017-11-07

    Identifying clinical features that predict conversion to bipolar disorder (BD) in those at high familial risk (HR) would assist in identifying a more focused population for early intervention. In total 287 participants aged 12-30 (163 HR with a first-degree relative with BD and 124 controls (CONs)) were followed annually for a median of 5 years. We used the baseline presence of DSM-IV depressive, anxiety, behavioural and substance use disorders, as well as a constellation of specific depressive symptoms (as identified by the Probabilistic Approach to Bipolar Depression) to predict the subsequent development of hypo/manic episodes. At baseline, HR participants were significantly more likely to report ⩾4 Probabilistic features (40.4%) when depressed than CONs (6.7%; p conversion' to threshold BD (hazard ratio = 6.9, p conversion were psychomotor retardation and ⩾5 MDEs. Behavioural disorders only predicted conversion to subthreshold BD (hazard ratio = 5.23, p disorders did not predict either threshold or subthreshold hypo/mania. This study suggests that specific depressive characteristics substantially increase the risk of young people at familial risk of BD going on to develop future hypo/manic episodes and may identify a more targeted HR population for the development of early intervention programs.

  14. Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland.

    Science.gov (United States)

    Ani, Cornelius; Reading, Richard; Lynn, Richard; Forlee, Simone; Garralda, Elena

    2013-06-01

    Little is known about conversion disorder in childhood. To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the U.K. and Ireland. Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System. In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a non-medical explanation of the symptoms either fully or partially. Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

  15. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression

    DEFF Research Database (Denmark)

    Bukh, J. D.; Andersen, P. K.; Kessing, L. V.

    2016-01-01

    .6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family......BACKGROUND: In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first...... lifetime episode of depression. METHOD: A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011...

  16. Downwards Vertical Attention Bias in Conversion Disorder vs Controls: A Pilot Study.

    Science.gov (United States)

    Gazit, Sivan; Elkana, Odelia; Dawidowicz, Liraz; Yeshayahu, Liel; Biran, Iftah

    Conversion disorder (CD) is a largely enigmatic disorder, one that requires a thorough ruling-out process. Prior research suggests that metaphors and conceptualization are rooted in physical experience, and that we interpret our affective world through metaphors. Spatial metaphors (interaction of affect and vertical space) are a prominent example of the grounding of metaphors. This is a relatively unpaved direction of research of CD. The present pilot study sought to explore this view by investigating the "healthy is up, sick is down" spatial metaphors (e.g., "fell ill" and "top shape") in patients with CD, examining the correlation between the processing of bodily-related words, CD, and vertical space. We hypothesized that patients with CD, who experience their bodies as ill, will demonstrate a downwards bias when processing bodily-related words; corresponding to the "healthy is up, sick is down" spatial metaphor. A total of 8 female patients (ages M-38.13 SD-10.44) and 42 female controls (ages M-36.4 SD-14.57) performed a visual attention task. Participants were asked to identify a spatial probe at the top or the bottom of a screen, following either a bodily related (e.g., arm) or non-bodily related (e.g., clock) prime word. As predicted, when processing bodily-related words, patients with CD demonstrated a downwards attention bias. Moreover, the higher the patient's level of somatization, the faster the patient detected lower (vs upper) spatial targets. This study suggests that the changed health paradigm of patients with CD is grounded in sensorimotor perception. Further research could propose new diagnostic and treatment options for CD. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  17. Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks.

    Science.gov (United States)

    Hubschmid, M; Aybek, S; Maccaferri, G E; Chocron, O; Gholamrezaee, M M; Rossetti, A O; Vingerhoets, F; Berney, A

    2015-01-01

    The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study.

    Science.gov (United States)

    McCormack, Ruaidhri; Moriarty, John; Mellers, John D; Shotbolt, Paul; Pastena, Rosa; Landes, Nadine; Goldstein, Laura; Fleminger, Simon; David, Anthony S

    2014-08-01

    Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases. To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit. All patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted. Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment. Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Can motor imagery and hypnotic susceptibility explain Conversion Disorder with motor symptoms?

    Science.gov (United States)

    Srzich, Alexander J; Byblow, Winston D; Stinear, James W; Cirillo, John; Anson, J Greg

    2016-08-01

    Marked distortions in sense of agency can be induced by hypnosis in susceptible individuals, including alterations in subjective awareness of movement initiation and control. These distortions, with associated disability, are similar to those experienced with Conversion Disorder (CD), an observation that has led to the hypothesis that hypnosis and CD share causal mechanisms. The purpose of this review is to explore the relationships among motor imagery (MI), hypnotic susceptibility, and CD, then to propose how MI ability may contribute to hypnotic responding and CD. Studies employing subjective assessments of mental imagery have found little association between imagery abilities and hypnotic susceptibility. A positive association between imagery abilities and hypnotic susceptibility becomes apparent when objective measures of imagery ability are employed. A candidate mechanism to explain motor responses during hypnosis is kinaesthetic MI, which engages a strategy that involves proprioception or the "feel" of movement when no movement occurs. Motor suppression imagery (MSI), a strategy involving inhibition of movement, may provide an alternate objective measurable phenomenon that underlies both hypnotic susceptibility and CD. Evidence to date supports the idea that there may be a positive association between kinaesthetic MI ability and hypnotic susceptibility. Additional evidence supports a positive association between hypnotic susceptibility and CD. Disturbances in kinaesthetic MI performance in CD patients indicate that MI mechanisms may also underlie CD symptoms. Further investigation of the above relationships is warranted to explain these phenomena, and establish theoretical explanations underlying sense of agency. Copyright © 2016. Published by Elsevier Ltd.

  20. Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study.

    Science.gov (United States)

    Bolger, Ashlee; Collins, Andrew; Michels, Michelle; Pruitt, David

    2018-03-14

    Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known. To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms. Retrospective study. Inpatient rehabilitation unit within a large children's hospital. All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period. Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics. 30 admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P conversion disorder and leads to sustained functional improvement and return to school after discharge. ?? Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  1. What's on Your Mind? Conversation Topics Chosen by People With Degenerative Cognitive-Linguistic Disorders for Communication Boards.

    Science.gov (United States)

    Fried-Oken, Melanie; Daniels, Darlene; Ettinger, Olivia; Mooney, Aimee; Noethe, Glory; Rowland, Charity

    2015-05-01

    Conversational topics chosen by a group of adults with degenerative cognitive-linguistic disorders for personalized communication board development were examined. The patient-generated themes commonly selected are presented to guide treatment planning and communication board development. Communication boards were created for 109 adults as part of a larger research project. One autobiographical topic that each participant would enjoy discussing multiple times was represented on each communication board with 16 pictures and word labels. For this review, topics were collapsed into general themes through a consensus process and examined by gender and age. Sixty unique conversational topics were identified from 109 participants and collapsed into 9 general themes: Hobbies, Family, Travel, Work, Home/Places I've Lived, Sports/Fitness, Religion, Animals, and World War II. Age and gender produced variations in themes chosen, though no significance in rank orders was found across groups. Topics selected by adults with degenerative cognitive-linguistic disorders for communication boards resemble common conversational adult themes and do not center around basic needs or medical issues. Differences in gender and age for topic selection tend to be based on traditional roles. These general themes should be used when creating personalized communication boards for those who benefit from conversational aids.

  2. A prospective study of diagnostic conversion of major depressive disorder to bipolar disorder in pregnancy and postpartum.

    Science.gov (United States)

    Sharma, Verinder; Xie, Bin; Campbell, M Karen; Penava, Debbie; Hampson, Elizabeth; Mazmanian, Dwight; Pope, Carley J

    2014-02-01

    The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM-IV at study intake and repeated using the Mini-International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. A total of 146 participants completed the intake interview and at least one follow-up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11- to 18-fold higher than the rates of switching in similar studies conducted in both men and women. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Treatment of post-transplantation lymphoproliferative disorders after kidney transplant with rituximab and conversion to m-TOR inhibitor.

    Science.gov (United States)

    Nieto-Rios, John Fredy; Gómez de Los Ríos, Sandra Milena; Serna-Higuita, Lina María; Ocampo-Kohn, Catalina; Aristizabal-Alzate, Arbey; Gálvez-Cárdenas, Kenny Mauricio; Zuluaga-Valencia, Gustavo Adolfo

    2016-12-30

    Post-transplantation lymphoproliferative disorders are serious complications of organ transplantation which treatment is not yet standardized. To describe the clinical response, overall and graft survival of patients in our center with this complication after kidney transplantation, which received rituximab as part of their treatment as well as conversion to m-TOR. Retrospective study, which included patients, diagnosed with post-transplant lymphoproliferative disorders after kidney transplantation from January 2011 to July 2014. Eight cases were found with a wide spectrum of clinical presentations. Most had monomorphic histology, 85% were associated with Epstein-Barr virus, 25% of patients had tumor involvement of the renal graft, and 12.5% ​​had primary central nervous system lymphoma. All patients were managed with reduction of immunosuppression, conversion to m-TOR (except one who lost the graft at diagnosis) and rituximab-based therapy. The overall response rate was 87.5% (62.5% complete response, 25% partial response). Survival was 87.5% with a median follow-up of 34 months. An additional patient lost the graft, with chronic nephropathy already known. All the remaining patients had stable renal function. There are no standardized treatment regimens for lymphoproliferative disorders after kidney transplantation, but these patients can be managed successfully with reduction of immunosuppression, conversion to m-TOR and rituximab-based schemes.

  4. The modified gait abnormality rating scale in patients with a conversion disorder: a reliability and responsiveness study.

    Science.gov (United States)

    Vandenberg, Justin M; George, Deanna R; O'Leary, Andrea J; Olson, Lindsay C; Strassburg, Kaitlyn R; Hollman, John H

    2015-01-01

    Individuals with conversion disorder have neurologic symptoms that are not identified by an underlying organic cause. Often the symptoms manifest as gait disturbances. The modified gait abnormality rating scale (GARS-M) may be useful for quantifying gait abnormalities in these individuals. The purpose of this study was to examine the reliability, responsiveness and concurrent validity of GARS-M scores in individuals with conversion disorder. Data from 27 individuals who completed a rehabilitation program were included in this study. Pre- and post-intervention videos were obtained and walking speed was measured. Five examiners independently evaluated gait performance according to the GARS-M criteria. Inter- and intrarater reliability of GARS-M scores were estimated with intraclass correlation coefficients (ICCs). Responsiveness was estimated with the minimum detectable change (MDC). Pre- to post-treatment changes in GARS-M scores were analyzed with a dependent t-test. The correlation between GARS-M scores and walking speed was analyzed to assess concurrent validity. GARS-M scores were quantified with good-to-excellent inter- (ICC = 0.878) and intrarater reliability (ICC = 0.989). The MDC was 2 points. Mean GARS-M scores decreased from 7 ± 5 at baseline to 1 ± 2 at discharge (t26 = 7.411, p conversion disorder. GARS-M scores provide objective measures upon which treatment effects can be assessed. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Transmural dispersion of repolarization and atrial electromechanical coupling: complementary indices for quantifying cardiac electrical heterogeneity in patients with conversion disorder

    Directory of Open Access Journals (Sweden)

    Tokatli A

    2015-07-01

    Full Text Available Alptug Tokatli,1 Omer Yiginer,2 Gokhan Degirmencioglu,2 Fethi Kilicaslan,3 Mehmet Uzun2 1Department of Cardiology, Golcuk Military Hospital, Kocaeli, 2Department of Cardiology, GATA Haydarpasa Hospital, 3Department of Cardiology, Medipol University, Istanbul, TurkeyWe read with great interest the article entitled “P-wave and QT dispersion in patients with conversion disorder” by Izci et al1 in Therapeutics and Clinical Risk Management. In this well designed research, Izci et al studied QT dispersion (QTd and P-wave dispersion (Pd in patients with conversion disorder (CD. In conclusion, they reported that corrected QT (QTc and QTd values were significantly altered in patients with CD when compared to healthy controls, but that there was no significant difference in terms of Pd.Read the original article

  6. An Open Conversation on Using Eye-Gaze Methods in Studies of Neurodevelopmental Disorders

    Science.gov (United States)

    Venker, Courtney E.; Kover, Sara T.

    2015-01-01

    Purpose: Eye-gaze methods have the potential to advance the study of neurodevelopmental disorders. Despite their increasing use, challenges arise in using these methods with individuals with neurodevelopmental disorders and in reporting sufficient methodological detail such that the resulting research is replicable and interpretable. Method: This…

  7. The creative use of unexpected responses in the hypnotherapy of patients with conversion disorders

    NARCIS (Netherlands)

    Moene, F.C.; Hoogduin, C.A.L.

    1999-01-01

    In a previously completed empirical study examining the use of hypnosis in a comprehensive treatment program with 85 patients who suffered motor conversion symptoms, 16 patients were reported by their therapists to have had unusual and unexpected responses during hypnosis. This article summarizes

  8. Proinsulin maturation disorder is a contributor to the defect of subsequent conversion to insulin in {beta}-cells

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jie, E-mail: jie.wang2@osumc.edu [Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, OH (United States); Osei, Kwame [Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, OH (United States)

    2011-07-22

    Highlights: {yields} Primary proinsulin maturation disorder is inherent in Ins2{sup +/Akita} islets/{beta}-cells. {yields} A consequence is the inefficient conversion of proinsulin to insulin. {yields} Post-translational defects occur as well in the involved PC1/3 and PC2 convertases. {yields} Proinsulin maturation chaos results in defects in the following conversion process. {yields} A link of the proinsulin maturation disorder and hyperproinsulinemia is suggested. -- Abstract: Disproportionate hyperproinsulinemia is an indicator of {beta}-cell dysfunction in diabetes and the basis underlying this abnormality remains obscure. Recently, we have found proinsulin is an aggregation-prone molecule inherent with a low relative folding rate and maintains a homeostatic balance of natively and plentiful non-natively folded states (i.e., proinsulin homeostasis, PIHO) in normal {beta}-cells as a result of the integration of maturation and disposal processes. PIHO is susceptible to environmental and genetic influences. Perturbation of PIHO produces a number of toxic consequences with known association to {beta}-cell failure in diabetes. To explore whether the perturbation of PIHO has a link to disproportionate hyperproinsulinemia, we investigated proinsulin conversion and the involved prohormone convertase 1/3 (PC1/3) and 2 (PC2) in mouse Ins2{sup +/Akita} islets/{beta}-cells that preserve a primary PIHO disorder due to a mutation (C96Y) in the insulin 2 (Ins2) gene. Our metabolic-labeling studies found an increased ratio of proinsulin to insulin in the cellular or released proteins of Ins2{sup +/Akita} islets. Histological, metabolic-labeling, and RT-PCR analyses revealed decreases of the PC1/3 and PC2 immunoreactivities in the {beta}-cells of Ins2{sup +/Akita} islets in spite of no declines of these two convertases at the transcriptional and translational levels. Immunoblot analyses in cloned Ins2{sup +/Akita} {beta}-cells further confirmed the increased ratio of proinsulin

  9. Proinsulin maturation disorder is a contributor to the defect of subsequent conversion to insulin in β-cells

    International Nuclear Information System (INIS)

    Wang, Jie; Osei, Kwame

    2011-01-01

    Highlights: → Primary proinsulin maturation disorder is inherent in Ins2 +/Akita islets/β-cells. → A consequence is the inefficient conversion of proinsulin to insulin. → Post-translational defects occur as well in the involved PC1/3 and PC2 convertases. → Proinsulin maturation chaos results in defects in the following conversion process. → A link of the proinsulin maturation disorder and hyperproinsulinemia is suggested. -- Abstract: Disproportionate hyperproinsulinemia is an indicator of β-cell dysfunction in diabetes and the basis underlying this abnormality remains obscure. Recently, we have found proinsulin is an aggregation-prone molecule inherent with a low relative folding rate and maintains a homeostatic balance of natively and plentiful non-natively folded states (i.e., proinsulin homeostasis, PIHO) in normal β-cells as a result of the integration of maturation and disposal processes. PIHO is susceptible to environmental and genetic influences. Perturbation of PIHO produces a number of toxic consequences with known association to β-cell failure in diabetes. To explore whether the perturbation of PIHO has a link to disproportionate hyperproinsulinemia, we investigated proinsulin conversion and the involved prohormone convertase 1/3 (PC1/3) and 2 (PC2) in mouse Ins2 +/Akita islets/β-cells that preserve a primary PIHO disorder due to a mutation (C96Y) in the insulin 2 (Ins2) gene. Our metabolic-labeling studies found an increased ratio of proinsulin to insulin in the cellular or released proteins of Ins2 +/Akita islets. Histological, metabolic-labeling, and RT-PCR analyses revealed decreases of the PC1/3 and PC2 immunoreactivities in the β-cells of Ins2 +/Akita islets in spite of no declines of these two convertases at the transcriptional and translational levels. Immunoblot analyses in cloned Ins2 +/Akita β-cells further confirmed the increased ratio of proinsulin to insulin despite the levels of PC1/3 and PC2 proteins were not reduced

  10. A study of the stressor, family environment and family burden in dissociative (conversion disorder patients

    Directory of Open Access Journals (Sweden)

    Kamal K Verma

    2017-01-01

    Full Text Available Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. Aim and Objective: To study presence of stressor, family environment, and assessment of family burden in dissociative disorder patients. Material and Method: This was a cross-sectional observational study in which 100 dissociatives disorder patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Results: In our study major part of the sample were women 60 (60%, among them most of were housewife and educated up to primary school. According to a stressor, 63 (63% patients had family stress/problem and out of them, 35 (58.4 were women. Seventy-four (74% patients had dissociative convulsion and out of them, 45 (75% were women. The dissociative disorder patients cause a considerable degree of burden over other family members in both men and women. There is a significant difference found in the family environment in term of personal growth dimension, relationship dimension in both men and women. Conclusion: Present study concludes that dissociative disorder patients cause a considerable degree of burden over other family members in term of leisure, physical, mental, financial, and routines family interrelationship domains. The family environment in term of personal growth dimension, relationship dimension has a casual effect on symptoms of dissociative disorder patients.

  11. La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder

    Directory of Open Access Journals (Sweden)

    van Meerkerk-Aanen PJ

    2017-08-01

    Full Text Available Petra J van Meerkerk-Aanen,1 Lars de Vroege,1,2 David Khasho,1 Aziza Foruz,1 J Thies van Asseldonk,3 Christina M van der Feltz-Cornelis1,2 1Clinical Center of Excellence for Body, Mind, and Health, GGz Breburg, 2Department Tranzo, Tilburg School of Behavioral and Social Sciences, Tilburg University, 3Department of Neurology, Elisabeth Hospital, Tilburg, the Netherlands Background: Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD. However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson’s syndrome (PSPS misdiagnosed as a case of CD.Case: A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient’s physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS.Conclusion: La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological

  12. La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder.

    Science.gov (United States)

    van Meerkerk-Aanen, Petra J; de Vroege, Lars; Khasho, David; Foruz, Aziza; van Asseldonk, J Thies; van der Feltz-Cornelis, Christina M

    2017-01-01

    Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD). However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson's syndrome (PSPS) misdiagnosed as a case of CD. A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient's physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS. La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological reexamination and reinterpretation of la belle indifférence should be considered.

  13. An epidemic of collective conversion and dissociation disorder in an indigenous group of Colombia: its relation to cultural change.

    Science.gov (United States)

    Piñeros, M; Rosselli, D; Calderon, C

    1998-06-01

    We describe a collective episode of psychogenic illness in an indigenous group (Embera) of Colombia, geographically isolated from its native homeland and surrounded by non-indigenous settlers. The condition, which affected three young adult men and six adolescent women, was attributed by them to a spell (maleficio). It was designated as ataques de locura (madness attacks) according to their traditional medical system; and as a conversive disorder with dissociative features by psychiatrists. Different therapeutic approaches, including antipsychotic medication, religious healers and traditional herbal remedies were unsuccessful. Contact with shamans of the same ethnic origin, on the other hand, proved to be an effective way of dealing with the symptoms. We interpret the situation as an expression of psychosocial stress secondary to cultural change. This medical problem bears close resemblance to other specific culture-bound syndromes such as ataques de nervios or possession syndromes and gives clues to ways of dealing with psychogenic expressions of cultural stress.

  14. Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication.

    Science.gov (United States)

    Soto, Gloria; Clarke, Michael T

    2017-07-12

    This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. https://doi.org/10.23641/asha.5150113.

  15. [What would you do when faced with a Muslim patient with a conversational disorder?

    Science.gov (United States)

    Martínez Gandolfi, A; Rodríguez Mir, J

    The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Embodied conversational agents for multimodal automated social skills training in people with autism spectrum disorders.

    Science.gov (United States)

    Tanaka, Hiroki; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

    2017-01-01

    Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social communication skills through interaction with a computer avatar. Even though previous work that simulated social skills training only considered acoustic and linguistic information, human social skills trainers take into account visual and other non-verbal features. In this paper, we create and evaluate a social skills training system that closes this gap by considering the audiovisual features of the smiling ratio and the head pose (yaw and pitch). In addition, the previous system was only tested with graduate students; in this paper, we applied our system to children or young adults with autism spectrum disorders. For our experimental evaluation, we recruited 18 members from the general population and 10 people with autism spectrum disorders and gave them our proposed multimodal system to use. An experienced human social skills trainer rated the social skills of the users. We evaluated the system's effectiveness by comparing pre- and post-training scores and identified significant improvement in their social skills using our proposed multimodal system. Computer-based social skills training is useful for people who experience social difficulties. Such a system can be used by teachers, therapists, and social skills trainers for rehabilitation and the supplemental use of human-based training anywhere and anytime.

  17. Conversion from depression to bipolar disorder in a cohort of young people in England, 1999-2011: A national record linkage study.

    Science.gov (United States)

    James, Anthony; Wotton, Clare J; Duffy, Anne; Hoang, Uy; Goldacre, Michael

    2015-10-01

    To estimate the conversion rate from unipolar depression (ICD10 codes F32-F33) to bipolar disorder (BP) (ICD10 codes F31) in an English national cohort. It was hypothesised that early-onset BP (age disorder, with a more rapid, and higher rate of conversion from depression to BP. This record linkage study used English national Hospital Episode Statistics (HES) covering all NHS inpatient and day case admissions between 1999 and 2011. The overall rate of conversion from depression to BP for all ages was 5.65% (95% CI: 5.48-5.83) over a minimum 4-year follow-up period. The conversion rate from depression to BP increased in a linear manner with age from 10-14 years - 2.21% (95% C: 1.16-4.22) to 30-34 years - 7.06% (95% CI: 6.44-7.55) (F1,23=77.6, p=0.001, R(2)=0.77). The time to conversion was constant across the age range. The rate of conversion was higher in females (6.77%; 95% CI: 6.53-7.02) compared to males, (4.17%; 95% CI: 3.95-4.40) (χ(2)=194, pconversion rate from depression to bipolar disorder with age, and constant time for conversion across the age range does not support the notion that early-onset BP is a more severe form of the disorder. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. The role of alexithymia in the development of functional motor symptoms (conversion disorder).

    Science.gov (United States)

    Demartini, Benedetta; Petrochilos, Panayiota; Ricciardi, Lucia; Price, Gary; Edwards, Mark J; Joyce, Eileen

    2014-10-01

    The mechanisms leading to the development of functional motor symptoms (FMS) are of pathophysiological and clinical relevance, yet are poorly understood. The aim of the present study was to evaluate whether impaired emotional processing at the cognitive level (alexithymia) is present in patients affected by FMS. We conducted a cross-sectional study in a population of patients with FMS and in two control groups (patients with organic movement disorders (OMD) and healthy volunteers). 55 patients with FMS, 33 patients affected by OMD and 34 healthy volunteers were recruited. The assessment included the 20-item Toronto Alexithymia Scale (TAS-20), the Montgomery-Asberg Depression Rating Scale, the Reading the Mind in the Eyes' Test and the Structured Clinical Interview for Personality Disorders. Alexithymia was present in 34.5% of patients with FMS, 9.1% with OMD and 5.9% of the healthy volunteers, which was significantly higher in the FMS group (χ(2) (2)=14.129, pOCPD) in the FMS group (χ(2) (2)=16.217, pOCPD also reached threshold criteria for alexithymia. Because alexithymia is a mental state denoting the inability to identify emotions at a cognitive level, one hypothesis is that some patients misattribute autonomic symptoms of anxiety, for example, tremor, paraesthesiae, paralysis, to that of a physical illness. Further work is required to understand the contribution of OCPD to the development of FMS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Do Children with Social Communication Disorder Have Explicit Knowledge of Pragmatic Rules They Break? A Comparison of Conversational Pragmatic Ability and Metapragmatic Awareness

    Science.gov (United States)

    Lockton, Elaine; Adams, Catherine; Collins, Anna

    2016-01-01

    Background: Children who have social communication disorder (CwSCD) demonstrate persistent difficulties with language pragmatics in conversations and other verbal interactions. Speech-language interventions for these children often include promotion of metapragmatic awareness (MPA); that is, the ability to identify explicitly and reflect upon…

  20. Effects of a Conversation-Based Intervention on the Linguistic Skills of Children with Motor Speech Disorders Who Use Augmentative and Alternative Communication

    Science.gov (United States)

    Soto, Gloria; Clarke, Michael T.

    2017-01-01

    Purpose: This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method: Eight children aged from 8 to 13 years participated in the study.…

  1. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study.

    Science.gov (United States)

    Bukh, J D; Andersen, P K; Kessing, L V

    2016-04-01

    In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first lifetime episode of depression. A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011 to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8.6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family history of affective disorder and co-morbid alcohol or drug abuse. The identified clinical characteristics of the first lifetime episode of depression should guide patients and clinicians for long-term individualized tailored treatment.

  2. The use of conversation analysis to study social accessibility of an online support group on eating disorders.

    Science.gov (United States)

    Stommel, Wyke; Meijman, Frans J

    2011-06-01

    We conducted a conversation analysis of 21 threads initiated by newcomers of an online support group (OSG) on eating disorders, to examine the discursive process of entering such a group. The analysis revealed three important issues. First, many newcomers articulate that the step to join the group is extremely difficult. Second, a presentation of the self in terms of a diagnosis works as a legitimization for joining the forum. The data suggest that participants who do not fulfil the conditions for such a legitimization do not join the forum. Third, the option of acquiring a serious symptom as a solution to the legitimization problem is offered by one of the regular members. Hence, the newcomers' discourse reveals issues relevant to the accessibility for undiagnosed sufferers. We discuss these findings theoretically as a phenomenon of self-presentation in relation to community norms. The analysis generates the hypothesis that newcomers are confronted with implicit norms regarding membership legitimacy that they should obey in their self-presentation, although they may not be ready yet to actually do so. OSGs should find strategies to facilitate various possibilities for newcomers to present themselves to the group while becoming a member.

  3. Evidence for somatic gene conversion and deletion in bipolar disorder, Crohn's disease, coronary artery disease, hypertension, rheumatoid arthritis, type-1 diabetes, and type-2 diabetes.

    Science.gov (United States)

    Ross, Kenneth Andrew

    2011-02-03

    During gene conversion, genetic information is transferred unidirectionally between highly homologous but non-allelic regions of DNA. While germ-line gene conversion has been implicated in the pathogenesis of some diseases, somatic gene conversion has remained technically difficult to investigate on a large scale. A novel analysis technique is proposed for detecting the signature of somatic gene conversion from SNP microarray data. The Wellcome Trust Case Control Consortium has gathered SNP microarray data for two control populations and cohorts for bipolar disorder (BD), cardiovascular disease (CAD), Crohn's disease (CD), hypertension (HT), rheumatoid arthritis (RA), type-1 diabetes (T1D) and type-2 diabetes (T2D). Using the new analysis technique, the seven disease cohorts are analyzed to identify cohort-specific SNPs at which conversion is predicted. The quality of the predictions is assessed by identifying known disease associations for genes in the homologous duplicons, and comparing the frequency of such associations with background rates. Of 28 disease/locus pairs meeting stringent conditions, 22 show various degrees of disease association, compared with only 8 of 70 in a mock study designed to measure the background association rate (P conversion could be a significant causative factor in each of the seven diseases. The specific genes provide potential insights about disease mechanisms, and are strong candidates for further study.

  4. Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder.

    Science.gov (United States)

    Kaplan, Marcia J; Dwivedi, Alok K; Privitera, Michael D; Isaacs, Kelly; Hughes, Cynthia; Bowman, Michelle

    2013-08-01

    It has been theorized that conversion disorder is the result of emotion that cannot be experienced consciously as feeling states or put into words (i.e., alexithymia), but there is little confirming empirical evidence. We sought to characterize subjects with conversion disorder compared to subjects with a distinct medical illness, using the model of psychogenic non-epileptic seizures (PNES) vs. epilepsy (ES), on measures of childhood traumatic experience, alexithymia and maturity of psychological defensive strategies. All subjects admitted to the Epilepsy Monitoring Unit of the University of Cincinnati Medical Center were offered self-report questionnaires (Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20 and Response Evaluation Measure-71) at the outset of evaluation. Diagnosis of each subject was confirmed by video-EEG and we compared subjects with PNES to those with ES on these measures. 82 subjects had ES AND 96 had PNES. Those with PNES were significantly more likely to have experienced childhood trauma in all domains (p=.005 to p=.05), and were significantly more likely to have alexithymia (p=.0267). There was a significant difference in the capacity to identify feelings, and a trend towards significance in capacity to describe feelings. There were no differences in defensive styles between the two groups. PNES diagnosis was associated with female sex, higher alexithymia scores and higher rates of childhood trauma, but not with differences in defensive styles compared to ES. These findings add empirical evidence for theories regarding the cause of conversion disorder and may aid in the design of prospective treatment trials in patients with conversion disorder. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Effects of propranolol on conversational reciprocity in autism spectrum disorder: a pilot, double-blind, single-dose psychopharmacological challenge study.

    Science.gov (United States)

    Zamzow, Rachel M; Ferguson, Bradley J; Stichter, Janine P; Porges, Eric C; Ragsdale, Alexandra S; Lewis, Morgan L; Beversdorf, David Q

    2016-04-01

    Pharmacological intervention for autism spectrum disorder (ASD) is an important addition to treatment, yet currently available agents target co-morbid psychiatric concerns, such as aggression and irritability. Propranolol, a beta-adrenergic antagonist with anxiolytic effects, has been shown to improve verbal fluency and working memory in adults and adolescents with ASD in single-dose challenges. The present pilot study explores the acute effects of propranolol on a measure of conversational reciprocity in this population. We also examined whether autonomic activity and anxiety moderate or mediate response to the drug, given relationships between these variables and ASD, as well as the drug's effects. In a within-subject crossover design, 20 individuals with ASD received a single dose of propranolol or placebo during two sessions in a double-blinded, counterbalanced manner. After drug administration, participants performed a conversational reciprocity task by engaging in a short conversation with the researcher. Measurements of autonomic activity and anxiety were obtained before and after drug administration. Propranolol significantly improved performance on the conversational reciprocity task total [d = 0.40] and nonverbal communication domain scores when compared to the placebo condition. However, neither autonomic activity nor anxiety was significantly associated with drug response. Acute propranolol administration improved conversational reciprocity in ASD. Further exploration of these preliminary findings, as well as other potential treatment response predictors, with serial doses is warranted.

  6. Training conversation partners of persons with communication disorders related to Parkinson's disease--a protocol and a pilot study.

    Science.gov (United States)

    Forsgren, Emma; Antonsson, Malin; Saldert, Charlotta

    2013-07-01

    This paper reports on the adaptation of a training programme for conversation partners of persons with Parkinson's disease, and a protocol for assessment of possible changes in conversational interaction as a result of intervention. We present data from an explorative multiple case study with three individuals with Parkinson's disease and their spouses. Repeated analysis of natural conversational interaction and measures of the participants' perception of communication as well as measures of different cognitive abilities were obtained. The results show that the communication in all three dyads was affected by both speech and language problems and that the conversation training model and the assessment protocol may work well after minor adjustments. Influence of different aspects of cognition on communication is discussed.

  7. Evidence for somatic gene conversion and deletion in bipolar disorder, Crohn's disease, coronary artery disease, hypertension, rheumatoid arthritis, type-1 diabetes, and type-2 diabetes

    Directory of Open Access Journals (Sweden)

    Ross Kenneth

    2011-02-01

    Full Text Available Abstract Background During gene conversion, genetic information is transferred unidirectionally between highly homologous but non-allelic regions of DNA. While germ-line gene conversion has been implicated in the pathogenesis of some diseases, somatic gene conversion has remained technically difficult to investigate on a large scale. Methods A novel analysis technique is proposed for detecting the signature of somatic gene conversion from SNP microarray data. The Wellcome Trust Case Control Consortium has gathered SNP microarray data for two control populations and cohorts for bipolar disorder (BD, cardiovascular disease (CAD, Crohn's disease (CD, hypertension (HT, rheumatoid arthritis (RA, type-1 diabetes (T1D and type-2 diabetes (T2D. Using the new analysis technique, the seven disease cohorts are analyzed to identify cohort-specific SNPs at which conversion is predicted. The quality of the predictions is assessed by identifying known disease associations for genes in the homologous duplicons, and comparing the frequency of such associations with background rates. Results Of 28 disease/locus pairs meeting stringent conditions, 22 show various degrees of disease association, compared with only 8 of 70 in a mock study designed to measure the background association rate (P -9. Additional candidate genes are identified using less stringent filtering conditions. In some cases, somatic deletions appear likely. RA has a distinctive pattern of events relative to other diseases. Similarities in patterns are apparent between BD and HT. Conclusions The associations derived represent the first evidence that somatic gene conversion could be a significant causative factor in each of the seven diseases. The specific genes provide potential insights about disease mechanisms, and are strong candidates for further study. Please see Commentary: http://www.biomedcentral.com/1741-7015/9/13/abstract.

  8. The use of effective treatments: the case of an adolescent girl with anorexia nervosa in the context of a conversion disorder.

    Science.gov (United States)

    Goldstein, Mandy; Madden, Sloane; Peters, Lorna

    2013-04-01

    The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.

  9. Conversion of broadband IR radiation and structural disorder in lithium niobate single crystals with low photorefractive effect

    Science.gov (United States)

    Litvinova, Man Nen; Syuy, Alexander V.; Krishtop, Victor V.; Pogodina, Veronika A.; Ponomarchuk, Yulia V.; Sidorov, Nikolay V.; Gabain, Aleksei A.; Palatnikov, Mikhail N.; Litvinov, Vladimir A.

    2016-11-01

    The conversion of broadband IR radiation when the noncritical phase matching condition is fulfilled in lithium niobate (LiNbO3) single crystals with stoichiometric (R = Li/Nb = 1) and congruent (R = 0.946) compositions, as well as in congruent single crystals doped with zinc has been investigated. It is shown that the spectrum parameters of converted radiation, such as the conversion efficiency, spectral width and position of maximum, depend on the ordering degree of structural units of the cation sublattice along the polar axis of crystal.

  10. Mode of presentation of patients of dissociative (conversion) disorder at the armed forces institute of mental health

    International Nuclear Information System (INIS)

    Jan, A.U.; Jehangir, S.

    2015-01-01

    To determine the mode of presentation of dissociative disorders presenting at Armed Forces Institute of Mental Health. Study Design: Cross sectional study. Place and Duration of Study: The study was conducted at the Armed Forces Institute of Mental Health (AFIMH) Rawalpindi from 1st June 2013 to 31st August 2013. Patients and Methods: Fifty four patients of dissociative disorders were included in the study by using consecutive non-probability sampling. Category of presentation of dissociative disorders in the participants was determined by the primary mode of presentation and by using international classification of diseases (ICD)-10 diagnostic guidelines. Results: The commonest type of presentation of dissociative disorders was mutism (40.7%), possession state (18.5%), pseudo fits (12.9%) followed by paraparesis (9.2%). Conclusion: Predominantly the patients presented with mutism (dissociative motor disorder). (author)

  11. Conversation analysis can help to distinguish between epilepsy and non-epileptic seizure disorders: a case comparison.

    Science.gov (United States)

    Plug, Leendert; Sharrack, Basil; Reuber, Markus

    2009-01-01

    Factual items in patients' histories are of limited discriminating value in the differential diagnosis of epilepsy and non-epileptic seizures (NES). A number of studies using a transcript-based sociolinguistic research method inspired by Conversation Analysis (CA) suggest that it is helpful to focus on how patients talk. Previous reports communicated these findings by using particularly clear examples of diagnostically relevant interactional, linguistic and topical features from different patients. They did not discuss the sequential display of different features although this is crucially important from a conversation analytic point of view. This case comparison aims to show clinicians how the discriminating features are displayed by individual patients over the course of a clinical encounter. CA-inspired brief sequential analysis of two first 30-min doctor-patient encounters by a linguist blinded to all medical information. A gold standard diagnosis was made by the recording of a typical seizure with video-EEG. The patient with epilepsy volunteered detailed first person accounts of seizures. The NES patient exhibited resistance to focusing on individual seizure episodes and only provided a detailed seizure description after repeated prompting towards the end of the interview. Although both patients also displayed some linguistic features favouring the alternative diagnosis, the linguist's final diagnostic hypothesis matched the diagnosis made by video-EEG in both cases. This study illustrates the importance of the time point at which patients share information with the doctor. It supports the notion that close attention to how patients communicate can help in the differential diagnosis of seizures.

  12. Everyday social and conversation applications of theory-of-mind understanding by children with autism-spectrum disorders or typical development.

    Science.gov (United States)

    Peterson, Candida C; Garnett, Michelle; Kelly, Adrian; Attwood, Tony

    2009-02-01

    Children with autism-spectrum disorders (ASD) often fail laboratory false-belief tests of theory of mind (ToM). Yet how this impacts on their everyday social behavior is less clear, partly owing to uncertainty over which specific everyday conversational and social skills require ToM understanding. A new caregiver-report scale of these everyday applications of ToM was developed and validated in two studies. Study 1 obtained parent ratings of 339 children (85 with autism; 230 with Asperger's; 24 typically-developing) on the new scale and results revealed (a) that the scale had good psychometric properties and (b) that children with ASD had significantly more everyday mindreading difficulties than typical developers. In Study 2, we directly tested links between laboratory ToM and everyday mindreading using teacher ratings on the new scale. The sample of 25 children included 15 with autism and 10 typical developers aged 5-12 years. Children in both groups who passed laboratory ToM tests had fewer everyday mindreading difficulties than those of the same diagnosis who failed. Yet, intriguingly, autistic ToM-passers still had more problems with everyday mindreading than younger typically-developing ToM-failers. The possible roles of family conversation and peer interaction, along with ToM, in everyday social functioning were considered.

  13. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Ludwig, Lea; Pasman, Joëlle A; Nicholson, Timothy; Aybek, Selma; David, Anthony S; Tuck, Sharon; Kanaan, Richard A; Roelofs, Karin; Carson, Alan; Stone, Jon

    2018-04-01

    Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder. We did a meta-analysis, with assessments of methodology, sources of bias, and sensitivity analyses. 34 case-control studies, with 1405 patients, were eligible. Studies were of moderate-to-low quality. The frequency of childhood and adulthood stressors was increased in cases compared with controls. Odds ratios (OR) were higher for emotional neglect in childhood (49% for cases vs 20% for controls; OR 5·6, 95% CI 2·4-13·1) compared with sexual abuse (24% vs 10%; 3·3, 2·2-4·8) or physical abuse (30% vs 12%; 3·9, 2·2-7·2). An association with stressful life events preceding onset (OR 2·8, 95% CI 1·4-6·0) was stronger in studies with better methods (interviews; 4·3, 1·4-13·2). Heterogeneity was significant between studies (I 2 21·1-90·7%). 13 studies that specifically ascertained that the participants had not had either severe life events or any subtype of maltreatment all found a proportion of patients with functional neurological disorder reporting no stressor. Stressful life events and maltreatment are substantially more common in people with functional neurological disorder than in healthy controls and patient controls. Emotional neglect had a higher risk than traditionally emphasised sexual and physical abuse, but many cases report no stressors. This outcome supports changes to diagnostic criteria in DSM-5; stressors, although relevant to the cause in many patients, are not a core diagnostic feature. This

  14. Uranium conversion

    International Nuclear Information System (INIS)

    Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina

    2006-03-01

    FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF 6 and UF 4 are present require equipment that is made of corrosion resistant material

  15. Conversation Analysis.

    Science.gov (United States)

    Schiffrin, Deborah

    1990-01-01

    Summarizes the current state of research in conversation analysis, referring primarily to six different perspectives that have developed from the philosophy, sociology, anthropology, and linguistics disciplines. These include pragmatics; speech act theory; interactional sociolinguistics; ethnomethodology; ethnography of communication; and…

  16. Pictorial Conversations.

    Science.gov (United States)

    Hooper, Kristina

    1982-01-01

    Provides the rationale for considering communication in a graphic domain and suggests a specific goal for designing work stations which provide graphic capabilities in educational settings. The central element of this recommendation is the "pictorial conversation", a highly interactive exchange that includes pictures as the central elements.…

  17. Quantum conversion

    OpenAIRE

    Mazilu, Michael

    2015-01-01

    ICOAM 2015 The electromagnetic momentum transferred transferred to scattering particles is proportional to the intensity of the incident fields, however, the momentum of single photons ℏk does not naturally appear in these classical expressions. Here, we discuss an alternative to Maxwell's stress tensor that renders the classical electromagnetic field momentum compatible to the quantum mechanical one. This is achieved through the introduction of the quantum conversion which allows the tran...

  18. Conversion Disorder— Mind versus Body: A Review

    Science.gov (United States)

    Jabeen, Shagufta; Pate, Rebecca J.; Shahid, Marwah; Chinala, Sandhya; Nathani, Milankumar; Shah, Rida

    2015-01-01

    In this article, the authors accentuate the signs and symptoms of conversion disorder and the significance of clinical judgment and expertise in order to reach the right diagnosis. The authors review the literature and provide information on the etiology, prevalence, diagnostic criteria, and the treatment methods currently employed in the management of conversion disorder. Of note, the advancements of neuropsychology and brain imaging have led to emergence of a relatively sophisticated picture of the neuroscientific psychopathology of complex mental illnesses, including conversion disorder. The available evidence suggests new methods with which to test hypotheses about the neural circuits underlying conversion symptoms. In context of this, the authors also explore the neurobiological understanding of conversion disorder. PMID:26155375

  19. Conversational sensemaking

    Science.gov (United States)

    Preece, Alun; Webberley, Will; Braines, Dave

    2015-05-01

    Recent advances in natural language question-answering systems and context-aware mobile apps create opportunities for improved sensemaking in a tactical setting. Users equipped with mobile devices act as both sensors (able to acquire information) and effectors (able to act in situ), operating alone or in collectives. The currently- dominant technical approaches follow either a pull model (e.g. Apple's Siri or IBM's Watson which respond to users' natural language queries) or a push model (e.g. Google's Now which sends notifications to a user based on their context). There is growing recognition that users need more flexible styles of conversational interaction, where they are able to freely ask or tell, be asked or told, seek explanations and clarifications. Ideally such conversations should involve a mix of human and machine agents, able to collaborate in collective sensemaking activities with as few barriers as possible. Desirable capabilities include adding new knowledge, collaboratively building models, invoking specific services, and drawing inferences. As a step towards this goal, we collect evidence from a number of recent pilot studies including natural experiments (e.g. situation awareness in the context of organised protests) and synthetic experiments (e.g. human and machine agents collaborating in information seeking and spot reporting). We identify some principles and areas of future research for "conversational sensemaking".

  20. Conversational sensing

    Science.gov (United States)

    Preece, Alun; Gwilliams, Chris; Parizas, Christos; Pizzocaro, Diego; Bakdash, Jonathan Z.; Braines, Dave

    2014-05-01

    Recent developments in sensing technologies, mobile devices and context-aware user interfaces have made it pos- sible to represent information fusion and situational awareness for Intelligence, Surveillance and Reconnaissance (ISR) activities as a conversational process among actors at or near the tactical edges of a network. Motivated by use cases in the domain of Company Intelligence Support Team (CoIST) tasks, this paper presents an approach to information collection, fusion and sense-making based on the use of natural language (NL) and controlled nat- ural language (CNL) to support richer forms of human-machine interaction. The approach uses a conversational protocol to facilitate a ow of collaborative messages from NL to CNL and back again in support of interactions such as: turning eyewitness reports from human observers into actionable information (from both soldier and civilian sources); fusing information from humans and physical sensors (with associated quality metadata); and assisting human analysts to make the best use of available sensing assets in an area of interest (governed by man- agement and security policies). CNL is used as a common formal knowledge representation for both machine and human agents to support reasoning, semantic information fusion and generation of rationale for inferences, in ways that remain transparent to human users. Examples are provided of various alternative styles for user feedback, including NL, CNL and graphical feedback. A pilot experiment with human subjects shows that a prototype conversational agent is able to gather usable CNL information from untrained human subjects.

  1. Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

    Science.gov (United States)

    Yamada, Shunsuke; Ueki, Kenji; Tokumoto, Masanori; Suehiro, Takaichi; Kimura, Hiroshi; Taniguchi, Masatomo; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

    2016-02-01

    Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  2. Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

    Science.gov (United States)

    Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

    2011-01-01

    Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts. PMID:21668080

  3. The Additive Effects of Video Self-Modeling on a Social Skills Training Package Addressing Conversational Skills in Adolescents with Autism Spectrum Disorder

    Science.gov (United States)

    Merrill, Anna

    2017-01-01

    Autism Spectrum Disorder (ASD) is a lifelong developmental disability that affects social development and social communication. As the prevalence of ASD increases, more children on the spectrum are growing into adolescents and young adults. Adolescents have unique needs as they transition from childhood to adulthood. One imperative skill deficit…

  4. Abnormal Parietal Function in Conversion Paresis

    NARCIS (Netherlands)

    van Beilen, Marije; de Jong, Bauke M.; Gieteling, Esther W.; Renken, Remco; Leenders, Klaus L.

    2011-01-01

    The etiology of medically unexplained symptoms such as conversion disorder is poorly understood. This is partly because the interpretation of neuroimaging results in conversion paresis has been complicated by the use of different control groups, tasks and statistical comparisons. The present study

  5. Teaching Children with Autism to Respond to Conversation Partners' Interest

    Science.gov (United States)

    Peters, Lindsay C.; Thompson, Rachel H.

    2015-01-01

    Successful conversation requires that the speaker's behavior is sensitive to nonvocal listener responses. We observed children with autism spectrum disorder during conversation probes in which a listener periodically displayed nonvocal cues that she was uninterested in the conversation. We used behavioral skills training to teach conversation…

  6. Special issue: Plasma Conversion

    NARCIS (Netherlands)

    Nozaki, T.; Bogaerts, A.; Tu, X.; van de Sanden, M. C. M.

    2017-01-01

    With growing concern of energy and environmental issues, the combination of plasma and heterogeneous catalysts receives special attention in greenhouse gas conversion, nitrogen fixation and hydrocarbon chemistry. Plasma gas conversion driven by renewable electricity is particularly important for the

  7. A Model for Conversation

    DEFF Research Database (Denmark)

    Ayres, Phil

    2012-01-01

    This essay discusses models. It examines what models are, the roles models perform and suggests various intentions that underlie their construction and use. It discusses how models act as a conversational partner, and how they support various forms of conversation within the conversational activity...

  8. Direct Conversion of Energy.

    Science.gov (United States)

    Corliss, William R.

    This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

  9. Elements of energy conversion

    CERN Document Server

    Russell, Charles R

    2013-01-01

    Elements of Energy Conversion brings together scattered information on the subject of energy conversion and presents it in terms of the fundamental thermodynamics that apply to energy conversion by any process. Emphasis is given to the development of the theory of heat engines because these are and will remain most important power sources. Descriptive material is then presented to provide elementary information on all important energy conversion devices. The book contains 10 chapters and opens with a discussion of forms of energy, energy sources and storage, and energy conversion. This is foll

  10. Iterated multidimensional wave conversion

    International Nuclear Information System (INIS)

    Brizard, A. J.; Tracy, E. R.; Johnston, D.; Kaufman, A. N.; Richardson, A. S.; Zobin, N.

    2011-01-01

    Mode conversion can occur repeatedly in a two-dimensional cavity (e.g., the poloidal cross section of an axisymmetric tokamak). We report on two novel concepts that allow for a complete and global visualization of the ray evolution under iterated conversions. First, iterated conversion is discussed in terms of ray-induced maps from the two-dimensional conversion surface to itself (which can be visualized in terms of three-dimensional rooms). Second, the two-dimensional conversion surface is shown to possess a symplectic structure derived from Dirac constraints associated with the two dispersion surfaces of the interacting waves.

  11. Computers and conversation

    CERN Document Server

    Luff, Paul; Gilbert, Nigel G

    1986-01-01

    In the past few years a branch of sociology, conversation analysis, has begun to have a significant impact on the design of human*b1computer interaction (HCI). The investigation of human*b1human dialogue has emerged as a fruitful foundation for interactive system design.****This book includes eleven original chapters by leading researchers who are applying conversation analysis to HCI. The fundamentals of conversation analysis are outlined, a number of systems are described, and a critical view of their value for HCI is offered.****Computers and Conversation will be of interest to all concerne

  12. Energy conversion alternatives study

    Science.gov (United States)

    Shure, L. T.

    1979-01-01

    Comparison of coal based energy systems is given. Study identifies and compares various advanced energy conversion systems using coal or coal derived fuels for baselaoad electric power generation. Energy Conversion Alternatives Study (ECAS) reports provede government, industry, and general public with technically consistent basis for comparison of system's options of interest for fossilfired electric-utility application.

  13. Hydrothermal conversion of biomass

    NARCIS (Netherlands)

    Knezevic, D.

    2009-01-01

    This thesis presents research of hydrothermal conversion of biomass (HTC). In this process, hot compressed water (subcritical water) is used as the reaction medium. Therefore this technique is suitable for conversion of wet biomass/ waste streams. By working at high pressures, the evaporation of

  14. Conversations in African Philosophy

    African Journals Online (AJOL)

    JONATHAN

    Conversational philosophy is articulated by Jonathan O. Chimakonam as the new wave of philosophical practice both in “place” and in “space”. This journal adopts and promotes this approach to philosophizing for African philosophy. Readers are encouraged to submit their conversational piece (maximum of 2000 words) ...

  15. Microwave plasma mode conversion

    International Nuclear Information System (INIS)

    Torres, H.S.; Sakanaka, P.H.; Villarroel, C.H.

    1985-01-01

    The behavior of hot electrons during the process of laser-produced plasma is studied. The basic equations of mode conversion from electromagnetic waves to electrostatic waves are presented. It is shown by mode conversion, that, the resonant absorption and parametric instabilities appear simultaneously, but in different plasma regions. (M.C.K.) [pt

  16. Political conversations on Facebook

    DEFF Research Database (Denmark)

    Sørensen, Mads P.

    2016-01-01

    Political conversations are according to theories on deliberative democracy essential to well-functioning democracies. Traditionally these conversations have taken place in face-to-face settings, in e.g. party meetings and town meetings. However, social media such as Facebook and Twitter offers new...... possibilities for online political conversations between citizens and politicians. This paper examines the presence on Facebook and Twitter of Members of the Danish national Parliament, the Folketing, and focusses on a quantitative mapping of the political conversation activities taking place in the threads...... following Facebook posts from Danish Members of Parliament (MPs). The paper shows that, in comparison with previous findings from other countries, Danish MPs have a relatively high degree of engagement in political conversations with citizens on Facebook – and that a large number of citizens follow MPs...

  17. Abnormal parietal function in conversion paresis.

    Directory of Open Access Journals (Sweden)

    Marije van Beilen

    Full Text Available The etiology of medically unexplained symptoms such as conversion disorder is poorly understood. This is partly because the interpretation of neuroimaging results in conversion paresis has been complicated by the use of different control groups, tasks and statistical comparisons. The present study includes these different aspects in a single data set. In our study we included both normal controls and feigners to control for conversion paresis. We studied both movement execution and imagery, and we contrasted both within-group and between-group activation. Moreover, to reveal hemisphere-specific effects that have not been reported before, we performed these analyses using both flipped and unflipped data. This approach resulted in the identification of abnormal parietal activation which was specific for conversion paresis patients. Patients also showed reduced activity in the prefrontal cortex, supramarginal gyrus and precuneus, including hemisphere-specific activation that is lateralized in the same hemisphere, regardless of right- or left-sided paresis. We propose that these regions are candidates for an interface between psychological mechanisms and disturbed higher-order motor control. Our study presents an integrative neurophysiological view of the mechanisms that contribute to the etiology of this puzzling psychological disorder, which can be further investigated with other types of conversion symptoms.

  18. Uranium conversion; Urankonvertering

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina [Swedish Defence Research Agency (FOI), Stockholm (Sweden)

    2006-03-15

    FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF{sub 6} and UF{sub 4} are present require equipment that is made of corrosion resistant material.

  19. Solar energy conversion systems

    CERN Document Server

    Brownson, Jeffrey R S

    2013-01-01

    Solar energy conversion requires a different mind-set from traditional energy engineering in order to assess distribution, scales of use, systems design, predictive economic models for fluctuating solar resources, and planning to address transient cycles and social adoption. Solar Energy Conversion Systems examines solar energy conversion as an integrative design process, applying systems thinking methods to a solid knowledge base for creators of solar energy systems. This approach permits different levels of access for the emerging broad audience of scientists, engineers, architects, planners

  20. Energy conversion statics

    CERN Document Server

    Messerle, H K; Declaris, Nicholas

    2013-01-01

    Energy Conversion Statics deals with equilibrium situations and processes linking equilibrium states. A development of the basic theory of energy conversion statics and its applications is presented. In the applications the emphasis is on processes involving electrical energy. The text commences by introducing the general concept of energy with a survey of primary and secondary energy forms, their availability, and use. The second chapter presents the basic laws of energy conversion. Four postulates defining the overall range of applicability of the general theory are set out, demonstrating th

  1. Uranium Conversion & Enrichment

    Energy Technology Data Exchange (ETDEWEB)

    Karpius, Peter Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-06

    The isotopes of uranium that are found in nature, and hence in ‘fresh’ Yellowcake’, are not in relative proportions that are suitable for power or weapons applications. The goal of conversion then is to transform the U3O8 yellowcake into UF6. Conversion and enrichment of uranium is usually required to obtain material with enough 235U to be usable as fuel in a reactor or weapon. The cost, size, and complexity of practical conversion and enrichment facilities aid in nonproliferation by design.

  2. Uranium conversion wastes

    International Nuclear Information System (INIS)

    Vicente, R.; Dellamano, J.C.

    1989-12-01

    A set of mathematical equations was developed and used to estimate the radiological significance of each radionuclide potentially present in the uranium refining industry effluents. The equations described the evolution in time of the radionuclides activities in the uranium fuel cycle, from mining and milling, through the yellowcake, till the conversion effluents. Some radionuclides that are not usually monitored in conversion effluents (e.g. Pa-231 and Ac-227) were found to be potentially relevant from the radiological point of view in conversion facilities, and are certainly relevant in mining and milling industry, at least in a few waste streams. (author) [pt

  3. Freely flowing conversations

    DEFF Research Database (Denmark)

    Aakjær, Marie Kirstejn; Andrade, David; Dexters, Peter

    and in regards to rehabilitation efforts. In the context of prisons UDI is inspired by the complexity approach (Stacey 2005). We seek to facilitate freely flowing conversations between inmates, staff and managers – pushing the boundaries of existing norms, roles and beliefs. In the end however we rely...... relations by changing conversations. Through the theoretical framework of the complexity approach, we discuss how this may lead to organizational change. Finally we suggest that inviting inmates to take part in conversations about core organizational development may be a fundamental strategy in trying...

  4. The brain-gut interaction: the conversation and the implications ...

    African Journals Online (AJOL)

    Bi-directional interactions between the gut and the brain play a role in health and disease. It is involved in glucose homeostasis, satiety and obesity, functional gastrointestinal disorders and possibly in inflammatory disorders such as inflammatory bowel disease. Data is starting to elucidate the conversation between the mini ...

  5. Mining Conversational Social Video

    OpenAIRE

    Biel, Joan-Isaac

    2013-01-01

    The ubiquity of social media in our daily life, the intense user participation, and the explo- sion of multimedia content have generated an extraordinary interest from computer and social scientists to investigate the traces left by users to understand human behavior online. From this perspective, YouTube can be seen as the largest collection of audiovisual human behavioral data, among which conversational video blogs (vlogs) are one of the basic formats. Conversational vlogs have evolved fro...

  6. Persuasion detection in conversation

    OpenAIRE

    Gilbert, Henry T.

    2010-01-01

    Approved for public release; distribution is unlimited In this thesis, we present a system for annotating persuasion in conversation based on a social-psychological model. We augmented the social model developed by James Cialdini with some of our own categories for annotators to label. The conversations consisted of 37 hostage negotiation transcripts from private and public sources, with all personal information removed from the private source transcripts. We evaluated the level of agre...

  7. Perspective on direct conversion

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W B

    1963-10-15

    The objective of direct conversion is high electrical output for minimum total cost, and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment, and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy, and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (auth)

  8. Conversational flow promotes solidarity.

    Science.gov (United States)

    Koudenburg, Namkje; Postmes, Tom; Gordijn, Ernestine H

    2013-01-01

    Social interaction is fundamental to the development of various aspects of "we-ness". Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here). The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay). Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition) increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed.

  9. Conversational flow promotes solidarity.

    Directory of Open Access Journals (Sweden)

    Namkje Koudenburg

    Full Text Available Social interaction is fundamental to the development of various aspects of "we-ness". Previous research has focused on the role the content of interaction plays in establishing feelings of unity, belongingness and shared reality (a cluster of variables referred to as solidarity here. The present paper is less concerned with content, but focuses on the form of social interaction. We propose that the degree to which conversations flow smoothly or not is, of itself, a cue to solidarity. We test this hypothesis in samples of unacquainted and acquainted dyads who communicate via headsets. Conversational flow is disrupted by introducing a delay in the auditory feedback (vs. no delay. Results of three studies show that smoothly coordinated conversations (compared with disrupted conversations and a control condition increase feelings of belonging and perceptions of group entitativity, independently of conversation content. These effects are driven by the subjective experience of conversational flow. Our data suggest that this process occurs largely beyond individuals' control. We conclude that the form of social interaction is a powerful cue for inferring group solidarity. Implications for the impact of modern communication technology on developing a shared social identity are discussed.

  10. Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

    Science.gov (United States)

    Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

    2011-01-01

    Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

  11. [Cognitive-behavioral therapy of conversion aphonia].

    Science.gov (United States)

    Kuljić, Blagoje

    2004-01-01

    Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

  12. Cognitive-behavioral therapy of conversion aphonia

    Directory of Open Access Journals (Sweden)

    Kuljić Blagoje

    2004-01-01

    Full Text Available Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

  13. Boiler conversions for biomass

    Energy Technology Data Exchange (ETDEWEB)

    Kinni, J [Tampella Power Inc., Tampere (Finland)

    1997-12-31

    Boiler conversions from grate- and oil-fired boilers to bubbling fluidized bed combustion have been most common in pulp and paper industry. Water treatment sludge combustion, need for additional capacity and tightened emission limits have been the driving forces for the conversion. To accomplish a boiler conversion for biofuel, the lower part of the boiler is replaced with a fluidized bed bottom and new fuel, ash and air systems are added. The Imatran Voima Rauhalahti pulverized-peat-fired boiler was converted to bubbling fluidized bed firing in 1993. In the conversion the boiler capacity was increased by 10 % to 295 MWth and NO{sub x} emissions dropped. In the Kymmene Kuusankoski boiler, the reason for conversion was the combustion of high chlorine content biosludge. The emissions have been under general European limits. During the next years, the emission limits will tighten and the boilers will be designed for most complete combustion and compounds, which can be removed from flue gases, will be taken care of after the boiler. (orig.) 3 refs.

  14. Boiler conversions for biomass

    Energy Technology Data Exchange (ETDEWEB)

    Kinni, J. [Tampella Power Inc., Tampere (Finland)

    1996-12-31

    Boiler conversions from grate- and oil-fired boilers to bubbling fluidized bed combustion have been most common in pulp and paper industry. Water treatment sludge combustion, need for additional capacity and tightened emission limits have been the driving forces for the conversion. To accomplish a boiler conversion for biofuel, the lower part of the boiler is replaced with a fluidized bed bottom and new fuel, ash and air systems are added. The Imatran Voima Rauhalahti pulverized-peat-fired boiler was converted to bubbling fluidized bed firing in 1993. In the conversion the boiler capacity was increased by 10 % to 295 MWth and NO{sub x} emissions dropped. In the Kymmene Kuusankoski boiler, the reason for conversion was the combustion of high chlorine content biosludge. The emissions have been under general European limits. During the next years, the emission limits will tighten and the boilers will be designed for most complete combustion and compounds, which can be removed from flue gases, will be taken care of after the boiler. (orig.) 3 refs.

  15. Photovoltaic solar energy conversion

    CERN Document Server

    Bauer, Gottfried H

    2015-01-01

    This concise primer on photovoltaic solar energy conversion invites readers to reflect on the conversion of solar light into energy at the most fundamental level and encourages newcomers to the field to help find meaningful answers on how photovoltaic solar energy conversion can work (better), eventually contributing to its ongoing advancement. The book is based on lectures given to graduate students in the Physics Department at the University of Oldenburg over the last two decades, yet also provides an easy-to-follow introduction for doctoral and postdoctoral students from related disciplines such as the materials sciences and electrical engineering. Inspired by classic textbooks in the field, it reflects the author’s own ideas on how to understand, visualize and eventually teach the microscopic physical mechanisms and effects, while keeping the text as concise as possible so as to introduce interested readers to the field and balancing essential knowledge with open questions.

  16. Catalytic Conversion of Carbohydrates

    DEFF Research Database (Denmark)

    Osmundsen, Christian Mårup

    a renewable route to aromatics. The conversion of biomass by high temperature processes is a desirable prospect due to the high volumetric production rates which can be achieved, and the ability of these types of processes to convert a wide range of substrates. Current processes however typically have rather...... with the production of commodity chemicals from the most abundantly available renewable source of carbon, carbohydrates. The production of alkyl lactates by the Lewis acid catalyzed conversion of hexoses is an interesting alternative to current fermentation based processes. A range of stannosilicates were...... to be an efficient initial conversion step in the utilization of biomass for chemicals production. The shift from an oil based chemical industry to one based on renewable resources is bound to happen sooner or later, however the environmental problems associated with the burning of fossil resources means...

  17. Predictability of Conversation Partners

    Science.gov (United States)

    Takaguchi, Taro; Nakamura, Mitsuhiro; Sato, Nobuo; Yano, Kazuo; Masuda, Naoki

    2011-08-01

    Recent developments in sensing technologies have enabled us to examine the nature of human social behavior in greater detail. By applying an information-theoretic method to the spatiotemporal data of cell-phone locations, [C. Song , ScienceSCIEAS0036-8075 327, 1018 (2010)] found that human mobility patterns are remarkably predictable. Inspired by their work, we address a similar predictability question in a different kind of human social activity: conversation events. The predictability in the sequence of one’s conversation partners is defined as the degree to which one’s next conversation partner can be predicted given the current partner. We quantify this predictability by using the mutual information. We examine the predictability of conversation events for each individual using the longitudinal data of face-to-face interactions collected from two company offices in Japan. Each subject wears a name tag equipped with an infrared sensor node, and conversation events are marked when signals are exchanged between sensor nodes in close proximity. We find that the conversation events are predictable to a certain extent; knowing the current partner decreases the uncertainty about the next partner by 28.4% on average. Much of the predictability is explained by long-tailed distributions of interevent intervals. However, a predictability also exists in the data, apart from the contribution of their long-tailed nature. In addition, an individual’s predictability is correlated with the position of the individual in the static social network derived from the data. Individuals confined in a community—in the sense of an abundance of surrounding triangles—tend to have low predictability, and those bridging different communities tend to have high predictability.

  18. Predictability of Conversation Partners

    Directory of Open Access Journals (Sweden)

    Taro Takaguchi

    2011-09-01

    Full Text Available Recent developments in sensing technologies have enabled us to examine the nature of human social behavior in greater detail. By applying an information-theoretic method to the spatiotemporal data of cell-phone locations, [C. Song et al., Science 327, 1018 (2010SCIEAS0036-8075] found that human mobility patterns are remarkably predictable. Inspired by their work, we address a similar predictability question in a different kind of human social activity: conversation events. The predictability in the sequence of one’s conversation partners is defined as the degree to which one’s next conversation partner can be predicted given the current partner. We quantify this predictability by using the mutual information. We examine the predictability of conversation events for each individual using the longitudinal data of face-to-face interactions collected from two company offices in Japan. Each subject wears a name tag equipped with an infrared sensor node, and conversation events are marked when signals are exchanged between sensor nodes in close proximity. We find that the conversation events are predictable to a certain extent; knowing the current partner decreases the uncertainty about the next partner by 28.4% on average. Much of the predictability is explained by long-tailed distributions of interevent intervals. However, a predictability also exists in the data, apart from the contribution of their long-tailed nature. In addition, an individual’s predictability is correlated with the position of the individual in the static social network derived from the data. Individuals confined in a community—in the sense of an abundance of surrounding triangles—tend to have low predictability, and those bridging different communities tend to have high predictability.

  19. Converse Barrier Certificate Theorem

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2013-01-01

    This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

  20. Dose conversion factors

    International Nuclear Information System (INIS)

    Kocher, D.C.; Eckerman, K.F.

    1992-01-01

    The following is discussed in this report: concepts and quantities used in calculating radiation dose from internal and external exposure. Tabulations of dose conversion factor for internal and external exposure to radionuclides. Dose conversion factors give dose per unit intake (internal) or dose per unit concentration in environment (external). Intakes of radionuclides for internal exposure and concentrations of radionuclides in environment for external exposure are assumed to be known. Intakes and concentrations are obtained, e.g., from analyses of environmental transport and exposure pathways. differences between dosimetry methods for radionuclides and hazardous chemicals are highlighted

  1. Ocean wave energy conversion

    CERN Document Server

    McCormick, Michael E

    2007-01-01

    This volume will prove of vital interest to those studying the use of renewable resources. Scientists, engineers, and inventors will find it a valuable review of ocean wave mechanics as well as an introduction to wave energy conversion. It presents physical and mathematical descriptions of the nine generic wave energy conversion techniques, along with their uses and performance characteristics.Author Michael E. McCormick is the Corbin A. McNeill Professor of Naval Engineering at the U.S. Naval Academy. In addition to his timely and significant coverage of possible environmental effects associa

  2. Magnetohydrodynamic energy conversion

    International Nuclear Information System (INIS)

    Rosa, R.J.

    1987-01-01

    The object of this book is to present a review of the basic principles and practical aspects of magnetohydrodynamic (MHD) energy conversion. The author has tried to give qualitative semiphysical arguments where possible for the benefit of the reader who is unfamiliar with plasma physics. The aim of MHD energy conversion is to apply to a specific practical goal a part of what has become a vast area of science called plasma physics. The author has attempted to note in the text where a broader view might be fruitful and to give appropriate references

  3. Catalytic Conversion of Biofuels

    DEFF Research Database (Denmark)

    Jørgensen, Betina

    This thesis describes the catalytic conversion of bioethanol into higher value chemicals. The motivation has been the unavoidable coming depletion of the fossil resources. The thesis is focused on two ways of utilising ethanol; the steam reforming of ethanol to form hydrogen and the partial oxida...

  4. Electrochemical solar energy conversion

    International Nuclear Information System (INIS)

    Gerischer, H.

    1991-01-01

    The principles of solar energy conversion in photoelectrochemical cells are briefly reviewed. Cells for the generation of electric power and for energy storage in form of electrochemical energy are described. These systems are compared with solid state photovoltaic devices, and the inherent difficulties for the operation of the electrochemical systems are analyzed. (author). 28 refs, 10 figs

  5. Converse Barrier Certificate Theorems

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2016-01-01

    This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

  6. Wavelength conversion devices

    DEFF Research Database (Denmark)

    Mikkelsen, Benny; Durhuus, Terji; Jørgensen, Carsten

    1996-01-01

    system requirements. The ideal wavelength converter should be transparent to the bit rate and signal format and provide an unchirped output signal with both a high extinction ratio and a large signal-to-noise ratio. It should allow conversion to both shorter and longer wavelengths with equal performance...

  7. Conversation and research

    NARCIS (Netherlands)

    Schuurman, Jan Gerrit; Veermans, K.H.

    2001-01-01

    Gordon Pask’s conversation theory was created in the 1970s. The theory encompasses a high-level framework for studying interactions between actors in artificial situations where people co-operate, have conflicts, follow rules, negotiate outcomes, invent new rules together, etc. Sadly, the theory is

  8. Catalyst for hydrocarbon conversion

    International Nuclear Information System (INIS)

    Duhaut, P.; Miquel, J.

    1975-01-01

    A description is given for a catalyst and process for hydrocarbon conversions, e.g., reforming. The catalyst contains an alumina carrier, platinum, iridium, at least one metal selected from uranium, vanadium, and gallium, and optionally halogen in the form of metal halide of one of the aforesaid components. (U.S.)

  9. The Nanticoke conversion study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-04-01

    A study was conducted to assess the conversion of the Nanticoke coal-fired power plant to cleaner burning natural gas combined-cycle gas turbines. The Nanticoke Generating Station on Lake Erie is responsible for more than 50 per cent of Ontario Power Generation's (OPG) coal-fired electricity production. The OPG is proposing to work towards compliance with the newly signed Ozone Annex to the 1991 Canada-United States Air Quality Agreement which will require fossil-fueled power plants in southern Ontario to reduce their smog-causing nitrogen oxides emissions by about 50 per cent by 2007. This study assessed the emission reduction benefits and financial costs of conversion compared to continuing to operate Nanticoke as a coal-fired plant. The analysis includes a base case set of data on fuel prices, retrofit costs, fuel efficiencies, annual capacity factors and other parameters. It was determined that conversion would cost the average household less than $3 per month on their electricity bill. Conversion would also reduce emissions nitrogen oxide, a major smog pollutant, by 83 per cent and the particulates that form the most health-threatening portion of smog would be reduced by 100 per cent. 15 tabs., 1 fig.

  10. Leadership is a conversation.

    Science.gov (United States)

    Groysberg, Boris; Slind, Michael

    2012-06-01

    Globalization and new technologies have sharply reduced the efficacy of command-and-control management and its accompanying forms of corporate communication. In the course of a recent research project, the authors concluded that by talking with employees, rather than simply issuing orders, leaders can promote operational flexibility, employee engagement, and tight strategic alignment. Groysberg and Slind have identified four elements of organizational conversation that reflect the essential attributes of interpersonal conversation: intimacy, interactivity, inclusion, and intentionality. Intimacy shifts the focus from a top-down distribution of information to a bottom-up exchange of ideas. Organizational conversation is less corporate in tone and more casual. And it's less about issuing and taking orders than about asking and answering questions. Interactivity entails shunning the simplicity of monologue and embracing the unpredictable vitality of dialogue. Traditional one-way media-print and broadcast, in particular-give way to social media buttressed by social thinking. Inclusion turns employees into full-fledged conversation partners, entitling them to provide their own ideas, often on company channels. They can create content and act as brand ambassadors, thought leaders, and storytellers. Intentionality enables leaders and employees to derive strategically relevant action from the push and pull of discussion and debate.

  11. Predicting AD conversion

    DEFF Research Database (Denmark)

    Liu, Yawu; Mattila, Jussi; Ruiz, Miguel �ngel Mu�oz

    2013-01-01

    To compare the accuracies of predicting AD conversion by using a decision support system (PredictAD tool) and current research criteria of prodromal AD as identified by combinations of episodic memory impairment of hippocampal type and visual assessment of medial temporal lobe atrophy (MTA) on MRI...

  12. Conversion tables. Appendix I

    International Nuclear Information System (INIS)

    McKerrell, H.

    1975-01-01

    Tables are presented for the conversion of standard (5568 year half-life) C-14 dates to calendar years. The major part of the data converts C-14 dates to tree-ring years: additional data are given, based on the Egyptian historical curve. (U.K.)

  13. Wavelength conversion technology

    DEFF Research Database (Denmark)

    Stubkjær, Kristian

    1998-01-01

    Optical wavelength conversion is currently attracting much interest. This is because it enables full flexibility and eases management of WDM fibre networks. The tutorial will review existing and potential application areas. Examples of node architectures and network demonstrators that use wavelen...

  14. Our Digital Conversion

    Science.gov (United States)

    Edwards, Mark

    2012-01-01

    In this article, the author describes their digital conversion initiative at Mooresville Graded School District. The project has placed a MacBook Air laptop in the hands of every 3rd through 12th grader and their teachers in the district over the past four years, with over 5,000 computers distributed. But they believe their academic successes have…

  15. Wind energy conversion system

    Science.gov (United States)

    Longrigg, Paul

    1987-01-01

    The wind energy conversion system includes a wind machine having a propeller connected to a generator of electric power, the propeller rotating the generator in response to force of an incident wind. The generator converts the power of the wind to electric power for use by an electric load. Circuitry for varying the duty factor of the generator output power is connected between the generator and the load to thereby alter a loading of the generator and the propeller by the electric load. Wind speed is sensed electro-optically to provide data of wind speed upwind of the propeller, to thereby permit tip speed ratio circuitry to operate the power control circuitry and thereby optimize the tip speed ratio by varying the loading of the propeller. Accordingly, the efficiency of the wind energy conversion system is maximized.

  16. Clinical linguistics: conversational reflections.

    Science.gov (United States)

    Crystal, David

    2013-04-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference participants during that time.

  17. Conversations with Miss Jane

    Directory of Open Access Journals (Sweden)

    Geneviève Fabre

    2006-05-01

    Full Text Available Considering the wide range of conversations in the autobiography, this essay will attempt to appraise the importance of these verbal exchanges in relation to the overall narrative structure of the book and to the prevalent oral tradition in Louisiana culture, as both an individual and communal expression. The variety of circumstances, the setting and staging, the interlocutors , and the complex intersection of time and place, of stories and History, will be examined; in these conversations with Miss Jane many actors participate, from  the interviewer-narrator, to most characters; even the reader becomes involved.Speaking, hearing, listening, keeping silent is an elaborate ritual that performs many functions; besides conveying news or rumors, it imparts information on the times and on the life of a “representative” woman whose existence - spanning a whole century- is both singular and emblematic. Most importantly this essay will analyse the resonance of an eventful and often dramatic era on her sensibility and conversely show how her evolving sensibility informs that history and draws attention to aspects that might have passed unnoticed or be forever silenced. Jane’s desire for liberty and justice is often challenged as she faces the possibilities of life or death.Conversations build up a complex, often contradictory, but compelling portrait: torn between silence and vehemence, between memories and the urge to meet the future, Jane summons body and mind to find her way through the maze of a fast changing world; self-willed and obstinate she claims her right to speak, to express with wit and wisdom her firm belief in the word, in the ability to express deep seated convictions and faith and a whole array of feelings and emotions.

  18. Conversion of Questionnaire Data

    International Nuclear Information System (INIS)

    Powell, Danny H.; Elwood, Robert H. Jr.

    2011-01-01

    During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC and A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC and A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relative risk values for all of the basic MC and A tasks performed in the facility. If a specific material protection, control, and accountability (MPC and A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC and A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC and A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A

  19. Embodied Conversational Agents in Clinical Psychology

    DEFF Research Database (Denmark)

    Provoost, Simon; Lau, Ho Ming; Ruwaard, Jeroen

    2017-01-01

    BACKGROUND: Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors....... OBJECTIVE: We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research. METHODS: Given the large variety of applied methodologies, types...... applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application...

  20. Nuclear spin conversion in formaldehyde

    OpenAIRE

    Chapovsky, Pavel L.

    2000-01-01

    Theoretical model of the nuclear spin conversion in formaldehyde (H2CO) has been developed. The conversion is governed by the intramolecular spin-rotation mixing of molecular ortho and para states. The rate of conversion has been found equal 1.4*10^{-4}~1/s*Torr. Temperature dependence of the spin conversion has been predicted to be weak in the wide temperature range T=200-900 K.

  1. Microbial Energy Conversion

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, Merry [American Society for Microbiology (ASM), Washington, DC (United States); Wall, Judy D. [Univ. of Missouri, Columbia, MO (United States)

    2006-10-01

    The American Academy of Microbiology convened a colloquium March 10-12, 2006, in San Francisco, California, to discuss the production of energy fuels by microbial conversions. The status of research into various microbial energy technologies, the advantages and disadvantages of each of these approaches, research needs in the field, and education and training issues were examined, with the goal of identifying routes for producing biofuels that would both decrease the need for fossil fuels and reduce greenhouse gas emissions. Currently, the choices for providing energy are limited. Policy makers and the research community must begin to pursue a broader array of potential energy technologies. A diverse energy portfolio that includes an assortment of microbial energy choices will allow communities and consumers to select the best energy solution for their own particular needs. Funding agencies and governments alike need to prepare for future energy needs by investing both in the microbial energy technologies that work today and in the untested technologies that will serve the world’s needs tomorrow. More mature bioprocesses, such as ethanol production from starchy materials and methane from waste digestors, will find applications in the short term. However, innovative techniques for liquid fuel or biohydrogen production are among the longer term possibilities that should also be vigorously explored, starting now. Microorganisms can help meet human energy needs in any of a number of ways. In their most obvious role in energy conversion, microorganisms can generate fuels, including ethanol, hydrogen, methane, lipids, and butanol, which can be burned to produce energy. Alternatively, bacteria can be put to use in microbial fuel cells, where they carry out the direct conversion of biomass into electricity. Microorganisms may also be used some day to make oil and natural gas technologies more efficient by sequestering carbon or by assisting in the recovery of oil and

  2. Infrared up-conversion microscope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented an up-conversion infrared microscope (110) arranged for imaging an associated object (130), wherein the up-conversion infrared microscope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein an objective optical...

  3. Infrared up-conversion telescope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented to an up-conversion infrared telescope (110) arranged for imaging an associated scene (130), wherein the up-conversion infrared telescope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein a first optical...

  4. The FLIC conversion codes

    International Nuclear Information System (INIS)

    Basher, J.C.

    1965-05-01

    This report describes the FORTRAN programmes, FLIC 1 and FLIC 2. These programmes convert programmes coded in one dialect of FORTRAN to another dialect of the same language. FLIC 1 is a general pattern recognition and replacement programme whereas FLIC 2 contains extensions directed towards the conversion of FORTRAN II and S2 programmes to EGTRAN 1 - the dialect now in use on the Winfrith KDF9. FII or S2 statements are replaced where possible by their E1 equivalents; other statements which may need changing are flagged. (author)

  5. Zinc phosphate conversion coatings

    Science.gov (United States)

    Sugama, Toshifumi

    1997-01-01

    Zinc phosphate conversion coatings for producing metals which exhibit enhanced corrosion prevention characteristics are prepared by the addition of a transition-metal-compound promoter comprising a manganese, iron, cobalt, nickel, or copper compound and an electrolyte such as polyacrylic acid, polymethacrylic acid, polyitaconic acid and poly-L-glutamic acid to a phosphating solution. These coatings are further improved by the incorporation of Fe ions. Thermal treatment of zinc phosphate coatings to generate .alpha.-phase anhydrous zinc phosphate improves the corrosion prevention qualities of the resulting coated metal.

  6. The FLIC conversion codes

    Energy Technology Data Exchange (ETDEWEB)

    Basher, J C [General Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1965-05-15

    This report describes the FORTRAN programmes, FLIC 1 and FLIC 2. These programmes convert programmes coded in one dialect of FORTRAN to another dialect of the same language. FLIC 1 is a general pattern recognition and replacement programme whereas FLIC 2 contains extensions directed towards the conversion of FORTRAN II and S2 programmes to EGTRAN 1 - the dialect now in use on the Winfrith KDF9. FII or S2 statements are replaced where possible by their E1 equivalents; other statements which may need changing are flagged. (author)

  7. Moodle 20 Course Conversion

    CERN Document Server

    Wild, Ian

    2011-01-01

    With clear instructions and plenty of screenshots, this book provides all the support and guidance you will need as you begin to convert your teaching to Moodle. Step-by-step tutorials use real-world examples to show you how to convert to Moodle in the most efficient and effective ways possible. Moodle Course Conversion carefully illustrates how Moodle can be used to teach content and ideas and clearly demonstrates the advantages of doing so. This book is for teachers, tutors, and lecturers who already have a large body of teaching material and want to use Moodle to enhance their course, rathe

  8. Solar energy conversion

    CERN Document Server

    Likhtenshtein, Gertz I

    2012-01-01

    Finally filling a gap in the literature for a text that also adopts the chemist?s view of this hot topic, Prof Likhtenshtein, an experienced author and internationally renowned scientist, considers different physical and engineering aspects in solar energy conversion. From theory to real-life systems, he shows exactly which chemical reactions take place when converting light energy, providing an overview of the chemical perspective from fundamentals to molecular harvesting systems and solar cells. This essential guide will thus help researchers in academia and industry better understa

  9. Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment

    OpenAIRE

    Belli, Hasan

    2014-01-01

    Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative expe...

  10. Communication in conversation in stroke patients.

    Science.gov (United States)

    Rousseaux, Marc; Daveluy, Walter; Kozlowski, Odile

    2010-07-01

    In stroke patients, it has been suggested that communication disorders could result from lexical and syntactic disorders in left hemisphere lesions and from pragmatics problems in right lesions. However, we have little information on patient behaviour in dyadic communication, especially in conversation. Here, we analyzed the various processes participating in communication difficulties at the rehabilitation phase (1-6 months) post-stroke, in order to define the main mechanisms of verbal and non-verbal communication (VC, NVC) disorders and their relationship with aphasic disorders. Sixty-three patients were recruited, who belonged to six groups, with left or right cortico-sub-cortical (L-CSC, R-CSC) or sub-cortical (L-SC, R-SC), frontal (Fro) or posterior fossa (PF) lesions. They were compared with an equivalent control group (gender, age, education level). We used the Lille Communication Test, which comprises three parts: participation to communication (greeting, attention, engagement), verbal communication (verbal comprehension, speech outflow, intelligibility, word production, syntax, verbal pragmatics and verbal feedback) and non-verbal communication (understanding gestures, affective expressivity, producing gestures, pragmatics and feedback). We also used the Functional Communication Profile and the Boston Diagnostic Aphasia Examination (BDAE). Decrease in participation was found in L-CSC, R-CSC and Fro patients. Verbal communication was essentially disrupted in L-SCS and L-SC groups, including by verbal pragmatic disorders, and to a lesser degree in frontal patients. Nonverbal communication was mainly affected in R-CSC patients, especially by pragmatic difficulties. L-CSC patients showed an increase in gesture production, compensating for aphasia. In conclusion, communication disorders were relatively complex and could not be summarised by syntactical and lexical difficulties in left stroke and pragmatic problems in right stroke. The former also showed severe

  11. Conversion program in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, E.B. [Studsvik Nuclear AB, Nykoeping (Sweden)

    1997-08-01

    The conversion of the Swedish 50 MW R2 reactor from HEU to LEU fuel has been successfully accomplished over a 16 cycles long process. The conversion started in January 1991 with the introduction of 6 LEU assemblies in the 8*8 core. The first all LEU core was loaded in March 1993 and physics measurements were performed for the final licensing reports. A total of 142 LEU fuel assemblies have been irradiated up until September 1994 without any fuel incident. The operating licence for the R2 reactor was renewed in mid 1994 taking into account new fuel type. The Swedish Nuclear Inspectorate (SKI) pointed out one crucial problem with the LEU operation, that the back end of the LEU fuel cycle has not yet been solved. For the HEU fuel Sweden had the reprocessing alternative. The country is now relying heavily on the success of the USDOEs Off Site Fuels Policy to take back the spent fuel from the research reactors. They have in the meantime increased their intermediate storage facilities. There is, however, a limit both in time and space for storage of MTR-type of assemblies in water. The penalty of the lower thermal neutron flux in LEU cores has been reduced by improvements of the new irradiation rigs and by fine tuning the core calculations. The Studsvik code package, CASMO-SIMULATE, widely used for ICFM in LWRs has been modified to suit the compact MTR type of core.

  12. Microbial conversion technologies

    Energy Technology Data Exchange (ETDEWEB)

    Lau, P. [National Research Council of Canada, Ottawa, ON (Canada). Bioconversion and Sustainable Development

    2006-07-01

    Microbes are a biomass and an valuable resource. This presentation discussed microbial conversion technologies along with background information on microbial cells, their characteristics and microbial diversity. Untapped opportunities for microbial conversion were identified. Metagenomic and genome mining approaches were also discussed, as they can provide access to uncultivated or unculturable microorganisms in communal populations and are an unlimited resource for biocatalysts, novel genes and metabolites. Genome mining was seen as an economical approach. The presentation also emphasized that the development of microbial biorefineries would require significant insights into the relevant microorganisms and that biocatalysts were the ultimate in sustainability. In addition, the presentation discussed the natural fibres initiative for biochemicals and biomaterials. Anticipated outputs were identified and work in progress of a new enzyme-retting cocktail to provide diversity and/or consistency in fibre characteristics for various applications were also presented. It was concluded that it is necessary to leverage understanding of biological processes to produce bioproducts in a clean and sustainable manner. tabs., figs.

  13. Communal biomass conversion plants

    International Nuclear Information System (INIS)

    1991-06-01

    The Coordinating Committee set up by the Danish government in 1986 were given the responsibility of investigating the potentials for biomass conversion plants in Denmark, especially in relation to agricultural, environmental and energy aspects. The results of the Committee's plan of management for this project are presented. This main report covers 13 background reports which deal with special aspects in detail. The report describes the overall plan of management, the demonstration and follow-up programme and the individual biogas demonstration plants. Information gained from these investigations is presented. The current general status, (with emphasis on the technical and economical aspects) and the prospects for the future are discussed. The interest other countries have shown in Danish activities within the field of biogas production is described, and the possibilities for Danish export of technology and know-how in this relation are discussed. It is claimed that Denmark is the first country that has instigated a coordinated development programme for biomass conversion plants. (AB) 24 refs

  14. Anxiety Disorders

    Science.gov (United States)

    ... Registry Residents & Medical Students Residents Medical Students Patients & Families Mental Health Disorders/Substance Use Find a Psychiatrist Addiction and Substance Use Disorders ADHD Anxiety Disorders Autism Spectrum Disorder Bipolar Disorders Depression Eating Disorders Obsessive-Compulsive ...

  15. Mental Disorders

    Science.gov (United States)

    Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play ...

  16. Schizoaffective disorder

    Science.gov (United States)

    ... or do not improve with treatment Thoughts of suicide or of harming others Alternative Names Mood disorder - schizoaffective disorder; Psychosis - schizoaffective disorder Images Schizoaffective disorder ...

  17. Conversation with Meir Sternberg

    Directory of Open Access Journals (Sweden)

    Federico Pianzola

    2011-07-01

    Full Text Available Below are the videos of the interview recorded the 21st May 2011 in Fribourg (CH, in occasion of the first RRN conference. Conversation with Meir Sternberg. Part 1 of 8 - Narratology: classical and postclassical studies. Part 2 of 8 - The development of an original theoretical framework. Part 3 of 8 - Sternberg and Genette: different ways for the same problems. Part 4 of 8 - «There are no forms except in terms of functions». Part 5 of 8 - A life writing articles: so many papers and just four books. Part 6 of 8 - Two arguments against mimetical approaches to narrative. Part 7 of 8 - «Narrative is not given, it is a construct». Part 8 of 8 - The proteus principle. the many-to-many correspondence between forms and functions.

  18. Thermodynamics and energy conversion

    CERN Document Server

    Struchtrup, Henning

    2014-01-01

    This textbook gives a thorough treatment of engineering thermodynamics with applications to classical and modern energy conversion devices.   Some emphasis lies on the description of irreversible processes, such as friction, heat transfer and mixing, and the evaluation of the related work losses. Better use of resources requires high efficiencies, therefore the reduction of irreversible losses should be seen as one of the main goals of a thermal engineer. This book provides the necessary tools.   Topics include: car and aircraft engines,  including Otto, Diesel and Atkinson cycles, by-pass turbofan engines, ramjet and scramjet;  steam and gas power plants, including advanced regenerative systems, solar tower, and compressed air energy storage; mixing and separation, including reverse osmosis, osmotic powerplants, and carbon sequestration; phase equilibrium and chemical equilibrium, distillation, chemical reactors, combustion processes, and fuel cells; the microscopic definition of entropy.    The book i...

  19. Communal biomass conversion plants

    International Nuclear Information System (INIS)

    Holm-Nielsen, J.B.; Huntingford, S.; Halberg, N.

    1993-03-01

    The aim was to show the agricultural advantages of farmers being in connection with Communal Biogas Plant. Whether a more environmentally protectire distribution of plant nutrients from animal manure takes place through a biogas plants distribution system, whether the nitrogen in the digested slurry is better utilized and whether the connection results in slurry transportation-time reduction, are discussed. The average amount of nitrogen from animal manure used per hectare was reduced. The area of manure distribution was larger. The nitrogen efficiency was increased when using digested slurry and purchase of N mineral fertilizer decreased, resulting in considerable reduction in nitrogen leaching. The amount of slurry delivered to the local storage tanks was approximately 45 per cent of the total amount treated on the biogas plant. Conditions of manure transport improved greatly as this was now the responsibility of the communal biomass conversion plant administrators. (AB) (24 refs.)

  20. Power conversion technologies

    Energy Technology Data Exchange (ETDEWEB)

    Newton, M. A.

    1997-02-01

    The Power Conversion Technologies thrust area identifies and sponsors development activities that enhance the capabilities of engineering at Lawrence Livermore National Laboratory (LLNL) in the area of solid- state power electronics. Our primary objective is to be a resource to existing and emerging LLNL programs that require advanced solid-state power electronic technologies.. Our focus is on developing and integrating technologies that will significantly impact the capability, size, cost, and reliability of future power electronic systems. During FY-96, we concentrated our research efforts on the areas of (1) Micropower Impulse Radar (MIR); (2) novel solid-state opening switches; (3) advanced modulator technology for accelerators; (4) compact accelerators; and (5) compact pulse generators.

  1. The Role of Conversation Policy in Carrying Out Agent Conversations

    International Nuclear Information System (INIS)

    Link, Hamilton E.; Phillips, Laurence R.

    1999-01-01

    Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word ''policy'' connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification

  2. Cooperative down-conversion of UV light in disordered scheelitelike Yb-doped NaGd(MoO4)2 and NaLa(MoO4)2 crystals

    Science.gov (United States)

    Subbotin, K. A.; Osipova, Yu. N.; Lis, D. A.; Smirnov, V. A.; Zharikov, E. V.; Shcherbakov, I. A.

    2017-07-01

    Concentration series of disordered scheelitelike Yb:NaGd(MoO4)2 and Yb:NaLa(MoO4)2 single crystals are grown by the Czochralski method. The actual concentrations of Yb3+ ions in the crystals are determined by optical-absorption spectroscopy. The luminescence of Yb3+ ions in these crystals in the region of 1 μm is studied under UV and IR excitation. In the case of UV excitation, this luminescence appears as a result of nonradiative excited state energy transfer from donor centers of unknown nature to ytterbium. The character of the concentration dependence of Yb3+ luminescence indicates that the energy transfer at high Yb concentrations occurs with active participation of a cooperative mechanism, according to which the excitation energy of one donor center is transferred simultaneously to two Yb3+ ions. In other words, the quantum yield of this transfer exceeds unity, which can be used to increase the efficiency of crystalline silicon (c-Si) solar cells.

  3. Factors determining conversion of laparoscopic to open cholecystectomy

    Directory of Open Access Journals (Sweden)

    Tapash Kumar Maitra

    2017-07-01

    Full Text Available Background and objectives:Laparoscopic cholecystectomy (LC has virtually replaced conventional open cholecystectomy (OC as the standard procedure of treatment for cholelithiasis and cholecystitis. However, OC sometimes becomes a necessity considering the feasibility and safety of the surgical procedure. But the factors that demand conversion from LC to OC differ widely. The present study aimed to determine the prevalence of conversion from LC to OC and to assess the causes of conversion and risk factors related to conversion. Methods: The study was conducted in a referral hospital – ‘Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM’ from September 2014 to September 2016. Cases of cholelithiasis with or without cholecystitis, and other gall bladder pathology were included in the study. A team of experienced surgeon performed LC of all selected cases. The causes of conversion to OC were systematically recorded by the surgical team and the risk factors (age, sex, obesity, history of previous abdominal surgery, gallbladder thickness related to conversion from LC to OC was investigated. Results: A total of 261 (M / F = 87 /174 patients were considered eligible for the study. The mean age of all patients was 43 (±1.75 years. For the male and female groups the mean ages were 44±1.9 and 42±1.6 years respectively. Of the total 261 cases, 210 (80.5% patients had cholelithiasis with chronic cholecystitis, 47 (18.0% had gallbladder stone plus acute cholecystitis and 4 (1.5% had gallbladder polyp. Open conversion was required in case of 19 patients. Thus, overall conversion rate was 7.3%. The common causes of conversion were a difficulty in defining Calot’s triangle (42.1%, b injury to cystic artery (21.1% and c injury to bile duct (15.8%. Both male and female had equal risk for conversion. The investigated risk factors like history of previous abdominal surgery, preoperative ERCP, acute

  4. Dissociative disorders in DSM-5.

    Science.gov (United States)

    Spiegel, David; Lewis-Fernández, Roberto; Lanius, Ruth; Vermetten, Eric; Simeon, Daphne; Friedman, Matthew

    2013-01-01

    The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. Dissociative identity disorder will include reference to possession as well as identity fragmentation, to make the disorder more applicable to culturally diverse situations. Dissociative amnesia will include dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia but does not always include confused wandering or loss of personality identity. Depersonalization disorder will include derealization as well, since the two often co-occur. A dissociative subtype of posttraumatic stress disorder (PTSD), defined by the presence of depersonalization or derealization in addition to other PTSD symptoms, is being recommended, based upon new epidemiological and neuroimaging evidence linking it to an early life history of adversity and a combination of frontal activation and limbic inhibition. Conversion disorder (functional neurological symptom disorder) will likely remain with the somatic symptom disorders, despite considerable dissociative comorbidity.

  5. Nanomaterials for photovoltaic conversion

    International Nuclear Information System (INIS)

    Davenas, J.; Ltaief, A.; Barlier, V.; Boiteux, G.; Bouazizi, A.

    2008-01-01

    A promising route for photovoltaic conversion has emerged from the combination of electroactive nanomaterials and small bandgap polymers. The formation of bulk heterojunctions resulting from the extended interfaces leads to efficient dissociation of the charge pairs generated under sunlight shown by the rapid extinction of the polymer photoluminescence for increasing contents of fullerenes or TiO 2 nanoparticles in MEH-PPV or PVK. Unconventional elaboration routes of the blends have been developed to increase the nanofiller dispersion and inhibit phase separation at high concentration. The size reduction of the acceptor domains led to a complete quenching of the radiative recombinations, obtained by specific solvent processing of MEH-PPV / C 60 nanocomposites or sol gel elaboration of TiO 2 nanoparticles in a PVK film. A simultaneous increase of the photocurrents could be achieved by the dispersion and size optimisation of the nanofillers. In situ generation of silver particles in MEH-PPV provides an example of enhanced charge separation induced by the plasmon resonance at the metal/polymer interface. The strong influence of the molecular morphology on the nanocomposite properties emphasizes the large improvements which can still be gained on the performances of organic solar cells

  6. Overview of fuel conversion

    International Nuclear Information System (INIS)

    Green, A.E.S.

    1991-01-01

    The conversion of solid fuels to cleaner-burning and more user-friendly solid liquid or gaseous fuels spans many technologies. In this paper, the authors consider coal, residual oil, oil shale, tar sends tires, municipal oil waste and biomass as feedstocks and examine the processes which can be used in the production of synthetic fuels for the transportation sector. The products of mechanical processing to potentially usable fuels include coal slurries, micronized coal, solvent refined coal, vegetable oil and powdered biomall. The thermochemical and biochemical processes considered include high temperature carbide production, liquefaction, gasification, pyrolysis, hydrolysis-fermentation and anaerobic digestion. The products include syngas, synthetic natural gas, methanol, ethanol and other hydrocarbon oxygenates synthetic gasoline and diesel and jet engine oils. The authors discuss technical and economic aspects of synthetic fuel production giving particular attention and literature references to technologies not discussed in the five chapters which follow. Finally the authors discuss economic energy, and environmental aspects of synthetic fuels and their relationship to the price of imported oil

  7. Geothermal energy conversion facility

    Energy Technology Data Exchange (ETDEWEB)

    Kutscher, C.F.

    1997-12-31

    With the termination of favorable electricity generation pricing policies, the geothermal industry is exploring ways to improve the efficiency of existing plants and make them more cost-competitive with natural gas. The Geothermal Energy Conversion Facility (GECF) at NREL will allow researchers to study various means for increasing the thermodynamic efficiency of binary cycle geothermal plants. This work has received considerable support from the US geothermal industry and will be done in collaboration with industry members and utilities. The GECF is being constructed on NREL property at the top of South Table Mountain in Golden, Colorado. As shown in Figure 1, it consists of an electrically heated hot water loop that provides heating to a heater/vaporizer in which the working fluid vaporizes at supercritical or subcritical pressures as high as 700 psia. Both an air-cooled and water-cooled condenser will be available for condensing the working fluid. In order to minimize construction costs, available equipment from the similar INEL Heat Cycle Research Facility is being utilized.

  8. Tree value conversion standards revisited

    Science.gov (United States)

    Paul S. DeBald; Martin E. Dale; Martin E. Dale

    1991-01-01

    Updated tree value conversion standards (TVCS) are presented for 12 important hardwood species of the oak-hickory forest. These updated standards-developed for each species by butt-log grade, merchantable height, and diameter at breast height-reflect the changes in lumber prices and in conversion costs which have occurred since 1976 when the original TVCS were...

  9. Optimization theory for ballistic conversion

    NARCIS (Netherlands)

    Xie, Yanbo; Versluis, Michel; van den Berg, Albert; Eijkel, Jan C.T.

    2016-01-01

    The growing demand of renewable energy stimulates the exploration of new materials and methods for clean energy. We recently demonstrated a high efficiency and power density energy conversion mechanism by using jetted charged microdroplets, termed as ballistic energy conversion. Hereby, we model and

  10. Career conversations in vocational schools

    NARCIS (Netherlands)

    Mittendorff, K.M.; Brok, den P.J.; Beijaard, D.

    2010-01-01

    The purpose of this study was to examine career conversations between teachers and students in competence-based vocational education in the Netherlands. A total of 32 career conversations were observed and analysed with respect to four elements: content, teacher activities, student activities and

  11. Improvement of skeleton conversion in ICRP reference phantom conversion project

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong [Dept. of Nuclear Engineering, Hanyang University, Seoul (Korea, Republic of); Kim, Seong Hoon [Dept. of Radiation Oncology, College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2014-11-15

    In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future.

  12. Improvement of skeleton conversion in ICRP reference phantom conversion project

    International Nuclear Information System (INIS)

    Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong; Kim, Seong Hoon

    2014-01-01

    In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future

  13. Direct conversion of fusion energy

    International Nuclear Information System (INIS)

    Johansson, Markus

    2003-03-01

    Deuterium and tritium are expected to be used as fuel in the first fusion reactors. Energy is released as kinetic energy of ions and neutrons, when deuterium reacts with tritium. One way to convert the kinetic energy to electrical energy, is to let the ions and neutrons hit the reactor wall and convert the heat that is caused by the particle bombardment to electrical energy with ordinary thermal conversion. If the kinetic energy of the ions instead is converted directly to electrical energy, a higher efficiency of the energy conversion is possible. The majority of the fusion energy is released as kinetic energy of neutrons, when deuterium reacts with tritium. Fusion reactions such as the D-D reactions, the D- 3 He reaction and the p- 11 B reaction, where a larger part of the fusion energy becomes kinetic energy of charged particles, appears therefore more suitable for direct conversion. Since they have lower reactivity than the D-T reaction, they need a larger βB 2 0 to give sufficiently high fusion power density. Because of this, the fusion configurations spherical torus (ST) and field-reversed configuration (FRC), where high β values are possible, appear interesting. Rosenbluth and Hinton come to the conclusion that efficient direct conversion isn't possible in closed field line systems and that open geometries, which facilitate direct conversion, provide inadequate confinement for D- 3 He. It is confirmed in this study that it doesn't seem possible to achieve as high direct conversion efficiency in closed systems as in open systems. ST and FRC fusion power plants that utilize direct conversion seem however interesting. Calculations with the help of Maple indicate that the reactor parameters needed for a D-D ST and a D 3 He ST hopefully are possible to achieve. The best energy conversion option for a D-D or D 3 He ST appears to be direct electrodynamic conversion (DEC) together with ordinary thermal conversion or liquid metal MHD conversion (LMMHD). For a D

  14. Conversion of Abbandoned Military Areas

    Directory of Open Access Journals (Sweden)

    Daiva Marcinkevičiūtė

    2011-03-01

    Full Text Available The article analyses the situation of abandoned military sites, their value and significance of their conservation. It also reviews their impact on their environment and their potential in tourism, environmental, economic and social spheres. Further the positive experiences in military sites' conversion are studied. The importance of society's involvement in the conversions is discussed. The situation of XIX-XX age's military object's, the significance of their conservation and their potential in tourism market is separately analysed. The results of two researches are introduced, one of which inquires about the Lithuanian military objects' potential in tourism sphere, another one explores the possibilities of conversion. Article in Lithuanian

  15. Direct conversion of fusion energy

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, Markus

    2003-03-01

    Deuterium and tritium are expected to be used as fuel in the first fusion reactors. Energy is released as kinetic energy of ions and neutrons, when deuterium reacts with tritium. One way to convert the kinetic energy to electrical energy, is to let the ions and neutrons hit the reactor wall and convert the heat that is caused by the particle bombardment to electrical energy with ordinary thermal conversion. If the kinetic energy of the ions instead is converted directly to electrical energy, a higher efficiency of the energy conversion is possible. The majority of the fusion energy is released as kinetic energy of neutrons, when deuterium reacts with tritium. Fusion reactions such as the D-D reactions, the D-{sup 3}He reaction and the p-{sup 11}B reaction, where a larger part of the fusion energy becomes kinetic energy of charged particles, appears therefore more suitable for direct conversion. Since they have lower reactivity than the D-T reaction, they need a larger {beta}B{sup 2}{sub 0} to give sufficiently high fusion power density. Because of this, the fusion configurations spherical torus (ST) and field-reversed configuration (FRC), where high {beta} values are possible, appear interesting. Rosenbluth and Hinton come to the conclusion that efficient direct conversion isn't possible in closed field line systems and that open geometries, which facilitate direct conversion, provide inadequate confinement for D-{sup 3}He. It is confirmed in this study that it doesn't seem possible to achieve as high direct conversion efficiency in closed systems as in open systems. ST and FRC fusion power plants that utilize direct conversion seem however interesting. Calculations with the help of Maple indicate that the reactor parameters needed for a D-D ST and a D{sub 3} He ST hopefully are possible to achieve. The best energy conversion option for a D-D or D{sub 3} He ST appears to be direct electrodynamic conversion (DEC) together with ordinary thermal conversion

  16. 5 CFR 317.302 - Conversion procedures.

    Science.gov (United States)

    2010-01-01

    ... conversion. (2) Pay. Upon conversion to the Senior Executive Service, an employee's SES rate will be... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion procedures. 317.302 Section... IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.302 Conversion...

  17. Red-yellow marrow conversion: Its effect on the location of some solitary bone lesions

    International Nuclear Information System (INIS)

    Kricun, M.E.

    1985-01-01

    The location of red marrow related bone lesions is dependent upon the distribution of red marrow. It is altered by the normal conversion of red marrow to yellow (fat) marrow and by the reconversion of yellow marrow to red marrow caused by marrow infiltrating disorders or marrow stress disorders. (orig.)

  18. Parents' Strategies to Elicit Autobiographical Memories in Autism Spectrum Disorders, Developmental Language Disorders and Typically Developing Children

    Science.gov (United States)

    Goldman, Sylvie; DeNigris, Danielle

    2015-01-01

    Conversations about the past support the development of autobiographical memory. Parents' strategies to elicit child's participation and recall during past event conversations were compared across three school-age diagnostic groups: autism spectrum disorder (ASD, n = 11), developmental language disorders (n = 11) and typically developing (TD,…

  19. Conversational evidence in therapeutic dialogue.

    Science.gov (United States)

    Strong, Tom; Busch, Robbie; Couture, Shari

    2008-07-01

    Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

  20. HYDROKINETIC ENERGY CONVERSION SYSTEMS: PROSPECTS ...

    African Journals Online (AJOL)

    eobe

    Hydrokinetic energy conversion systems utilize the kinetic energy of flowing water bodies with little or no head to generate ... generator. ... Its principle of operation is analogous to that of wind ..... Crisis-solar and wind power systems, 2009,.

  1. Conversion electrons in the SDC

    International Nuclear Information System (INIS)

    Wicklund, A.B.

    1991-01-01

    We summarize a preliminary analysis of the rates for conversion electrons in the SDC detector, relative to other interesting sources of prompt electrons. We have used Papageno V3.30, and other available NLO calculations to estimate inclusive rates in the central region (η less than 2.0), and we have cross checked these using CDF data at 1.8 TeV. We have considered three sources of ''isolated'' electrons, namely inclusive W/Z production; top quark (Mt=140); and QCD prompt photon production, followed by conversion in 10% XO. This value approximates the inner silicon detector at SDC. Additional conversions will occur in the outer tracking chamber, but the trigger and track reconstruction efficiency will be lower. We have also considered ''nonisolated'' leptons coming from inclusive bottom production, photon conversions resulting from π 0 ,η production in jets, and high pt hadrons faking electrons

  2. Energy conversion at dipolarization fronts

    Science.gov (United States)

    Khotyaintsev, Yu. V.; Divin, A.; Vaivads, A.; André, M.; Markidis, S.

    2017-02-01

    We use multispacecraft observations by Cluster in the Earth's magnetotail and 3-D particle-in-cell simulations to investigate conversion of electromagnetic energy at the front of a fast plasma jet. We find that the major energy conversion is happening in the Earth (laboratory) frame, where the electromagnetic energy is being transferred from the electromagnetic field to particles. This process operates in a region with size of the order several ion inertial lengths across the jet front, and the primary contribution to E·j is coming from the motional electric field and the ion current. In the frame of the front we find fluctuating energy conversion with localized loads and generators at sub-ion scales which are primarily related to the lower hybrid drift instability excited at the front; however, these provide relatively small net energy conversion.

  3. Ocean energy conversion - A reality

    Digital Repository Service at National Institute of Oceanography (India)

    Sarkar, A.

    -depth analysis of application and achievements of OTEC, tidal energy, impact of astronomical forces on tide, prospects of tidal power plants, wave energy conversion and its mathematical approach for both linear and non-linear waves, economic viability, problems...

  4. Enzymes for improved biomass conversion

    Science.gov (United States)

    Brunecky, Roman; Himmel, Michael E.

    2016-02-02

    Disclosed herein are enzymes and combinations of the enzymes useful for the hydrolysis of cellulose and the conversion of biomass. Methods of degrading cellulose and biomass using enzymes and cocktails of enzymes are also disclosed.

  5. Hydrogen photoproduction by photoelectrochemical conversion

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    The water-splitting reaction by photoelectrochemical processes has gained much more attention than any of many reactions proposed for solar generation of energy-rich molecules (fuels). The conversion efficiency of the photosystem is the key factor. The higher the efficiency, the more economically feasible will be the conversion scheme. The conversion efficiency is a function of the semiconductor properties, light intensity, spectral quality, properties of the electrolyte, counterelectrode, cell configuration, etc. The semiconductor parameters include band gap, absorption coefficient and diffusion length. The area and material used for a counterelectrode are important when considering polarization losses in a two-electrode system. Besides, the stability problem is also a very important one to meet the requirement for practical applications. This paper reviews some important issues on photoelectrochemical generation of hydrogen by water splitting. It includes energy conversion efficiency, market assessment and cost goal, state of the technology, and future directions for research

  6. Effective communication during difficult conversations.

    Science.gov (United States)

    Polito, Jacquelyn M

    2013-06-01

    A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

  7. Electron spectrometers with internal conversion

    International Nuclear Information System (INIS)

    Suita, J.C.; Lemos Junior, O.F.; Auler, L.T.; Silva, A.G. da

    1981-01-01

    The efforts that the Department of Physics (DEFI) of Institute of Nuclear Engineering (IEN) are being made aiming at adjusting the electron spectrometers with internal conversion to its necessity, are shown. (E.G.) [pt

  8. A Conversation Well Worth Remembering

    Science.gov (United States)

    Woolven-Allen, John

    2009-01-01

    To mark the 200th anniversary of Charles Darwin's birth, a special event was held at Oxford, which included a "Conversation" between Professor Richard Dawkins and Bishop Richard Harries. Here we present a personal reminiscence of the event.

  9. Computer code conversion using HISTORIAN

    International Nuclear Information System (INIS)

    Matsumoto, Kiyoshi; Kumakura, Toshimasa.

    1990-09-01

    When a computer program written for a computer A is converted for a computer B, in general, the A version source program is rewritten for B version. However, in this way of program conversion, the following inconvenient problems arise. 1) The original statements to be rewritten for B version are lost. 2) If the original statements of the A version rewritten for B version would remain as comment lines, the B version source program becomes quite large. 3) When update directives of the program are mailed from the organization which developed the program or when some modifications are needed for the program, it is difficult to point out the part to be updated or modified in the B version source program. To solve these problems, the conversion method using the general-purpose software management aid system, HISTORIAN, has been introduced. This conversion method makes a large computer code a easy-to-use program for use to update, modify or improve after the conversion. This report describes the planning and procedures of the conversion method and the MELPROG-PWR/MOD1 code conversion from the CRAY version to the JAERI FACOM version as an example. This report would provide useful information for those who develop or introduce large programs. (author)

  10. Frequency conversion of structured light.

    Science.gov (United States)

    Steinlechner, Fabian; Hermosa, Nathaniel; Pruneri, Valerio; Torres, Juan P

    2016-02-15

    Coherent frequency conversion of structured light, i.e. the ability to manipulate the carrier frequency of a wave front without distorting its spatial phase and intensity profile, provides the opportunity for numerous novel applications in photonic technology and fundamental science. In particular, frequency conversion of spatial modes carrying orbital angular momentum can be exploited in sub-wavelength resolution nano-optics and coherent imaging at a wavelength different from that used to illuminate an object. Moreover, coherent frequency conversion will be crucial for interfacing information stored in the high-dimensional spatial structure of single and entangled photons with various constituents of quantum networks. In this work, we demonstrate frequency conversion of structured light from the near infrared (803 nm) to the visible (527 nm). The conversion scheme is based on sum-frequency generation in a periodically poled lithium niobate crystal pumped with a 1540-nm Gaussian beam. We observe frequency-converted fields that exhibit a high degree of similarity with the input field and verify the coherence of the frequency-conversion process via mode projection measurements with a phase mask and a single-mode fiber. Our results demonstrate the suitability of exploiting the technique for applications in quantum information processing and coherent imaging.

  11. Conversion factors and oil statistics

    International Nuclear Information System (INIS)

    Karbuz, Sohbet

    2004-01-01

    World oil statistics, in scope and accuracy, are often far from perfect. They can easily lead to misguided conclusions regarding the state of market fundamentals. Without proper attention directed at statistic caveats, the ensuing interpretation of oil market data opens the door to unnecessary volatility, and can distort perception of market fundamentals. Among the numerous caveats associated with the compilation of oil statistics, conversion factors, used to produce aggregated data, play a significant role. Interestingly enough, little attention is paid to conversion factors, i.e. to the relation between different units of measurement for oil. Additionally, the underlying information regarding the choice of a specific factor when trying to produce measurements of aggregated data remains scant. The aim of this paper is to shed some light on the impact of conversion factors for two commonly encountered issues, mass to volume equivalencies (barrels to tonnes) and for broad energy measures encountered in world oil statistics. This paper will seek to demonstrate how inappropriate and misused conversion factors can yield wildly varying results and ultimately distort oil statistics. Examples will show that while discrepancies in commonly used conversion factors may seem trivial, their impact on the assessment of a world oil balance is far from negligible. A unified and harmonised convention for conversion factors is necessary to achieve accurate comparisons and aggregate oil statistics for the benefit of both end-users and policy makers

  12. Weight conversations in romantic relationships: What do they sound like and how do partners respond?

    Science.gov (United States)

    Berge, Jerica M; Pratt, Keeley; Miller, Laura

    2016-09-01

    The limited research examining weight conversations (i.e., conversations about weight, body shape, or size) in adult romantic relationships has shown associations between engaging in these conversations and disordered eating behaviors, overweight/obesity, and psychosocial problems in adults. Given the potential harmful consequences of these conversations, it is important to gather more rich qualitative data to understand how weight talk is experienced in romantic relationships and how romantic partners respond to these conversations. Adults (n = 118; mean age 35 years) from a cross-sectional study were interviewed in their homes. The majority of adults (90% female; mean age = 35 years) were from minority (64% African American) and low-income (content analysis. Sixty-five percent of participants reported that weight conversations were occurring in their romantic relationships. Qualitative themes included the following: (a) Weight conversations were direct and focused on physical characteristics; (b) weight conversations included joking or sarcastic remarks; (c) weight conversations focused on "we" and being healthy; (d) weight conversations occurred after watching TV or movies, as a result of insecurities in oneself, as length of the relationship increased, or as partners aged; and (e) partners responded to weight conversations by feeling insecure or by engaging in reciprocal weight conversations with their romantic partner. Weight conversations were prevalent in romantic relationships, with some conversations experienced as negative and some positive. Qualitative themes from the current study should be confirmed in quantitative studies to inform future intervention research targeting weight conversations in romantic relationships. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Information for Consumers about Alternative Fuel Conversions

    Science.gov (United States)

    Here are some factors to be aware of if you are considering fuel conversion, including background information on fuel conversion, instructions for demonstrating compliance, and other related information.

  14. Neutron scattering and proton spin conversion in solid CH4

    International Nuclear Information System (INIS)

    Lushington, K.J.; Morrison, J.A.

    1977-01-01

    The total neutron cross section of pure and O 2 -doped condensed CH 4 has been measured in the temperature range 0.75< T<100 K. The neutron wave length was sufficiently long (4.7 A) so that changes in cross section could be directly related to changes in γI(I + 1)μ, the mean squared proton nuclear angular momentum per molecule, to a sensitivity of about 1%. The temperature dependences of γI(I + 1)μ for the pure and doped specimens differ considerably in solid phase II(T<20.4 K). For the former specimen, the change in cross section is consistent with conversion occurring between the nuclear spin symmetry species on the orientationally disordered sublattices only. The addition of oxygen enhances the rate of conversion such that the value of γI(I + 1)μ corresponds to conversion on both the disordered and ordered sublattices. The characteristic lifetimes of the catalyzed and uncatalyzed conversion processes have been estimated. (author)

  15. Analysis of internal conversion coefficients

    International Nuclear Information System (INIS)

    Coursol, N.; Gorozhankin, V.M.; Yakushev, E.A.; Briancon, C.; Vylov, Ts.

    2000-01-01

    An extensive database has been assembled that contains the three most widely used sets of calculated internal conversion coefficients (ICC): [Hager R.S., Seltzer E.C., 1968. Internal conversion tables. K-, L-, M-shell Conversion coefficients for Z=30 to Z=103, Nucl. Data Tables A4, 1-237; Band I.M., Trzhaskovskaya M.B., 1978. Tables of gamma-ray internal conversion coefficients for the K-, L- and M-shells, 10≤Z≤104, Special Report of Leningrad Nuclear Physics Institute; Roesel F., Fries H.M., Alder K., Pauli H.C., 1978. Internal conversion coefficients for all atomic shells, At. Data Nucl. Data Tables 21, 91-289] and also includes new Dirac-Fock calculations [Band I.M. and Trzhaskovskaya M.B., 1993. Internal conversion coefficients for low-energy nuclear transitions, At. Data Nucl. Data Tables 55, 43-61]. This database is linked to a computer program to plot ICCs and their combinations (sums and ratios) as a function of Z and energy, as well as relative deviations of ICC or their combinations for any pair of tabulated data. Examples of these analyses are presented for the K-shell and total ICCs of the gamma-ray standards [Hansen H.H., 1985. Evaluation of K-shell and total internal conversion coefficients for some selected nuclear transitions, Eur. Appl. Res. Rept. Nucl. Sci. Tech. 11.6 (4) 777-816] and for the K-shell and total ICCs of high multipolarity transitions (total, K-, L-, M-shells of E3 and M3 and K-shell of M4). Experimental data sets are also compared with the theoretical values of these specific calculations

  16. Mechanisms of Ectopic Gene Conversion

    Directory of Open Access Journals (Sweden)

    P.J. Hastings

    2010-11-01

    Full Text Available Gene conversion (conversion, the unidirectional transfer of DNA sequence information, occurs as a byproduct of recombinational repair of broken or damaged DNA molecules. Whereas excision repair processes replace damaged DNA by copying the complementary sequence from the undamaged strand of duplex DNA, recombinational mechanisms copy similar sequence, usually in another molecule, to replace the damaged sequence. In mitotic cells the other molecule is usually a sister chromatid, and the repair does not lead to genetic change. Less often a homologous chromosome or homologous sequence in an ectopic position is used. Conversion results from repair in two ways. First, if there was a double-strand gap at the site of a break, homologous sequence will be used as the template for synthesis to fill the gap, thus transferring sequence information in both strands. Second, recombinational repair uses complementary base pairing, and the heteroduplex molecule so formed is a source of conversion, both as heteroduplex and when donor (undamaged template information is retained after correction of mismatched bases in heteroduplex. There are mechanisms that favour the use of sister molecules that must fail before ectopic homology can be used. Meiotic recombination events lead to the formation of crossovers required in meiosis for orderly segregation of pairs of homologous chromosomes. These events result from recombinational repair of programmed double-strand breaks, but in contrast with mitotic recombination, meiotic recombinational events occur predominantly between homologous chromosomes, so that transfer of sequence differences by conversion is very frequent. Transient recombination events that do not form crossovers form both between homologous chromosomes and between regions of ectopic homology, and leave their mark in the occurrence of frequent non-crossover conversion, including ectopic conversion.

  17. [Conversation analysis for improving nursing communication].

    Science.gov (United States)

    Yi, Myungsun

    2007-08-01

    Nursing communication has become more important than ever before because quality of nursing services largely depends on the quality of communication in a very competitive health care environment. This article was to introduce ways to improve nursing communication using conversation analysis. This was a review study on conversation analysis, critically examining previous studies in nursing communication and interpersonal relationships. This study provided theoretical backgrounds and basic assumptions of conversation analysis which was influenced by ethnomethodology, phenomenology, and sociolinguistic. In addition, the characteristics and analysis methods of conversation analysis were illustrated in detail. Lastly, how conversation analysis could help improve communication was shown, by examining researches using conversation analysis not only for ordinary conversations but also for extraordinary or difficult conversations such as conversations between patients with dementia and their professional nurses. Conversation analysis can help in improving nursing communication by providing various structures and patterns as well as prototypes of conversation, and by suggesting specific problems and problem-solving strategies in communication.

  18. Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

    Science.gov (United States)

    Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

    2005-01-01

    Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

  19. The relationship between borderline personality disorder and bipolar disorder

    Science.gov (United States)

    Zimmerman, Mark; Morgan, Theresa A.

    2013-01-01

    It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum. PMID:24174890

  20. Energy conversion and utilization technologies

    International Nuclear Information System (INIS)

    1988-01-01

    The DOE Energy Conversion and Utilization Technologies (ECUT) Program continues its efforts to expand the generic knowledge base in emerging technological areas that support energy conservation initiatives by both the DOE end-use sector programs and US private industry. ECUT addresses specific problems associated with the efficiency limits and capabilities to use alternative fuels in energy conversion and end-use. Research is aimed at understanding and improving techniques, processes, and materials that push the thermodynamic efficiency of energy conversion and usage beyond the state of the art. Research programs cover the following areas: combustion, thermal sciences, materials, catalysis and biocatalysis, and tribology. Six sections describe the status of direct contact heat exchange; the ECUT biocatalysis project; a computerized tribology information system; ceramic surface modification; simulation of internal combustion engine processes; and materials-by-design. These six sections have been indexed separately for inclusion on the database. (CK)

  1. Environmental effects of energy conversion

    International Nuclear Information System (INIS)

    Hansmeyer, K.H.; Fortak, H.; Knoepp, H.; Lindackers, K.H.; Schafhausen, F.; Schoedel, J.P.

    1984-01-01

    The article presents an analysis of energy conversion systems by the ''Council of Environmental Experts'' in order to correct the erroneous assumption that small energy conversion systems will also be small-scale and negligible emitters of pollutants. The additional pollution caused by Neurath power plant is considered to be low, at least in its immediate vicinity, owing to the implementation of the most recent technical developments. The environmental effects of energy conversion processes are discussed, including the waste heat problem and processes for water-cooling of power plants. General aspects of a new concept of energy taxation are discussed which is to reduce energy consumption. The problem of radioactive waste is discussed from spent fuel storage and reprocessing to the decommissioning of older power plants. The author points out that also new fossil-fuel technologies will pollute the environment. (orig.) [de

  2. Blind-date Conversation Joining

    Directory of Open Access Journals (Sweden)

    Luca Cesari

    2013-07-01

    Full Text Available We focus on a form of joining conversations among multiple parties in service-oriented applications where a client may asynchronously join an existing conversation without need to know in advance any information about it. More specifically, we show how the correlation mechanism provided by orchestration languages enables a form of conversation joining that is completely transparent to clients and that we call 'blind-date joining'. We provide an implementation of this strategy by using the standard orchestration language WS-BPEL. We then present its formal semantics by resorting to COWS, a process calculus specifically designed for modelling service-oriented applications. We illustrate our approach by means of a simple, but realistic, case study from the online games domain.

  3. [Hydroxylamine conversion by anammox enrichment].

    Science.gov (United States)

    Hu, Anhui; Zheng, Ping; Lu, Huifeng; Ding, Shuang; Wang, Caihua

    2010-04-01

    Hydroxylamine is an important intermediate product of anammox. This study was focused on the characteristics of hydroxylamine and nitrite conversions by anammox enrichment. The changes of nitrogenous substrates and related products with time were measured using batch tests with anammox enrichment as inoculum. Since hydroxylamine didn't react with nitrite in uninoculated control culture, these two compounds were chemically stable. Both of them decreased with time in anammox enrichment inoculated cultures, in which ammonia as intermediate product would be produced and converted with the maximum concentration being 0.338 mg/L. The total nitrogen concentration decreased from 4.694 mmol/L to 0.812 mmol/L with conversion rate 82.7% in the end. When hydroxylamine and nitrite concentrations were about 2.5 mmol/L respectively, the maximum specific sludge conversion rates of hydroxylamine was 0.535 mmol/(gVSS.h), which was 1.81 times bigger than that of ammonia in ammonia reaction system; the maximum specific sludge rate of total nitrogen was slightly higher than that in ammonia reaction system. When hydroxylamine concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 26.7% and 120.7% respectively; and the maximum ammonia accumulated was 1.810 mmol/L. When nitrite concentration increased to 5.0 mmol/L, the hydroxylamine and nitrite conversion rates promoted by 6.9% and 9.0% respectively; and the maximum ammonia accumulated was 0.795 mmol/L. Anammox enrichment was capable of converting hydroxylamine and nitrite simultaneously and had the higher conversion rate of hydroxylamine than ammonia conversion rate. Hydroxylamine and nitrite conversion rates were less affected by increase in nitrite concentration, but more significantly influenced by increase in hydroxylamine. The maximum ammonia concentration accumulated would rise as the result of increasing both hydroxylamine and nitrite. The result of experiment was consistent with pathway

  4. Wavelength conversion techniques and devices

    DEFF Research Database (Denmark)

    Danielsen, Søren Lykke; Mikkelsen, Benny; Hansen, Peter Bukhave

    1997-01-01

    Taking into account the requirements to the converters e.g., bit rate transparency (at least up to 10 Gbit/s), polarisation independence, wavelength independence, moderate input power levels, high signal-to-noise ratio and high extinction ratio interferometric wavelength convertors are very...... interesting for use in WDM optical fibre networks. However, the perfect converter has probably not yet been fabricated and new techniques such as conversion relying on cross-absorption modulation in electro-absorption modulators might also be considered in pursue of effective conversion devices...

  5. Solar energy conversion. Chemical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Likhtenshtein, Gertz [Ben-Gurion Univ. of the Negev, Beersheba (Israel). Dept. of Chemistry

    2012-07-01

    Finally filling a gap in the literature for a text that also adopts the chemist's view of this hot topic, Professor Likhtenshtein, an experienced author and internationally renowned scientist, considers different physical and engineering aspects in solar energy conversion. From theory to real-life systems, he shows exactly which chemical reactions take place when converting light energy, providing an overview of the chemical perspective from fundamentals to molecular harvesting systems and solar cells. This essential guide will thus help researchers in academia and industry better understand solar energy conversion, and so ultimately help this promising, multibillion euro/dollar field to expand. (orig.)

  6. A perspective on direct conversion

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W. B.

    1963-10-15

    As flowing energy, electricity is sought for its versatility. Its generation from some other flow or release of energy without mechanical power, or even sometimes heat, as intermediary is called direct conversion. The objective is high electrical output for minimum total cost and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (author)

  7. A perspective on direct conversion

    International Nuclear Information System (INIS)

    Lewis, W.B.

    1963-10-01

    As flowing energy, electricity is sought for its versatility. Its generation from some other flow or release of energy without mechanical power, or even sometimes heat, as intermediary is called direct conversion. The objective is high electrical output for minimum total cost and not always high conversion efficiency. The wide range of techniques embracing cryogenics and hot plasma derives from the special requirements of source, environment and application. Sources include solar and other radiation, nuclear fission and fusion, chemical energy and heat. Environments and applications range from space vehicles to submarines and from giant power networks to isolated buoys and pocket devices. (author)

  8. Gene conversion in the rice genome

    DEFF Research Database (Denmark)

    Xu, Shuqing; Clark, Terry; Zheng, Hongkun

    2008-01-01

    -chromosomal conversions distributed between chromosome 1 and 5, 2 and 6, and 3 and 5 are more frequent than genome average (Z-test, P ... is not tightly linked to natural selection in the rice genome. To assess the contribution of segmental duplication on gene conversion statistics, we determined locations of conversion partners with respect to inter-chromosomal segment duplication. The number of conversions associated with segmentation is less...... involved in conversion events. CONCLUSION: The evolution of gene families in the rice genome may have been accelerated by conversion with pseudogenes. Our analysis suggests a possible role for gene conversion in the evolution of pathogen-response genes....

  9. Effects of a random spatial variation of the plasma density on the mode conversion in cold, unmagnetized, and stratified plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Jung Yu, Dae [School of Space Research, Kyung Hee University, Yongin 446-701 (Korea, Republic of); Kim, Kihong [Department of Energy Systems Research, Ajou University, Suwon 443-749 (Korea, Republic of)

    2013-12-15

    We study the effects of a random spatial variation of the plasma density on the mode conversion of electromagnetic waves into electrostatic oscillations in cold, unmagnetized, and stratified plasmas. Using the invariant imbedding method, we calculate precisely the electromagnetic field distribution and the mode conversion coefficient, which is defined to be the fraction of the incident wave power converted into electrostatic oscillations, for the configuration where a numerically generated random density variation is added to the background linear density profile. We repeat similar calculations for a large number of random configurations and take an average of the results. We obtain a peculiar nonmonotonic dependence of the mode conversion coefficient on the strength of randomness. As the disorder increases from zero, the maximum value of the mode conversion coefficient decreases initially, then increases to a maximum, and finally decreases towards zero. The range of the incident angle in which mode conversion occurs increases monotonically as the disorder increases. We present numerical results suggesting that the decrease of mode conversion mainly results from the increased reflection due to the Anderson localization effect originating from disorder, whereas the increase of mode conversion of the intermediate disorder regime comes from the appearance of many resonance points and the enhanced tunneling between the resonance points and the cutoff point. We also find a very large local enhancement of the magnetic field intensity for particular random configurations. In order to obtain high mode conversion efficiency, it is desirable to restrict the randomness close to the resonance region.

  10. Effects of a random spatial variation of the plasma density on the mode conversion in cold, unmagnetized, and stratified plasmas

    International Nuclear Information System (INIS)

    Jung Yu, Dae; Kim, Kihong

    2013-01-01

    We study the effects of a random spatial variation of the plasma density on the mode conversion of electromagnetic waves into electrostatic oscillations in cold, unmagnetized, and stratified plasmas. Using the invariant imbedding method, we calculate precisely the electromagnetic field distribution and the mode conversion coefficient, which is defined to be the fraction of the incident wave power converted into electrostatic oscillations, for the configuration where a numerically generated random density variation is added to the background linear density profile. We repeat similar calculations for a large number of random configurations and take an average of the results. We obtain a peculiar nonmonotonic dependence of the mode conversion coefficient on the strength of randomness. As the disorder increases from zero, the maximum value of the mode conversion coefficient decreases initially, then increases to a maximum, and finally decreases towards zero. The range of the incident angle in which mode conversion occurs increases monotonically as the disorder increases. We present numerical results suggesting that the decrease of mode conversion mainly results from the increased reflection due to the Anderson localization effect originating from disorder, whereas the increase of mode conversion of the intermediate disorder regime comes from the appearance of many resonance points and the enhanced tunneling between the resonance points and the cutoff point. We also find a very large local enhancement of the magnetic field intensity for particular random configurations. In order to obtain high mode conversion efficiency, it is desirable to restrict the randomness close to the resonance region

  11. Evolution of energy conversion plants

    International Nuclear Information System (INIS)

    Osnaghi, C.

    2001-01-01

    The paper concerns the evolution and the future development of energy conversion plants and puts into evidence the great importance of the scientific and technological improvement in machines design, in order to optimize the use of energy resources and to improve ambient compatibility [it

  12. Direct digital conversion detector technology

    Science.gov (United States)

    Mandl, William J.; Fedors, Richard

    1995-06-01

    Future imaging sensors for the aerospace and commercial video markets will depend on low cost, high speed analog-to-digital (A/D) conversion to efficiently process optical detector signals. Current A/D methods place a heavy burden on system resources, increase noise, and limit the throughput. This paper describes a unique method for incorporating A/D conversion right on the focal plane array. This concept is based on Sigma-Delta sampling, and makes optimum use of the active detector real estate. Combined with modern digital signal processors, such devices will significantly increase data rates off the focal plane. Early conversion to digital format will also decrease the signal susceptibility to noise, lowering the communications bit error rate. Computer modeling of this concept is described, along with results from several simulation runs. A potential application for direct digital conversion is also reviewed. Future uses for this technology could range from scientific instruments to remote sensors, telecommunications gear, medical diagnostic tools, and consumer products.

  13. Restarts in Conversation and Literature.

    Science.gov (United States)

    Person, Raymond F., Jr.

    1996-01-01

    Analyzes restarts, a common feature of conversation, in literary discourse. The term "restart" refers to the repetition of a word or words within an utterance by the same speaker. Restarts in literary discourse are of two types: (1) those produced by the characters in their "real" narrative world and (2) those produced by the narrators themselves.…

  14. Direct Energy Conversion Literature Abstracts

    Science.gov (United States)

    1962-12-01

    TMMOELECTRIC 6 CONVERSION SYSTEMS. compiled by Edda 7p.. Aug.1960. (Spec. Bibl. 430) Barber. 48p., Mar. 1962. (Lit. Search 392) (Contract NAS 7-100) Covers...2865 BaranskiiP.I ............... 2905, 2945 Brogan, T.R. .............. 3322 Barber, Edda ................. . 2866 Brooklyn Polytechnic

  15. Photovoltaic conversion of laser energy

    Science.gov (United States)

    Stirn, R. J.

    1976-01-01

    The Schottky barrier photovoltaic converter is suggested as an alternative to the p/n junction photovoltaic devices for the conversion of laser energy to electrical energy. The structure, current, output, and voltage output of the Schottky device are summarized. The more advanced concepts of the multilayer Schottky barrier cell and the AMOS solar cell are briefly considered.

  16. Conversations to Transform Geometry Class

    Science.gov (United States)

    Szydlik, Jennifer Earles; Parrott, Amy; Belnap, Jason Knight

    2016-01-01

    Classroom culture is negotiated and established through both conversations and practices. Traditionally, teachers and researchers have focused primarily on the individual and social construction of mathematical content--that is, students' conceptual understanding and procedural skills--through mathematical actions and practices. This article…

  17. Conversation Analysis and Applied Linguistics.

    Science.gov (United States)

    Schegloff, Emanuel A.; Koshik, Irene; Jacoby, Sally; Olsher, David

    2002-01-01

    Offers biographical guidance on several major areas of conversation-analytic work--turn-taking, repair, and word selection--and indicates past or potential points of contact with applied linguistics. Also discusses areas of applied linguistic work. (Author/VWL)

  18. Facilitating Conversations about Managerial Identities

    DEFF Research Database (Denmark)

    Madsen, Mona Toft

    -based organization in the engineering consulting sector b) a reflection meeting, where the same three managers were gathered, and conversations were facilitated based on identity work in the context of earlier interviews. More specifically, three themes were discussed; flat organizational structure, tensions between...

  19. Humor and Embodied Conversational Agents

    NARCIS (Netherlands)

    Nijholt, Antinus

    This report surveys the role of humor in human-to-human interaction and the possible role of humor in human-computer interaction. The aim is to see whether it is useful for embodied conversational agents to integrate humor capabilities in their internal model of intelligence, emotions and

  20. Energy Conversion and Storage Program

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, E.J.

    1992-03-01

    The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in (1) production of new synthetic fuels, (2) development of high-performance rechargeable batteries and fuel cells, (3) development of advanced thermochemical processes for energy conversion, (4) characterization of complex chemical processes, and (5) application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis. Electrochemistry research aims to develop advanced power systems for electric vehicle and stationary energy storage applications. Topics include identification of new electrochemical couples for advanced rechargeable batteries, improvements in battery and fuel-cell materials, and the establishment of engineering principles applicable to electrochemical energy storage and conversion. Chemical Applications research includes topics such as separations, catalysis, fuels, and chemical analyses. Included in this program area are projects to develop improved, energy-efficient methods for processing waste streams from synfuel plants and coal gasifiers. Other research projects seek to identify and characterize the constituents of liquid fuel-system streams and to devise energy-efficient means for their separation. Materials Applications research includes the evaluation of the properties of advanced materials, as well as the development of novel preparation techniques. For example, the use of advanced techniques, such as sputtering and laser ablation, are being used to produce high-temperature superconducting films.

  1. Eating Disorders

    Science.gov (United States)

    ... of-control eating Women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders, and substance abuse. Eating disorders can ...

  2. Eating Disorders

    Science.gov (United States)

    ... Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH Home Research ... About Eating Disorders More Publications About Eating Disorders Research Results PubMed: Journal Articles about Eating Disorders Contact Us The National ...

  3. Personality Disorders

    Science.gov (United States)

    ... Disorders in Adults Data Sources Share Personality Disorders Definitions Personality disorders represent “an enduring pattern of inner ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  4. Schizoaffective Disorder

    Science.gov (United States)

    ... variations in brain chemistry and structure. Risk factors Factors that increase the risk of developing schizoaffective disorder include: Having a close blood relative who has schizoaffective disorder, schizophrenia or bipolar disorder Stressful events that trigger symptoms ...

  5. Autonomous renewable energy conversion system

    Energy Technology Data Exchange (ETDEWEB)

    Valtchev, V. [Technical University of Varna (Bulgaria). Dept. of Electronics; Bossche, A. van den; Ghijselen, J.; Melkebeek, J. [University of Gent (Belgium). Dept. of Electrical Power Engineering

    2000-02-01

    This paper briefly reviews the need for renewable power generation and describes a medium-power Autonomous Renewable Energy Conversion System (ARECS), integrating conversion of wind and solar energy sources. The objectives of the paper are to extract maximum power from the proposed wind energy conversion scheme and to transfer this power and the power derived by the photovoltaic system in a high efficiency way to a local isolated load. The wind energy conversion operates at variable shaft speed yielding an improved annual energy production over constant speed systems. An induction generator (IG) has been used because of its reduced cost, robustness, absence of separate DC source for excitation, easier dismounting and maintenance. The maximum energy transfer of the wind energy is assured by a simple and reliable control strategy adjusting the stator frequency of the IG so that the power drawn is equal to the peak power production of the wind turbine at any wind speed. The presented control strategy also provides an optimal efficiency operation of the IG by applying a quadratic dependence between the IG terminal voltage and frequency V {approx} f{sup 2}. For improving the total system efficiency, high efficiency converters have been designed and implemented. The modular principle of the proposed DC/DC conversion provides the possibility for modifying the system structure depending on different conditions. The configuration of the presented ARECS and the implementation of the proposed control algorithm for optimal power transfer are fully discussed. The stability and dynamic performance as well as the different operation modes of the proposed control and the operation of the converters are illustrated and verified on an experimental prototype. (author)

  6. The national conversion pilot project

    International Nuclear Information System (INIS)

    Van Der Puy, M.; Francis, G.; Konczal, M.

    1994-01-01

    The Department of Energy is now faced with the prospect of terminating traditional defense production missions at several Department of Energy sites. Because of this, there is a critical need to develop a DOE process to convert former defense production facilities to private use so that underutilized workers and facilities may be used to minimize the impact on the United States economy. The purpose of the National Conversation Pilot Project (NCPP) at Rocky Flats near Denver, Colorado is to explore and demonstrate the feasibility of economic conversion of DOE facilities, in a manner consistent with ongoing site waste management and cleanup activities, and non-prejudicial to future land use planning decisions. The NCPP is divided into three stages: The first stage, now under way, is one of detailed planning for cleanup and building maintenance activities. The second stage involves building cleanup necessary to support the proposed industrial activities, maintenance of equipment and building infrastructure necessary to assure protection of human health and the environment, declassification work, and some small scale research and development activities. Stage III would involve DOE metals recycling. Specific approval from the DOE is required prior to each project stage. To ensure stakeholder involvement, a steering committee will advise the DOE on the desirability to proceed with the project from stage to stage. A key question in the conversion process is whether a competitive economic and regulatory environment can be created on a DOE facility, allowing an onsite conversion business to effectively compete with offsite businesses. If successful, the Rocky Flats project could become the model for economic conversion at other DOE facilities

  7. Somatic symptom disorder

    Science.gov (United States)

    ... related disorders; Somatization disorder; Somatiform disorders; Briquet syndrome; Illness anxiety disorder References American Psychiatric Association. Somatic symptom disorder. Diagnostic and Statistical Manual of Mental Disorders . ...

  8. Analog-to-digital conversion

    CERN Document Server

    Pelgrom, Marcel

    2017-01-01

    This textbook is appropriate for use in graduate-level curricula in analog-to-digital conversion, as well as for practicing engineers in need of a state-of-the-art reference on data converters. It discusses various analog-to-digital conversion principles, including sampling, quantization, reference generation, nyquist architectures and sigma-delta modulation. This book presents an overview of the state of the art in this field and focuses on issues of optimizing accuracy and speed, while reducing the power level. This new, third edition emphasizes novel calibration concepts, the specific requirements of new systems, the consequences of 22-nm technology and the need for a more statistical approach to accuracy. Pedagogical enhancements to this edition include additional, new exercises, solved examples to introduce all key, new concepts and warnings, remarks and hints, from a practitioner’s perspective, wherever appropriate. Considerable background information and practical tips, from designing a PCB, to lay-o...

  9. Hemicellulose conversion by anaerobic digestion

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, S; Honry, M P; Christopher, R W

    1985-01-01

    This research was undertaken to study the digestibility of the hemicellulose fractions of an aquatic biomass, a land-based biomass and a biomass-waste blend under various fermentation conditions. The conversion of hemicellulose was higher than those of cellulose and protein under the mesophilic condition. Hemicellulose was converted at a much lower efficency than cellulose during thermophilic digestion. In contrast, cellulose conversion was about the same under mesophilic and thermophilic conditions. Cellulose was utilized in preference to hemicellulose during mesophilic fermentation of nitrogen-supplemented Bermuda grass. It was speculated that Bermuda grass cellulose was converted at a higher efficiency than hemicellulose in the pressure of external nitrogen because the metabolism of the breakdown product (glucose) of cellulose required the least investment of enzymes and energy. 4 references.

  10. IMAGE CONVERSION FOR LASER PYROGRAPHY

    Directory of Open Access Journals (Sweden)

    Adrian PETRU

    2015-12-01

    Full Text Available All previous studies of pyrography have been focussed on colour obtained through modifying the work parameters. This paper analyses colour nuances obtained by laser woodworking by measuring colour changes digitally. The investigated parameter is colour reproduction by laser technology, using different image conversion methods (Halftone Round, Jarvis, and so on. The changes of image reproduction are analysed globally and colour by colour. The results show that the colour nuances are represented to a more and less degree, according to the conversion method selected. To evaluate the aesthetic changes, CIEL*a*b* colour measurements were applied. The results show that laser burning on wood surfaces has a great influence on wood colour. These findings will be useful to develop innovative design possibilities for wood surfaces for furniture and other products.

  11. Rating Instructional Conversations: A Guide

    OpenAIRE

    Rueda, Robert; Goldenberg, Claude; Gallimore, Ronald

    1992-01-01

    The current focus on more effective ways to foster literacy in school-age children, especially language minority students, has led to the development of alternative instructional approaches. One such approach is the instructional conversation (IC), based on early work in the Hawaiian Kamehameha Elementary Education Project (KEEP), on neo-Vygotskian theory, and on recent classroom-based research on reading comprehension. The present report outlines preliminary efforts to operationaliz...

  12. FRM-II conversion revisited

    International Nuclear Information System (INIS)

    Glaser, A.; Pistner, C.; Liebert, W.

    2000-01-01

    The possibilities for a conversion of the currently constructed research reactor FRM-II has been extensively discussed at various RERTR meetings over the past years. In order to support the ongoing decision-making process in Germany, we prepared computer simulations providing extra information on the scientific usability of the converted reactor based on designs proposed by ANL and TUM. The most important results of these calculations are presented and discussed. Special attention is thereby given to the specific German context. (author)

  13. Conversation Analysis and Classroom Interaction

    Institute of Scientific and Technical Information of China (English)

    DING A-ning; LI Fan; CUI Jing

    2015-01-01

    Conversation Analysis shows the evidence of the social nature of people’s action including talk-in-interaction from a micro-level perspective. The method for basing its analysis on the authentic data rather than the retrospective interviews for gain⁃ing the participants’perception makes it unique in discovering the emic perspective of the social interaction. CA, often called as a“micro”methodology, provides theoretical insights and useful analytical tool for exploring the interaction in classrooms.

  14. A Conversation with Adam Heller

    OpenAIRE

    Heller, A; Cairns, EJ

    2015-01-01

    © 2015 by Annual Reviews. All rights reserved. Adam Heller, Ernest Cockrell Sr. Chair in Engineering Emeritus of the John J. McKetta Department of Chemical Engineering at The University of Texas at Austin, recalls his childhood in the Holocaust and his contributions to science and technology that earned him the US National Medal of Technology and Innovation in a conversation with Elton J. Cairns, Professor of Chemical and Biomolecular Engineering at the University of California, Berkeley. Dr....

  15. The National Conversion Pilot Project

    International Nuclear Information System (INIS)

    Roberts, A.V.

    1995-01-01

    The National Conversion Pilot Project (NCPP) is a recycling project under way at the U.S. Department of Energy (DOE) Rocky Flats Environmental Technology Site (RFETS) in Colorado. The recycling aim of the project is threefold: to reuse existing nuclear weapon component production facilities for the production of commercially marketable products, to reuse existing material (uranium, beryllium, and radioactively contaminated scrap metals) for the production of these products, and to reemploy former Rocky Flats workers in this process

  16. Metylcyclohexane conversion to light olefins

    Directory of Open Access Journals (Sweden)

    SCOFIELD C.F.

    1998-01-01

    Full Text Available This study consists in the evaluation of the catalytic properties of zeolites with different structures in the conversion of methylcyclohexane to light olefins. Results obtained suggest that the steric constrictions of the catalysts used play an important role in hydrogen transfer reactions. Higher selectivities for light olefins (C3= and C4= were observed for zeolites having more closed structures, like MFI and ferrerite, when compared to those having more open ones, like beta, omega and faujasite.

  17. Metylcyclohexane conversion to light olefins

    OpenAIRE

    SCOFIELD, C.F.; BENAZZI, E.; CAUFFRIEZ, H.; MARCILLY, C.

    1998-01-01

    This study consists in the evaluation of the catalytic properties of zeolites with different structures in the conversion of methylcyclohexane to light olefins. Results obtained suggest that the steric constrictions of the catalysts used play an important role in hydrogen transfer reactions. Higher selectivities for light olefins (C3= and C4=) were observed for zeolites having more closed structures, like MFI and ferrerite, when compared to those having more open ones, like beta, omega and fa...

  18. High conversion burner type reactor

    International Nuclear Information System (INIS)

    Higuchi, Shin-ichi; Kawashima, Masatoshi

    1987-01-01

    Purpose: To simply and easily dismantle and reassemble densified fuel assemblies taken out of a high conversion ratio area thereby improve the neutron and fuel economy. Constitution: The burner portion for the purpose of fuel combustion is divided into a first burner region in adjacent with the high conversion ratio area at the center of the reactor core, and a second burner region formed to the outer circumference thereof and two types of fuels are charged therein. Densified fuel assemblies charged in the high conversion ratio area are separatably formed as fuel assemblies for use in the two types of burners. In this way, dense fuel assembly is separated into two types of fuel assemblies for use in burner of different number and arranging density of fuel elements which can be directly charged to the burner portion and facilitate the dismantling and reassembling of the fuel assemblies. Further, since the two types of fuel assemblies are charged in the burner portion, utilization factor for the neutron fuels can be improved. (Kamimura, M.)

  19. Measurements of weak conversion lines

    International Nuclear Information System (INIS)

    Feoktistov, A.I.; Frantsev, Yu.E.

    1979-01-01

    Described is a new methods for measuring weak conversion lines with the help of the β spectrometer of the π √ 2 type which permits to increase the reliability of the results obtained. According to this method the measurements were carried out by short series with the storage of the information obtained on the punched tape. The spectrometer magnetic field was stabilized during the measuring of the conversion spectra with the help of three nmr recorders. Instead of the dependence of the pulse calculation rate on the magnetic field value was measured the dependence of the calculation rate on the value of the voltage applied between the source and the spectrometer chamber. A short description of the automatic set-up for measuring conversion lines according to the method proposed is given. The main set-up elements are the voltage multiplexer timer, printer, scaler and the pulse analyzer. With the help of the above methods obtained is the K 1035, 8 keV 182 Ta line. It is obtained as a result of the composition of 96 measurement series. Each measurement time constitutes 640 s 12 points are taken on the line

  20. Experimental techniques of conversion coefficient measurements

    International Nuclear Information System (INIS)

    Hamilton, J.H.

    1975-01-01

    Discusses briefly the history of conversion electron spectra measurements, and the interpretation of the collected data. Then provides a comprehensive review of techniques presently available to measure the conversion coefficients. (Auth.)

  1. Vertical Scan-Conversion for Filling Purposes

    OpenAIRE

    Hersch, R. D.

    1988-01-01

    Conventional scan-conversion algorithms were developed independently of filling algorithms. They cause many problems, when used for filling purposes. However, today's raster printers and plotters require extended use of filling, especially for the generation of typographic characters and graphic line art. A new scan-conversion algorithm, called vertical scan-conversion has been specifically designed to meet the requirements of parity scan line fill algorithms. Vertical scan-conversion ensures...

  2. Adaptive Feedback Improving Learningful Conversations at Workplace

    Science.gov (United States)

    Gaeta, Matteo; Mangione, Giuseppina Rita; Miranda, Sergio; Orciuoli, Francesco

    2013-01-01

    This work proposes the definition of an Adaptive Conversation-based Learning System (ACLS) able to foster computer-mediated tutorial dialogues at the workplace in order to increase the probability to generate meaningful learning during conversations. ACLS provides a virtual assistant selecting the best partner to involve in the conversation and…

  3. 5 CFR 534.506 - Conversion provisions.

    Science.gov (United States)

    2010-01-01

    ... conversion, other than to the minimum rate under 5 U.S.C. 5376, the increase must be approved by the head of... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion...

  4. 5 CFR 536.303 - Geographic conversion.

    Science.gov (United States)

    2010-01-01

    ... after geographic conversion is the employee's existing payable rate of basic pay in effect immediately before the action. (b) Geographic conversion when a retained rate employee's official worksite is changed... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Geographic conversion. 536.303 Section...

  5. 47 CFR 80.761 - Conversion graphs.

    Science.gov (United States)

    2010-10-01

    ... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.761 Conversion graphs. The following graphs must be employed where conversion from one to the other of the indicated types of units is... 47 Telecommunication 5 2010-10-01 2010-10-01 false Conversion graphs. 80.761 Section 80.761...

  6. Algal Energy Conversion and Capture

    Science.gov (United States)

    Hazendonk, P.

    2015-12-01

    We address the potential for energy conversions and capture for: energy generation; reduction in energy use; reduction in greenhouse gas emissions; remediation of water and air pollution; protection and enhancement of soil fertility. These processes have the potential to sequester carbon at scales that may have global impact. Energy conversion and capture strategies evaluate energy use and production from agriculture, urban areas and industries, and apply existing and emerging technologies to reduce and recapture energy embedded in waste products. The basis of biocrude production from Micro-algal feedstocks: 1) The nutrients from the liquid fraction of waste streams are concentrated and fed into photo bioreactors (essentially large vessels in which microalgae are grown) along with CO2 from flue gasses from down stream processes. 2) The algae are processed to remove high value products such as proteins and beta-carotenes. The advantage of algae feedstocks is the high biomass productivity is 30-50 times that of land based crops and the remaining biomass contains minimal components that are difficult to convert to biocrude. 3) The remaining biomass undergoes hydrothermal liquefaction to produces biocrude and biochar. The flue gasses of this process can be used to produce electricity (fuel cell) and subsequently fed back into the photobioreactor. The thermal energy required for this process is small, hence readily obtained from solar-thermal sources, and furthermore no drying or preprocessing is required keeping the energy overhead extremely small. 4) The biocrude can be upgraded and refined as conventional crude oil, creating a range of liquid fuels. In principle this process can be applied on the farm scale to the municipal scale. Overall, our primary food production is too dependent on fossil fuels. Energy conversion and capture can make food production sustainable.

  7. Conversion of Semipalatinsk test site

    International Nuclear Information System (INIS)

    Cherepnin, Yu. S.

    1997-01-01

    The conversion of the former defense enterprises of STS (Semipalatinsk Test Sate) started under very difficult conditions, when not only research and production activity, but all social life of Kurchatov city were conversed which was caused by a fast curtailment and restationing of Russian military units from the test site. A real risk of a complete destruction of the whole research and production structure of the city existed. From this point of view, the decision of the Republic of Kazakhstan Government to create the National Nuclear Center on the base of the test site research enterprises was actual and timely. During 1993, three research institutes of NNC RK - Institute of Atomic Energy, Institute of Geophysics Research and Institute of Radiation Safety and Environment were established. This decision, under conditions of the Ussr disintegration and liquidation of the test site military divisions, allowed to preserve the qualified personnel, to provide and follow-up the operation of nuclear dangerous facilities, to develop and start the realization of the full scale conversion program.At present time, directions and structure of basic research work in NNC RK are as follows: - liquidation of nuclear explosions consequences; - liquidation of technological infrastructure used for preparation and conduction of nuclear weapon testing; - creation of technology, equipment and places for acceptance and storage of radioactive wastes; - working out of atomic energy development conception in Kazakhstan; - study of reactor core melt behavior under severe accidents in NPP; - development of methods and means of nuclear testing detection, continuous monitoring of nuclear explosions; - experimental work on a study of structure materials behavior of ITER thermonuclear reactor; - creation of industries requiring a lage implementation of science

  8. Natural gas conversion. Part VI

    International Nuclear Information System (INIS)

    Iglesia, E.; Spivey, J.J.; Fleisch, T.H.

    2001-01-01

    This volume contains peer-reviewed manuscripts describing the scientific and technological advances presented at the 6th Natural Gas Conversion Symposium held in Alaska in June 2001. This symposium continues the tradition of excellence and the status as the premier technical meeting in this area established by previous meetings. The 6th Natural Gas Conversion Symposium is conducted under the overall direction of the Organizing Committee. The Program Committee was responsible for the review, selection, editing of most of the manuscripts included in this volume. A standing International Advisory Board has ensured the effective long-term planning and the continuity and technical excellence of these meetings. The titles of the contributions are: Impact of syngas generation technology selection on a GTL FPSO; Methane conversion via microwave plasma initiated by a metal initiator; Mechanism of carbon deposit/removal in methane dry reforming on supported metal catalysts; Catalyst-assisted oxidative dehydrogenation of light paraffins in short contact time reactors; Catalytic dehydrogenation of propane over a PtSn/SiO 2 catalyst with oxygen addition: selective oxidation of H2 in the presence of hydrocarbons; Hydroconversion of a mixture of long chain n-paraffins to middle distillate: effect of the operating parameters and products properties; Decomposition/reformation processes and CH4 combustion activity of PdO over Al2O3 supported catalysts for gas turbine applications; Lurgi's mega-methanol technology opens the door for a new era in down-stream applications;Expanding markets for GTL fuels and specialty products; Some critical issues in the analysis of partial oxidation reactions in monolith reactors

  9. High temperature thermoelectric energy conversion

    International Nuclear Information System (INIS)

    Wood, C.

    1986-01-01

    Considerable advances were made in the late '50's and early early '60's in the theory and development of materials for high-temperature thermoelectric energy conversion. This early work culminated in a variety of materials, spanning a range of temperatures, with the product of the figure of merit, Z, and temperature, T, i.e., the dimensionless figure of merit, ZT, of the order of one. This experimental limitation appeared to be universal and led a number of investigators to explore the possibility that a ZT - also represents a theoretical limitation. It was found not to be so

  10. Responsive turns in Indonesian informal conversation

    Directory of Open Access Journals (Sweden)

    M.J. van Naerssen

    2015-04-01

    Full Text Available People have all sorts of expectations about how interlocutors will and should behave linguistically when engaged in a conversation. These conversational norms are usually implicit and are sometimes difficult to master in a language that is new to you. This paper presents a model of different types of responses in informal conversation, illustrated with Indonesian examples. It builds upon the conversation analytic notion of preference; distinguishing preferred – or constructive – responses and dispreferred – or competitive – responses. The model is meant as a tool to cross-linguistically compare response behaviour to gain insight in language specific expectations about interaction in informal conversation.

  11. Biomass thermochemical conversion program: 1987 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Schiefelbein, G.F.; Stevens, D.J.; Gerber, M.A.

    1988-01-01

    The objective of the Biomass Thermochemical Conversion Program is to generate a base of scientific data and conversion process information that will lead to establishment of cost-effective processes for conversion of biomass resources into clean fuels. To accomplish this objective, in fiscal year 1987 the Thermochemical Conversion Program sponsored research activities in the following four areas: Liquid Hydrocarbon Fuels Technology; Gasification Technology; Direct Combustion Technology; Program Support Activities. In this report an overview of the Thermochemical Conversion Program is presented. Specific research projects are then described. Major accomplishments for 1987 are summarized.

  12. Biomass thermochemical conversion program. 1985 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Schiefelbein, G.F.; Stevens, D.J.; Gerber, M.A.

    1986-01-01

    Wood and crop residues constitute a vast majority of the biomass feedstocks available for conversion, and thermochemical processes are well suited for conversion of these materials. The US Department of Energy (DOE) is sponsoring research on this conversion technology for renewable energy through its Biomass Thermochemical Conversion Program. The Program is part of DOE's Biofuels and Municipal Waste Technology Division, Office of Renewable Technologies. This report briefly describes the Thermochemical Conversion Program structure and summarizes the activities and major accomplishments during fiscal year 1985. 32 figs., 4 tabs.

  13. Echolalia or functional repetition in conversation--a case study of an individual with Huntington's disease.

    Science.gov (United States)

    Saldert, Charlotta; Hartelius, Lena

    2011-01-01

    In this case study, we investigated the use of repetition in an individual with a neurogenic communication disorder. We present an analysis of interaction in natural conversations between a woman with advanced Huntington's disease (HD), whose speech had been described as sometimes characterised by echolalia, and her personal assistant. The conversational interaction is analysed on a sequential level, and recurrent patterns are explored. Although the ability of the person with HD to interact is affected by chorea, word retrieval problems and reduced comprehension, she takes an active part in conversation. The conversational partner's contributions are often adapted to her communicative ability as they are formulated as questions or suggestions that can be elaborated on or responded to with a simple 'yes' or 'no'. The person with HD often repeats the words of her conversational partner in a way that extends her contributions and shows listenership, and this use of repetition is also frequent in ordinary conversations between non-brain-damaged individuals. The results show that the conversation partners in this case cooperate in making the conversation proceed and evolve, and that verbal repetition is used in a way that works as a strategy for compensating for the impairment.

  14. Overview of biomass conversion technologies

    International Nuclear Information System (INIS)

    Noor, S.; Latif, A.; Jan, M.

    2011-01-01

    A large part of the biomass is used for non-commercial purposes and mostly for cooking and heating, but the use is not sustainable, because it destroys soil-nutrients, causes indoor and outdoor pollution, adds to greenhouse gases, and results in health problems. Commercial use of biomass includes household fuelwood in industrialized countries and bio-char (charcoal) and firewood in urban and industrial areas in developing countries. The most efficient way of biomass utilization is through gasification, in which the gas produced by biomass gasification can either be used to generate power in an ordinary steam-cycle or be converted into motor fuel. In the latter case, there are two alternatives, namely, the synthesis of methanol and methanol-based motor fuels, or Fischer-Tropsch hydrocarbon synthesis. This paper deals with the technological overview of the state-of-the-art key biomass-conversion technologies that can play an important role in the future. The conversion routes for production of Heat, power and transportation fuel have been summarized in this paper, viz. combustion, gasification, pyrolysis, digestion, fermentation and extraction. (author)

  15. Bilingualism accentuates children's conversational understanding.

    Directory of Open Access Journals (Sweden)

    Michael Siegal

    Full Text Available BACKGROUND: Although bilingualism is prevalent throughout the world, little is known about the extent to which it influences children's conversational understanding. Our investigation involved children aged 3-6 years exposed to one or more of four major languages: English, German, Italian, and Japanese. In two experiments, we examined the children's ability to identify responses to questions as violations of conversational maxims (to be informative and avoid redundancy, to speak the truth, be relevant, and be polite. PRINCIPAL FINDINGS: In Experiment 1, with increasing age, children showed greater sensitivity to maxim violations. Children in Italy who were bilingual in German and Italian (with German as the dominant language L1 significantly outperformed Italian monolinguals. In Experiment 2, children in England who were bilingual in English and Japanese (with English as L1 significantly outperformed Japanese monolinguals in Japan with vocabulary age partialled out. CONCLUSIONS: As the monolingual and bilingual groups had a similar family SES background (Experiment 1 and similar family cultural identity (Experiment 2, these results point to a specific role for early bilingualism in accentuating children's developing ability to appreciate effective communicative responses.

  16. Electromagnetic wave energy conversion research

    Science.gov (United States)

    Bailey, R. L.; Callahan, P. S.

    1975-01-01

    Known electromagnetic wave absorbing structures found in nature were first studied for clues of how one might later design large area man-made radiant-electric converters. This led to the study of the electro-optics of insect dielectric antennae. Insights were achieved into how these antennae probably operate in the infrared 7-14um range. EWEC theoretical models and relevant cases were concisely formulated and justified for metal and dielectric absorber materials. Finding the electromagnetic field solutions to these models is a problem not yet solved. A rough estimate of losses in metal, solid dielectric, and hollow dielectric waveguides indicates future radiant-electric EWEC research should aim toward dielectric materials for maximum conversion efficiency. It was also found that the absorber bandwidth is a theoretical limitation on radiant-electric conversion efficiency. Ideally, the absorbers' wavelength would be centered on the irradiating spectrum and have the same bandwith as the irradiating wave. The EWEC concept appears to have a valid scientific basis, but considerable more research is needed before it is thoroughly understood, especially for the complex randomly polarized, wide band, phase incoherent spectrum of the sun. Specific recommended research areas are identified.

  17. Astrophysicists' conversational connections on Twitter.

    Directory of Open Access Journals (Sweden)

    Kim Holmberg

    Full Text Available Because Twitter and other social media are increasingly used for analyses based on altmetrics, this research sought to understand what contexts, affordance use, and social activities influence the tweeting behavior of astrophysicists. Thus, the presented study has been guided by three research questions that consider the influence of astrophysicists' activities (i.e., publishing and tweeting frequency and of their tweet construction and affordance use (i.e. use of hashtags, language, and emotions on the conversational connections they have on Twitter. We found that astrophysicists communicate with a variety of user types (e.g. colleagues, science communicators, other researchers, and educators and that in the ego networks of the astrophysicists clear groups consisting of users with different professional roles can be distinguished. Interestingly, the analysis of noun phrases and hashtags showed that when the astrophysicists address the different groups of very different professional composition they use very similar terminology, but that they do not talk to each other (i.e. mentioning other user names in tweets. The results also showed that in those areas of the ego networks that tweeted more the sentiment of the tweets tended to be closer to neutral, connecting frequent tweeting with information sharing activities rather than conversations or expressing opinions.

  18. Analog-to-digital conversion

    CERN Document Server

    Pelgrom, Marcel J. M

    2013-01-01

    This textbook is appropriate for use in graduate-level curricula in analog to digital conversion, as well as for practicing engineers in need of a state-of-the-art reference on data converters.  It discusses various analog-to-digital conversion principles, including sampling, quantization, reference generation, nyquist architectures and sigma-delta modulation.  This book presents an overview of the state-of-the-art in this field and focuses on issues of optimizing accuracy and speed, while reducing the power level. This new, second edition emphasizes novel calibration concepts, the specific requirements of new systems, the consequences of 45-nm technology and the need for a more statistical approach to accuracy.  Pedagogical enhancements to this edition include more than twice the exercises available in the first edition, solved examples to introduce all key, new concepts and warnings, remarks and hints, from a practitioner’s perspective, wherever appropriate.  Considerable background information and pr...

  19. Light-voltage conversion apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Fujioka, Yoshiki

    1987-09-19

    In a light-voltage conversion unit, when input signal is applied, the output signal to the control circuit has quick rise-up time and slow breaking time. In order to improve this, a short-circuit transistor is placed at the diode, and this transistor is forced ON, when an output signal to the control circuit is lowered down to a constant voltage, to short-circuit between the output terminals. This, however, has a demerit of high power consumption by a transistor. In this invention, by connecting a light-emitting element which gets ON at the first transition and a light-emitting element which gets ON at the last transition, placing a light receiving element in front of each light-emitting element, when an input signal is applied; thus a load is driven only with ON signal of each light-emitting element, eliminating the delay in the last transition. All of these give a quick responsive light-voltage conversion without unnecessary power consumption. (5 figs)

  20. The effects of enactment on communicative competence in aphasic casual conversation: a functional linguistic perspective.

    Science.gov (United States)

    Groenewold, Rimke; Armstrong, Elizabeth

    2018-05-14

    Previous research has shown that speakers with aphasia rely on enactment more often than non-brain-damaged language users. Several studies have been conducted to explain this observed increase, demonstrating that spoken language containing enactment is easier to produce and is more engaging to the conversation partner. This paper describes the effects of the occurrence of enactment in casual conversation involving individuals with aphasia on its level of conversational assertiveness. To evaluate whether and to what extent the occurrence of enactment in speech of individuals with aphasia contributes to its conversational assertiveness. Conversations between a speaker with aphasia and his wife (drawn from AphasiaBank) were analysed in several steps. First, the transcripts were divided into moves, and all moves were coded according to the systemic functional linguistics (SFL) framework. Next, all moves were labelled in terms of their level of conversational assertiveness, as defined in the previous literature. Finally, all enactments were identified and their level of conversational assertiveness was compared with that of non-enactments. Throughout their conversations, the non-brain-damaged speaker was more assertive than the speaker with aphasia. However, the speaker with aphasia produced more enactments than the non-brain-damaged speaker. The moves of the speaker with aphasia containing enactment were more assertive than those without enactment. The use of enactment in the conversations under study positively affected the level of conversational assertiveness of the speaker with aphasia, a competence that is important for speakers with aphasia because it contributes to their floor time, chances to be heard seriously and degree of control over the conversation topic. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

  1. The conversational interface talking to smart devices

    CERN Document Server

    McTear, Michael; Griol, David

    2016-01-01

    This book provides a comprehensive introduction to the conversational interface, which is becoming the main mode of interaction with virtual personal assistants, smart devices, various types of wearables, and social robots. The book consists of four parts: Part I presents the background to conversational interfaces, examining past and present work on spoken language interaction with computers; Part II covers the various technologies that are required to build a conversational interface along with practical chapters and exercises using open source tools; Part III looks at interactions with smart devices, wearables, and robots, and then goes on to discusses the role of emotion and personality in the conversational interface; Part IV examines methods for evaluating conversational interfaces and discusses future directions. · Presents a comprehensive overview of the various technologies that underlie conversational user interfaces; · Combines descriptions of conversational user interface technologies with a gui...

  2. Biomass Thermochemical Conversion Program: 1986 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Schiefelbein, G.F.; Stevens, D.J.; Gerber, M.A.

    1987-01-01

    Wood and crop residues constitute a vast majority of the biomass feedstocks available for conversion, and thermochemical processes are well suited for conversion of these materials. Thermochemical conversion processes can generate a variety of products such as gasoline hydrocarbon fuels, natural gas substitutes, or heat energy for electric power generation. The US Department of Energy is sponsoring research on biomass conversion technologies through its Biomass Thermochemical Conversion Program. Pacific Northwest Laboratory has been designated the Technical Field Management Office for the Biomass Thermochemical Conversion Program with overall responsibility for the Program. This report briefly describes the Thermochemical Conversion Program structure and summarizes the activities and major accomplishments during fiscal year 1986. 88 refs., 31 figs., 5 tabs.

  3. Anxiety Disorders

    Science.gov (United States)

    ... the death of a loved one or parents' divorce) and major life transitions (like moving to a ... Ways to Deal With Anxiety Dealing With Difficult Emotions Anxiety Disorders Posttraumatic Stress Disorder Fears and Phobias ...

  4. Bipolar Disorder

    Science.gov (United States)

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go ... The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  5. Mathematics disorder

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001534.htm Mathematics disorder To use the sharing features on this page, please enable JavaScript. Mathematics disorder is a condition in which a child's ...

  6. Personality Disorders

    Science.gov (United States)

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  7. Cephalic Disorders

    Science.gov (United States)

    ... destructive lesions, but are sometimes the result of abnormal development. The disorder can occur before or after birth. Porencephaly most ... decade of life. SCHIZENCEPHALY is a rare developmental disorder characterized by abnormal slits, or clefts, in the cerebral hemispheres. Schizencephaly ...

  8. Oppositional defiant disorder

    Science.gov (United States)

    ... as possibilities: Anxiety disorders Attention-deficit/hyperactivity disorder (ADHD) Bipolar disorder Depression Learning disorders Substance abuse disorders Treatment The best treatment for the child is to ...

  9. Panic Disorder and Women

    Science.gov (United States)

    ... health illnesses Alcoholism, substance abuse, and addictive behavior Anxiety disorders Attention deficit hyperactivity disorder Bipolar disorder (manic depressive illness) Borderline personality disorder Depression Eating disorders Post-traumatic ...

  10. Eating Disorders

    OpenAIRE

    Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E

    2004-01-01

    Abstract Health Issue Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. Key Issues Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and...

  11. Bipolar Disorder.

    Science.gov (United States)

    Spearing, Melissa

    Bipolar disorder, a brain disorder that causes unusual shifts in a person's mood, affects approximately one percent of the population. It commonly occurs in late adolescence and is often unrecognized. The diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and when possible, family history. Thoughts of suicide are…

  12. Microturbine Power Conversion Technology Review

    Energy Technology Data Exchange (ETDEWEB)

    Staunton, R.H.

    2003-07-21

    In this study, the Oak Ridge National Laboratory (ORNL) is performing a technology review to assess the market for commercially available power electronic converters that can be used to connect microturbines to either the electric grid or local loads. The intent of the review is to facilitate an assessment of the present status of marketed power conversion technology to determine how versatile the designs are for potentially providing different services to the grid based on changes in market direction, new industry standards, and the critical needs of the local service provider. The project includes data gathering efforts and documentation of the state-of-the-art design approaches that are being used by microturbine manufacturers in their power conversion electronics development and refinement. This project task entails a review of power converters used in microturbines sized between 20 kW and 1 MW. The power converters permit microturbine generators, with their non-synchronous, high frequency output, to interface with the grid or local loads. The power converters produce 50- to 60-Hz power that can be used for local loads or, using interface electronics, synchronized for connection to the local feeder and/or microgrid. The power electronics enable operation in a stand-alone mode as a voltage source or in grid-connect mode as a current source. Some microturbines are designed to automatically switch between the two modes. The information obtained in this data gathering effort will provide a basis for determining how close the microturbine industry is to providing services such as voltage regulation, combined control of both voltage and current, fast/seamless mode transfers, enhanced reliability, reduced cost converters, reactive power supply, power quality, and other ancillary services. Some power quality improvements will require the addition of storage devices; therefore, the task should also determine what must be done to enable the power conversion circuits to

  13. An Evaluation of English versus Spanish Language Choice during Conversation Training Intervention for Children with Autism

    Science.gov (United States)

    Vaughn, Jamie Lee

    2013-01-01

    In children with Autism Spectrum Disorder, social communication deficits are identified as core developmental impairments. The ability to carry on a conversation through verbal exchanges poses challenges for individuals on the spectrum. The impact of exposure to a multilingual and multicultural environment on children with ASD is unknown and few…

  14. Conversational Behaviors in Youth with High-Functioning ASD and Asperger Syndrome

    Science.gov (United States)

    Paul, Rhea; Orlovski, Stephanie Miles; Marcinko, Hillary Chuba; Volkmar, Fred

    2009-01-01

    Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. "Psychol Med" 22:245-254, 1992). The ASD group…

  15. Life as the Middle Child: A Conversation With Mary Margaret Kerr

    Science.gov (United States)

    Teagarden, James M.; Zabel, Robert H.; Kaff, Marilyn S.

    2015-01-01

    As part of an ongoing oral history project, a conversation was held with Dr. Mary Margaret Kerr on the past, present, and possible future of the field of providing services to children with emotional-behavioral disorders. Dr. Wood stresses the increasing importance of providing an interdisciplinary approach to meet the needs for children or, as…

  16. Review: The nucleation of disorder

    International Nuclear Information System (INIS)

    Cahn, R.W.; Johnson, W.L.

    1986-01-01

    Four types of phase transformation that involve the conversion of crystalline phases into more disordered forms are reviewed: melting, disordering of superlattices, amorphization by diffusion between crystalline phases, and irradation amorphization. In the review emphasis is placed on evidence for the heterogeneous nucleation of the product phases; in this connection, the role of surfaces, antiphase domain boundaries, dislocations, vacancies, and grain boundaries is specifically discussed. All of these features have been either observed, or hypothesized, to play a role as heterogeneous nucleation sites in one or more of the four transformations. An attempt is made to draw parallels between nucleation mechanisms in the various processes

  17. Speech disorders - children

    Science.gov (United States)

    ... disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering ... evaluation tools that can help identify and diagnose speech disorders: Denver Articulation Screening Examination Goldman-Fristoe Test of ...

  18. Conversation Simulation and Sensible Surprises

    Science.gov (United States)

    Hutchens, Jason L.

    I have entered the Loebner Prize five times, winning the "most humanlike program" category in 1996 with a surly ELIZA-clone named HeX, but failed to repeat the performance in subsequent years with more sophisticated techniques. Whether this is indicative of an unanticipated improvement in "conversation simulation" technology, or whether it highlights the strengths of ELIZA-style trickery, is as an exercise for the reader. In 2000, I was invited to assume the role of Chief Scientist at Artificial Intelligence Ltd. (Ai) on a project inspired by the advice given by Alan Turing in the final section of his classic paper - our quest was to build a "child machine" that could learn and use language from scratch. In this chapter, I will discuss both of these experiences, presenting my thoughts regarding the Chinese Room argument and Artificial Intelligence (AI) in between.

  19. Fundamentals of thermophotovoltaic energy conversion

    CERN Document Server

    Chubb, Donald L

    2007-01-01

    This is a text book presenting the fundamentals of thermophotovoltaic(TPV) energy conversion suitable for an upper undergraduate or first year graduate course. In addition it can serve as a reference or design aid for engineers developing TPV systems. Mathematica design programs for interference filters and a planar TPV system are included on a CD-Rom disk. Each chapter includes a summary and concludes with a set of problems. The first chapter presents the electromagnetic theory and radiation transfer theory necessary to calculate the optical properties of the components in a TPV optical cavity. Using a simplified model, Chapter 2 develops expressions for the maximum efficiency and power density for an ideal TPV system. The next three chapters consider the three major components in a TPV system; the emitter, filter and photovoltaic(PV) array. Chapter 3 applies the electromagnetic theory and radiation transfer theory presented in Chapter 1 in the calculation of spectral emittance. From the spectral emittance t...

  20. Supported Conversation for hospital staff

    DEFF Research Database (Denmark)

    Forchhammer, Hysse B; Løvholt, Annelise P.; Mathiesen, Lone Lundbak

    in communication and interaction, Supported Conversation for Adults with Aphasia (SCA) was adapted and implemented in a large neurological department at Rigshospitalet-Glostrup in Copenhagen. Method 152 staff members representing different health professionals were assigned to one of eleven courses during a six...... month period. Each course had 10-12 participants and lasted 6 hours, including instruction in the SCA principles, video analysis, interdisciplinary group work, and practice sessions with PWAs. Self-assessed learning outcomes were evaluated with a brief questionnaire filled out by staff members...... in communication, also showed significant improvements across all staff groups. After the course, more time to spend with patients was perceived as the most important factor to further increase communication success with PWA. Conclusion The results show that interdisciplinary SCA-courses successfully increase...

  1. Conversation Analysis in Applied Linguistics

    DEFF Research Database (Denmark)

    Kasper, Gabriele; Wagner, Johannes

    2014-01-01

    on applied CA, the application of basic CA's principles, methods, and findings to the study of social domains and practices that are interactionally constituted. We consider three strands—foundational, social problem oriented, and institutional applied CA—before turning to recent developments in CA research...... on learning and development. In conclusion, we address some emerging themes in the relationship of CA and applied linguistics, including the role of multilingualism, standard social science methods as research objects, CA's potential for direct social intervention, and increasing efforts to complement CA......For the last decade, conversation analysis (CA) has increasingly contributed to several established fields in applied linguistics. In this article, we will discuss its methodological contributions. The article distinguishes between basic and applied CA. Basic CA is a sociological endeavor concerned...

  2. Tacit to explicit knowledge conversion.

    Science.gov (United States)

    Cairó Battistutti, Osvaldo; Bork, Dominik

    2017-11-01

    The ability to create, use and transfer knowledge may allow the creation or improvement of new products or services. But knowledge is often tacit: It lives in the minds of individuals, and therefore, it is difficult to transfer it to another person by means of the written word or verbal expression. This paper addresses this important problem by introducing a methodology, consisting of a four-step process that facilitates tacit to explicit knowledge conversion. The methodology utilizes conceptual modeling, thus enabling understanding and reasoning through visual knowledge representation. This implies the possibility of understanding concepts and ideas, visualized through conceptual models, without using linguistic or algebraic means. The proposed methodology is conducted in a metamodel-based tool environment whose aim is efficient application and ease of use.

  3. Conversion of Ulba Metallurgy Plant

    International Nuclear Information System (INIS)

    Onoprienko, O.

    1996-01-01

    General Information 'Ulba Metallurgical plant' Joint Stock Company successfully operates for more than 46 years. The plant was established by MINSREDMASH, USSR and at the present moment has finished complexes for production of nuclear fuel for atomic power stations, tantalum and superconducting materials production, beryllium, hydrofluoric acid manufacture and engineering production. Problem Essence In spite of the monopoly possession of tantalum manufacture, beryllium and uranium fuel, superconducting materials in Commonwealth of Independent States countries, company has serious financial problems due to the critical situation in Commonwealth of Independent States countries, production ties collapse and fast market demand decrease for the Ulba Metallurgical Plant Joint Stock Company products. The alternative decision is to create substitute productions, conversion integrating and introducing new products to the world market

  4. A Map Enters the Conversation

    DEFF Research Database (Denmark)

    Munk, Anders Kristian

    Over the past decade STS scholars have been engaged in a continuous dialogue about the performativity of their methods and the interventions of their research practices. A frequently posed question is how STS can make a difference to its fields of study, what John Law has called its different...... 'modes of mattering'. In this paper I explore what difference digital cartography can make to STS practice. I draw on three examples from my own work where digitally mediated maps have entered the conversation and made critical, often surprising, differences to the research process. In my first example...... the map is brought along as an ethnographic device on a piece of fieldwork, in my second example it serves as the central collaborative object in a participatory design project, and in my third example the map becomes the object of contestation as it finds itself centre stage in the controversy...

  5. Bipolar disorders

    DEFF Research Database (Denmark)

    Vieta, Eduard; Berk, Michael; Schulze, Thomas G

    2018-01-01

    Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease...... and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand...... a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary....

  6. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-05-01

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

  7. Topological energy conversion through the bulk or the boundary of driven systems

    Science.gov (United States)

    Peng, Yang; Refael, Gil

    2018-04-01

    Combining physical and synthetic dimensions allows a controllable realization and manipulation of high-dimensional topological states. In our work, we introduce two quasiperiodically driven one-dimensional systems which enable tunable topological energy conversion between different driving sources. Using three drives, we realize a four-dimensional quantum Hall state which allows energy conversion between two of the drives within the bulk of the one-dimensional system. With only two drives, we achieve energy conversion between the two at the edge of the chain. Both effects are a manifestation of the effective axion electrodynamics in a three-dimensional time-reversal-invariant topological insulator. Furthermore, we explore the effects of disorder and commensurability of the driving frequencies, and show the phenomena are robust. We propose two experimental platforms, based on semiconductor heterostructures and ultracold atoms in optical lattices, in order to observe the topological energy conversion.

  8. Rare-earth magnet applications in energy conversion

    International Nuclear Information System (INIS)

    Tripathi, K.C.

    1998-01-01

    In recent years there has been considerable progress in the field of development and variety of new applications of rare-earth and rare-earth transition metal magnets. High energy content Nd-Fe-B magnet system which competes with superconducting magnets is very promising for the use in energy conversion machines, levitation systems, magnetic resonance investigation and other magnetic applications. Energy conversion machines such as motors and generators are of interest in this context. Motor converts electrical energy into mechanical energy using permanent magnets and ferromagnetic materials as its components. Electric generator converts mechanical energy into electricity using permanent magnets and ferromagnetic material. In both cases symmetry and symmetry breaking play an important role. Symmetry exists above curie temperature, as temperature is lowered symmetry is broken due to spontaneous magnetisation. Author and coworkers developed some new and highest efficiency, permanent magnet based, electronically controlled, dynamically synchronised pulsed dc linear and rotational motors which are briefly described here. Based on such experience and considering field interactions inside material under dynamical conditions and special geometrical situations, order-disorder processes, symmetry breaking and energy transfer on the basis of manifold aspects as a cooperative many body interaction, thermal fluctuations, zero-point energy, dissipation of energy, entropy exchange are discussed in context of conversion of environmental heat into electricity as suggested by Tripathi earlier. (orig.)

  9. Conversion of autoimmune hypothyroidism to hyperthyroidism

    OpenAIRE

    Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

    2014-01-01

    Background Graves’ disease and Hashimoto’s thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. Case presentation We are reporting three cases of middle aged Asian female...

  10. Treatment of borderline personality disorder and co-occurring anxiety disorders

    Science.gov (United States)

    Valenstein, Helen R.

    2013-01-01

    Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

  11. Disease network of mental disorders in Korea.

    Science.gov (United States)

    Choi, Myoungje; Lee, Dong-Woo; Cho, Maeng Je; Park, Jee Eun; Gim, Minsook

    2015-12-01

    Network medicine considers networks among genes, diseases, and individuals. Networks of mental disorders remain poorly understood, despite their high comorbidity. In this study, a network of mental disorders in Korea was constructed to offer a complementary approach to treatment. Data on the prevalence and morbidity of mental disorders were obtained from the 2006 and 2011 Korean Epidemiologic Catchment Area Study, including 22 psychiatric disorders. Nodes in the network were disease phenotypes identified by Diagnostic and Statistical Manual of Mental Disorders-IV, and the links connected phenotypes showing significant comorbidity. Odds ratios were used to quantify the distance between disease pairs. Network centrality was analyzed with and without weighting of the links between disorders. Degree centrality was correlated with suicidal behaviors and use of mental health services. In 2011 and 2006, degree centrality was highest for major depressive disorder, followed by nicotine dependence and generalized anxiety disorder (2011) or alcohol dependence (2006). Weighted degree centrality was highest in conversion disorder in both years. Therefore, major depressive disorder and nicotine dependence are highly connected to other mental disorders in Korea, indicating their comorbidity and possibility of shared biological mechanisms. The use of networks could enhance the understanding of mental disorders to provide effective mental health services.

  12. U.S. Domestic Reactor Conversion Programs

    International Nuclear Information System (INIS)

    Woolstenhulme, Eric

    2008-01-01

    The Conversion Projects Include: the revision of the facilities safety basis documents and supporting analysis, the fabrication of new LEU fuel, the change-out of the reactor core, and the removal of the used HEU fuel (by INL University Fuels Program or DOE-NE). The major entities involved are: the U.S. Nuclear Regulatory Commission, the University reactor department, the fuel and hardware fabricators, the Spent fuel receipt facilities, the Spent fuel shipping services, and the U.S. Department of Energy and their subcontractors. Three major Reactor Conversion Program milestones have been accomplished since 2006: the conversion of the TRIGA reactor at Texas A and M University Nuclear Science Center, the conversion of the University of Florida Training Reactor, and the conversion of the Purdue University Reactor. Four Reactor Conversion Program milestones yet to be accomplished in 2008 and 2009: the Washington State University Nuclear Radiation Center reactor, the Oregon State University TRIGA Reactor, the University of Wisconsin Nuclear Reactor, and the Neutron Radiography Reactor Facility. NNSA is committed to doing things cheaper, better, smarter, safer through a 'Lessons Learned' process. The conversion team assessed each major activity grouping: Project Initiation, Conversion Proposal Development, Fuel Fabrication and Hardware, Core Conversion, and Spent Nuclear Fuel Removal. Issues were identified and recommendations were given

  13. Conversational Agents in E-Learning

    Science.gov (United States)

    Kerry, Alice; Ellis, Richard; Bull, Susan

    This paper discusses the use of natural language or 'conversational' agents in e-learning environments. We describe and contrast the various applications of conversational agent technology represented in the e-learning literature, including tutors, learning companions, language practice and systems to encourage reflection. We offer two more detailed examples of conversational agents, one which provides learning support, and the other support for self-assessment. Issues and challenges for developers of conversational agent systems for e-learning are identified and discussed.

  14. Single conversion stage amplifier - SICAM

    Energy Technology Data Exchange (ETDEWEB)

    Ljusev, P.

    2005-12-15

    This Ph.D. thesis presents a thorough analysis of the so called SICAM - SIngle Converter stage AMplifier approach to building direct energy conversion audio power amplifiers. The mainstream approach for building isolated audio power amplifiers today consists of isolated DC power supply and Class D amplifier, which essentially represents a two stage solution, where each of the components can be viewed as separate and independent part. The proposed SICAM solution strives for direct energy conversion from the mains to the audio output, by dedicating the operation of the components one to another and integrating their functions, so that the final audio power amplifier represents a single-stage topology with higher efficiency, lower volume, less board space, lower component count and subsequently lower cost. The SICAM approach is both applicable to non-isolated and isolated audio power amplifiers, but the problems encountered in these two cases are different. Non-isolated SICAM solutions are intended for both AC mains-connected and battery-powered devices. In non-isolated mains-connected SICAMs the main idea is to simplify the power supply or even provide integrated power factor correction (PFC) functions, while still maintaining low component stress and good audio performance by generally decreasing the input voltage level to the Class D audio power amplifier. On the other hand, non-isolated battery-powered SICAMs have to cope with the ever changing battery voltage and provide output voltage levels which are both lower and higher than the battery voltage, while still being simple and single-stage energy conversion solutions. In isolated SICAMs the isolation transformer adjusts the voltage level on the secondary side to the desired level, so the main challenges here are decreasing the size of the magnetic core and reducing the number and size of bulky reactive components as much as possible. The main focus of this thesis is directed towards the isolated SICAMs and

  15. Mental disorders, brain disorders, neurodevelopmental disorders ...

    African Journals Online (AJOL)

    . Amongst DSM's most vocal 'insider' critics has been Thomas Insel, Director of the US National Institute of Mental Health. Insel has publicly criticised DSM's adherence to a symptom-based classification of mental disorder, and used the weight ...

  16. [Eating disorders].

    Science.gov (United States)

    Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa

    2015-02-01

    Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.

  17. Keep Meaning in Conversational Coordination

    Directory of Open Access Journals (Sweden)

    Elena Clare Cuffari

    2014-12-01

    Full Text Available Coordination is a widely employed term across recent quantitative and qualitative approaches to intersubjectivity, particularly approaches that give embodiment and enaction central explanatory roles. With a focus on linguistic and bodily coordination in conversational contexts, I review the operational meaning of coordination in recent empirical research and related theorizing of embodied intersubjectivity. This discussion articulates what must be involved in treating linguistic meaning as dynamic processes of coordination. The coordination approach presents languaging as a set of dynamic self-organizing processes and actions on multiple timescales and across multiple modalities that come about and work in certain domains (those jointly constructed in social, interactive, high-order sense-making. These processes go beyond meaning at the level that is available to first-person experience. I take one crucial consequence of this to be the ubiquitously moral nature of languaging with others. Languaging coordinates experience, among other levels of behavior and event. Ethical effort is called for by the automatic autonomy-influencing forces of languaging as coordination.

  18. NASA thermionic-conversion program

    International Nuclear Information System (INIS)

    Morris, J.F.

    1977-01-01

    NASA's program for applied research and technology (ART) in thermionic energy conversion (TEC) has made worthwhile contributions in a relatively short time: Many of these accomplishments are incremental, yet important. And their integration has yielded gains in performance as well as in the knowledge necessary to point productive directions for future work. Both promise and problems derive from the degrees of freedom allowed by the current programmatic emphasis on out-of-core thermionics. Materials and designs previously prohibited by in-core nucleonics and geometries now offer new potentialities. But as a result a major TEC-ART responsibility is the efficient reduction of the glitter of diverse possibilities to the hard glint of reality. As always high-temperature material effects are crucial to the level and duration of TEC performance: New electrodes must increase and maintain power output regardless of emitter-vapor deposition on collectors. They must also serve compatibly with hot-shell alloys. And while space TEC must face high-temperature vaporization problems externally as well as internally, terrestrial TEC must tolerate hot corrosive atmospheres outside and near-vacuum inside. Furthermore, some modes for decreasing interelectrode losses appear to require rather demanding converter geometries to produce practical power densities. In these areas and others significant progress is being made in the NASA TEC-ART Program

  19. Phase conversion for fusion lasers

    International Nuclear Information System (INIS)

    Kessler, T.; Castle, W.; Sampat, N.; Skupsky, S.; Smith, D.; Swales, S.

    1988-01-01

    An essential requirement for direct drive laser fusion is the uniform irradiation of spherical targets that are located in the quasi-far field of a laser system. A major impediment to irradiation uniformity with high-power solid-state laser systems is the presence of a hot-spot structure at the target plane. The hot-spot intensity nonuniformities are caused by spatial variations in the near-field phase front of each laser beam. Although for many tabletop applications diffraction-limited laser performance can be obtained through static phase correction, adaptive optics, or phase conjugation, such approaches are either excessively expensive, difficult to implement, or not yet available for large-aperture, high-peak-power laser beams. An alternative to phase correcting a wavefront involves modifying the laser beam's coherence properties thereby changing its focusing characteristics. The method of induced spatial incoherence (ISI) involves a reduction in both spatial and temporal coherence. Other methods are based on modifications of only the spatial coherence of a laser beam. A phase conversion technology which incorporates a distribution of near-field phases to either perform static phase correction or induce spatial incoherence offers a route toward increasingly higher levels of irradiation uniformity

  20. Energy Conversion Alternatives Study (ECAS)

    Science.gov (United States)

    1977-01-01

    ECAS compared various advanced energy conversion systems that can use coal or coal-derived fuels for baseload electric power generation. It was conducted in two phases. Phase 1 consisted of parametric studies. From these results, 11 concepts were selected for further study in Phase 2. For each of the Phase 2 systems and a common set of ground rules, performance, cost, environmental intrusion, and natural resource requirements were estimated. In addition, the contractors defined the state of the associated technology, identified the advances required, prepared preliminary research and development plans, and assessed other factors that would affect the implementation of each type of powerplant. The systems studied in Phase 2 include steam systems with atmospheric- and pressurized-fluidized-bed boilers; combined cycle gas turbine/steam systems with integrated gasifiers or fired by a semiclean, coal derived fuel; a potassium/steam system with a pressurized-fluidized-bed boiler; a closed-cycle gas turbine/organic system with a high-temperature, atmospheric-fluidized-bed furnace; a direct-coal-fired, open- cycle magnetohydrodynamic/steam system; and a molten-carbonate fuel cell/steam system with an integrated gasifier. The sensitivity of the results to changes in the ground rules and the impact of uncertainties in capital cost estimates were also examined.

  1. Tropospheric effects of energy conversion

    International Nuclear Information System (INIS)

    Derwent, R.G.

    1992-01-01

    The tropospheric concentrations of a number of trace gases are increasing due to man's activities. For some trace gases, their atmospheric life cycles are not fully understood and it is difficult to be certain about the role of man's activities. Emissions from the energy industries and energy conversion processes represent an important subset of source terms in these life cycles, along with agriculture, deforestation, cement manufacture, biomass burning, process industries and natural biospheric processes. Global Warming Potentials (GWPs) allow the tropospheric effects of a range of climate forcing trace gases to be assessed on a comparable basis. If a short term view of the commitment to global warming is adopted then the contribution from other trace gases may approach and exceed that of carbon dioxide, itself. Over longer time horizons, the long atmospheric lifetime of carbon dioxide shows through as a major influence and the contributions from the other trace gases appear to be much smaller, representing an additional 13-18% contribution on top of that from CO 2 itself

  2. Energy conversion in polyelectrolyte hydrogels

    Science.gov (United States)

    Olvera de La Cruz, Monica; Erbas, Aykut; Olvera de la Cruz Team

    Energy conversion and storage have been an active field of research in nanotechnology parallel to recent interests towards renewable energy. Polyelectrolyte (PE) hydrogels have attracted considerable attention in this field due to their mechanical flexibility and stimuli-responsive properties. Ideally, when a hydrogel is deformed, applied mechanical work can be converted into electrostatic, elastic and steric-interaction energies. In this talk, we discuss the results of our extensive molecular dynamics simulations of PE hydrogels. We demonstrate that, on deformation, hydrogels adjust their deformed state predominantly by altering electrostatic interactions between their charged groups rather than excluded-volume and bond energies. This is due to the hydrogel's inherent tendency to preserve electro-neutrality in its interior, in combination with correlations imposed by backbone charges. Our findings are valid for a wide range of compression ratios and ionic strengths. The electrostatic-energy alterations that we observe in our MD simulations may induce pH or redox-potential changes inside the hydrogels. The resulting energetic difference can be harvested, for instance, analogously to a Carnot engine, or facilitated for sensor applications. Center for Bio-inspired Energy Science (CBES).

  3. Ocean thermal-energy conversion

    Energy Technology Data Exchange (ETDEWEB)

    Ford, G; Niblett, C; Walker, L

    1983-03-01

    Ocean thermal-energy conversion (OTEC) is a novel 'alternative' energy technology that has created much interest in a number of countries; namely, the USA, Japan, France, Sweden, Holland, India and most recently, the UK. In particular, the first three of these have had programmes to develop the required technology. However, most interest has been centred in the USA, where the current hiatus in Federal funding provides a timely opportunity to assess progress. This paper offers a survey of the prevailing position there; outlining the outstanding technical and associated problems, and likely future developments. Non-USA programmes are only mentioned to contrast them with the American position. At present, it does not appear that OTEC plants will be commercially viable on a widespread basis even in the tropics. This is particularly true of the larger plants (400 MWe, MWe = megawatts of electrical energy, the final output of a power station) towards which the American programme is ultimately geared. There does seem to be a strong possibility that small OTEC plants, around 40 MWe or less, can be commercial in certain circumstances. This would be possible when one or, preferably, more of the following conditions are met: (i) where a land-based rather than 'at sea' plant is possible, (ii) where alternative energy supplies are at a premium, i.e. islands or regions without indigenous energy supplies, and (iii) where conditions are such that an OTEC plant could operate in conjunction with either or both an aquaculture or desalination plant.

  4. Catalytic conversion of light alkanes

    Energy Technology Data Exchange (ETDEWEB)

    Lyons, J.E.

    1992-06-30

    The second Quarterly Report of 1992 on the Catalytic Conversion of Light Alkanes reviews the work done between April 1, 1992 and June 31, 1992 on the Cooperative Agreement. The mission of this work is to devise a new catalyst which can be used in a simple economic process to convert the light alkanes in natural gas to oxygenate products that can either be used as clean-burning, high octane liquid fuels, as fuel components or as precursors to liquid hydrocarbon uwspomdon fuel. During the past quarter we have continued to design, prepare, characterize and test novel catalysts for the mild selective reaction of light hydrocarbons with air or oxygen to produce alcohols directly. These catalysts are designed to form active metal oxo (MO) species and to be uniquely active for the homolytic cleavage of the carbon-hydrogen bonds in light alkanes producing intermediates which can form alcohols. We continue to investigate three molecular environments for the active catalytic species that we are trying to generate: electron-deficient macrocycles (PHASE I), polyoxometallates (PHASE II), and regular oxidic lattices including zeolites and related structures as well as other molecular surface structures having metal oxo groups (PHASE I).

  5. Analog-to-digital conversion

    CERN Document Server

    Pelgrom, Marcel J M

    2010-01-01

    The design of an analog-to-digital converter or digital-to-analog converter is one of the most fascinating tasks in micro-electronics. In a converter the analog world with all its intricacies meets the realm of the formal digital abstraction. Both disciplines must be understood for an optimum conversion solution. In a converter also system challenges meet technology opportunities. Modern systems rely on analog-to-digital converters as an essential part of the complex chain to access the physical world. And processors need the ultimate performance of digital-to-analog converters to present the results of their complex algorithms. The same progress in CMOS technology that enables these VLSI digital systems creates new challenges for analog-to-digital converters: lower signal swings, less power and variability issues. Last but not least, the analog-to-digital converter must follow the cost reduction trend. These changing boundary conditions require micro-electronics engineers to consider their design choices for...

  6. Overcoming difficult conversations in clinical supervision

    Directory of Open Access Journals (Sweden)

    Williams B

    2016-06-01

    Full Text Available Brett Williams,1 Christine King,1 Tanya Edlington,21Department of Community Emergency Health and Paramedic Practice, Monash University, Franskton, VIC, 2The Conversation Clinic Pty Ltd, Melbourne, VIC, Australia Background: Clinical supervisors are responsible for managing many facets of clinical learning and face a range of challenges when the need for "difficult" conversations arises, including the need to manage conflict and relationships. Methods: Spotlight on Conversations Workshop was developed to improve the capacity of clinical supervisors to engage in difficult conversations. They were designed to challenge the mindset of clinical supervisors about difficult conversations with students, the consequences of avoiding difficult conversations, and to offer activities for practicing difficult conversations. Preworkshop, postworkshop, and 4-month follow-up evaluations assessed improvements in knowledge, intent to improve, and confidence along with workshop satisfaction. Results: Nine workshops were delivered in a range of locations across Victoria, Australia, involving a total of 117 clinical supervisors. Preworkshop evaluations illustrated that more than half of the participants had avoided up to two difficult conversations in the last month in their workplace. Postworkshop evaluation at 4 months showed very high levels of satisfaction with the workshop's relevancy, content, and training, as well as participants' intention to apply knowledge and skills. Also shown were significant changes in participants' confidence to have difficult conversations not only with students but also with other peers and colleagues. In follow-up in-depth interviews with 20 of the 117 participants, 75% said they had made definite changes in their practice because of what they learned in the workshop and another 10% said they would make changes to their practice, but had not had the opportunity yet to do so. Conclusion: We conclude that the Spotlight on

  7. The Conversion of Wiswesser Line Notations to Ring Codes. I. The Conversion of Ring Systems

    Science.gov (United States)

    Granito, Charles E.; And Others

    1972-01-01

    The computerized conversion of Wiswesser Line Notations to Ring Codes, using a two-part approach, and the set of computer programs generated for the conversion of ring systems are described. (9 references) (Author)

  8. Discourse analysis: Conversational analysis of the internal conversation in Oracle Corporation Malaysia

    Directory of Open Access Journals (Sweden)

    Marwa Marwa

    2017-07-01

    Full Text Available This study highlights the internal conversation which takes place in Oracle CorporationMalaysia. Through the study, it will be shown how conversational analysis is used toanalyze the transcription of a telephone conversation between Oracle staffs. The analysisof the transcriptions will apply a few basic concepts of conversational analysis; turntakingorganization, and the adjacency pair. The objective of the study is to find out howthe internal conversations takes place by focusing on the conversation itself, that is, theconversational structures spontaneously produced by people during talk ranging fromturn-taking strategies, how topics are introduced, conversation closings and so on. Bylooking in detail at such talk, we can gain a detailed understanding of how the staffs seethemselves in relation to the company that influence their daily lives.Keywords: conversational analysis, turn-taking, adjacency pairs

  9. Cephalic Disorders

    Science.gov (United States)

    ... information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). Patient Organizations Birth Defect Research for Children, Inc. 976 Lake Baldwin Lane Suite 104 Orlando ...

  10. Spontaneous conversion of first onset atrial fibrillation

    DEFF Research Database (Denmark)

    Lindberg, Søren Østergaard; Hansen, Sidsel; Nielsen, Tonny

    2011-01-01

    Background  We studied all patients admitted to hospital with first onset atrial fibrillation (AF) to determine the probability of spontaneous conversion to sinus rhythm and to identify factors predictive of such a conversion. Methods and Results  We retrospectively reviewed charts of 438...

  11. Optimization theory for ballistic energy conversion

    NARCIS (Netherlands)

    Xie, Yanbo; Versluis, Michel; Van Den Berg, Albert; Eijkel, Jan C.T.

    2016-01-01

    The growing demand of renewable energy stimulates the exploration of new materials and methods for clean energy. We recently demonstrated a high efficiency and power density energy conversion mechanism by using jetted charged microdroplets, termed as ballistic energy conversion. Hereby, we model and

  12. Bilingualism and Conversational Understanding in Young Children

    Science.gov (United States)

    Siegal, Michael; Iozzi, Laura; Surian, Luca

    2009-01-01

    The purpose of the two experiments reported here was to investigate whether bilingualism confers an advantage on children's conversational understanding. A total of 163 children aged 3-6 years were given a Conversational Violations Test to determine their ability to identify responses to questions as violations of Gricean maxims of conversation…

  13. Critical Exchange: Religion and Schooling in Conversation

    Science.gov (United States)

    Stern, Julian

    2017-01-01

    Given the complex and messy contexts of schooling, conversations between religion and schooling can be "admitted" as examples of the sort of situated conversation that goes beyond the "false necessity" of universal state-controlled school-based education. There are distinct claims to be made about religion and schooling in…

  14. Jensen's operator inequality and its converses

    DEFF Research Database (Denmark)

    Hansen, Frank; Pecaric, Josip; Peric, Ivan

    2007-01-01

    We give a general formulation of Jensen's operator inequality for unital fields of positive linear mappings, and we consider different types of converse inequalities......We give a general formulation of Jensen's operator inequality for unital fields of positive linear mappings, and we consider different types of converse inequalities...

  15. Improving Teamwork through Awareness of Conversational Styles

    Science.gov (United States)

    Rehling, Louise

    2004-01-01

    Conversational styles can sometimes cause conflicts on problem-solving writing teams. In self-defense, students often resort to blaming and shaming around conversational styles, which can just worsen unproductive group behaviors, limiting idea exchanges and deflecting attention from substantive issues and onto what is often labeled "personality…

  16. Reflection during Portfolio-Based Conversations

    Science.gov (United States)

    Oosterbaan, Anne E.; van der Schaaf, Marieke F.; Baartman, Liesbeth K. J.; Stokking, Karel M.

    2010-01-01

    This study aims to explore the relationship between the occurrence of reflection (and non-reflection) and thinking activities (e.g., orientating, selecting, analysing) during portfolio-based conversations. Analysis of 21 transcripts of portfolio-based conversations revealed that 20% of the segments were made up of reflection (content reflection…

  17. Exergy conversion in the Japanese society

    International Nuclear Information System (INIS)

    Wall, G.

    1989-01-01

    In this paper exergy concept is reviewed as a tool for resource accounting. Conversions of energy and material resources in the Japanese society are described in terms of exergy. Necessary concepts and conventions are introduced. Exergy losses in transformations of material resources and in conversions of various forms of energy are described in some detail

  18. Conversational Memory Employing Cued and Free Recall.

    Science.gov (United States)

    Benoit, Pamela J.; Benoit, William L.

    1988-01-01

    Tests two hypotheses: (1) that cued recall elicits significantly more conversational information than free recall; and (2) that conversational interactants recall more of their partner's utterances than their own. Finds cued recall produced significantly higher amounts of remembering than free recall. (MS)

  19. Provoking Reflective Thinking in Post Observation Conversations

    Science.gov (United States)

    Kim, Younhee; Silver, Rita Elaine

    2016-01-01

    We present a micro-analysis of post observation conversations between classroom teachers and mentors. Using the approach of conversation analysis, we show how the sequential organization of an episode (i.e., who initiates the interaction, question format used by mentors) could potentially serve to provoke or hinder teacher reflection. Our analysis…

  20. Enhancing Classroom Conversation for All Students

    Science.gov (United States)

    Goldsmith, William

    2013-01-01

    The author, a 5th-grade teacher, offers strategies intended to assist and encourage ELL students to participate in academic conversations. They include insisting that children take part in conversations despite their apprehension and teaching them the language they need to communicate their ideas. One strategy is Think, Pair, Share--a simple…

  1. Large-video-display-format conversion

    NARCIS (Netherlands)

    Haan, de G.

    2000-01-01

    High-quality video-format converters apply motion estimation and motion compensation to prevent jitter resulting from picture-rate conversion, and aliasing due to de-interlacing, in sequences with motion. Although initially considered as too expensive, high-quality conversion is now economically

  2. Teaching communication aid use in everyday conversation

    DEFF Research Database (Denmark)

    Pilesjö, Maja Sigurd; Norén, Niklas

    2017-01-01

    This Conversation Analysis study investigated how a speech and language therapist (SLT) created opportunities for communication aid use in multiparty conversation. An SLT interacted with a child with multiple disabilities and her grandparents in a home setting, using a bliss board. The analyses...

  3. Observation of changing of the internal conversion coefficient under Moessbauer effect at magnetic transition in Rh-Fe system

    International Nuclear Information System (INIS)

    Ruskov, T.

    1998-01-01

    The magnetic disorder-order transition in the Rh-Fe alloy is studied by conversion electron Moessbauer spectroscopy. The drastic increase of the area under the Moessbauer spectrum at the transition from the paramagnetic to the magnetic state could be explained by diminishing the internal conversion coefficient. Thus our experimental results directly confirm the theory of the collective effect in the system of radiating developed by Yukalov

  4. The organization of digital conversation on MSN

    Directory of Open Access Journals (Sweden)

    Artarxerxes Tiago Tácito Modesto

    2012-02-01

    Full Text Available The emergence of the Internet has caused a revolution with regard to new forms of interaction between people, offering experiences of real-time communication in so-called virtual environments. Given this scenario, new textual genres emerge, making room for innumerous possibilities of analysis under various approaches. In this paper, we aim at analyzing digital conversations, trying to verify, at first, the extent to which they approach or move away from face-to-face conversations. We also seek to identify, describe and analyze some interactional strategies inherent in this new genre. We base our analyzes on Conversation Analysis theory and Interactional Sociolinguistics to define conversational strategies of the “spoken written text” on the Internet. The corpus used in this work consists of digital conversations coming from the MSN instant messaging software from Microsoft Corporation, chosen because of its wide use among people who use the internet for communication.

  5. Measuring Online Dialogic Conversations: A Scale Development

    DEFF Research Database (Denmark)

    Romenti, Stefania; Valentini, Chiara; Murtarelli, Grazia

    2016-01-01

    Purpose: The scope of this paper is to develop and test a measurement scale for assessing the quality of dialogic conversations among companies and digital publics in social media. It is argued that dialogic conversations are the drivers of dialogic engagement and the result of dialogic...... interactivity. Dialogic conversations are defined as sequences of communicative actions and counteractions taken by social actors for different purposes based on specific linguistic choices and characterised by diverse communicative approaches and the role played by the involved parties. Design....../methodology/approach: A multidimensional scale for measuring dialogic conversations is developed from relevant literature concerning dialogue and public engagement in the fields of corporate communication, public relations, management studies and conversation analysis. The scale was pre-tested to redefine and purify it from irrelevant...

  6. Does pedagogical documentation support maternal reminiscing conversations?

    Directory of Open Access Journals (Sweden)

    Bethany Fleck

    2015-12-01

    Full Text Available When parents talk with their children about lessons learned in school, they are participating in reminiscing of an unshared event. This study sought to understand if pedagogical documentation, from the Reggio Approach to early childhood education, would support and enhance the conversation. Mother–child dyads reminisced two separate times about preschool lessons, one time with documentation available to them and one time without. Transcripts were coded extracting variables indicative of high and low maternal reminiscing styles. Results indicate that mother and child conversation characteristics were more highly elaborative when documentation was present than when it was not. In addition, children added more information to the conversation supporting the notion that such conversations enhanced memory for lessons. Documentation could be used as a support tool for conversations and children’s memory about lessons learned in school.

  7. A Conversation with Adam Heller.

    Science.gov (United States)

    Heller, Adam; Cairns, Elton J

    2015-01-01

    Adam Heller, Ernest Cockrell Sr. Chair in Engineering Emeritus of the John J. McKetta Department of Chemical Engineering at The University of Texas at Austin, recalls his childhood in the Holocaust and his contributions to science and technology that earned him the US National Medal of Technology and Innovation in a conversation with Elton J. Cairns, Professor of Chemical and Biomolecular Engineering at the University of California, Berkeley. Dr. Heller, born in 1933, describes the enslavement of his father by Hungarians in 1942; the confiscation of his family's home, business, and all its belongings in 1944; and his incarceration in a brick factory with 18,000 Jews who were shipped by the Hungarians to be gassed by Germans in Auschwitz. Dr. Heller and his immediate family survived the Holocaust and arrived in Israel in 1945. He studied under Ernst David Bergmann at the Hebrew University, and then worked at Bell Laboratories and GTE Laboratories, where he headed Bell Lab's Electronic Materials Research Department. At GTE Laboratories, he built in 1966 the first neodymium liquid lasers and in 1973 with Jim Auborn conceived and engineered the lithium thionyl chloride battery, one of the first to be manufactured lithium batteries, which is still in use. After joining the faculty of engineering of The University of Texas at Austin, he cofounded with his son Ephraim Heller TheraSense, now a major part of Abbott Diabetes Care, which produced a microcoulometer that made the monitoring of glucose painless by accurately measuring the blood glucose concentration in 300 nL of blood. He also describes the electrical wiring of enzymes, the basis for Abbott's state-of-the-art continuous glucose monitoring system. He discusses his perspective of reducing the risk of catastrophic global warming in a wealth-accumulating, more-energy-consuming world and provides advice for students entering careers in science or engineering.

  8. Conduct disorders

    NARCIS (Netherlands)

    Buitelaar, J.K.; Smeets, K.C.; Herpers, P.; Scheepers, F.; Glennon, J.; Rommelse, N.N.J.

    2013-01-01

    Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic

  9. Personality disorders

    NARCIS (Netherlands)

    van den Bosch, L.M.C.; Verheul, R.; Verster, J.C.; Brady, K.; Galanter, M.; Conrod, P.

    2012-01-01

    Subject of this chapter is the often found combination of personality disorders and ­substance abuse disorders. The serious nature of this comorbidity is shown through the discussion of prevalence and epidemiological data. Literature shows that the comorbidity, hampering the diagnostic process, is

  10. Diffusion and transport in locally disordered driven lattices

    Energy Technology Data Exchange (ETDEWEB)

    Wulf, Thomas, E-mail: Thomas.Wulf@physnet.uni-hamburg.de; Okupnik, Alexander [Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg (Germany); Schmelcher, Peter, E-mail: Peter.Schmelcher@physnet.uni-hamburg.de [Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg (Germany); The Hamburg Centre for Ultrafast Imaging, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg (Germany)

    2016-09-15

    We study the effect of disorder on the particle density evolution in a classical Hamiltonian driven lattice setup. If the disorder is localized within a finite sub-domain of the lattice, the emergence of strong tails in the density distribution which even increases towards larger positions is shown, thus yielding a highly non-Gaussian particle density evolution. As the key underlying mechanism, we identify the conversion between different components of the unperturbed systems mixed phase space which is induced by the disorder. Based on the introduction of individual conversion rates between chaotic and regular components, a theoretical model is developed which correctly predicts the scaling of the particle density. The effect of disorder on the transport properties is studied where a significant enhancement of the transport for cases of localized disorder is shown, thereby contrasting strongly the merely weak modification of the transport for global disorder.

  11. Diffusion and transport in locally disordered driven lattices

    International Nuclear Information System (INIS)

    Wulf, Thomas; Okupnik, Alexander; Schmelcher, Peter

    2016-01-01

    We study the effect of disorder on the particle density evolution in a classical Hamiltonian driven lattice setup. If the disorder is localized within a finite sub-domain of the lattice, the emergence of strong tails in the density distribution which even increases towards larger positions is shown, thus yielding a highly non-Gaussian particle density evolution. As the key underlying mechanism, we identify the conversion between different components of the unperturbed systems mixed phase space which is induced by the disorder. Based on the introduction of individual conversion rates between chaotic and regular components, a theoretical model is developed which correctly predicts the scaling of the particle density. The effect of disorder on the transport properties is studied where a significant enhancement of the transport for cases of localized disorder is shown, thereby contrasting strongly the merely weak modification of the transport for global disorder.

  12. Personality disorder

    DEFF Research Database (Denmark)

    Tyrer, Peter; Mulder, Roger; Crawford, Mike

    2010-01-01

    and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting......Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services...... increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task....

  13. Gambling disorders.

    Science.gov (United States)

    Hodgins, David C; Stea, Jonathan N; Grant, Jon E

    2011-11-26

    Gambling disorders, including pathological gambling and problem gambling, have received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. This Seminar reviews prevalence, causes and associated features, screening and diagnosis, and treatment approaches. Gambling disorders affect 0·2-5·3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favourably evaluated, such as cognitive behavioural and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Autism spectrum disorder - childhood disintegrative disorder

    Science.gov (United States)

    ... part of the larger developmental disorder category of autism spectrum disorder . ... American Psychiatric Association. Autism spectrum disorder. ... VA: American Psychiatric Publishing: 2013;50-59. Raviola GJ, ...

  15. Ownership conversions and nursing home performance.

    Science.gov (United States)

    Grabowski, David C; Stevenson, David G

    2008-08-01

    To examine the effects of ownership conversions on nursing home performance. Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004. Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods. The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement. Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.

  16. Optical analysis of down-conversion OLEDs

    Science.gov (United States)

    Krummacher, Benjamin; Klein, Markus; von Malm, Norwin; Winnacker, Albrecht

    2008-02-01

    Phosphor down-conversion of blue organic light-emitting diodes (OLEDs) is one approach to generate white light, which offers the possibility of easy color tuning, a simple device architecture and color stability over lifetime. In this article previous work on down-conversion devices in the field of organic solid state lighting is briefly reviewed. Further, bottom emitting down-conversion OLEDs are studied from an optical point of view. Therefore the physical processes occurring in the down-conversion layer are translated into a model which is implemented in a ray tracing simulation. By comparing its predictions to experimental results the model is confirmed. For the experiments a blue-emitting polymer OLED (PLED) panel optically coupled to a series of down-conversion layers is used. Based on results obtained from ray tracing simulation some of the implications of the model for the performance of down-conversion OLEDs are discussed. In particular it is analysed how the effective reflectance of the underlying blue OLED and the particle size distribution of the phosphor powder embedded in the matrix of the down-conversion layer influence extraction efficiency.

  17. [Dissociative disorders and affective disorders].

    Science.gov (United States)

    Montant, J; Adida, M; Belzeaux, R; Cermolacce, M; Pringuey, D; Da Fonseca, D; Azorin, J-M

    2014-12-01

    The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  18. Linear mode conversion in a toroidal plasma

    International Nuclear Information System (INIS)

    Hellsten, T.

    1980-05-01

    Linear mode conversion at the perpendicular ion cyclotron resonance has been treated for an axially symmetric toroidal plasma. The mode conversion appears between a fast electromagnetic wave and a slow-quasi electrostatic wave, due to finite electron inertia. The problem reduces to the Orr-Sommerfeld equation where the coefficients determining the reflectron, transmission and conversion are functions of the arc length along a poloidal intersection of the resonance surface. These coefficients can be determined from eigenfunctions of an ordinary differential equation. (author)

  19. Entropy fluxes, endoreversibility, and solar energy conversion

    Science.gov (United States)

    de Vos, A.; Landsberg, P. T.; Baruch, P.; Parrott, J. E.

    1993-09-01

    A formalism illustrating the conversion of radiation energy into work can be obtained in terms of energy and entropy fluxes. Whereas the Landsberg equality was derived for photothermal conversion with zero bandgap, a generalized inequality for photothermal/photovoltaic conversion with a single, but arbitrary, bandgap was deduced. This result was derived for a direct energy and entropy balance. The formalism of endoreversible dynamics was adopted in order to show the correlation with the latter approach. It was a surprising fact that the generalized Landsberg inequality was derived by optimizing some quantity W(sup *), which obtains it maximum value under short-circuit condition.

  20. Conversion electron spectroscopy in transfermium nuclei

    International Nuclear Information System (INIS)

    Herzberg, R.D.

    2003-01-01

    Conversion electron spectroscopy is an essential tool for the spectroscopy of heavy deformed nuclei. The conversion electron spectrometer SACRED has been used in conjunction with the gas-filled recoil separator RITU to study conversion electron cascades in 254 No. The spectra reveal the ground state rotational bands down to low spin. A detailed analysis of the background seen for 254 No shows that approximately 40% of the decay path goes via excited high K bands which may be built on an isomer. (orig.)

  1. The conversion factor of α radiation efficiency

    International Nuclear Information System (INIS)

    Wang Weida; Zhou Zhixin; Xia Junding

    1997-01-01

    It is important in fine-grain TL dating that the full α dose must be converted into the equivalent β dose. Although the conversion coefficient K for internal radiation efficiency can not be measured directly for each sample, it is possible to measure the external radiation efficiency K 3.7 . For this purpose a special study for the conversion factor of K to K 3.7 has been made using ultrathin TLD. The results show that the conversion factor of the TLD for archaeological samples is 0.847, which is in agreement with the calculated value 0.85

  2. Energy Conversion & Storage Program, 1993 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, E.J.

    1994-06-01

    The Energy Conversion and Storage Program applies chemistry and materials science principles to solve problems in: production of new synthetic fuels; development of high-performance rechargeable batteries and fuel cells; development of high-efficiency thermochemical processes for energy conversion; characterization of complex chemical processes and chemical species; and the study and application of novel materials for energy conversion and transmission. Projects focus on transport-process principles, chemical kinetics, thermodynamics, chemical kinetics, thermodynamics, separation processes, organic and physical chemistry, novel materials, and advanced methods of analysis.

  3. Energy conversion and management principles and applications

    CERN Document Server

    Petrecca, Giovanni

    2014-01-01

    This book provides an overall view of energy conversion and management in industry and in buildings by following the streams of energy from the site boundaries to the end users. Written for an audience of both practitioners and faculty/students, Energy Conversion and Management: Principles and Applications presents general principles of energy conversion and energy sources, both traditional and renewable, in a broad range of facilities such as electrical substations, boiler plants, heat and power plants, electrical networks, thermal fluid distributions lines and insulations, pumps and fans, ai

  4. Meeting Disorders.

    Science.gov (United States)

    Yager, Joel; Katzman, Jeffrey W

    2017-12-01

    Although meetings are central to organizational work, considerable time devoted to meetings in Academic Health Centers appears to be unproductively spent. The primary purposes of this article are to delineate and describe Meeting Disorders, pathological processes resulting in these inefficient and ineffective scenarios, and Meeting Fatigue Disorder (MFD), a clinical syndrome. The paper also offers preliminary approaches to remedies. The authors integrate observations made during tens of thousands of hours in administrative meetings in academic medical settings with information in the literature regarding the nature, causes and potential interventions for dysfunctional groups and meetings. Meeting Disorders, resulting from distinct pathologies of leadership and organization, constitute prevalent subgroups of the bureaucrapathologies, pathological conditions caused by dysfunctional bureaucratic processes that generate excesses of wasted time, effort, and other resources. These disorders also generate frustration and demoralization among participants, contributing to professional burnout. Meeting Fatigue Disorder (MFD) is a subjective condition that develops in individuals who overdose on these experiences and may reflect one manifestation of burnout. Meeting disorders and Meeting Fatigue Disorder occur commonly in bureaucratic life. Resources and potential remedies are available to help ameliorate their more deleterious effects.

  5. Passenger and Cell Phone Conversations in Simulated Driving

    Science.gov (United States)

    Drews, Frank A.; Pasupathi, Monisha; Strayer, David L.

    2008-01-01

    This study examines how conversing with passengers in a vehicle differs from conversing on a cell phone while driving. We compared how well drivers were able to deal with the demands of driving when conversing on a cell phone, conversing with a passenger, and when driving without any distraction. In the conversation conditions, participants were…

  6. Land Conversion, Social Impacts, and Legal Remedies ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Land Conversion, Social Impacts, and Legal Remedies: Understanding the Role of Community Paralegals in Addressing Impacts of Land Use Change in Asia. This project addresses the ... Pays d' institution. United States. Site internet.

  7. Compact Energy Conversion Module, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — This STTR project delivers a compact vibration-based Energy Conversion Module (ECM) that powers sensors for purposes such as structural health monitoring (SHM). NASA...

  8. Compact energy conversion module, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This STTR project delivers a compact vibration-based Energy Conversion Module (ECM) that powers sensors for purposes like structural health monitoring (SHM). NASA...

  9. Alternative Fuels Data Center: Conversion Regulations

    Science.gov (United States)

    . Conversion systems must meet the same emissions standards that gasoline or diesel products do. Refer to EPA's manufacturer that holds the relevant emissions-related certifications and tampering exemptions. New and

  10. FLOUTING MAXIMS IN INDONESIA LAWAK KLUB CONVERSATION

    Directory of Open Access Journals (Sweden)

    Rahmawati Sukmaningrum

    2017-04-01

    Full Text Available This study aims to identify the types of maxims flouted in the conversation in famous comedy show, Indonesia Lawak Club. Likewise, it also tries to reveal the speakers‘ intention of flouting the maxim in the conversation during the show. The writers use descriptive qualitative method in conducting this research. The data is taken from the dialogue of Indonesia Lawak club and then analyzed based on Grice‘s cooperative principles. The researchers read the dialogue‘s transcripts, identify the maxims, and interpret the data to find the speakers‘ intention for flouting the maxims in the communication. The results show that there are four types of maxims flouted in the dialogue. Those are maxim of quality (23%, maxim of quantity (11%, maxim of manner (31%, and maxim of relevance (35. Flouting the maxims in the conversations is intended to make the speakers feel uncomfortable with the conversation, show arrogances, show disagreement or agreement, and ridicule other speakers.

  11. Expertise in Everyday Nurse–Patient Conversations

    Directory of Open Access Journals (Sweden)

    Lindsay M. Macdonald

    2016-04-01

    Full Text Available A great deal of nursing activity is embedded in what is considered to be everyday conversation. These conversations are important to health professionals because communication can affect health outcomes, and they are important to patients who want to know they are being heard and cared for. How do nurses talk with patients and what are the features of effective communication in practice? In this exploratory study, two expert nurses recorded conversations with patients during domiciliary visits. Linguistic discourse analysis, informed by contextual knowledge of domiciliary nursing shows the nurses skillfully used small talk to support their clinical work. In their conversations, nurses elicit specific information, normalize unpleasant procedures, manage the flow of the interaction, and strengthen the therapeutic relationship. Small talk can be big talk in achieving nursing goals. Critically reflecting on recorded clinical interactions can be a useful method of professional development and a way of demonstrating nursing expertise.

  12. NASA-OAST photovoltaic energy conversion program

    Science.gov (United States)

    Mullin, J. P.; Loria, J. C.

    1984-01-01

    The NASA program in photovoltaic energy conversion research is discussed. Solar cells, solar arrays, gallium arsenides, space station and spacecraft power supplies, and state of the art devices are discussed.

  13. Trends and Challenges in Catalytic Biomass Conversion

    DEFF Research Database (Denmark)

    Osmundsen, Christian Mårup; Egeblad, Kresten; Taarning, Esben

    2013-01-01

    The conversion of biomass to the plethora of chemicals used in modern society is one of the major challenges of the 21st century. Due to the significant differences between biomass resources and the current feedstock, crude oil, new technologies need to be developed encompassing all steps...... in the value chain, from pretreatment to purification. Heterogeneous catalysis is at the heart of the petrochemical refinery and will likely play an equally important role in the future biomass-based chemical industry. Three potentially important routes to chemicals from biomass are highlighted in this chapter....... The conversion of biomass-derived substrates, such as glycerol, by hydrogenolysis to the important chemicals ethylene glycol and propane diols. Secondly, the conversion of carbohydrates by Lewis acidic zeolites to yield alkyl lactates, and finally the conversion of lignin, an abundant low value source of biomass...

  14. Advances in wind energy conversion technology

    CERN Document Server

    Sathyajith, Mathew

    2011-01-01

    The technology of generating energy from wind has significantly changed during the past five years. The book brings together all the latest aspects of wind energy conversion technology - from wind resource analysis to grid integration of generated electricity.

  15. Interfacing feedstock logistics with bioenergy conversion

    Energy Technology Data Exchange (ETDEWEB)

    Sokhansanj, S. [British Columbia Univ., Vancouver, BC (Canada). Oak Ridge National Lab

    2010-07-01

    The interface between biomass production and biomass conversion platforms was investigated. Functional relationships were assembled in a modeling platform to simulate the flow of biomass feedstock from farm and forest to a densification plant. The model considers key properties of biomass for downstream pre-processing and conversion. These properties include moisture content, cellulose, hemicelluloses, lignin, ash, particle size, specific density and bulk density. The model simulates logistical operations such as grinding to convert biomass to pellets that are supplied to a biorefinery for conversion to heat, power, or biofuels. Equations were developed to describe the physical aspects of each unit operation. The effect that each of the process variables has on the efficiency of the conversion processes was described.

  16. 49 CFR 1018.7 - Conversion claims.

    Science.gov (United States)

    2010-10-01

    ... Conversion claims. These procedures are directed primarily to the recovery of money on behalf of the Government. The Board may demand: (a) The return of specific property; or (b) Either the return of property or the payment of its value. ...

  17. Condenser design for AMTEC power conversion

    Science.gov (United States)

    Crowley, Christopher J.

    1991-01-01

    The condenser and the electrodes are the two elements of an alkali metal thermal-to-electric conversion (AMTEC) cell which most greatly affect the energy conversion performance. A condenser is described which accomplishes two critical functions in an AMTEC cell: management of the fluid under microgravity conditions and optimization of conversion efficiency. The first function is achieved via the use of a controlled surface shape, along with drainage grooves and arteries to collect the fluid. Capillary forces manage the fluid in microgravity and dominate hydrostatic effects on the ground so the device is ground-testable. The second function is achieved via a smooth film of highly reflective liquid sodium on the condensing surface, resulting in minimization of parasitic heat losses due to radiation heat transfer. Power conversion efficiencies of 25 percent to 30 percent are estimated with this condenser using present technology for the electrodes.

  18. Solar spectrum conversion for photovoltaics using nanoparticles

    NARCIS (Netherlands)

    Sark, W.G.J.H.M. van; Meijerink, A.; Schropp, R.E.I.

    2012-01-01

    The possibility to tune chemical and physical properties in nanosized materials has a strong impact on a variety of technologies, including photovoltaics. One of the prominent research areas of nanomaterials for photovoltaics involves spectral conversion. Conventional single-junction

  19. Electrochemical conversion of micropollutants in gray water

    NARCIS (Netherlands)

    Butkovskyi, A.; Jeremiasse, A.W.; Hernandez Leal, L.; Zande, van der T.; Rijnaarts, H.; Zeeman, G.

    2014-01-01

    Electrochemical conversion of micropollutants in real gray water effluent was studied for the first time. Six compounds that are frequently found in personal care and household products, namely methylparaben, propylparaben, bisphenol A, triclosan, galaxolide, and 4- methylbenzilidene camphor

  20. Land Conversion, Social Impacts, and Legal Remedies ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Land Conversion, Social Impacts, and Legal Remedies: Understanding the Role of ... There is a recognized need for intermediary institutions, such as media, ... Birth registration is the basis for advancing gender equality and children's rights.

  1. Persuasive Conversational Agent with Persuasion Tactics

    Science.gov (United States)

    Narita, Tatsuya; Kitamura, Yasuhiko

    Persuasive conversational agents persuade people to change their attitudes or behaviors through conversation, and are expected to be applied as virtual sales clerks in e-shopping sites. As an approach to create such an agent, we have developed a learning agent with the Wizard of Oz method in which a person called Wizard talks to the user pretending to be the agent. The agent observes the conversations between the Wizard and the user, and learns how to persuade people. In this method, the Wizard has to reply to most of the user's inputs at the beginning, but the burden gradually falls because the agent learns how to reply as the conversation model grows.

  2. Wind Energy Conversion Systems Technology and Trends

    CERN Document Server

    2012-01-01

    Wind Energy Conversion System covers the technological progress of wind energy conversion systems, along with potential future trends. It includes recently developed wind energy conversion systems such as multi-converter operation of variable-speed wind generators, lightning protection schemes, voltage flicker mitigation and prediction schemes for advanced control of wind generators. Modeling and control strategies of variable speed wind generators are discussed, together with the frequency converter topologies suitable for grid integration. Wind Energy Conversion System also describes offshore farm technologies including multi-terminal topology and space-based wind observation schemes, as well as both AC and DC based wind farm topologies. The stability and reliability of wind farms are discussed, and grid integration issues are examined in the context of the most recent industry guidelines. Wind power smoothing, one of the big challenges for transmission system operators, is a particular focus. Fault ride th...

  3. Conduct disorder

    Science.gov (United States)

    ... develop problems with drug abuse and the law. Depression and bipolar disorder may develop in the teen years and early adulthood. Suicide and violence toward others are also possible complications.

  4. Sleep Disorders

    Science.gov (United States)

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  5. Eating Disorders

    Science.gov (United States)

    ... to control them. Avoidant/Restrictive Food Intake Disorder (ARFID) ARFID is a new term that some people think ... eating issues can also cause it. People with ARFID don't have anorexia or bulimia, but they ...

  6. Neurocutaneous Disorders.

    Science.gov (United States)

    Rosser, Tena

    2018-02-01

    This article presents an up-to-date summary of the genetic etiology, diagnostic criteria, clinical features, and current management recommendations for the most common neurocutaneous disorders encountered in clinical adult and pediatric neurology practices. The phakomatoses are a phenotypically and genetically diverse group of multisystem disorders that primarily affect the skin and central nervous system. A greater understanding of the genetic and biological underpinnings of numerous neurocutaneous disorders has led to better clinical characterization, more refined diagnostic criteria, and improved treatments in neurofibromatosis type 1, Legius syndrome, neurofibromatosis type 2, Noonan syndrome with multiple lentigines, tuberous sclerosis complex, Sturge-Weber syndrome, and incontinentia pigmenti. Neurologists require a basic knowledge of and familiarity with a wide variety of neurocutaneous disorders because of the frequent involvement of the central and peripheral nervous systems. A simple routine skin examination can often open a broad differential diagnosis and lead to improved patient care.

  7. Factitious Disorder

    Science.gov (United States)

    ... support their claims. Factitious disorder signs and symptoms may include: Clever and convincing medical or psychological problems Extensive knowledge of medical terms and diseases Vague or inconsistent symptoms Conditions that get worse for no apparent ...

  8. Neuromuscular Disorders

    Science.gov (United States)

    ... lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include Amyotrophic lateral sclerosis Multiple sclerosis Myasthenia ...

  9. Conduct Disorder

    Science.gov (United States)

    ... objections runs away from home often truant from school Children who exhibit these behaviors should receive a comprehensive evaluation by an experience mental health professional. Many children with a conduct disorder may ...

  10. Amnestic Disorders

    NARCIS (Netherlands)

    Kessels, R.P.C.; Savage, G.; Cautin, R.L.; Lilienfeld, S.O.

    2015-01-01

    Amnestic disorders may involve deficits in the encoding or storage of information in memory, or in retrieval of information from memory. Etiologies vary and include traumatic brain injury, neurodegenerative disease, and psychiatric illness. Different forms of amnesia can be distinguished:

  11. Sleep Disorders

    DEFF Research Database (Denmark)

    Rahbek Kornum, Birgitte; Mignot, Emmanuel

    2014-01-01

    mediates circadian regulation of sleep. Misalignment with the rhythm of the sun results in circadian disorders and jet lag. The molecular basis of homeostatic sleep regulation is mostly unknown. A network of mutually inhibitory brain nuclei regulates sleep states and sleep-wake transitions. Abnormalities...... in these networks create sleep disorders, including rapid eye movement sleep behavior disorder, sleep walking, and narcolepsy. Physiological changes associated with sleep can be imbalanced, resulting in excess movements such as periodic leg movements during sleep or abnormal breathing in obstructive sleep apneas....... As every organ in the body is affected by sleep directly or indirectly, sleep and sleep-associated disorders are frequent and only now starting to be understood....

  12. TMJ Disorders

    Science.gov (United States)

    ... Aching pain in and around your ear Difficulty chewing or pain while chewing Aching facial pain Locking of the joint, making ... disorder. When to see a doctor Seek medical attention if you have persistent pain or tenderness in ...

  13. Autoimmune disorders

    Science.gov (United States)

    ... exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  14. Conversion Rate Optimization through Evolutionary Computation

    OpenAIRE

    Miikkulainen, Risto; Iscoe, Neil; Shagrin, Aaron; Cordell, Ron; Nazari, Sam; Schoolland, Cory; Brundage, Myles; Epstein, Jonathan; Dean, Randy; Lamba, Gurmeet

    2017-01-01

    Conversion optimization means designing a web interface so that as many users as possible take a desired action on it, such as register or purchase. Such design is usually done by hand, testing one change at a time through A/B testing, or a limited number of combinations through multivariate testing, making it possible to evaluate only a small fraction of designs in a vast design space. This paper describes Sentient Ascend, an automatic conversion optimization system that uses evolutionary op...

  15. μ- conversion via doubly charged Higgs scalar

    International Nuclear Information System (INIS)

    Picciotto, C.E.; Zahir, M.S.

    1982-10-01

    A new mechanism is used to calculate μ - → e + conversion in nuclei, based on the existence of a doubly charged Higgs scalar. The scalar is part of a triplet which generates the spontaneous breakdown of B-L symmetry in an extension of the standard model, as proposed by Gelmini and Roncadelli. We find a limit for conversion rates which is comparable to those of earlier calculations

  16. Measuring international relations in social media conversations

    OpenAIRE

    Barnett, GA; Xu, WW; Chu, J; Jiang, K; Huh, C; Park, JY; Park, HW

    2017-01-01

    © 2016 Elsevier Inc. This paper examines international relations as perceived by the public in their social media conversations. It examines over 1.8 billion Facebook postings in English and 51 million Chinese posts on Weibo, to reveal the relations among nations as expressed in social media conversations. It argues that social media represent a transnational electronic public sphere, in which public discussions reveal characteristics of international relations as perceived by a foreign publi...

  17. A simple theory of linear mode conversion

    International Nuclear Information System (INIS)

    Cairns, R.A.; Lashmore-Davies, C.N.; Woods, A.M.

    1984-01-01

    A summary is given of the basic theory of linear mode conversion involving the construction of differential equations for the mode amplitudes based on the properties of the dispersion relation in the neighbourhood of the mode conversion point. As an example the transmission coefficient for tunneling from the upper hybrid resonance through the evanescent region to the adjacent cut-off is treated. 7 refs, 3 figs

  18. Mineralogical conversion of asbestos containing materials

    International Nuclear Information System (INIS)

    Pulsford, S.K.; Foltz, A.D.; Ek, R.B.

    1996-01-01

    The principal objective of the Technical Task Plan (TTP) is to demonstrate a thermal-chemical mineralogical asbestos conversion unit at the Hanford Site, which converts non-radiological asbestos containing materials (ACMs) into an asbestos-free material. The permanent thermal-chemical mineralogical conversion of ACMs to a non-toxic, non-hazardous, potentially marketable end product should not only significantly reduce the waste stream volumes but terminate the open-quotes cradle to graveclose quotes ownership liabilities

  19. A Converse of Fermat's Little Theorem

    Science.gov (United States)

    Bruckman, P. S.

    2007-01-01

    As the name of the paper implies, a converse of Fermat's Little Theorem (FLT) is stated and proved. FLT states the following: if p is any prime, and x any integer, then x[superscript p] [equivalent to] x (mod p). There is already a well-known converse of FLT, known as Lehmer's Theorem, which is as follows: if x is an integer coprime with m, such…

  20. Eating disorders

    OpenAIRE

    Kontić Olga; Vasiljević Nadja; Trišović Marija; Jorga Jagoda; Lakić Aneta; Jašović-Gašić Miroslava

    2012-01-01

    Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis...