WorldWideScience

Sample records for naturalistic observational study

  1. The value of site-based observations complematary to naturalistic driving observations : a pilot study on the right turn manoeuvre.

    NARCIS (Netherlands)

    Nes, N. van Christoph, M.W.T. Hoedemaeker, M. & Horst, A.R.A. van der

    2013-01-01

    Naturalistic driving studies are increasingly applied in different shapes and sizes. The European project PROLOGUE has investigated the value and feasibility of a large-scale naturalistic driving study in Europe. Within PROLOGUE several pilot studies have been conducted in different countries. The

  2. Comparison between risperidone, olanzapine, and clozapine in the management of chronic schizophrenia: a naturalistic prospective 12-week observational study.

    Science.gov (United States)

    Strous, Rael D; Kupchik, Marina; Roitman, Suzana; Schwartz, Sima; Gonen, Noach; Mester, Roberto; Weizman, Abraham; Spivak, Baruch

    2006-06-01

    Risperidone, olanzapine, and clozapine are three atypical antipsychotic medications commonly used in the management of chronic schizophrenia. While they offer advantages with regard to clinical efficacy and side-effect profile, few studies have compared them in a naturalistic prospective observational manner. This study therefore investigated their comparative efficacy over 12 weeks including illness characteristics and adverse effects. One hundred thirty-one patients (76 M, 55 F) with DSMI-V schizophrenia or schizoaffective disorder were treated with risperidone (n = 38), olanzapine (n = 38), or clozapine (n = 55). All patients showed a significant decrease of Positive and Negative Syndrome Scale (PANSS)-positive scores. Decreases in tardive dyskinesia and impulsivity scores were noted with clozapine and olanzapine, respectively. No differences between the medications were noted on depression, anxiety, EPS, or overt aggression scores. Olanzapine and clozapine appeared to be more effective in females. Males showed a decreased sexual performance irrespective of the medication and those treated with risperidone and clozapine showed greater proportional reduction of overt aggression. Clozapine-treated patients showed significant increased weight, increased glucose levels, and lowered sexual performance. Risperidone patients tended to exhibit reduced cholesterol levels. Higher creatine kinase (CK) levels were noted in risperidone-treated patients. While cautious given the nature of the study design, results suggest differences in the response to various atypical antipsychotic medications regarding efficacy and side-effect susceptibility. Copyright 2006 John Wiley & Sons, Ltd.

  3. Naturalistic Observations of Nonverbal Children with Autism: A Study of Intentional Communicative Acts in the Classroom

    Directory of Open Access Journals (Sweden)

    Samantha Drain

    2013-01-01

    Full Text Available We examined evoked and spontaneous communicative acts in six nonverbal children with autism (10–15 years, M = 12.8, SD = 2.1. All participants attended the same special school for children with autism but were in different classes. Each was observed for 30 minutes during a typical school day. An observer coded the presence/absence of an antecedent, the form and function of the communicative act, and the teacher’s response to the child. One hundred and fifty-five communicative acts were observed, 41% were spontaneous and 59% were evoked. The main antecedents to evoked communicative acts were verbal prompts, and most of the evoked communicative acts were physical in nature (i.e., motor acts and gestures. However, verbalizations and the use of the Picture Exchange Communication System (PECS were higher for spontaneous communicative acts. The functions of spontaneous communicative acts were primarily requests. Results showed a substantial number of “nonresponses” from teachers, even following evoked communicative acts. These results suggest that teachers may not actively promote intentional communication as much as possible. Therefore, our findings provide information concerning ways in which educators could facilitate intentional communication in non-verbal children with autism.

  4. Naturalistically observed conflict and youth asthma symptoms.

    Science.gov (United States)

    Tobin, Erin T; Kane, Heidi S; Saleh, Daniel J; Naar-King, Sylvie; Poowuttikul, Pavadee; Secord, Elizabeth; Pierantoni, Wayne; Simon, Valerie A; Slatcher, Richard B

    2015-06-01

    To investigate the links between naturalistically observed conflict, self-reported caregiver-youth conflict, and youth asthma symptoms. Fifty-four youth with asthma (age range: 10-17 years) wore the Electronically Activated Recorder (EAR) for a 4-day period to assess interpersonal conflict and caregiver-youth conflict as they occur in daily life. Conflict also was assessed with baseline self-report questionnaires and daily diaries completed by youth participants and their caregivers. Asthma symptoms were assessed using daily diaries, baseline self-reports, and wheezing, as coded from the EAR. EAR-observed measures of conflict were strongly associated with self-reported asthma symptoms (both baseline and daily diaries) and wheezing coded from the EAR. Further, when entered together in regression analyses, youth daily reports of negative caregiver-youth interactions and EAR-observed conflict uniquely predicted asthma symptoms; only EAR-observed conflict was associated with EAR-observed wheezing. These findings demonstrate the potential impact of daily conflict on youth asthma symptoms and the importance of assessing conflict as it occurs in everyday life. More broadly, they point to the importance of formulating a clear picture of family interactions outside of the lab, which is essential for understanding how family relationships "get under the skin" to affect youth health. (c) 2015 APA, all rights reserved).

  5. Naturalistic Study of Truck Following Behavior

    Science.gov (United States)

    2016-04-01

    Volpe conducted the Naturalistic study of truck following behavior to gain a better understanding of how trucks follow other vehicles in the real world, with the ultimate goal of supporting the Federal Highway Administration in the development of aut...

  6. Naturalistically-Observed Conflict and Youth Asthma Symptoms

    Science.gov (United States)

    Tobin, Erin T.; Kane, Heidi S.; Saleh, Daniel J.; Naar-King, Sylvie; Poowuttikul, Pavadee; Secord, Elizabeth; Pierantoni, Wayne; Simon, Valerie; Slatcher, Richard B.

    2014-01-01

    Objective To investigate the links between naturalistically-observed conflict, self-reported caregiver-youth conflict, and youth asthma symptoms. Method Fifty-four youth with asthma (aged 10-17) wore the Electronically Activated Recorder (EAR) for a 4-day period to assess interpersonal conflict and caregiver-youth conflict as they occur in daily life. Conflict also was assessed with baseline self-report questionnaires and daily diaries completed by the youth participants and their caregiver. Asthma symptoms were assessed via daily diaries and baseline self-reports and wheezing as coded from the EAR. Results EAR-observed measures of conflict were strongly associated with self-reported asthma symptoms (both baseline and daily diaries) and wheezing coded from the EAR. Further, when entered together in regression analyses, youth daily reports of negative caregiver-youth interactions and EAR-observed conflict uniquely predicted asthma symptoms; only EAR-observed conflict was associated with EAR-observed wheezing. Conclusions These findings demonstrate the potential impact of daily conflict on youth asthma symptoms and the importance of assessing conflict as it occurs in everyday life. More broadly, they point to the importance of formulating a clear picture of family interactions outside of the lab, which is essential for understanding how family relationships “get under the skin” to affect youth health. PMID:25222090

  7. Areas of interest of potential users for naturalistic observation studies. PROmoting real Life Observations for Gaining Understanding of road user behaviour in Europe PROLOGUE, Deliverable D1.2.

    NARCIS (Netherlands)

    Schagen, I.N.L.G. van Craen, S. de Nes, N. van & Eenink, R.

    2010-01-01

    Identification of the interests of potential users is crucial for setting up a useful and broadly supported large-scale naturalistic driving (ND) study. This report describes the results of a survey amongst 72 road transport professionals in Europe from different organisation types that aimed at

  8. Naturalistic driving observations of manual and visual-manual interactions with navigation systems and mobile phones while driving.

    NARCIS (Netherlands)

    Christoph, M. Nes, N. van & Knapper, A.

    2014-01-01

    This paper discusses a naturalistic driving study on the use of mobile phones and navigation systems while driving. Manual interactions with these devices while driving can cause distraction from the driving task and reduce traffic safety. In this study 21 subjects were observed for 5 weeks. Their

  9. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 6, Driver Behaviour Monitoring through Naturalistic Driving: Deliverable 6.2: Part A: Study design of naturalistic driving observations within ERSO - development of innovative indicators for exposure and safety performance measures.

    NARCIS (Netherlands)

    Bonnard, A. Brusque, C. Hugot, M. Commandeur, J.J.F. & Christoph, M.W.T.

    2015-01-01

    The objective of the Task 6.2 of DaCoTA is to specify the study design of naturalistic driving study in the perspective of the European Road Safety Observatory. More precisely, the task deals with three main issues: 1) the experimental design, 2) the procedures to Risk Exposure Data (RED) and Safety

  10. Naturalistic study of olanzapine in treatment-resistaant ...

    African Journals Online (AJOL)

    Naturalistic study of olanzapine in treatment-resistaant schizophrenia and acute mania, depression and obsessional disorder. ... Whereas the Fiji government provides all aspects of mental health care services free of charge to its citizens, many schizophrenics have failed to respond to classical antipsychotic drugs.

  11. Naturalistic driving studies: The effectiveness of the methodology in monitoring driver behaviour

    CSIR Research Space (South Africa)

    Muronga, Khangwelo

    2017-07-01

    Full Text Available Naturalistic Driving Studies (NDS) is a research methodology that has the potential to improve existing approaches for collecting data about driver behaviour and performance in normal driving conditions. Analysis of naturalistic driving data...

  12. Naturalistic Observations of Sex Differences in Adult Involvement with Girls and Boys of Different Ages.

    Science.gov (United States)

    Hoffman, Charles D.; Teyber, Edward C.

    1985-01-01

    Compares the participation of men and of women in child-related activities. Naturalistic observations of children (ranging from infancy to adolescence) and adults in public places were obtained. Findings support a sex-traditional model of adult involvement with children. (Author/KS)

  13. Children's Expressions of Positive Emotion Are Sustained by Smiling, Touching, and Playing with Parents and Siblings: A Naturalistic Observational Study of Family Life

    Science.gov (United States)

    Bai, Sunhye; Repetti, Rena L.; Sperling, Jacqueline B.

    2016-01-01

    Research on family socialization of positive emotion has primarily focused on the infant and toddler stages of development, and relied on observations of parent-child interactions in highly structured laboratory environments. Little is known about how children's spontaneous expressions of positive emotion are maintained in the uncontrolled…

  14. Stereotypic information about drinkers and students' observed alcohol intake: an experimental study on prototype-behavior relations in males and females in a naturalistic drinking context

    NARCIS (Netherlands)

    Teunissen, H.A.; Spijkerman, R.; Larsen, H.; Kremer, K.A.; Kuntsche, E.; Gibbons, F.X.; Scholte, R.H.J.; Engels, R.C.M.E.

    2012-01-01

    Background: Cross-sectional and longitudinal research has shown that favorable drinker prototypes (i.e., perceptions about the typical drinker) are related to higher levels of alcohol consumption in adolescents and college students. So far, few studies have experimentally tested the causality of

  15. Stereotypic information about drinkers and students' observed alcohol intake: An experimental study on prototype-behavior relations in males and females in a naturalistic drinking context

    NARCIS (Netherlands)

    Teunissen, H.A.; Spijkerman, R.; Larsen, H.; Kremer, K.A.; Kuntsche, E.N.; Gibbons, F.X.; Scholte, R.H.J.; Engels, R.C.M.E.

    2012-01-01

    Background: Cross-sectional and longitudinal research has shown that favorable drinker prototypes (i.e., perceptions about the typical drinker) are related to higher levels of alcohol consumption in adolescents and college students. So far, few studies have experimentally tested the causality of

  16. Who walks into vape shops in Southern California?: a naturalistic observation of customers.

    Science.gov (United States)

    Sussman, Steve; Allem, Jon-Patrick; Garcia, Jocelyn; Unger, Jennifer B; Cruz, Tess Boley; Garcia, Robert; Baezconde-Garbanati, Lourdes

    2016-01-01

    The rising popularity of electronic cigarettes (e-cigarettes) has been accompanied by the proliferation of vape shops in the United States. Vape shops are devoted to the sale of e-cigarettes and e-juices. This study aimed to describe the age, gender, and ethnicity of customers who frequent these shops, determine whether conversations transpire between retailers and customers, as well as identify the types of activities taking place while customers are inside the store. A naturalistic observation study of 186 customers in 59 vape shops in Southern California was completed in locations that were relatively high in Korean, Non-Hispanic white, Hispanic, or African American ethnicity. Across all shops, the average estimated age of customers was 30.29 years old (SD = 9.70), 53 % were estimated to be non-Hispanic white, and 79 % were males; few minors entered the shops. Conversations about vaping related topics were prevalent (e.g., sampling e-juices, receiving help on hardware, and talking about vaping). Purchases were commonly observed as well as customers lounging in the shop. Vape shops provide consumers a place to purchase and discuss e-cigarettes and offer an environment that serves as a place of recreation with customers lounging once inside. Findings should inform local tobacco control efforts and regulatory policies in the future.

  17. Science of the Particular: An Advocacy of Naturalistic Case Study in Health Research

    NARCIS (Netherlands)

    Abma, T.A.; Stake, R.E.

    2014-01-01

    Case studies can provide us with in-depth understanding of a single demarcated entity. Cases can be corporations and clinics, but are usually people. There are several approaches to case study. Naturalistic case study constitutes the science of the particular. The aim of naturalistic case study is

  18. A Fresh Pair of Eyes: A Blind Observation Method for Evaluating Social Skills of Children with ASD in a Naturalistic Peer Situation in School

    Science.gov (United States)

    Dekker, Vera; Nauta, Maaike H.; Mulder, Erik J.; Sytema, Sjoerd; de Bildt, Annelies

    2016-01-01

    The Social skills Observation Measure (SOM) is a direct observation method for social skills used in naturalistic everyday situations in school. This study describes the development of the SOM and investigates its psychometric properties in 86 children with Autism spectrum disorder, aged 9.8-13.1 years. The interrater reliability was found to be…

  19. A Fresh Pair of Eyes : A Blind Observation Method for Evaluating Social Skills of Children with ASD in a Naturalistic Peer Situation in School

    NARCIS (Netherlands)

    Dekker, Vera; Nauta, Maaike H.; Mulder, Erik J.; Sytema, Sjoerd; de Bildt, Annelies

    The Social skills Observation Measure (SOM) is a direct observation method for social skills used in naturalistic everyday situations in school. This study describes the development of the SOM and investigates its psychometric properties in 86 children with Autism spectrum disorder, aged 9.8-13.1

  20. Naturalist Sentimentalism

    DEFF Research Database (Denmark)

    Wohlmann, Anita

    2018-01-01

    This article examines four short stories by the American writer Rebecca Harding Davis (1831-1910), who became a nationally acclaimed writer with the stylistically innovative novella Life in the Iron Mills (1861). Using the double perspective of age studies and ‘naturalist sentimentalism’, the essay...... analyses Davis’s representation of the paradoxes of old age. Davis blends sentimental ideals of sympathy, sacrifice, and hope with naturalist themes of entrapment, the inevitability of decline, and biological determinism. Four short stories by Davis will serve as cases in point: ‘At Noon’ (1887), ‘At......, Davis discusses the meanings of age and ageing, intergenerational conflicts, gender, and the impact of the body and social context on the experience of ageing. In drawing on both sentimental and naturalist themes and combining them, Davis’s stories reflect conflicting notions about ageing and old age...

  1. Naturalist Sentimentalism

    DEFF Research Database (Denmark)

    Wohlmann, Anita

    2018-01-01

    This article examines four short stories by the American writer Rebecca Harding Davis (1831-1910), who became a nationally acclaimed writer with the stylistically innovative novella Life in the Iron Mills (1861). Using the double perspective of age studies and ‘naturalist sentimentalism’, the essay...... analyses Davis’s representation of the paradoxes of old age. Davis blends sentimental ideals of sympathy, sacrifice, and hope with naturalist themes of entrapment, the inevitability of decline, and biological determinism. Four short stories by Davis will serve as cases in point: ‘At Noon’ (1887), ‘At...

  2. Naturalistic Teenage Driving Study: Findings and Lessons Learned

    Science.gov (United States)

    Simons-Morton, Bruce G.; Klauer, Sheila G.; Ouimet, Marie Claude; Guo, Feng; Albert, Paul S.; Lee, Suzanne E.; Ehsani, Johnathon P.; Pradhan, Anuj K.; Dingus, Thomas A.

    2015-01-01

    Problem This paper summarizes the findings on novice teenage driving outcomes (e.g., crashes and risky driving behaviors) from the Naturalistic Teenage Driving Study. Method Survey and driving data from a data acquisition system (Global Positioning System, accelerometers, cameras) were collected from 42 newly-licensed teenage drivers and their parents during the first 18 months of teenage licensure; stress responsivity was also measured in teenagers. Result Overall teenage crash and near crash (CNC) rates declined over time, but were >4 times higher among teenagers than adults. Contributing factors to teenage CNC rates included secondary task engagement (e.g., distraction), kinematic risky driving, low stress responsivity, and risky social norms. Conclusion The data support the contention that the high novice teenage CNC risk is due both to inexperience and risky driving behavior, particularly kinematic risky driving and secondary task engagement. Practical Applications Graduated driver licensing policy and other prevention efforts should focus on kinematic risky driving, secondary task engagement, and risky social norms. PMID:26403899

  3. Naturalistic teenage driving study: Findings and lessons learned.

    Science.gov (United States)

    Simons-Morton, Bruce G; Klauer, Sheila G; Ouimet, Marie Claude; Guo, Feng; Albert, Paul S; Lee, Suzanne E; Ehsani, Johnathon P; Pradhan, Anuj K; Dingus, Thomas A

    2015-09-01

    This paper summarizes the findings on novice teenage driving outcomes (e.g., crashes and risky driving behaviors) from the Naturalistic Teenage Driving Study. Survey and driving data from a data acquisition system (global positioning system, accelerometers, cameras) were collected from 42 newly licensed teenage drivers and their parents during the first 18 months of teenage licensure; stress responsivity was also measured in teenagers. Overall teenage crash and near-crash (CNC) rates declined over time, but were >4 times higher among teenagers than adults. Contributing factors to teenage CNC rates included secondary task engagement (e.g., distraction), kinematic risky driving, low stress responsivity, and risky social norms. The data support the contention that the high novice teenage CNC risk is due both to inexperience and risky driving behavior, particularly kinematic risky driving and secondary task engagement. Graduated driver licensing policy and other prevention efforts should focus on kinematic risky driving, secondary task engagement, and risky social norms. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  4. South African novice driver behaviour: findings from a naturalistic driving study

    CSIR Research Space (South Africa)

    Venter, Karien

    2014-07-01

    Full Text Available : FINDINGS FROM A NATURALISTIC DRIVING STUDY VENTER, K. AND SINCLAIR, M* CSIR Built Environment, PO Box 395, Pretoria, Tel: 012 841 3856, E-mail: kventer@csir.co.za. *Department of Civil Engineering Stellenbosch University, Tel: 021 808 3838, E... acquired skill. With practice, skills such as scanning behaviour and handling of the vehicle improve significantly. This study used naturalistic driving study methodology to investigate novice driver behaviour in South Africa. Data acquisition systems...

  5. A synthetic approach to compare the large truck crash causation study and naturalistic driving data.

    Science.gov (United States)

    Hickman, Jeffrey S; Hanowski, Richard J; Bocanegra, Joseph

    2018-03-01

    Truck crashes represent a significant problem on our nation's highways. There is a great opportunity to learn about crash causation by analyzing and comparing the Large Truck Crash Causation Study (LTCCS) and naturalistic driving (ND) data. These data sets provide in-depth information, but have contrasting strengths and weaknesses. The LTCCS contains information on high-severity crashes (crashes and fatal crashes), but relied on data collected during crash investigations. The LTCCS identified principal driver errors in the crash, such as the Critical Reason, but not detailed behaviors or scenario sequences. The ND data sets relate primarily to non-crashes that are detectable from dynamic vehicle events, such as hard braking, swerve, etc., provide direct video observations of the driver and the surrounding driving scene and precise information on driver inputs (kinematics) and captured events, and provide certain types of exposure data that cannot easily be obtained using crash reconstruction data. The ND data are collected continuously, thereby capturing both safety-critical events and normative driving (i.e., baseline). The current project evaluated large-truck crash data from the LTCCS and two large-truck ND data sets, the Naturalistic Truck Driving Study and the Drowsy Driver Warning System Field Operational Test. A synthetic risk ratio analysis on the associated factor, Following Too Closely, indicated that truck drivers in the LTCCS were 1.34 times more likely to be involved in a crash, than an ND crash-relevant conflict, if they were following too closely (i.e., tailgating). Given several caveats noted in the paper, this study suggests it's possible to use the ND data set to calculate the exposure of a given behavior and use the LTCCS data set to calculate the crash exposure to the same behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. A Naturalistic Study of Collaborative Play Transformations of Preschoolers with Hearing Impairments.

    Science.gov (United States)

    Selmi, Ann M.; Rueda, Robert S.

    1998-01-01

    This naturalistic study examined the classroom collaborative play activities of nine preschoolers with hearing impairments and language delays, but without sign-language skills. Findings indicated the children constructed collaborative play episodes which incorporated role, action, and object transformations using a nonverbal metacommunication…

  7. Pathways to Language: A Naturalistic Study of Children with Williams Syndrome and Children with Down Syndrome

    Science.gov (United States)

    Levy, Yonata; Eilam, Ariela

    2013-01-01

    This is a naturalistic study of the development of language in Hebrew-speaking children with Williams syndrome (WS) and children with Down syndrome (DS), whose MLU extended from 1[multiplied by]0 to 4[multiplied by]4. Developmental curves over the entire span of data collection revealed minor differences between children with WS, children with DS,…

  8. Clergymen abiding in the fields: the making of the naturalist observer in eighteenth-century Norwegian natural history.

    Science.gov (United States)

    Brenna, Brita

    2011-06-01

    By the mid-eighteenth century, governors of the major European states promoted the study of nature as part of natural-resource based schemes for improvement and economic self-sufficiency. Procuring beneficial knowledge about nature, however, required observers, collectors, and compilers who could produce usable and useful descriptions of nature. The ways governments promoted scientific explorations varied according to the form of government, the makeup of the civil society, the state's economic ideologies and practices, and the geographical situation. This article argues that the roots of a major natural history initiative in Denmark-Norway were firmly planted in the state-church organization. Through the clergymen and their activities, a bishop, supported by the government in Copenhagen, could gather an impressive collection of natural objects, receive observations and descriptions of natural phenomena, and produce natural historical publications that described for the first time many of the species of the north. Devout naturalists were a common species in the eighteenth century, when clergymen and missionaries involved themselves in the investigation of nature in Europe and far beyond. The specific interest here is in how natural history was supported and enforced as part of clerical practice, how specimen exchange was grafted on to pre-existing institutions of gift exchange, and how this influenced the character of the knowledge produced.

  9. Naturalistic driving study of rear seat child occupants: Quantification of head position using a Kinect™ sensor.

    Science.gov (United States)

    Arbogast, Kristy B; Kim, Jinyong; Loeb, Helen; Kuo, Jonny; Koppel, Sjaan; Bohman, Katarina; Charlton, Judith L

    2016-09-01

    Restraint performance is evaluated using anthropomorphic test devices (ATDs) positioned in prescribed, optimal seating positions. Anecdotally, humans-children in particular-assume a variety of positions that may affect restraint performance. Naturalistic driving studies (NDSs), where cameras and other data acquisition systems are placed in a vehicle used by participants during their regular transportation, offer means to collect these data. To date, these studies have used conventional video and analysis methods and, thus, analyses have largely been qualitative. This article describes a recently completed NDS of child occupants in which their position was monitored using a Kinect sensor to quantify their head position throughout normal, everyday driving trips. A study vehicle was instrumented with a data acquisition system to measure vehicle dynamics, a set of video cameras, and a Kinect sensor providing 3D motion capture at 1 Hz of the rear seat occupants. Participant families used the vehicle for all driving trips over 2 weeks. The child occupants' head position was manually identified via custom software from each Kinect color image. The 3D head position was then extracted and its distribution summarized by seat position (left, rear, center) and restraint type (forward-facing child restraint system [FFCRS], booster seat, seat belt). Data from 18 families (37 child occupants) resulted in 582 trips (with children) for analysis. The average age of the child occupants was 45.6 months and 51% were male. Twenty-five child occupants were restrained in FFCRS, 9 in booster seats, and 3 in seat belts. As restraint type moved from more to less restraint (FFCRS to booster seat to seat belt), the range of fore-aft head position increased: 218, 244, and 340 mm on average, respectively. This observation was also true for left-right movement for every seat position. In general, those in the center seat position demonstrated a smaller range of head positions. For the first

  10. Naturalistic nursing.

    Science.gov (United States)

    Hussey, Trevor

    2011-01-01

    Where nurse education aims to provide an overarching intellectual framework, this paper argues that it should be the framework of naturalism. After an exposition of the chief features of naturalism and its relationship to science and morality, the paper describes naturalistic nursing, contrasting it with some other perspectives. There follows a defence of naturalism and naturalistic nursing against several objections, including those concerning spirituality, religion, meaning, morality, and alternative sources of knowledge. The paper ends with some of the advantages of the naturalistic approach. © 2010 Blackwell Publishing Ltd.

  11. Treatment of bipolar disorder in the Netherlands and concordance with treatment guidelines : study protocol of an observational, longitudinal study on naturalistic treatment of bipolar disorder in everyday clinical practice

    NARCIS (Netherlands)

    Renes, Joannes W.; Regeer, Eline J.; van der Voort, Trijntje Y. G.; Nolen, Willem A.; Kupka, Ralph W.

    2014-01-01

    Background: While various guidelines on the treatment of bipolar disorder have been published over the last decades, adherence to guidelines has been reported to be low. In this article we describe the protocol of a nationwide, multicenter, longitudinal, non-intervention study on the treatment of

  12. Safety and effectiveness of olanzapine in monotherapy: a multivariate analysis of a naturalistic study.

    Science.gov (United States)

    Ciudad, Antonio; Gutiérrez, Miguel; Cañas, Fernando; Gibert, Juan; Gascón, Josep; Carrasco, José-Luis; Bobes, Julio; Gómez, Juan-Carlos; Alvarez, Enrique

    2005-07-01

    This study investigated safety and effectiveness of olanzapine in monotherapy compared with conventional antipsychotics in treatment of acute inpatients with schizophrenia. This was a prospective, comparative, nonrandomized, open-label, multisite, observational study of Spanish inpatients with an acute episode of schizophrenia. Data included safety assessments with an extrapyramidal symptoms (EPS) questionnaire and the report of spontaneous adverse events, plus clinical assessments with the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions-Severity of Illness (CGI-S). A multivariate methodology was used to more adequately determine which factors can influence safety and effectiveness of olanzapine in monotherapy. 339 patients treated with olanzapine in monotherapy (OGm) and 385 patients treated with conventional antipsychotics (CG) were included in the analysis. Treatment-emergent EPS were significantly higher in the CG (pOGm (p=0.005). Logistic regression analyses revealed that the only variable significantly correlated with treatment-emergent EPS and clinical response was treatment strategy, with patients in OGm having 1.5 times the probability of obtaining a clinical response and patients in CG having 5 times the risk of developing EPS. In this naturalistic study olanzapine in monotherapy was better-tolerated and at least as effective as conventional antipsychotics.

  13. Examining construct validity of a new naturalistic observational assessment of hand skills for preschool- and school-age children.

    Science.gov (United States)

    Chien, Chi-Wen; Brown, Ted; McDonald, Rachael

    2012-04-01

    The Assessment of Children's Hand Skills is a new assessment that utilises a naturalistic observational method to capture children's real-life hand skill performance when engaged at various types of daily activities in everyday living contexts. The Assessment of Children's Hand Skills is designed for use with 2- to 12-year-old children with a range of disabilities or health conditions. The study aimed to investigate construct validity of the Assessment of Children's Hand Skills in Australian children. Rasch analysis was used to examine internal construct validity of the Assessment of Children's Hand Skills in a mixed sample of 53 children with disabilities (including autism spectrum disorder, developmental/genetic disorders and physical disabilities) and 85 typically developing children. External construct validity was examined by correlating with three questionnaires evaluating daily living skills and hand skills. Rasch goodness-of-fit analysis suggested that all 22 activity items and 19 of 20 hand skill items in the Assessment of Children's Hand Skills measured a single construct. The Assessment of Children's Hand Skills items were placed in a clinically meaningful hierarchy from easy to hard, and the difficulty range of the items also matched the majority of children with disabilities and typically developing preschool-aged children. Moderate to high correlations (0.59 ≤ Spearman's ρ coefficients ≤ 0.89, P skills. This study provided preliminary evidence supporting the construct validity of the Assessment of Children's Hand Skills for its clinical application in assessing children's real-life hand skill performance in Australian contexts. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

  14. A Naturalistic Study of Sex Differences in Children's Aggression.

    Science.gov (United States)

    Barrett, David E.

    1979-01-01

    Examines the naturally occurring social interactions of five- to eight-year-old children at a summer day camp. Children were observed in their routine camp activities, which took place in a variety of settings: some highly structured and adult-centered, some less highly regulated. (Author/MP)

  15. Memorabeatlia: a naturalistic study of long-term memory.

    Science.gov (United States)

    Hyman, I E; Rubin, D C

    1990-03-01

    Seventy-six undergraduates were given the titles and first lines of Beatles' songs and asked to recall the songs. Seven hundred and four different undergraduates were cued with one line from each of 25 Beatles' songs and asked to recall the title. The probability of recalling a line was best predicted by the number of times a line was repeated in the song and how early the line first appeared in the song. The probability of cuing to the title was best predicted by whether the line shared words with the title. Although the subjects recalled only 21% of the lines, there were very few errors in recall, and the errors rarely violated the rhythmic, poetic, or thematic constraints of the songs. Acting together, these constraints can account for the near verbatim recall observed. Fourteen subjects, who transcribed one song, made fewer and different errors than the subjects who had recalled the song, indicating that the errors in recall were not primarily the result of errors in encoding.

  16. Driving characteristics and adaptive cruise control : A naturalistic driving study

    NARCIS (Netherlands)

    Schakel, W.J.; Gorter, C.M.; de Winter, J.C.F.; van Arem, B.

    2017-01-01

    With the increasing number of vehicles equipped with Adaptive Cruise Control (ACC), it becomes important to assess its impact on traffic flow efficiency, in particular with respect to capacity and queue discharge rate. Simulation studies and surveys suggest that ACC has both positive and negative

  17. Linking appearance to neural activity through the study of the perception of lightness in naturalistic contexts.

    Science.gov (United States)

    Maertens, Marianne; Shapley, Robert

    2013-11-01

    The present paper deals with the classical question how a psychological experience, in this case apparent lightness, is linked by intervening neural processing to physical variables. We address two methodological issues: (a) how does one know the appropriate physical variable (what is the right x?) to look at, and (b) how can behavioral measurements be used to probe the internal transformation that leads to psychological experience. We measured so-called lightness transfer functions (LTFs), that is the functions that describe the mapping between retinal luminance and perceived lightness for naturalistic checkerboard stimuli. The LTFs were measured for different illumination situations: plain view, a cast shadow, and an intervening transparent medium. Observers adjusted the luminance of a comparison patch such that it had the same lightness as each of the test patches. When the data were plotted in luminance-luminance space, we found qualitative differences between mapping functions in different contexts. These differences were greatly diminished when the data were plotted in terms of contrast. On contrast-contrast coordinates, the data were compatible with a single linear generative model. This result is an indication that, for the naturalistic scenes used here, lightness perception depends mostly on local contrast. We further discuss that, in addition to the mean adjustments, one may find it useful to consider also the variability of an observer's adjustments in order to infer the true luminance-to-lightness mapping function.

  18. Naturalistic Observations of Schoolyard Social Participation: Marker Variables for Socio-Emotional Functioning in Early Adolescence

    Science.gov (United States)

    Coplan, Robert J.; Ooi, Laura L.; Rose-Krasnor, Linda

    2015-01-01

    The goal of this study was to examine links between observed social participation in the schoolyard and indices of socio-emotional functioning in early adolescence. Participants were children (N = 290) aged 9 to 12 years. Social participation (e.g., solitary play, dyadic interaction, group interaction) was assessed in the schoolyard during recess…

  19. [A naturalistic study: 100 consecutive episodes of acute agitation in a psychiatric emergency department].

    Science.gov (United States)

    Pascual, J C; Madre, M; Puigdemont, D; Oller, S; Corripio, I; Díaz, A; Faus, G; Perez, V; Alvarez, E

    2006-01-01

    Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation

  20. Three year naturalistic outcome study of panic disorder patients treated with paroxetine

    Directory of Open Access Journals (Sweden)

    Lowengrub Katherine

    2004-06-01

    Full Text Available Abstract Background This naturalistic open label follow-up study had three objectives: 1 To observe the course of illness in Panic Disorder patients receiving long-term versus intermediate-term paroxetine treatment 2 To compare the relapse rates and side-effect profile after long-term paroxetine treatment between patients with Panic Disorder and Panic Disorder with Agoraphobia. 3 To observe paroxetine's tolerability over a 24 month period. Methods 143 patients with panic disorder (PD, with or without agoraphobia, successfully finished a short-term (ie 12 week trial of paroxetine treatment. All patients then continued to receive paroxetine maintenance therapy for a total of 12 months. At the end of this period, 72 of the patients chose to discontinue paroxetine pharmacotherapy and agreed to be monitored throughout a one year discontinuation follow-up phase. The remaining 71 patients continued on paroxetine for an additional 12 months and then were monitored, as in the first group, for another year while medication-free. The primary limitation of our study is that the subgroups of patients receiving 12 versus 24 months of maintenance paroxetine therapy were selected according to individual patient preference and therefore were not assigned in a randomized manner. Results Only 21 of 143 patients (14% relapsed during the one year medication discontinuation follow-up phase. There were no significant differences in relapse rates between the patients who received intermediate-term (up to 12 months paroxetine and those who chose the long-term course (24 month paroxetine treatment. 43 patients (30.1% reported sexual dysfunction. The patients exhibited an average weight gain of 5.06 kg. All patients who eventually relapsed demonstrated significantly greater weight increase (7.3 kg during the treatment phase. Conclusions The extension of paroxetine maintenance treatment from 12 to 24 months did not seem to further decrease the risk of relapse after

  1. Naturalistic Observation in the Study of Parent-Child Interaction.

    Science.gov (United States)

    Baumrind, Diana

    This project investigated patterns of parental authority among Berkeley preschool children and the processes by which these parents contributed to the development of children's social responsibility and individuality. Subjects were 140 families from city-sponsored, private cooperative, and university-operated nursery schools. Eight constructs were…

  2. Driver Behavior During Overtaking Maneuvers from the 100-Car Naturalistic Driving Study.

    Science.gov (United States)

    Chen, Rong; Kusano, Kristofer D; Gabler, Hampton C

    2015-01-01

    Lane changes with the intention to overtake the vehicle in front are especially challenging scenarios for forward collision warning (FCW) designs. These overtaking maneuvers can occur at high relative vehicle speeds and often involve no brake and/or turn signal application. Therefore, overtaking presents the potential of erroneously triggering the FCW. A better understanding of driver behavior during lane change events can improve designs of this human-machine interface and increase driver acceptance of FCW. The objective of this study was to aid FCW design by characterizing driver behavior during lane change events using naturalistic driving study data. The analysis was based on data from the 100-Car Naturalistic Driving Study, collected by the Virginia Tech Transportation Institute. The 100-Car study contains approximately 1.2 million vehicle miles of driving and 43,000 h of data collected from 108 primary drivers. In order to identify overtaking maneuvers from a large sample of driving data, an algorithm to automatically identify overtaking events was developed. The lead vehicle and minimum time to collision (TTC) at the start of lane change events was identified using radar processing techniques developed in a previous study. The lane change identification algorithm was validated against video analysis, which manually identified 1,425 lane change events from approximately 126 full trips. Forty-five drivers with valid time series data were selected from the 100-Car study. From the sample of drivers, our algorithm identified 326,238 lane change events. A total of 90,639 lane change events were found to involve a closing lead vehicle. Lane change events were evenly distributed between left side and right side lane changes. The characterization of lane change frequency and minimum TTC was divided into 10 mph speed bins for vehicle travel speeds between 10 and 90 mph. For all lane change events with a closing lead vehicle, the results showed that drivers change

  3. The effect of glass shape on alcohol consumption in a naturalistic setting: a feasibility study.

    Science.gov (United States)

    Troy, David M; Maynard, Olivia M; Hickman, Matthew; Attwood, Angela S; Munafò, Marcus R

    2015-12-01

    Alcohol-related harms are a major public health concern, and population-level interventions are needed to reduce excessive alcohol consumption. Glass shape is an easily modifiable target for public health intervention. Laboratory findings show beer is consumed slower from a straight glass compared to a curved glass, but these findings have not been replicated in a naturalistic setting. The purpose of this study is to investigate the feasibility of conducting a randomised controlled trial investigating the effect of glass shape on alcohol consumption in public houses. Straight and curved half-pint and pint glasses were delivered to three public houses over two weekends. Glass type was counterbalanced over the two weekends and between the public houses. Monetary takings were recorded as an indirect measure of consumption. Replacing stocks of glassware in public houses was feasible and can be enacted in a short space of time. One landlord found the study too disruptive, possibly due to a laborious exchange of glassware and complaints about the new glassware from some customers. One public house's dishwasher could not accommodate the supplied curved full-pint glasses. Obtaining monetary takings from public house staff was a feasible and efficient way of measuring consumption, although reporting absolute amounts may be commercially sensitive. Monetary takings were reduced by 24 % (95 % confidence interval 77 % reduction to 29 % increase) when straight glasses were used compared to curved glasses. This study shows that it is feasible to carry out a trial investigating glass shape in a naturalistic environment, although a number of challenges were encountered. Brewery owners and landlords are willing to engage with public health research in settings where alcohol is consumed, such as public houses. Good communication with stakeholders was vital to acquire good data, and highlighting the potential commercial benefits of participating was vital to the study's success. A

  4. Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.

    Science.gov (United States)

    Moulding, Richard; Nedeljkovic, Maja; Kyrios, Michael; Osborne, Debra; Mogan, Christopher

    2017-01-01

    The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. A 12-week group programme delivered in a community setting was effective for helping with

  5. A prospective naturalistic multicentre study of intravenous medications in behavioural emergencies: haloperidol versus flunitrazepam.

    Science.gov (United States)

    Hatta, Kotaro; Nakamura, Mitsuru; Yoshida, Kenichi; Hamakawa, Hiroshi; Wakejima, Toru; Nishimura, Takao; Furuta, Ko; Kawabata, Toshitaka; Hirata, Toyoaki; Usui, Chie; Nakamura, Hiroyuki; Sawa, Yutaka

    2010-06-30

    A prospective naturalistic multicentre study for deep sedation was conducted in intensive care with continuous electrocardiogram (ECG) monitoring. Clinical purpose was enough sedation, which made uncooperative and disrupted patients receive brain computed tomography (CT), magnetic resonance imaging (MRI), or fluid therapy, with minimum drug doses. A first infusion was either haloperidol (HAL group) or flunitrazepam (FNP group). If enough sedation was not achieved, a second infusion, which was the opposite drug to the first infusion, was given. The proportion requiring a second infusion was higher in the HAL group than in the FNP group (82% vs. 36%, PFNP first group (FNP+HAL group) than the HAL first group (HAL+FNP group) (68% [S.D. 17] vs. 54% [S.D. 31], P=0.02). The mean dose of flunitrazepam in the HAL+FNP group was significantly lower than that in the FNP+HAL-group (1.3 mg vs. 3.5 mg, P=0.0003). Thus, in terms of monotherapy and speed of action, flunitrazepam has advantages over haloperidol as a first infusion for deep sedation. Regarding drug dosages, haloperidol has an advantage over flunitrazepam as a first infusion in safety.

  6. Cognitive risk factors and suicide attempts among formerly hospitalized adolescents: a prospective naturalistic study.

    Science.gov (United States)

    Goldston, D B; Daniel, S S; Reboussin, B A; Reboussin, D M; Frazier, P H; Harris, A E

    2001-01-01

    To examine the relationship between cognitive variables and time until suicide attempts among 180 adolescents who were monitored for as much as 6.9 years after discharge from an inpatient psychiatry unit. In a prospective naturalistic study, adolescents were assessed at the time of their psychiatric hospitalization and semiannually thereafter. Suicidal behavior at index hospitalization and over the follow-up period was assessed with semistructured psychiatric diagnostic interviews. At hospitalization, cognitive risk factors were assessed with a problem-solving task and with questionnaires assessing hopelessness, expectations for posthospitalization suicidal behavior, reasons for living, and dysfunctional attitudes. Expectations about future suicidal behavior were related to posthospitalization suicide attempts. Among youths with previous suicide attempts, higher levels of hopelessness were associated with increased risk, and greater survival and coping beliefs were associated with decreased risk for posthospitalization suicide attempts. Hopelessness and survival and coping beliefs were not related to posthospitalization attempts among adolescents without prior suicidal behavior, and hopelessness was not predictive after controlling for overall severity of depression. Expectations for suicidal behavior, hopelessness, and survival and coping beliefs provide important prognostic information about later suicidal behavior and should be targeted in interventions with suicidal youths.

  7. A naturalistic open-label study of mirtazapine in autistic and other pervasive developmental disorders.

    Science.gov (United States)

    Posey, D J; Guenin, K D; Kohn, A E; Swiezy, N B; McDougle, C J

    2001-01-01

    The aim of this study was to conduct a naturalistic, open-label examination of the efficacy and tolerability of mirtazapine (a medication with both serotonergic and noradrenergic properties) in the treatment of associated symptoms of autism and other pervasive developmental disorders (PDDs). Twenty-six subjects (5 females, 21 males; ages 3.8 to 23.5 years; mean age 10.1 +/- 4.8 years) with PDDs (20 with autistic disorder, 1 with Asperger's disorder, 1 with Rett's disorder, and 4 with PDDs not otherwise specified were treated with open-label mirtazapine (dose range, 7.5-45 mg daily; mean 30.3 +/- 12.6 mg daily). Twenty had comorbid mental retardation, and 17 were taking concomitant psychotropic medications. At endpoint, subjects' primary caregivers were interviewed using the Clinical Global Impressions (CGI) scale, the Aberrant Behavior Checklist, and a side-effect checklist. Twenty-five of 26 subjects completed at least 4 weeks of treatment (mean 150 +/- 103 days). Nine of 26 subjects (34.6%) were judged responders ("much improved" or "very much improved" on the CGI) based on improvement in a variety of symptoms including aggression, self-injury, irritability, hyperactivity, anxiety, depression, and insomnia. Mirtazapine did not improve core symptoms of social or communication impairment. Adverse effects were minimal and included increased appetite, irritability, and transient sedation. Mirtazapine was well tolerated but showed only modest effectiveness for treating the associated symptoms of autistic disorder and other PDDs.

  8. The effects of self-esteem and ego threat on interpersonal appraisals of men and women: a naturalistic study.

    Science.gov (United States)

    Vohs, Kathleen D; Heatherton, Todd F

    2003-11-01

    A naturalistic study examined the effects of self-esteem and threats to the self on interpersonal appraisals. Self-esteem scores, ego threat (operationalized as a substantial decrease in self-esteem across an average of 9 months), and their interaction were used to predict likability and personality perceptions of college men and women. The results revealed a curvilinear function explaining likability: Moderate to low self-esteem men and women were higher in likability when threatened, whereas high self-esteem men were seen as less likable when threatened. Personality ratings indicated that high self-esteem men and women who were threatened were rated highest on Antagonism (i.e., fake, arrogant, unfriendly, rude, and uncooperative). Mediational analyses revealed that differences in Antagonism statistically accounted for differences in likability. These patterns are interpreted with respect to gender and time in interpersonal perceptions as well as naturalistic versus laboratory investigations.

  9. Using dual tasks to test immediate transfer of training between naturalistic movements: A proof-of-principle study

    Science.gov (United States)

    Schaefer, Sydney Y.; Lang, Catherine E.

    2012-01-01

    Theories of motor learning predict that training a movement reduces the amount of attention needed for its performance (i.e. more automatic). If training one movement transfers, then the amount of attention needed for performing a second movement should also be reduced, as measured under dual task conditions. The purpose of this study was to test whether dual task paradigms are feasible for detecting transfer of training between two naturalistic movements. Immediately following motor training, subjects improved performance of a second untrained movement under both single and dual task conditions. Subjects with no training did not. Improved performance in the untrained movement was likely due to transfer, and suggests that dual tasks may be feasible for detecting transfer between naturalistic actions. PMID:22934682

  10. A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

    OpenAIRE

    Alves, Lucas P. C.; Freire, Thiago F. V.; Fleck, Marcelo P. A.; Rocha, Neusa S.

    2016-01-01

    Background Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Methods Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17...

  11. Investigate moped-car conflicts in China using a naturalistic driving study approach.

    Science.gov (United States)

    Glaser, Yi G; Guo, Feng; Fang, Youjia; Deng, Bing; Hankey, Jonathan

    2017-12-01

    Mopeds are a popular transportation mode in Europe and Asia. Moped-related traffic accidents account for a large proportion of crash fatalities. To develop moped-related crash countermeasures, it is important to understand the characteristics of moped-related conflicts. Naturalistic driving study data were collected in Shanghai, China from 36 car drivers. The data included 2,878h and 78,296km driven from 13,149 trips. Moped-car conflicts were identified and examined from the passenger car driver's perspective using kinematic trigger algorithms and manual video reduction. A total of 119 moped-car conflicts were identified, including 74 high g-force conflicts and 45 low g-force events. These conflicts were classified into 22 on-road configurations where both similarities and differences were found as compared to Western Countries. The majority of the conflicts occurred on secondary main roads and branch roads. Hard braking was the primary response that the car drivers made to these conflicts rather than hard steering. The identified on-road vehicle-moped conflict configurations in Shanghai, China may be attributed to the complicated traffic environment and risky behavior of moped riders. The lower prevalence of hard steering in Shanghai as compared to the United States may be due to the lower speeds at event onsets or less available steering space, e.g., less available shoulder area on Chinese urban roads. The characteristics of moped-car conflicts may impact the design of active safety countermeasures on passenger cars. The pilot data from Shanghai urban areas suggest that countermeasures developed for China may require some modifications to those developed for the United States and European countries, although this recommendation may not be conclusive given the small sample size of the study. Future studies with large samples may help better understand the characteristics of moped-car conflicts. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights

  12. Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

    Science.gov (United States)

    Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

    2015-06-01

    A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

  13. Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD.

    Science.gov (United States)

    Imeraj, Lindita; Antrop, Inge; Roeyers, Herbert; Deschepper, Ellen; Bal, Sarah; Deboutte, Dirk

    2011-08-01

    Previous studies suggest an altered circadian regulation of arousal in children with attention-deficit hyperactivity disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns. Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-h heart rate patterns differentiate between children with and without ADHD. In this study, 24-h heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during 5 days. Simultaneously, 24-h activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed. Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p < 0.01)--with the largest effects during afternoon and night--in a model controlling for age. Other factors did not significantly contribute to variations in heart rate levels. Compared to controls, children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p < 0.05). Post hoc analyses showed that environmental effects might influence daytime variations. Findings suggest an autonomic imbalance in children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.

  14. Naturalistic study on the usage of smartphone applications among Finnish drivers.

    Science.gov (United States)

    Kujala, Tuomo; Mäkelä, Jakke

    2018-03-14

    We present results from a naturalistic study that tracked how Finnish drivers use their smartphones while on the move. We monitored 30 heavy in-car smartphone users in Finland during June-September 2016, recording the times that they used their phones, the application used at the time of touch (calls excluded), the location and driving speed. Touches per time unit were used as a proxy for estimating visual-manual distraction due to visual-manual tasks. Our data set allows the determining of whether drivers use their phones differently on varying road types (highway, main road, local rural road, urban road). We found that the road type has an effect on phone use but the effect is contrary to what we expected. Drivers produced more touches per hour on urban roads, yet the use instances tend to be shorter than on the highway or main roads. We also collected statistics on the applications that were used. By far the highest overall rankings in the number of drivers using, number of uses, and duration per use instance was associated with the WhatsApp messaging service. One instance of WhatsApp use had a median of 8 touches, and had a median duration of 35 s. In contrast, navigation application use included a median of 3 touches and lasted for 11 s. The findings suggest that the Finnish smartphone heavy-users do not decrease their phone use when the demands of the traffic conditions increase and that the greatest risk from smartphone use may be currently caused by messaging applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. The impact of sleep disorders on driving safety-findings from the Second Strategic Highway Research Program naturalistic driving study.

    Science.gov (United States)

    Liu, Shu-Yuan; Perez, Miguel A; Lau, Nathan

    2018-04-01

    This study investigated the association between driving safety and seven sleep disorders amongst 3541 participants of the Second Strategic Highway Research Program (SHRP 2) naturalistic driving study. SHRP 2 collected naturalistic driving data from participants between 16 and 98 years old by instrumenting participants' vehicles. The analyses used logistic regression to determine the likelihood of crash or near-crash involvement, Poisson log-linear regression to assess crash or near-crash rate, and ordinal logistic regression to assess driver maneuver appropriateness and crash or near-crash severity. These analyses did not account for any medical treatments for the sleep disorders. Females with restless legs syndrome/Willis-Ekbom disease (RLS/WED), drivers with insomnia or narcolepsy, are associated with significantly higher risk of crash or near-crash. Drivers with shift work sleep disorder (SWSD) are associated with significantly increased crash or near-crash rate. Females with RLS/WED or sleep apnea and drivers with SWSD are associated with less safe driver maneuver and drivers with periodic limb movement disorder are associated with more severe events. The four analyses provide no evidence of safety decrements associated with migraine. This study is the first examination on the association between seven sleep disorders and different measures of driving risk using large-scale naturalistic driving study data. The results corroborate much of the existing simulator and epidemiological research related to sleep-disorder patients and their driving safety, but add ecological validity to those findings. These results contribute to the empirical basis for medical professionals, policy makers, and employers in making decisions to aid individuals with sleep disorders in balancing safety and personal mobility.

  16. Identities and motives of naturalist development program attendees and their relation to professional careers

    Science.gov (United States)

    Mraz, Jennifer Arin

    In recent years, there has been much concern over the decline of biologists who actually identify themselves to be naturalists, which negatively impacts the field of conservation and the study of biology as a whole. This could result in a decrease in individuals who participate in naturalist-like activities, such as informal environmental education and environmental volunteerism. The purpose of my study was to determine what discourse identities were held by naturalist development program participants, how these discourse identities related to their volunteer motives in environmental settings, and how discourse identity related to professional careers. I defined identity through the lens of discourse-identity, which describes a person's identity as being conveyed through that individual's communication and actions. I conducted individual interviews or used an online questionnaire to ask questions to naturalist development program attendees about their workshop experience, relationship with nature, volunteer motives and activities, as well as professional career or career aspiration. Volunteer motives were quantitatively measured in both types of program participants using the published Volunteer Motivation Questionnaire. Overall, I found that 100 study participants had six discourse identities: naturalist (n = 27), aspiring naturalist ( n = 32), nature steward (n = 5), outreach volunteer (n = 6), casual nature observer (n = 22), and recreational nature user (n = 8). Naturalist development programs should focus on developing more naturalist-like discourse identities in their participants to help encourage participation in naturalist activities. Volunteer motives were ranked by importance to participants in the following order: helping the environment, learning, user, project organization, values and esteem, social, and career. The majority of Master Naturalist Program study participants that stated a career were in non-STEM careers; however, the majority of

  17. Influence of the way of reporting alpha-Amylase values in saliva in different naturalistic situations: A pilot study.

    Directory of Open Access Journals (Sweden)

    María Dolores Contreras-Aguilar

    Full Text Available The objective of this pilot study was to compare the different ways of measuring salivary alpha-amylase (sAA, enzymatic vs. concentration and to evaluate the influence that the different ways of reporting the results can have in sAA interpretation. For this purpose, sAA was measured by direct quantification and also by an enzymatic assay in three different naturalistic situations, a physical stressor (situation 1 and two mental stressors of different intensity (situations 2 and 3. The results were expressed in three different ways (without correction, multiplied by flow rate and divided by protein concentration. sAA concentration and activity increased just after situations 1 and 3. When values were multiplied by the flow rate, significant changes after situation 1 were detected only for sAA activity but not for sAA concentration, being these changes of lower significance and magnitude that those observed for sAA activity without any correction. In addition, a significant increase in sAA activity was found at T+15 in situation 2. In situation 3 the significant decrease in sAA at T+15 disappeared. When values were divided by protein concentration, there were no significant changes in situations 1 or 3, but a decrease in situation 2 at T+0 and an increase at T+15. sAA activity and concentration showed a significant correlation in all situations. This pilot study points out that the way of expressing sAA can influence the results obtained in different stress models and also their interpretation. Therefore, how sAA is reported and the factors involved in the different ways of expressing sAA, should be taken into consideration for an objective interpretation of sAA values.

  18. Continuity of Depressive Disorders From Childhood and Adolescence to Adulthood: A Naturalistic Study in Community Mental Health Centers

    Science.gov (United States)

    Carballo, Juan J.; Muñoz-Lorenzo, Laura; Blasco-Fontecilla, Hilario; Lopez-Castroman, Jorge; García-Nieto, Rebeca; Dervic, Kanita; Oquendo, Maria A.

    2011-01-01

    Objective: To determine and compare rates of homotypic continuity of childhood- and adolescent-onset depression into adulthood. Method: This was a naturalistic, prospective cohort study of children and adolescents receiving psychiatric care at all community mental health centers in Madrid, Spain, from January 1986 to December 2007. Data were obtained from a regional registry wherein all psychiatric visits to public mental health centers are recorded. Patients received their first diagnosis of an ICD-10 F32 or F33 depressive disorder between 6 and 17 years of age and were at least 20 years old at the time of their last visit. Subjects whose first diagnosis was in childhood (aged 6–12 years: depressed-child group) and subjects whose first diagnosis was in adolescence (aged 13–17 years: depressed-adolescent group) were compared in terms of demographic characteristics, psychiatric comorbidity, and rates of homotypic continuity in adulthood. Results: Five hundred twenty-eight patients with depressive disorders met inclusion criteria. The depressed-adolescent group had a higher proportion of girls (60.3%) compared to the depressed-child group, but did not differ on other demographic or clinical variables. Most subjects who later received treatment in adult mental health facilities (n = 243; 57.2%; 95% CI, 50.9–57.2) continued to be diagnosed with a depressive disorder. High rates of anxiety disorders, bipolar disorder, personality disorders, and psychotic disorders in adulthood were observed among subjects from both groups. The absence of psychiatric comorbidity prior to age 18 years was associated with homotypic continuity of depressive disorder into adulthood. Conclusions: Subjects with adolescent-onset depression and subjects without comorbid psychiatric disorders in youth appear to have a higher level of homotypic continuity into adulthood. Both children and adolescents with depressive disorders are at risk for other psychiatric disorders in adulthood. PMID

  19. Naturalistas viajantes Travel naturalists

    Directory of Open Access Journals (Sweden)

    Miriam L. Moreira Leite

    1995-02-01

    Full Text Available O naturalista viajante é aquele que nos séculos XVIII e XIX dedicava-se ao estudo da história natural, ou seja, da natureza, compreendendo os astros, o ar, os animais, os vegetais e minerais da superfície e da profundidade da terra. Enquanto os naturalistas-viajantes do período colonial eram exclusivamente súditos da Coroa portuguesa, encarregados de revelar as riquezas e utilidade dos recursos naturais, os que percorreram o Brasil no século XIX, após 1808, vinham de diversas regiões da Europa e estavam empenhados na observação e classificação dos homens e de suas línguas considerados entre as espécies da natureza. Ligados à nobreza ou a sociedades científicas, percorriam o solo brasileiro num esforço conjunto e planejado de revelar, colecionar e classificar os reinos naturais da América.During the XVIIIth and XIXth centuries, travelers that studied natural history were referred to as travel naturalists. Nature included the stars and planets, the atmosphere, flora and fauna, and surface and underground minerals. While in colonial times they were limited to citizens of Portugal who were instructed to discover natural resources and their uses, those who traveled through Brazil after 1808 came from different regions of Europe and were concerned with observing and classifying people and natural specimens found along the way. Sponsored by either noblemen or scientific societies, they traveled around Brazil in a combined endeavor of discovering, collecting, and classifying natural specimens on the American continent.

  20. What predicts outcome, response, and drop-out in CBT of depressive adults? a naturalistic study.

    Science.gov (United States)

    Schindler, Amrei; Hiller, Wolfgang; Witthöft, Michael

    2013-05-01

    The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.

  1. Children's books and the nature of science: A multisite naturalistic case study of three elementary teachers in the rural southeast

    Science.gov (United States)

    Bricker, Patricia Lynn

    This naturalistic case study describes the efforts of three elementary teachers in a rural southeastern school to use children's books in support of inquiry-based science and specifically addresses issues related to the nature of science. Data were collected through 26 classroom and meeting observations, 16 semi-structured and informal interviews, 35 documents and 76 children's books used by the teachers. Three themes were identified related to the nature of science and the selection and use of children's books in the teachers' second, fourth, and fifth grade classrooms. (1) Science was portrayed as a human endeavor that connects to the lives of people and that involves fascination, passion, and interest; imagination and creativity; values; and diverse views. The collection of books was analyzed to look specifically at race, culture, and gender issues. While women, people of color, and different cultures were represented in the book collection, they were not represented well when considering the collection as a whole. (2) Books and the teachers' use of them supported firsthand investigation of the natural world and the idea that empirical evidence underlies scientific understanding. This theme involved observation and journaling, identification of questions to investigate and procedures to use, reasonable interpretations of results, and inferential thinking. (3) Books helped teach about the durable body of scientific knowledge we have discovered over time. They were used to broaden background knowledge and as references after firsthand investigations. The complexity of science education is revealed in these cases. The teachers were able to artfully balance multiple aspects of the nature of science in their book selection and presentation. Particularly promising aspects include their work to use fiction and poetry to promote connections between imagination, creativity and science and their innovative use of books to help students interpret data and infer. Important

  2. Characterizing the motivational orientation of students in higher education: a naturalistic study in three Hong Kong universities.

    Science.gov (United States)

    Kember, David; Hong, Celina; Ho, Amber

    2008-06-01

    Consideration of motivation in higher education has often been drawn upon theories and research that were based upon school or workplace studies. This paper reports an open naturalistic study to better characterize the motivational orientation of students in higher education. Open semi-structured individual interviews were conducted with 36 students from three universities in Hong Kong. The analysis used an exploratory grounded theory approach. Motivation was characterized as a framework with six continua with positive and negative poles. On enrolment, students had positions on the six facets of motivation, which shifted as they progressed through their degree, according to perceptions of their teaching and learning environment. The positive poles of the six continua were given labels: compliance, individual goal setting, interest, career, sense of belonging and university lifestyle. The formulation of motivational orientation is consistent with contemporary social cognitive theories of motivation in that it has been characterized as a multifaceted phenomenon, with students expressing context-dependent multiple motives.

  3. Late potentials in the signal-averaged electrocardiogram in schizophrenia patients maintained on antipsychotic agents: a preliminary naturalistic study.

    Science.gov (United States)

    Nahshoni, Eitan; Strasberg, Boris; Imbar, Shula; Rotem, Ofer; Gur, Shay; Hermesh, Hagai; Weizman, Abaraham

    2010-03-01

    In the present, preliminary, naturalistic study, cardiac ventricular late potentials (LPs), were measured in 33 physically healthy schizophrenia patients (13 - females and 26 - males, age - 45.5+/-8.8years) maintained on typical and atypical antipsychotic agents. These LPs represent delayed ventricular activation that might predispose to fatal ventricular arrhythmias and sudden cardiac death (SCD) in cardiac patients. Sixteen of the 33 patients ( approximately 48%) were found to be positive for LPs (compared to 3.7-6% in the general population). No association was found with any of the following: drug type, anti-cholinergic burden, daily dose of antipsychotic agents, age, gender, disease duration, QT(c) interval and QT dispersion. Further large-scale longitudinal prospective studies are warranted to substantiate our findings and to clarify their impact on the excess cardiac morbidity and mortality in schizophrenia patients. Copyright 2009. Published by Elsevier B.V.

  4. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

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    Eberhard J

    2016-08-01

    Full Text Available Jonas Eberhard,1 Emmanuelle Weiller2 1Department of Clinical Sciences, Lund University, Lund, Sweden; 2H. Lundbeck A/S, Copenhagen, Denmark Purpose: Patients with a bipolar I disorder (BD-I manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5, criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study.Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts.Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6% met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms. These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients. A greater incidence of suicidal ideation was observed in the severe AIA group (71.9% than in the mild AIA group (47.6%. Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05 and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively.Conclusion: The high risk of suicide among BD-I mania patients with depressive

  5. Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study

    NARCIS (Netherlands)

    Houtjes, W.; Deeg, D.J.H.; van de Ven, P.M.; van Meijel, B.; van Tilburg, T.G.; Beekman, A.T.F.

    Objectives: To test the interrelation of the naturalistic course of depression in older people with long-term support received. Design: Longitudinal cohort study. Methods: A sample of 277 adults age 55-85years participating in the Longitudinal Aging Study Amsterdam, with clinically relevant

  6. Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study

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    Albert U

    2015-07-01

    Full Text Available Umberto Albert,1 David De Cori,1 Andrea Aguglia,1 Francesca Barbaro,1 Fabio Lanfranco,2 Filippo Bogetto,1 Giuseppe Maina3 1Anxiety and Mood Disorders Unit, Rita Levi Montalcini Department of Neuroscience, University of Turin, Torino, Italy; 2Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Torino, Italy; 3Department of Mental Health, San Luigi-Gonzaga Hospital, University of Turin, Orbassano, Italy Objective: The aim of this retrospective longitudinal naturalistic study was to evaluate the effects of maintenance lithium treatment on parathyroid hormone (PTH and calcium levels. Methods: A retrospective longitudinal naturalistic study design was used. Data were collected from the database of a tertiary psychiatric center covering the years 2010–2014. Included were bipolar patients who had never been exposed to lithium and had lithium started, and who had PTH, and total and ionized calcium levels available before and during lithium treatment. Paired t-tests were used to analyze changes in PTH and calcium levels. Linear regressions were performed, with mean lithium level and duration of lithium exposure as independent variables and change in PTH levels as dependent variable. Results: A total 31 patients were included. The mean duration of lithium treatment was 18.6±11.4 months. PTH levels significantly increased during lithium treatment (+13.55±14.20 pg/mL; the rate of hyperparathyroidism was 12.9%. Neither total nor ionized calcium increased from baseline to follow-up; none of our patients developed hypercalcemia. Linear regressions analyses did not show an effect of duration of lithium exposure or mean lithium level on PTH levels. Conclusion: Lithium-associated stimulation of parathyroid function is more common than assumed to date. Among parameters to be evaluated prior to lithium implementation, calcium and PTH should be added. Keywords: bipolar disorder, follow-up study, lithium

  7. Neuronal encoding of object and distance information: A model simulation study on naturalistic optic flow processing

    Directory of Open Access Journals (Sweden)

    Patrick eHennig

    2012-03-01

    Full Text Available We developed a model of the input circuitry of the FD1 cell, an identified motion-sensitive interneuron in the blowfly’s visual system. The model circuit successfully reproduces the FD1 cell’s most conspicuous property: Its larger responses to objects than to spatially extended patterns. The model circuit also mimics the time-dependent responses of FD1 to dynamically complex naturalistic stimuli, shaped by the blowfly’s saccadic flight and gaze strategy: The FD1 responses are enhanced when, as a consequence of self-motion, a nearby object crosses the receptive field during intersaccadic intervals. Moreover, the model predicts that these object-induced responses are superimposed by pronounced pattern-dependent fluctuations during movements on virtual test flights in a three-dimensional environment with systematic modifications of the environmental patterns. Hence, the FD1 cell is predicted to detect not unambiguously objects defined by the spatial layout of the environment, but to be also sensitive to objects distinguished by textural features. These ambiguous detection abilities suggest an encoding of information about objects - irrespective of the features by which the objects are defined - by a population of cells, with the FD1 cell presumably playing a prominent role in such an ensemble.

  8. A naturalistic study of the directional interpretation process of discrete emotions during high-stakes table tennis matches.

    Science.gov (United States)

    Martinent, Guillaume; Ferrand, Claude

    2009-06-01

    The purpose of this study was to explore the directional interpretation process of discrete emotions experienced by table tennis players during competitive matches by adopting a naturalistic qualitative video-assisted approach. Thirty self-confrontation interviews were conducted with 11 national table tennis players (2 or 3 matches per participants). Nine discrete emotions were identified through the inductive analyses of the participants' transcriptions: anger, anxiety, discouragement, disappointment, disgust, joy, serenity, relief, and hope. Inductive analyses revealed the emergence of 4 categories and 13 themes among the 9 discrete emotions: positive direction (increased concentration, increased motivation, increased confidence, positive sensations, and adaptive behaviors), negative direction (decreased concentration, decreased motivation, too confident, decreased confidence, negative sensations, and maladaptive behaviors), neutral direction (take more risk and take less risk), and no perceived influence on own performance. Results are discussed in terms of current research on directional interpretation and emotions in sport.

  9. A naturalistic long-term comparison study of selective serotonin reuptake inhibitors in the treatment of panic disorder.

    Science.gov (United States)

    Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Gonopolsky, Yehudit; Musin, Ernest; Grunhaus, Leon; Kotler, Moshe

    2007-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are currently considered as the first drug of choice in the treatment of panic disorder (PD). The aim of this long-term, naturalistic comparison study was to compare 4 SSRIs with respect to tolerability and treatment outcome of PD. Outcome measures included relapse rates and adverse effects. Two hundred patients with PD were enrolled in our study. All subjects met DSM-IV criteria for PD or PD with agoraphobia (PDA). All patients were assigned to receive SSRI monotherapy for 12 months with either citalopram (n = 50), fluoxetine (n = 50), fluvoxamine (n = 50), or paroxetine (n = 50) in a randomized, nonblinded fashion. Both the treating psychiatrist and the patients were not blind to the assigned treatment, but the clinician raters were blind to the study medication. The study design allowed for assignment of a particular SSRI as indicated according to the clinical judgment of the study psychiatrists. The Panic Self-Questionnaire, which is a self-report scale, was administered at baseline and then once per month during the duration of the 12-month study. The visual analog scale and the Clinical Global Impression Scale were administered at baseline and then once per month during the period of the study. Reports of sexual dysfunction were assessed using a nonstructured clinical interview at monthly visits. The body weight of study subjects was measured at baseline, and then at the 12th month visit end point. Of 200 patients who entered the study, 127 patients (63.5%) completed the full 12-month protocol. Retention rates were highest for paroxetine (76% [38/50]), intermediate for citalopram (68% [34/50]) and fluvoxamine (60% [30/50]), and lowest for fluoxetine (50% [25/50]). Patients who completed the 12-month protocol responded favorably to the study treatment. The paroxetine and the citalopram groups had significantly lower rates of panic symptoms as measured at visits on weeks 4 and 8. At visits on months 3, 6, 9, and

  10. Naturalistic Cognition: A Research Paradigm for Human-Centered Design

    Directory of Open Access Journals (Sweden)

    Peter Storkerson

    2010-01-01

    Full Text Available Naturalistic thinking and knowing, the tacit, experiential, and intuitive reasoning of everyday interaction, have long been regarded as inferior to formal reason and labeled primitive, fallible, subjective, superstitious, and in some cases ineffable. But, naturalistic thinking is more rational and definable than it appears. It is also relevant to design. Inquiry into the mechanisms of naturalistic thinking and knowledge can bring its resources into focus and enable designers to create better, human-centered designs for use in real-world settings. This article makes a case for the explicit, formal study of implicit, naturalistic thinking within the fields of design. It develops a framework for defining and studying naturalistic thinking and knowledge, for integrating them into design research and practice, and for developing a more integrated, consistent theory of knowledge in design. It will (a outline historical definitions of knowledge, attitudes toward formal and naturalistic thinking, and the difficulties presented by the co-presence of formal and naturalistic thinking in design, (b define and contrast formal and naturalistic thinking as two distinct human cognitive systems, (c demonstrate the importance of naturalistic cognition in formal thinking and real-world judgment, (d demonstrate methods for researching naturalistic thinking that can be of use in design, and (e briefly discuss the impact on design theory of admitting naturalistic thinking as valid, systematic, and knowable.

  11. Synthesizing Naturalistic Driving Data: a further review

    CSIR Research Space (South Africa)

    Venter, Karien

    2016-07-01

    Full Text Available The Naturalistic Driving Study (NDS) methodology has in the past decade proven extremely valuable in providing rich contextual information about the driver, the vehicle and driving environment. Internationally the uptake of the methodology...

  12. Naturalistic Inquiry in E-Learning Research

    Directory of Open Access Journals (Sweden)

    Shirley Agostinho

    2005-03-01

    Full Text Available In this article, the author explains how and why one particular qualitative research approach, the naturalistic inquiry paradigm, was implemented in an e-learning research study that investigated the use of the World Wide Web technology in higher education. A framework is presented that situates the research study within the qualitative research literature. The author then justifies how the study was compliant with naturalistic inquiry and concludes by presenting a model for judging the quality of such research. The purpose of this article is to provide an example of how naturalistic inquiry can be implemented in e-learning research that can serve as a guide for researchers undertaking this form of qualitative inquiry. As such, the focus of the article is to illustrate how methodological issues pertaining to naturalistic inquiry were addressed and justified to represent a rigorous research approach rather than presenting the results of the research study.

  13. Comparison of escitalopram and citalopram in outpatients with severe major depressive disorder: a prospective, naturalistic, 8-week study.

    Science.gov (United States)

    Lançon, Christophe; Sapin, Christophe; Note, Ivan; Farisse, Jean

    2006-01-01

    Objective. Escitalopram is a new selective serotonin reuptake inhibitor indicated for the treatment of major depressive disorder (MDD). The objective of this study is to examine its efficacy in the treatment of severe MDD compared with that of citalopram in daily practice. Method. A prospective, naturalistic, 8-week study was conducted involving 127 patients fulfilling DSM-IV criteria for severe MDD and having a baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score of at least 30. A full non-parsimonious logistic model, called the propensity score, was first defined to reduce bias associated with non-randomization. The primary efficacy analysis was the mean change from baseline to week 8 in MADRS score between the escitalopram and citalopram groups, after stratification on the propensity score. Other efficacy measurements consisted of the Clinical Global Impression of Severity and Improvement scales (CGI-S and CGI-I, respectively), response (defined as a reduction of at least 50% on MADRS from baseline to week 8) and remission rates (defined as MADRS ≤ 12 at week 8), after adjustment on propensity score for escitalopram use. Results. A total of 67 escitalopram-treated patients and 60 citalopram-treated patients were enrolled in this study. Escitalopram reduced mean MADRS total score at week 8 compared with citalopram (-23.5 vs. -17.5; Pbiases due to non-randomization, this study indicates better efficacy and tolerability of escitalopram versus citalopram in severe MDD outpatients.

  14. Atypical Antipsychotics in the Treatment of Depressive and Psychotic Symptoms in Patients with Chronic Schizophrenia: A Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Marco Innamorati

    2013-01-01

    Full Text Available Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients’ awareness of their illness. Methods. Twenty-three adult outpatients (15 men and 8 women treated with clozapine and 23 patients (16 men and 7 women treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS, and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD. Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression. Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds.

  15. Risperidone use in children with Down syndrome, severe intellectual disability, and comorbid autistic spectrum disorders: a naturalistic study.

    Science.gov (United States)

    Capone, George T; Goyal, Parag; Grados, Marco; Smith, Brandon; Kammann, Heather

    2008-04-01

    We report on an open-label, naturalistic study using risperidone to treat disruptive behaviors and self-injury in children with Down syndrome, severe intellectual disability, and comorbid autism spectrum disorders (DS+ASDs). We hypothesized that hyperactivity and disruptive behaviors would improve in response to risperidone treatment consistent with previous studies of children with ASD. Subjects were children (mean age, 7.8 +/- 2.6 years), consisting of 20 males and three females identified through our outpatient Down Syndrome Clinic between 2000 and 2004. Using the Aberrant Behavior Checklist as the primary outcome measure, all five subscales showed significant improvement following risperidone treatment. The mean duration of treatment was 95.8 +/- 16.8 days, and mean total daily dose was 0.66 +/- 0.28 mg/day. The Hyperactivity, Stereotypy, and Lethargy subscale scores showed the most significant reduction (p Children with disruptive behavior and self-injury showed the greatest improvement. Sleep quality improved for 88% of subjects with preexisting sleep disturbance. Subjects for whom a follow-up weight was available showed a mean weight increase of 2.8 +/- 1.5 kg during the treatment period. These findings support our clinical impression of improvement on important target behaviors such as aggression, disruptiveness, self-injury, stereotypy, and social withdrawal. Low-dose risperidone appears to be well tolerated in children with DS+ASD, although concerns about weight gain and metabolic alterations may limit its usefulness over the long term in some children.

  16. Comparing augmentation with non-antidepressants over sticking to antidepressants after treatment failure in depression: a naturalistic study.

    Science.gov (United States)

    Köhler, S; Unger, T; Hoffmann, S; Steinacher, B; Fydrich, T; Bschor, T

    2013-03-01

    Non-response to an antidepressant monotherapy in unipolar depression is quite common. Therefore strategies for subsequent treatment steps are necessary. However, there is a lack of direct comparisons of these different strategies. In this naturalistic study we compared the outcome to different strategies after failure of the primary antidepressant treatment. Failure of primary antidepressant monotherapy occurred in 135 patients. 98 of these patients have been administered 4 treatment strategies of the physicians' choice: lithium augmentation (Li-Augm), switching to another antidepressant (AD-Switch), combination of 2 antidepressants (AD-Comb) or augmentation with second generation antipsychotic (SGA-Augm). Primary outcome measure was the 17-item Hamilton rating scale for depression (HRSD). Patients who received Li-Augm or augmentation with SGAs showed significantly greater improvement in HRSD and BDI compared to patients with antidepressant switch or antidepressant combination. Remission rates for Li-Augm and SGA-Augm were 89.3% and 86.2% compared to 40.7% for AD-Switch and 42.9% for AD-Comb. Changing to another pharmacological class (Li-Augm or augmentation with SGAs) showed better treatment results than sticking to the class of antidepressants (AD-Switch and AD-Comb) after primary failure in response to antidepressant monotherapy in unipolar depression. The lack of randomization and absence of a non-response definition are design flaws. Controlled studies are required to confirm the findings of this trial. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Baseline Face Detection, Head Pose Estimation, and Coarse Direction Detection for Facial Data in the SHRP2 Naturalistic Driving Study

    Energy Technology Data Exchange (ETDEWEB)

    Paone, Jeffrey R [ORNL; Bolme, David S [ORNL; Ferrell, Regina Kay [ORNL; Aykac, Deniz [ORNL; Karnowski, Thomas Paul [ORNL

    2015-01-01

    Keeping a driver focused on the road is one of the most critical steps in insuring the safe operation of a vehicle. The Strategic Highway Research Program 2 (SHRP2) has over 3,100 recorded videos of volunteer drivers during a period of 2 years. This extensive naturalistic driving study (NDS) contains over one million hours of video and associated data that could aid safety researchers in understanding where the driver s attention is focused. Manual analysis of this data is infeasible, therefore efforts are underway to develop automated feature extraction algorithms to process and characterize the data. The real-world nature, volume, and acquisition conditions are unmatched in the transportation community, but there are also challenges because the data has relatively low resolution, high compression rates, and differing illumination conditions. A smaller dataset, the head pose validation study, is available which used the same recording equipment as SHRP2 but is more easily accessible with less privacy constraints. In this work we report initial head pose accuracy using commercial and open source face pose estimation algorithms on the head pose validation data set.

  18. Measuring heightened attention to alcohol in a naturalistic setting: A validation study.

    Science.gov (United States)

    Monem, Ramey G; Fillmore, Mark T

    2017-12-01

    Attentional bias to alcohol-related stimuli is believed to be an important contributor to the development and maintenance of drug abuse. There is a considerable body of research examining attentional bias, much of which has typically utilized image-display tasks as a means to assess the phenomenon. Little, however, is known about the nature of this bias in an individual's natural environment. The current study sought to implement a novel approach to assessing attentional bias in vivo. Participants wore portable eye-tracking glasses that recorded video from their point of view and measured fixation time to objects they observed. They entered a room that was designed to represent a recreational setting in which both alcohol- and nonalcoholic-neutral beverages were placed along with other stimuli. In two different testing sessions, participants were free to visually explore the room. Participants showed similar fixation times to alcohol and neutral beverages during Session 1. Attentional bias to alcoholic beverages was observed in Session 2 because fixation time decreased to neutral but not to alcoholic beverages. The magnitude of attentional bias was positively associated with drinking habits, with heavier drinkers demonstrating a higher degree of bias to alcohol. These findings provide an ecological model of how attentional bias can develop as the net result of attention being sustained to alcoholic stimuli while diminishing to other stimuli over time. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study.

    Science.gov (United States)

    Vinberg, Maj; Mikkelsen, Rie Lambaek; Kirkegaard, Thomas; Christensen, Ellen Margrethe; Kessing, Lars Vedel

    2017-01-15

    In a naturalistic clinical study of patients in the early stages of bipolar disorders the aim was to assess differences between patients with bipolar I (BD I) and bipolar II (BD II) disorders on clinical characteristics including affective symptoms, subjective cognitive complaints, functional level, the presence of comorbid personality disorders and coping strategies. Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status using the Functional Assessment Short Test. Cognitive complaints were assessed using the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire, the presence of comorbid personality disorders using the Standardized Assessment of Personality - Abbreviated Scale and coping style using the Coping Inventory for Stressful Situations. In total, 344 patients were included (BD I (n=163) and BD II (n=181). Patients with BD II presented with significantly more depressive symptoms, more cognitive complaints, lower overall functioning, and a higher prevalence of comorbid personality disorders. Finally, they exhibited a trend towards using less adaptive coping styles. It cannot be omitted that some patients may have progressed from BD II to BD I. Most measures were based on patient self report. Overall, BD II was associated with a higher disease burden. Clinically, it is important to differentiate BD II from BD I and research wise, there is a need for tailoring and testing specific interventions towards BD II. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Effectiveness and Predictors of Continuation of Paliperidone Palmitate Long-Acting Injection Treatment: A 12-Month Naturalistic Cohort Study.

    Science.gov (United States)

    Whale, Richard; Pereira, Marco; Cuthbert, Sharon; Fialho, Renata

    2015-10-01

    Antipsychotic long-acting injectable (LAI) medication has an important place as a treatment option in schizophrenia with evolving evidence to support clinical benefit over oral medication. Paliperidone palmitate is recently licensed as an LAI. We studied a naturalistic cohort of all identifiable patients who initiated paliperidone LAI in a specific United Kingdom region (Sussex) from first availability up to January 2013 (n = 179). Favorably, 60% of the cohort continued paliperidone LAI beyond 12 months from initiation. Schizophrenia diagnosis was significantly associated with 12-month continuation on univariate analysis (65% continuation rate at 12 months in this diagnostic subgroup). No baseline variables were identified as independently associated with 12-month continuation. However, fewer inpatient days after initiation (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.003-1.011; P = 0.002), dose adjustment up or down (OR, 3.46; 95% CI, 1.26-9.51; P = 0.016), and a higher maintenance dose (OR, 8.31; 95% CI, 1.84-37.51; P = 0.006) during treatment course were all independently associated with continuation on multivariate analysis. Our findings support the importance of a collaborative approach with the LAI recipient in treatment decision making to enhance treatment effectiveness.

  1. Escitalopram tolerability as mono- versus augmentative therapy in patients with affective disorders: a naturalistic study

    Directory of Open Access Journals (Sweden)

    Dell'Osso B

    2013-02-01

    Full Text Available Bernardo Dell’Osso, Chiara Arici, Cristina Dobrea, Giulia Camuri, Beatrice Benatti, A Carlo AltamuraUniversity of Milan, Department of Psychiatry, Fondazione IRCSS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, ItalyBackground: Escitalopram is a selective serotonin reuptake inhibitor, widely used in the treatment of affective disorders. The purpose of this study was to examine its safety and tolerability, as mono- versus augmentative therapy, in a group of patients with affective disorders.Materials and methods: The sample consisted of 131 patients suffering from different affective disorders, including major depressive disorder, bipolar disorder, and generalized anxiety disorder, who received escitalopram for at least 4 weeks. Data were analyzed on the basis of mono- versus augmentative therapy, as well as age, gender, mean daily dosage, and patterns of combination therapy.Results: Sixty-seven (51.1% patients were treated with monotherapy (mean dose of 11.76 mg/day and 64 (48.9% with augmentative escitalopram (mean dose of 12.81 mg/day. The mean duration of escitalopram treatment was 14 months. The most frequently combined compounds were: other antidepressants (36.5%, mood stabilizers (33.4%, and atypical antipsychotics (30.1%. Side effects were reported in 5.3% of the total sample and the most common were insomnia (2.3%, nausea (2.3%, and dizziness (0.8%. No significant difference, in terms of tolerability, in mono- versus augmentative therapy groups was found. In addition, neither age nor gender was significantly correlated with a greater presence of side effects. Finally, no significant correlation between dosage and side effects was observed.Conclusion: Over a 14-month observation period, escitalopram, either as monotherapy or an augmentative treatment, was found to be well tolerated in a large sample of patients with affective disorders, with an overall low rate of side effects.Keywords: affective disorders, escitalopram

  2. Communal proactive coping strategies among Tamil refugees in Norway: A case study in a naturalistic setting

    Directory of Open Access Journals (Sweden)

    Guribye Eugene

    2011-04-01

    Full Text Available Abstract Background An exclusive focus on individual or family coping strategies may be inadequate for people whose major point of concern may be collective healing on a more communal level. Methods To our knowledge, the current study is the first to make use of ethnographic fieldwork methods to investigate this type of coping as a process in a natural setting over time. Participant observation was employed within a Tamil NGO in Norway between August 2006 and December 2008. Results Tamil refugees in Norway co-operated to appraise their shared life situation and accumulate resources communally to improve it in culturally meaningful ways. Long term aspirations were related to both the situation in the homeland and in exile. However, unforeseen social events created considerable challenges and forced them to modify and adapt their coping strategies. Conclusions We describe a form of coping previously not described in the scientific literature: Communal proactive coping strategies, defined as the process by which group members feel collectively responsible for their future well-being and co-operate to promote desired outcomes and prevent undesired changes. The study shows that proactive coping efforts occur in a dynamic social setting which may force people to use their accumulated proactive coping resources in reactive coping efforts. Theoretical and clinical implications are explored.

  3. Modeling naturalistic craving, withdrawal, and affect during early nicotine abstinence: A pilot ecological momentary assessment study.

    Science.gov (United States)

    Bujarski, Spencer; Roche, Daniel J O; Sheets, Erin S; Krull, Jennifer L; Guzman, Iris; Ray, Lara A

    2015-04-01

    Despite the critical role of withdrawal, craving, and positive affect (PA) and negative affect (NA) in smoking relapse, relatively little is known about the temporal and predictive relationship between these constructs within the first day of abstinence. This pilot study aims to characterize dynamic changes in withdrawal, craving, and affect over the course of early abstinence using ecological momentary assessment. Beginning immediately after smoking, moderate and heavy smoking participants (n = 15 per group) responded to hourly surveys assessing craving, withdrawal, NA, and PA. Univariate and multivariate multilevel random coefficient modeling was used to describe the progression of craving, withdrawal/NA, and PA and to test correlations between these constructs at the subject level over the course of early abstinence. Heavy smokers reported greater craving from 1-4 hr of abstinence and greater withdrawal/NA after 3 or more hours as compared with moderate smokers. Level of withdrawal/NA was strongly positively associated with craving, and PA was negatively correlated with craving; however, the temporal dynamics of these correlations differed substantially. The association between withdrawal/NA and craving decreased over early abstinence, whereas the reverse was observed for PA. These findings can inform experimental studies of nicotine abstinence as well as their clinical applications to smoking cessation efforts. In particular, these results help to elucidate the role of PA in nicotine abstinence by demonstrating its independent association with nicotine craving over and above withdrawal/NA. If supported by future studies, these findings can refine experimental methods and clinical approaches for smoking cessation. (c) 2015 APA, all rights reserved).

  4. Brief Report: Excessive Alcohol Use Negatively Affects the Course of Adolescent Depression--One Year Naturalistic Follow-Up Study

    Science.gov (United States)

    Meririnne, Esa; Kiviruusu, Olli; Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Tuisku, Virpi; Marttunen, Mauri

    2010-01-01

    The impact of alcohol use on the course of adolescent depression over one-year was investigated by following 197 consecutive adolescent outpatients with unipolar depression in a naturalistic treatment setting. Their baseline alcohol consumption was categorized in three groups: excessive use (defined as weekly drunkenness), regular use (monthly…

  5. Effect of paliperidone palmitate on hospitalisation in a naturalistic cohort - a four-year mirror image study.

    Science.gov (United States)

    Taylor, D M; Sparshatt, A; O'Hagan, M; Dzahini, O

    2016-09-01

    Clinical trial outcomes are heavily influenced by the non-naturalistic clinical trial process. Observations of outcomes in clinical practice are a valuable adjunct to clinical trial results. Our null hypothesis was that clinically indicated switching to paliperidone palmitate had no effect on hospital admissions or hospital bed days. This was a part-prospective mirror image study examining outcomes 2years before starting paliperidone palmitate and 2years after. Sensitivity analyses examined the effect of different placings of the mirror in the mirror image design. We prospectively followed-up 225 patients prescribed paliperidone palmitate in clinical practice. At 2years, 41.8% of patients were still receiving paliperidone palmitate. In the primary analysis, the mean number of admissions fell from 1.80 in the two years before starting paliperidone palmitate to 0.81 in two years following the drug's initiation (outpatients) or two years following hospital discharge (inpatients) (Ppaliperidone palmitate initiation or discharge (PPaliperidone palmitate initiation is associated with a substantial reduction in hospital admissions and days spent in hospital. The reduction in costs associated with reduced use of health care facilities is likely to exceed the purchase and administration costs of the drug. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Age and gender differences in time to collision at braking from the 100-Car Naturalistic Driving Study.

    Science.gov (United States)

    Montgomery, Jade; Kusano, Kristofer D; Gabler, Hampton C

    2014-01-01

    Forward collision warning (FCW) is an active safety system that aims to mitigate the effect of forward collisions by warning the driver of objects in front of the vehicle. Success of FCW relies on how drivers react to the alerts. Drivers who receive too many warnings that they deem as unnecessary-that is, nuisance alarms-may grow to distrust and turn the system off. To reduce the perception of nuisance alarms, FCW systems can be tailored to individual driving styles, but these driving styles must first be characterized. The objective of this study was to characterize differences in braking behavior between age and gender groups in car-following scenarios using data from the 100-Car Naturalistic Driving Study. The data source for this study was the 100-Car Naturalistic Driving Study, which recorded the driving of 108 primary drivers for approximately a year. Braking behavior was characterized in terms of time to collision (TTC) at brake application, a common metric used in the design of warning thresholds of FCW. Because of the large volume of data analyzed, the TTC at which drivers braked during car-following situations was collected via an automated search algorithm. The minimum TTC for each vehicle speed 10 mph increment from 10 mph to 80 mph was recorded for each driver. Mixed model analysis of variance was used to examine the differences between age and gender groups. In total, 527,861 brake applications contained in 11,503 trips were analyzed. Differences in TTC at braking were statistically significant for age and gender (P<.01 for both cases). Males age 18-20 (n=7) had the lowest average minimum TTC at braking of 2.5±0.8 s, and females age 31-50 (n=6) had the highest average minimum TTC at braking of 6.4±0.9 s. On average, women (n=32) braked at a TTC 1.3 s higher than men (n=52). Age was a statistically significant factor for TTC at braking between participants under 30 (n=42) and participants over 30 (n=42), with the latter braking 1.7 s on average

  7. Driving context influences drivers' decision to engage in visual-manual phone tasks: Evidence from a naturalistic driving study.

    Science.gov (United States)

    Tivesten, Emma; Dozza, Marco

    2015-06-01

    Visual-manual (VM) phone tasks (i.e., texting, dialing, reading) are associated with an increased crash/near-crash risk. This study investigated how the driving context influences drivers' decisions to engage in VM phone tasks in naturalistic driving. Video-recordings of 1,432 car trips were viewed to identify VM phone tasks and passenger presence. Video, vehicle signals, and map data were used to classify driving context (i.e., curvature, other vehicles) before and during the VM phone tasks (N=374). Vehicle signals (i.e., speed, yaw rate, forward radar) were available for all driving. VM phone tasks were more likely to be initiated while standing still, and less likely while driving at high speeds, or when a passenger was present. Lead vehicle presence did not influence how likely it was that a VM phone task was initiated, but the drivers adjusted their task timing to situations when the lead vehicle was increasing speed, resulting in increasing time headway. The drivers adjusted task timing until after making sharp turns and lane change maneuvers. In contrast to previous driving simulator studies, there was no evidence of drivers reducing speed as a consequence of VM phone task engagement. The results show that experienced drivers use information about current and upcoming driving context to decide when to engage in VM phone tasks. However, drivers may fail to sufficiently increase safety margins to allow time to respond to possible unpredictable events (e.g., lead vehicle braking). Advanced driver assistance systems should facilitate and possibly boost drivers' self-regulating behavior. For instance, they might recognize when appropriate adaptive behavior is missing and advise or alert accordingly. The results from this study could also inspire training programs for novice drivers, or locally classify roads in terms of the risk associated with secondary task engagement while driving. Copyright © 2015. Published by Elsevier Ltd.

  8. A randomized, naturalistic, parallel-group study for the long-term treatment of panic disorder with clonazepam or paroxetine.

    Science.gov (United States)

    Nardi, Antonio E; Freire, Rafael C; Mochcovitch, Marina D; Amrein, Roman; Levitan, Michelle N; King, Anna L; Valença, Alexandre M; Veras, André B; Paes, Flávia; Sardinha, Aline; Nascimento, Isabella; de-Melo-Neto, Valfrido L; Dias, Gisele P; E Silva, Adriana Cardoso de O; Soares-Filho, Gastão L; da Costa, Rafael T; Mezzasalma, Marco A; de Carvalho, Marcele R; de Cerqueira, Ana C; Hallak, Jaime E; Crippa, José A; Versiani, Marcio

    2012-02-01

    This long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)-Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale -3.48 vs -3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.

  9. Analysis of clinical characteristics and antipsychotic medication prescribing practices of first-episode schizophrenia in Israel: a naturalistic prospective study.

    Science.gov (United States)

    Strous, Rael D; Bar, Faina; Keret, Noa; Lapidus, Raya; Kosov, Nikolai; Chelben, Joseph; Kotler, Moshe

    2006-01-01

    Investigation of the clinical presentation and treatment of first-episode psychosis is important in order to exclude effects of age, chronic illness, long-term treatment and institutionalization. The aim of this descriptive study was to investigate the management practices of first-episode schizophrenia in a cohort of patients in Israel and to document use of the various "typical" or "atypical" antipsychotic agents. Fifty-one consecutive patients (26 M, 25 F) with first-episode psychosis were recruited for study participation and were administered either typical or atypical antipsychotic medications in a naturalistic manner. While an approximately equal number of subjects received typical and atypical medications at illness onset, a prominent shift to atypical antipsychotic treatment occurred over the study course; 18 subjects had medication class shifts: 17 from typical to atypical, and one from atypical to typical. Negative symptoms did not affect length of hospitalization, but were associated with aggression. Higher depression rates were noted in patients with long hospitalizations who received typical antipsychotic medications. Immigrants were admitted at an age approximately four years older than native-born Israelis. The prominent shift from "typical" to "atypical" antipsychotic medications may indicate sensitivity of first-episode psychotic patients to side-effects of "typical" medications and prominence of use of atypical medications in this patient subpopulation be it due to improved efficacy over time or successful marketing. Unique cultural and population characteristics may contribute to the manifestation of first-episode psychosis and suggest the importance of more effective outreach to the immigrant population in order to manage an apparent treatment delay.

  10. Does Stress Increase Imitation of Drinking Behavior? An Experimental Study in a (Semi-)Naturalistic Context

    NARCIS (Netherlands)

    Larsen, H.; Engels, R.C.M.E.; Granic, I.; Huizink, A.C.

    2013-01-01

    Background That alcohol consumption is strongly influenced by the drinking behavior of social company has been demonstrated in observational research. However, not everyone is equally vulnerable to other people's drinking, and it is important to unravel which factors underlie these individual

  11. Does stress increase imitation of drinking behavior? An experimental study in a (semi-)naturalistic contex

    NARCIS (Netherlands)

    Larsen, H.; Engels, R.C.M.E.; Granic, I.; Huizink, A.C.

    2013-01-01

    BACKGROUND: That alcohol consumption is strongly influenced by the drinking behavior of social company has been demonstrated in observational research. However, not everyone is equally vulnerable to other people's drinking, and it is important to unravel which factors underlie these individual

  12. Does Stress Increase Imitation of Drinking Behavior? An Experimental Study in a (Semi-)Naturalistic Context

    NARCIS (Netherlands)

    Larsen, H.; Engels, R.C.M.E.; Granic, I.; Huizink, A.C.

    2013-01-01

    Background: That alcohol consumption is strongly influenced by the drinking behavior of social company has been demonstrated in observational research. However, not everyone is equally vulnerable to other people's drinking, and it is important to unravel which factors underlie these individual

  13. Prospective and concurrent correlates of emotion perception in psychotic disorders: a naturalistic, longitudinal study of neurocognition, affective blunting and avolition.

    Science.gov (United States)

    Vaskinn, Anja; Johnsen, Erik; Jørgensen, Hugo A; Kroken, Rune A; Løberg, Else-Marie

    2013-06-01

    This naturalistic study investigated longitudinal and cross-sectional symptomatic and neurocognitive correlates of social cognition indexed by emotion perception. Participants were 31 persons admitted to a psychiatric emergency ward due to acute psychosis. Positive and negative (i.e., affective blunting and avolition) symptoms were assessed at baseline and 12-month follow-up using the Positive and Negative Syndrome Scale. Participants completed neuropsychological assessments with alternative versions of the Repeatable Battery for the Assessment of Neuropsychological Status at baseline and at 12-month follow-up. Emotion perception was measured using the Face/Voice Emotion Test at 12-month follow-up. Correlational analyses (Spearman's rho) revealed strong and statistically significant associations between neurocognition and emotion perception (baseline r = 0.58, follow-up r = 0.43). Associations between positive symptoms and emotion perception were weak or non-existent (baseline r = 0.13, follow-up r  =  -0.01). Emotion perception was moderately, but not significantly, associated with affective blunting at follow-up (r = 0.33), but not at baseline (r = 0.21). The association with avolition was non-existent (baseline r  =  -0.05, follow-up r = 0.01). This study supports the notion that emotion perception has neurocognitive correlates. The cross-sectional trend level association with affective blunting suggests that the ability to perceive emotions might be related to, but dissociable from the ability to express emotions. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

  14. Actigraphy-assessed sleep during school and vacation periods: a naturalistic study of restricted and extended sleep opportunities in adolescents.

    Science.gov (United States)

    Bei, Bei; Allen, Nicholas B; Nicholas, Christian L; Dudgeon, Paul; Murray, Greg; Trinder, John

    2014-02-01

    School-related sleep restriction in adolescents has been identified by studies comparing weekday and weekend sleep. This study compared weekday and vacation sleep to assess restricted and extended sleep opportunities. One-hundred and forty-six adolescents (47.3% male) aged 16.2 ± 1.0 years (M ± SD) from the general community wore an actigraph continuously for 4 weeks: the last week of a school term (Time-E), the following 2-week vacation, and the first week of the next term. Self-reported sleep was assessed for each of the three time intervals, and chronotype was assessed using the Morningness-Eveningness Questionnaire at Time-E. Daily actigraphy bedtime, rise-time, time-in-bed, total sleep time, sleep onset latency, sleep efficiency, and % wake after sleep onset were analysed using latent growth curve modelling. The removal of school-related sleep restriction was associated with an abrupt delay in sleep timing and increase in sleep duration. Subsequently, bedtime and rise-time showed further linear delays throughout the vacation, while changes in time-in-bed were non-significant. Sleep onset latency increased linearly, peaking in the middle of the second vacation week. Across the first vacation week, total sleep time and sleep efficiency linearly decreased, while % wake after sleep onset increased. These changes stabilized during the second vacation week. Older age and eveningness were associated with later bedtime and rise-time, whilst females had longer time-in-bed, total sleep time and sleep onset latency. Compared with school days, sleep during the vacation was characterized by later timing, longer duration, lower quality and greater variability. Recovery from school-related sleep restriction appeared to be completed within the 2 weeks of naturalistic extended sleep. © 2013 European Sleep Research Society.

  15. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study.

    Science.gov (United States)

    Schmaal, Lianne; Marquand, Andre F; Rhebergen, Didi; van Tol, Marie-José; Ruhé, Henricus G; van der Wee, Nic J A; Veltman, Dick J; Penninx, Brenda W J H

    2015-08-15

    A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the prognostic value of different neuroimaging modalities, clinical characteristics, and their combination to classify MDD course trajectories. One hundred eighteen MDD patients underwent structural and functional magnetic resonance imaging (MRI) (emotional facial expressions and executive functioning) and were clinically followed-up at 2 years. Three MDD trajectories (chronic n = 23, gradual improving n = 36, and fast remission n = 59) were identified based on Life Chart Interview measuring the presence of symptoms each month. Gaussian process classifiers were employed to evaluate prognostic value of neuroimaging data and clinical characteristics (including baseline severity, duration, and comorbidity). Chronic patients could be discriminated from patients with more favorable trajectories from neural responses to various emotional faces (up to 73% accuracy) but not from structural MRI and functional MRI related to executive functioning. Chronic patients could also be discriminated from remitted patients based on clinical characteristics (accuracy 69%) but not when age differences between the groups were taken into account. Combining different task contrasts or data sources increased prediction accuracies in some but not all cases. Our findings provide evidence that the prediction of naturalistic course of depression over 2 years is improved by considering neuroimaging data especially derived from neural responses to emotional facial expressions. Neural responses to emotional salient faces more accurately predicted outcome than clinical data. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  16. Persistence of Cholinesterase Inhibitor Treatment in Dementia: Insights from a Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Javier Olazarán

    2013-03-01

    Full Text Available Background: Cholinesterase inhibitors (ChEI are widely used in dementia, but there is a lack of practice guidelines in case of intolerance or absence of perceived effect. Methods: Two hundred and forty patients (mean age 77 years, SD 6.3, 66% female with Alzheimer's disease or Lewy body dementia were prescribed a ChEI and evaluated annually under conditions of standard practice. Of these, 152 patients maintained, 36 switched, and 52 abandoned ChEI treatment. Results: Less behavioural disturbance and less cognitive deterioration were observed, respectively, at the 3- and 4-year follow-up assessments in the patients who maintained the first prescribed ChEI (p Conclusions: Maintenance of the first prescribed ChEI was supported when some benefit was perceived by the patient or caregiver, even in cases of nonserious adverse events.

  17. A Naturalistic Investigation of Media Multitasking While Studying and the Effects on Exam Performance

    Science.gov (United States)

    Patterson, Michael C.

    2017-01-01

    The present study investigated the use of multiple digital media technologies, including social networking platforms, by students while preparing for an examination (media multitasking) and the subsequent effects on exam performance. The level of media multitasking (number of simultaneous media technologies) and duration of study were used as…

  18. Inpatient Treatment for Early Sexually Abused Adults: A Naturalistic 12-Month Follow-Up Study

    NARCIS (Netherlands)

    Jepsen, E.K.K.; Langeland, W.; Sexton, H.; Heir, T.

    2014-01-01

    To date, most of the inpatient outcome studies among early traumatized individuals lack data on dissociative disorders. More research is needed to evaluate whether severely dissociative patients can improve following specialized inpatient treatment for chronic childhood abuse. The objectives of this

  19. Metabolic syndrome in a cohort of affectively ill patients, a naturalistic study

    DEFF Research Database (Denmark)

    Vinberg, Maj; Madsen, Maiken; Breum, Leif

    2012-01-01

    at a Mood Disorder Clinic. Methods: Patients were evaluated for the presence of metabolic syndrome (MeS) according to modified NCEP ATP III criteria. Results: Of the 143 patients eligible for participation, 100 patients participated in the study (32% male, mean age 43.6 ± 14.2); the prevalence of MeS was 26...

  20. Predictors for treatment outcome of binge eating with obesity: A naturalistic study

    NARCIS (Netherlands)

    Deumens, R.A.; Noorthoorn, E.O.; Verbraak, M.J.P.M.

    2012-01-01

    This study examines predictors of short-term treatment outcome for obese individuals with binge eating disorder (BED). A battery of assessment questionnaires was given to 212 patients on admission of a CBT day-treatment program for BED. Treatment outcome assessed by changes in eating disorder

  1. Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.M.; Hilbink-Smolders, M.; Spreeuwenberg, P.; Laurant, M.G.H.; Meer, K. van der; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  2. Outcomes for depression and anxiety in primary care and details of treatment : a naturalistic longitudinal study

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; Hilbink-Smolders, Mirrian; Spreeuwenberg, Peter; Laurant, Miranda G. H.; van der Meer, Klaas; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  3. Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.; Hilbink-Smolders, M.; Spreeuwenberg, P.; Laurant, M.G.; van der Meer, K.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  4. Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study.

    Science.gov (United States)

    Weisman, Omri; Guri, Yael; Gur, Raquel E; McDonald-McGinn, Donna M; Calkins, Monica E; Tang, Sunny X; Emanuel, Beverly; Zackai, Elaine H; Eliez, Stephan; Schneider, Maude; Schaer, Marie; Kates, Wendy R; Antshel, Kevin M; Fremont, Wanda; Shashi, Vandana; Hooper, Stephen R; Armando, Marco; Vicari, Stefano; Pontillo, Maria; Kushan, Leila; Jalbrzikowski, Maria; Bearden, Carrie E; Cubells, Joseph F; Ousley, Opal Y; Walker, Elaine F; Simon, Tony J; Stoddard, Joel; Niendam, Tara A; van den Bree, Marianne B M; Gothelf, Doron

    2017-09-01

    Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a full-blown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For

  5. Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme.

    Science.gov (United States)

    Tchanturia, Kate; Adamson, James; Leppanen, Jenni; Westwood, Heather

    2017-11-01

    Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index. Autism Spectrum Quotient, short version scores remained relatively stable from admission to discharge but there was a small, significant reduction in scores. There was no interaction between time and Autism Spectrum Quotient, short version scores on clinical symptom change. In anorexia nervosa, autism spectrum disorder symptoms appear to be associated with a more severe clinical presentation on admission to inpatient care. Autism spectrum disorder symptoms as assessed by self-report measures may be exacerbated by other mental health psychopathology, which warrants further investigation.

  6. Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community.

    Science.gov (United States)

    Bernardo, Miguel; Cañas, Fernando; Herrera, Berta; García Dorado, Marta

    Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%. Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Emerging Adults' Text Message Use and Sleep Characteristics: A Multimethod, Naturalistic Study.

    Science.gov (United States)

    Murdock, Karla Klein; Horissian, Mikael; Crichlow-Ball, Caroline

    2017-01-01

    Emerging adults use text messaging as a principal form of social communication, day and night, and this may compromise their sleep. In this study, a hypothetical model was tested linking daytime and nighttime text message use with multiple sleep characteristics. Subjective and objective measures of texting and sleep were utilized to assess 83 college students over a seven-day period during an academic term. Greater number of daily texts, awareness of nighttime cell phone notifications, and compulsion to check nighttime notifications were significantly associated with poorer subjective sleep quality. Awareness of nighttime notifications was significantly associated with higher self-reported global sleep problems and more sleep disruptions. Results suggest potential benefits of targeting nighttime texting habits in health promotion efforts for emerging adults.

  8. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Charnsilp Chawanun

    2007-04-01

    Full Text Available Abstract Background Not only the prevalence, but also the progress of metabolic abnormalities in schizophrenic patients is of importance for treatment planning and policy making. However, there have been very few prospective studies of metabolic disturbance in schizophrenic patients. This study aimed to assess the progress of metabolic abnormalities in Thai individuals with schizophrenia by estimating their one-year incidence rate of metabolic syndrome (MetS. Methods We screened all schizophrenic patients who visited our psychiatric clinic. After the exclusion of participants with MetS at baseline, each subject was reassessed at 6 and 12 months to determine the occurrence of MetS. The definition of MetS, as proposed by the International Diabetes Federation (IDF, was applied. Results Fifty-seven participants (24 males and 33 females had a mean of age and duration of antipsychotic treatment of 37.5 years old and 8.4 years, respectively. At baseline, 13 subjects met the MetS definition. Of 44 subjects who had no MetS at baseline, 35 could be followed up. Seven of these 35 subjects (20.0% had developed MetS at the 6- or 12-month visit, after already having 2 MetS components at baseline. The demographic data and characteristics of those developing and not developing MetS were not different in any respect. Conclusion Thai schizophrenic patients are likely to develop MetS. Their metabolic abnormalities may progress rapidly and fulfill the MetS definition within a year of follow-up. These findings support the importance of assessing and monitoring metabolic syndrome in schizophrenic patients.

  9. A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome

    Directory of Open Access Journals (Sweden)

    Harada T

    2014-11-01

    Full Text Available Tsuyoto Harada, Ken Inada, Kazuo Yamada, Kaoru Sakamoto, Jun Ishigooka Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan Objective: Patients often develop neuropsychiatric symptoms such as anxiety and agitation after they have started taking an antidepressant, and this is thought to be associated with a potentially increased risk of suicide. However, the incidence of antidepressant-induced jitteriness/anxiety syndrome has not been fully investigated, and little has been reported on its predictors. The aim of this study was to survey the incidence of antidepressant-induced jitteriness/anxiety syndrome and clarify its predictors in a natural clinical setting.Materials and methods: Between January 2009 and July 2012, we prospectively surveyed 301 patients who had not taken any antidepressants for 1 month before presentation, and who were prescribed antidepressants for 1 month after their initial visit. Patients were classified as developing antidepressant-induced jitteriness/anxiety syndrome if they experienced any symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, or mania during the first month.Results: Among the 301 patients, 21 (7.0% developed antidepressant-induced jitteriness/anxiety syndrome. Major depressive disorder and a diagnosis of mood disorder in first-degree relatives of patients were significantly associated with induction of antidepressant-induced jitteriness/anxiety syndrome (odds ratio 10.2, P=0.001; odds ratio 4.65, P=0.02; respectively. However, there was no such relationship for sex, age, class of antidepressant, combined use of benzodiazepines, or diagnosis of anxiety disorder.Conclusion: The findings of this study suggest that major depressive disorder and a diagnosis of mood disorder in first-degree relatives may be clinical predictors of antidepressant-induced jitteriness/anxiety syndrome

  10. Mortality in dementia with Lewy bodies compared with Alzheimer's dementia: a retrospective naturalistic cohort study.

    Science.gov (United States)

    Price, Annabel; Farooq, Redwan; Yuan, Jin-Min; Menon, Vandana B; Cardinal, Rudolf N; O'Brien, John T

    2017-11-03

    To use routine clinical data to investigate survival in dementia with Lewy bodies (DLB) compared with Alzheimer's dementia (AD). DLB is the second most common dementia subtype after AD, accounting for around 7% of dementia diagnoses in secondary care, though studies suggest that it is underdiagnosed by up to 50%. Most previous studies of DLB have been based on select research cohorts, so little is known about the outcome of the disease in routine healthcare settings. Cambridgeshire & Peterborough NHS Foundation Trust, a mental health trust providing secondary mental health care in England. 251 DLB and 222 AD identified from an anonymised database derived from electronic clinical case records across an 8-year period (2005-2012), with mortality data updated to May 2015. Raw (uncorrected) median survival was 3.72 years for DLB (95% CI 3.33 to 4.14) and 6.95 years for AD (95% CI 5.78 to 8.12). Controlling for age at diagnosis, comorbidity and antipsychotic prescribing the model predicted median survival for DLB was 3.3 years (95% CI 2.88 to 3.83) for males and 4.0 years (95% CI 3.55 to 5.00) for females, while median survival for AD was 6.7 years (95% CI 5.27 to 8.51) for males and 7.0 years (95% CI 5.92 to 8.73) for females. Survival from first presentation with cognitive impairment was markedly shorter in DLB compared with AD, independent of age, sex, physical comorbidity or antipsychotic prescribing. This finding, in one of the largest clinical cohorts of DLB cases assembled to date, adds to existing evidence for poorer survival for DLB versus AD. There is an urgent need for further research to understand possible mechanisms accounting for this finding. © 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.

  11. Outcomes of inpatients with severe mental illness: a naturalistic descriptive study

    Directory of Open Access Journals (Sweden)

    Gabriela L. Nuernberg

    2016-01-01

    Full Text Available Objective: To describe and evaluate the response and predictors of remission during inpatient treatment in a psychiatric unit in a general hospital based on symptomatology, functionality, and quality of life (QoL. Methods: Patients were admitted to a psychiatric unit in a tertiary general hospital in Brazil from June 2011 to December 2013 and included in the study if they met two of the severe mental illness (SMI criteria: Global Assessment of Functioning (GAF ≤ 50 and duration of service contact ≥ 2 years. Patients were assessed by the Brief Psychiatric Rating Scale (BPRS, the Clinical Global Impression (CGI Severity Scale , GAF, the World Health Organization Quality of Life Instrument – Abbreviated version (WHOQOL-Bref, and specific diagnostic scales. Results: A total of 239 patients were included. BPRS mean scores were 25.54±11.37 at admission and 10.96±8.11 at discharge (p < 0.001. Patients with manic episodes (odds ratio: 4.03; 95% confidence interval: 1.14-14.30; p = 0.03 were more likely to achieve remission (CGI ≤ 2 at discharge than those with depressive episodes. Mean length of stay was 28.95±19.86 days. All QoL domains improved significantly in the whole sample. Conclusion: SMI patients had marked improvements in symptomatic and functional measures during psychiatric hospitalization. Patients with manic episodes had higher chance of remission according to the CGI.

  12. A naturalistic study of recovering gamblers: What gets better and when they get better.

    Science.gov (United States)

    Rossini-Dib, Danielle; Fuentes, Daniel; Tavares, Hermano

    2015-05-30

    Gambling recovery has typically been assessed through the lens of gambling behavior and its consequences. Little attention has been given to less obvious features of gambling disorder, such as negative affectivity, gambling cognitive distortions, impulsivity, cognitive flexibility, planning, inhibitory control, and decision-making. The current study investigates how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment. A subset of 48 patients was additionally assigned to cognitive behavioral therapy (CBT). Seventy-two patients were reassessed 6 months after treatment onset. Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. Three outcome variables were strongly related with gambling recovery: negative affectivity, cognitive distortions and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. A Canadian naturalistic study of a community-based cohort treated for bipolar disorder

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    Chandresena Ranjith

    2010-03-01

    Full Text Available Abstract Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year was also evaluated. Methods 496 patients were enrolled at 75 psychiatric practices across Canada. The Olanzapine cohort (n = 287 included patients who had olanzapine added to their medication regimen or the dose of olanzapine increased. The Other cohort (n = 209 had a medication other than olanzapine added or the dose adjusted. Changes from baseline in the Young Mania Rating Scale (YMRS, Montgomery Asberg Depression Rating Scale, Beck Anxiety Inventory and SF-12 Health Survey were compared at one month using ANCOVA. Categorical variables at one month for health resource utilization, employment status, abuse/dependency, and the number of suicide attempts were compared using Fisher's Exact test. Patients were followed for one year and a subgroup was evaluated. Results At one month, patients in the Olanzapine cohort recorded a mean reduction in the YMRS of 11.5, significantly greater than the mean reduction in the Other cohort of 9.7 (ANCOVA P = 0.002. The Olanzapine cohort was significantly improved compared to the Other cohort on the scales for depression and anxiety and did not experience the deterioration in physical functioning seen in the Other cohort. No significant differences were detected in health-related quality-of-life measures, employment status, drug abuse/dependency, number of suicide attempts, mental functioning, emergency room visits or inpatient psychiatric hospitalizations. In a subgroup treated for 12 months with a single second generation

  14. Benefits of Naturalistic Methods in Research in Science Education.

    Science.gov (United States)

    Smith, Mary Lee

    1982-01-01

    Argues that naturalistic research is appropriate for studying science education. Stages of naturalistic research are explained and illustrated with material from NSF-sponsored Case Studies in Science Education. Problems in traditional research methods are presented as justification for inductive models or models based on multiple methods,…

  15. The Impact of Driver Inattention on Near-Crash/Crash Risk: An Analysis Using the 100-Car Naturalistic Driving Study Data

    OpenAIRE

    Klauer, Sheila G.; Dingus, Thomas A.; Neale, Vicki L.; Sudweeks, Jeremy D.; Ramsey, D. J.

    2006-01-01

    The purpose of this report was to conduct in-depth analyses of driver inattention using the driving data collected in the 100-Car Naturalistic Driving Study. An additional database of baseline epochs was reduced from the raw data and used in conjunction with the crash and near-crash data identified as part of the original 100-Car Study to account for exposure and establish near-crash/crash risk. The analyses presented in this report are able to establish direct relationships between driving b...

  16. Predictors and course of vocational status, income, and quality of life in people with severe mental illness: a naturalistic study.

    Science.gov (United States)

    Nordt, Carlos; Müller, Brigitte; Rössler, Wulf; Lauber, Christoph

    2007-10-01

    Due to high unemployment rates, people with mental illness are at risk of poverty and are deprived of the social and psychological functions of work, such as the provision of social support, structuring of time, and self-esteem, with a negative effect on their perceived quality of life (QoL). Two distinct processes are held responsible for the low work force participation of people with mental illness: 'Social underachievement' and 'social decline'. Social underachievement signifies that, due to early illness onset, the educational attainment of people with mental illness is low and entry to the labor market fails. Social decline, on the other hand, describes the loss of competitive employment after illness onset, followed by prolonged periods of unemployment and difficulties to re-enter the labor market. This study examines how social underachievement and decline are reflected in the course of vocational status, income, and QoL of people with severe mental illness in the years after a psychiatric admission in a naturalistic longitudinal design. A total of 176 participants diagnosed with schizophrenia or affective disorders were interviewed during an index hospitalization in two large psychiatric hospitals in Zurich. Follow-up interviews were conducted 12 and 30 months after. Random coefficient models (multilevel models) were used to examine simultaneously the predictors and course of the variables of interest. A low number of psychiatric hospitalizations, a higher educational degree, a diagnosis of schizophrenia, and years of work experience predicted a higher vocational status. Vocational status decreased in first-admission participants with prolonged hospitalizations during the follow-up period. Income did not change over time and was positively influenced by a higher age of illness onset, competitive employment, higher education, and not having had a longer hospitalization recently. Subjective QoL significantly improved and was rated higher by people with any

  17. The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques.

    Science.gov (United States)

    Owsley, Cynthia; McGwin, Gerald; Antin, Jonathan F; Wood, Joanne M; Elgin, Jennifer

    2018-02-07

    Older drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver's own vehicle. The DAS continuously records multi-channel video of driver and roadway, sensor-based kinematics, GPS location, and presence of nearby objects in front of the vehicle, providing an objective measure of driving exposure. In this naturalistic driving study, the purpose is to examine the relationship between vision and crashes and near-crashes, lane-keeping, turning at intersections, driving performance during secondary tasks demands, and the role of front-seat passengers. An additional aim is to compare results of the on-road driving evaluation by a certified driving rehabilitation specialist to objective indicators of driving performance derived from the naturalistic data. Drivers ≥70 years old are recruited from ophthalmology clinics and a previous population-based study of older drivers, with the goal of recruiting persons with wide ranging visual function. Target samples size is 195 drivers. At a baseline visit, the DAS is installed in the participant's vehicle and a battery of health and functional assessments are administered to the driver including visual-sensory and visual-cognitive tests. The DAS remains installed in the vehicle for six months while the participant goes about his/her normal driving with no imposed study restrictions. After six months, the driver returns for DAS de-installation, repeat vision testing, and an on-road driving evaluation by a certified

  18. Do naturalistic enclosures provide suitable environments for zoo animals?

    Science.gov (United States)

    Fàbregas, María C; Guillén-Salazar, Federico; Garcés-Narro, Carlos

    2012-01-01

    Zoo visitors perceive naturalistic enclosures (i.e. those attempting to replicate identifiable parts of the landscape of the species' habitat) as those that best satisfy the biological needs of the animals, and ensure therefore their welfare. However, the provision of a suitable environment with the resources that will allow the animals to satisfy their main biological needs in naturalistic enclosures has never been systematically explored; instead, it has been assumed. In this study we provide evidence that supports the general idea that naturalistic designs provide suitable environments for the animals. For that purpose, we analyzed 1,381 naturalistic and non-naturalistic enclosures in 63 Spanish zoological parks. In order to assess the suitability of the environment provided within each enclosure, a number of aspects related to the animals' main biological requirements were analyzed. We found a relationship between naturalistic designs and the suitability of the environment for the species housed. Most naturalistic enclosures (77.8%) provided suitable environments for their inhabitants. Non-naturalistic ones also had suitable environments, but in a lower percentage (39.7%). These results should be taken into account during zoo inspection and accreditation appointments, where enclosure suitability must be assessed in an accurate and fast manner. In this regard, a naturalistic design can be used as an adjunct indicator of enclosure suitability, but not exclusively, as not every naturalistic enclosure was suitable for the animals, neither as an indispensable one, given that near 40% of non-naturalistic ones were appropriate for the species housed. © 2011 Wiley Periodicals, Inc.

  19. The parasitic model of L2 and L3 vocabulary acquisition: evidence from naturalistic and experimental studies

    Directory of Open Access Journals (Sweden)

    Peter Ecke

    2014-09-01

    Full Text Available This paper reviews evidence for the Parasitic Model of Vocabulary Acquisition for second and third language learners/developing multilinguals. It first describes the model’s predictions about default processes based on the detection and use of similarity at the three stages involved in the development of individual lexical items: (1 the establishing of a form representation, (2 the building of connections to syntactic frame and concept representations, and (3 the strengthening and automatization of representations and access routes. The paper then summarizes both naturalistic and experimental evidence for processes involved at these three stages. Finally it discusses open issues and potential areas for future investigation.

  20. Talking on a Wireless Cellular Device While Driving: Improving the Validity of Crash Odds Ratio Estimates in the SHRP 2 Naturalistic Driving Study

    Directory of Open Access Journals (Sweden)

    Richard A. Young

    2017-12-01

    Full Text Available Dingus and colleagues (Proc. Nat. Acad. Sci. U.S.A. 2016, 113, 2636–2641 reported a crash odds ratio (OR estimate of 2.2 with a 95% confidence interval (CI from 1.6 to 3.1 for hand-held cell phone conversation (hereafter, “Talk” in the SHRP 2 naturalistic driving database. This estimate is substantially higher than the effect sizes near one in prior real-world and naturalistic driving studies of conversation on wireless cellular devices (whether hand-held, hands-free portable, or hands-free integrated. Two upward biases were discovered in the Dingus study. First, it selected many Talk-exposed drivers who simultaneously performed additional secondary tasks besides Talk but selected Talk-unexposed drivers with no secondary tasks. This “selection bias” was removed by: (1 filtering out records with additional tasks from the Talk-exposed group; or (2 adding records with other tasks to the Talk-unexposed group. Second, it included records with driver behavior errors, a confounding bias that was also removed by filtering out such records. After removing both biases, the Talk OR point estimates declined to below 1, now consistent with prior studies. Pooling the adjusted SHRP 2 Talk OR estimates with prior study effect size estimates to improve precision, the population effect size for wireless cellular conversation while driving is estimated as 0.72 (CI 0.60–0.88.

  1. Melatonin for sleep disturbance in children with neurodevelopmental disorders: prospective observational naturalistic study.

    Science.gov (United States)

    Ayyash, Hani F; Preece, Phillip; Morton, Richard; Cortese, Samuele

    2015-06-01

    Although melatonin is increasingly used for sleep disturbances in children with neurodevelopmental disorders, evidence on effective dose and impact on specific types of sleep disturbance is limited. We assessed 45 children (35 males, mean age: 6.3 ± 1.7 years) with neurodevelopmental disorders (n = 29: intellectual disability; n = 9: autism spectrum disorder; n = 7: attention-deficit/hyperactivity disorder) and sleep disturbances, treated with melatonin (mean duration: 326 days) with doses increased according to response. Thirty-eight percent of children responded to low (2.5-3 mg), 31% to medium (5-6 mg) and 9% to high doses (9-10 mg) of melatonin, with a significant increase in total hours of sleep/night, decreased sleep onset delay and decreased number of awakenings/night (all: p = 0.001), as measured with sleep diaries. No serious adverse events were reported. Melatonin is generally effective and safe in children with neurodevelopmental conditions. Increasing above 6 mg/night adds further benefit only in a small percentage of children.

  2. Criteria for Assessing Naturalistic Inquiries as Reports.

    Science.gov (United States)

    Lincoln, Yvonna S.; Guba, Egon G.

    Research on the assessment of naturalistic inquiries is reviewed, and criteria for assessment are outlined. Criteria reviewed include early foundational and non-foundational criteria, trustworthiness criteria, axiomatic criteria, rhetorical criteria, action criteria, and application/transferability criteria. Case studies that are reports of…

  3. Naturalistic acquisition in an early language classroom.

    Science.gov (United States)

    Dahl, Anne; Vulchanova, Mila D

    2014-01-01

    This study investigated whether it is possible to provide naturalistic second language acquisition (SLA) of vocabulary for young learners in a classroom situation without resorting to a classical immersion approach. Participants were 60 first-grade pupils in two Norwegian elementary schools in their first year. The control group followed regular instruction as prescribed by the school curriculum, while the experimental group received increased naturalistic target language input. This entailed extensive use of English by the teacher during English classes, and also during morning meetings and for simple instructions and classroom management throughout the day. Our hypothesis was that it is possible to facilitate naturalistic acquisition through better quality target language exposure within a normal curriculum. The students' English vocabulary knowledge was measured using the Peabody Picture Vocabulary Test, version 4 (PPVT-IV, Dunn and Dunn, 2007a), at the beginning and the end of the first year of school. Findings are that (1) early-start second-language (L2) programs in school do not in themselves guarantee vocabulary development in the first year, (2) a focus on increased exposure to the L2 can lead to a significant increase in receptive vocabulary comprehension in the course of only 8 months, and (3) even with relatively modest input, learners in such an early-start L2 program can display vocabulary acquisition comparable in some respects to that of younger native children matched on vocabulary size. The overall conclusion is that naturalistic vocabulary acquisition is in fact possible in a classroom setting.

  4. Naturalistic acquisition in an early language classroom

    Directory of Open Access Journals (Sweden)

    Anne eDahl

    2014-04-01

    Full Text Available This study investigated whether it is possible to provide naturalistic second language acquisition (SLA of vocabulary for young learners in a classroom situation without resorting to a classical immersion approach. Participants were 60 first-grade pupils in Norwegian two elementary schools in their first year. The control group followed regular instruction as prescribed by the school curriculum, while the experimental group received increased naturalistic target language input. This entailed extensive use of English by the teacher during English classes, and also during morning meetings and for simple instructions and classroom management throughout the day. Our hypothesis was that it is possible to facilitate naturalistic acquisition through better quality target language exposure within a normal curriculum. The students' English vocabulary knowledge was measured using the Peabody Picture Vocabulary Test, version 4 (PPVT-IV, Dunn & Dunn, 2007, at the beginning and the end of the first year of school. Findings are that 1 early-start second-language (L2 programs in school do not in themselves guarantee vocabulary development in the first year, 2 a focus on increased exposure to the L2 can lead to a significant increase in receptive vocabulary comprehension in the course of only eight months, and 3 even with relatively modest input, learners in such an early-start L2 program can display vocabulary acquisition comparable in some respects to that of younger native children matched on vocabulary size. The overall conclusion is that naturalistic vocabulary acquisition is in fact possible in a classroom setting.

  5. Long-term treatment of ADHD with stimulants: A large observational study of real-life patients

    DEFF Research Database (Denmark)

    Powell, Shelagh G.; Thomsen, Per Hove; Frydenberg, Morten

    2011-01-01

    Objective: To evaluate 410 real-life patients treated with stimulants and assessed systematically over several years. Method: Naturalistic observational study. A database was compiled on the basis of a review of the medical charts of patients attending a specialized ADHD clinic. Results: The dive......Objective: To evaluate 410 real-life patients treated with stimulants and assessed systematically over several years. Method: Naturalistic observational study. A database was compiled on the basis of a review of the medical charts of patients attending a specialized ADHD clinic. Results...

  6. A large, naturalistic, community-based study of rivastigmine in mild-to-moderate AD: the EXTEND Study.

    Science.gov (United States)

    Gauthier, Serge; Juby, Angela; Morelli, Lidia; Rehel, Bonita; Schecter, Robyn

    2006-11-01

    Previous studies in Alzheimer's Disease (AD) suggest a benefit from switching from one cholinesterase (ChE) inhibitor to another in the event of treatment failure on the index agent. This observational, open-label study sought to evaluate the efficacy of the ChE inhibitor rivastigmine on cognition, functional autonomy and behavior in patients with mild-to-moderate AD previously treated with other ChE inhibitors (switched patients) as well as in those previously ChE-inhibitor-naive (de novo users). Patients were eligible for a switch if they experienced a lack or loss of efficacy or had experienced intolerance to prior ChE inhibitor therapy. Rivastigmine was initiated at a dose of 1.5 mg b.i.d. and titration was done as per standard medical practice. Efficacy was assessed using the mini-mental state examination (MMSE) and an abbreviated version of the Clinician's Global Impression of Change (CGI-C) at Month 3 and Month 6. Caregiver burden was also assessed at Month 6 using a self-rated scale. Overall, 2633 subjects were enrolled in this study. The mean MMSE improved from 20.6 at baseline to 21.5 at Month 6. More patients improved than deteriorated on every domain of the CGI-C. Caregivers felt less burdened after the 6 month evaluation period. Efficacy parameters demonstrated favorable results for both de novo and switched patients, but more so in the first group. Open-label studies have an inherent potential for bias by both the caregiver and the physician. In this study, there was also a large percentage of missing patient records for each of the follow-up visits (Months 3 and 6). Patients with mild-to-moderate AD switched from previous ChE inhibitor therapy to rivastigmine can obtain measurable benefits, although the treatment effect may be less than in de novo patients. Further research into switching cholinesterase inhibitors is warranted.

  7. [Effects of psychosomatic treatment for the elderly on cognition and quality of life : Naturalistic study at the psychosomatic day care hospital for the elderly in Nuremberg].

    Science.gov (United States)

    Wunner, Christina; Reichhart, Corinne; Strauss, Bernhard; Söllner, Wolfgang

    2016-11-16

    In 2006 the psychosomatic day care hospital for the treatment of acute mental illness of elderly people opened as the first clinic of its kind in Germany. The aim of the study was to determine treatment effectiveness regarding quality of life and cognition. Designed as a naturalistic study of a population sample of 116 patients, the cognitive capacity (memory performance and cognitive speed) and the subjective quality of life were measured by the Nuremberg aging inventory (NAI) and the World Health Organization quality of life for elderly persons (WHOQOL-OLD). The patients were surveyed at four points in time including at 8‑month follow-up. A 5-week waiting time before admission to the 5‑week therapy was implemented as a control condition. In comparison with the waiting time, after treatment significant improvement (psychosomatic day care hospital treatment of the elderly improves subjective quality of life and cognitive capacity.

  8. A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

    Directory of Open Access Journals (Sweden)

    Ana M Gaviria

    Full Text Available The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain.A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.The most used antipsychotic was risperidone, identified in 463 (26.3% patients, followed by olanzapine in 249 (14.1%, paliperidone in 225 (12.7%, zuclopenthixol in 201 (11.4%, quetiapine in 141 (8%, aripiprazole in 100 (5.7%, and clozapine in 100 (5.7%. Almost 8 out of 10 patients (79.3% were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6% were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97, LAI (OR 9.99, 95% CI 6.45-15.45, psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64, and paliperidone (OR 3.13, 95% CI 1.23-7.92 were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83 and older age (OR 0.98, 95% CI 0.97-0.99 were related to a low polypharmacy probability.Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or

  9. Implementing the compassion intervention, a model for integrated care for people with advanced dementia towards the end of life in nursing homes: a naturalistic feasibility study.

    Science.gov (United States)

    Moore, Kirsten J; Candy, Bridget; Davis, Sarah; Gola, Anna; Harrington, Jane; Kupeli, Nuriye; Vickerstaff, Victoria; King, Michael; Leavey, Gerard; Nazareth, Irwin; Omar, Rumana Z; Jones, Louise; Sampson, Elizabeth L

    2017-07-10

    Many people with dementia die in nursing homes, but quality of care may be suboptimal. We developed the theory-driven 'Compassion Intervention' to enhance end-of-life care in advanced dementia. To (1) understand how the Intervention operated in nursing homes in different health economies; (2) collect preliminary outcome data and costs of an interdisciplinary care leader (ICL) to facilitate the Intervention; (3) check the Intervention caused no harm. A naturalistic feasibility study of Intervention implementation for 6 months. Two nursing homes in northern London, UK. Thirty residents with advanced dementia were assessed of whom nine were recruited for data collection; four of these residents' family members were interviewed. Twenty-eight nursing home and external healthcare professionals participated in interviews at 7 (n=19), 11 (n=19) and 15 months (n=10). An ICL led two core Intervention components: (1) integrated, interdisciplinary assessment and care; (2) education and support for paid and family carers. Process and outcome data were collected. Symptoms were recorded monthly for recruited residents. Semistructured interviews were conducted at 7, 11 and 15 months with nursing home staff and external healthcare professionals and at 7 months with family carers. ICL hours were costed using Department of Health and Health Education England tariffs. Contextual differences were identified between sites: nursing home 2 had lower involvement with external healthcare services. Core components were implemented at both sites but multidisciplinary meetings were only established in nursing home 1. The Intervention prompted improvements in advance care planning, pain management and person-centred care; we observed no harm. Six-month ICL costs were £18 255. Implementation was feasible to differing degrees across sites, dependent on context. Our data inform future testing to identify the Intervention's effectiveness in improving end-of-life care in advanced dementia

  10. Individual differences in compliance and agreement for sleep logs and wrist actigraphy: A longitudinal study of naturalistic sleep in healthy adults.

    Directory of Open Access Journals (Sweden)

    Steven M Thurman

    Full Text Available There is extensive laboratory research studying the effects of acute sleep deprivation on biological and cognitive functions, yet much less is known about naturalistic patterns of sleep loss and the potential impact on daily or weekly functioning of an individual. Longitudinal studies are needed to advance our understanding of relationships between naturalistic sleep and fluctuations in human health and performance, but it is first necessary to understand the efficacy of current tools for long-term sleep monitoring. The present study used wrist actigraphy and sleep log diaries to obtain daily measurements of sleep from 30 healthy adults for up to 16 consecutive weeks. We used non-parametric Bland-Altman analysis and correlation coefficients to calculate agreement between subjectively and objectively measured variables including sleep onset time, sleep offset time, sleep onset latency, number of awakenings, the amount of wake time after sleep onset, and total sleep time. We also examined compliance data on the submission of daily sleep logs according to the experimental protocol. Overall, we found strong agreement for sleep onset and sleep offset times, but relatively poor agreement for variables related to wakefulness including sleep onset latency, awakenings, and wake after sleep onset. Compliance tended to decrease significantly over time according to a linear function, but there were substantial individual differences in overall compliance rates. There were also individual differences in agreement that could be explained, in part, by differences in compliance. Individuals who were consistently more compliant over time also tended to show the best agreement and lower scores on behavioral avoidance scale (BIS. Our results provide evidence for convergent validity in measuring sleep onset and sleep offset with wrist actigraphy and sleep logs, and we conclude by proposing an analysis method to mitigate the impact of non-compliance and measurement

  11. Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

    Science.gov (United States)

    Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

    2013-09-20

    Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about

  12. Into the field: naturalistic education and the future of conservation.

    Science.gov (United States)

    Hayes, Mark A

    2009-10-01

    Some educational psychologists and researchers have argued that there are multiple ways of being intelligent. In the early 1980s, Howard Gardner presented a theory of multiple intelligences by proposing that humans can be described not by a single kind of intelligence, or intelligence quotient score, but rather by a variety of kinds of intelligence. This idea of considering multiple views of intelligence has helped educators look at intelligence from a less rigid, more expansive perspective. I considered how the relatively new concept of naturalistic intelligence, which is the cognitive potential to process information that is exhibited by expert naturalists, might influence the design of undergraduate biology curricula. Naturalistic intelligence can be fostered in undergraduate biology students by emphasizing the need for well-rounded scientific naturalists; developing curricula that involves students in outdoor inquiry-based projects; and helping students learn how to observe both the natural world and their own learning, skills that are essential to developing expert naturalistic knowledge. Professors, graduate students, and administrators can improve the naturalistic intelligence of undergraduate biology students by giving these students opportunities to be involved in outdoor research. Time spent outdoors alone and among people with expertise in natural history, ecology, and conservation biology will have important influences on the knowledge and skills biology undergraduates learn, the careers they pursue, and the contributions they make to conserving Earth's biodiversity.

  13. Naturalistic Extremes in Al Aswaany’s The Yacoubian Building

    Directory of Open Access Journals (Sweden)

    Hussein H. Zeidanin

    2016-01-01

    Full Text Available Emile Zola and other naturalistic novelists such as Stephen Crane, Jack London, Edith Wharton, Frank Norris, John Steinbeck and Richard Wright perceive naturalism as an anti-romantic philosophy dispensing with emotions, sentiments and imagination and parodying the romantic paradigm for idealizing the past and avoiding realities. They view literature as experimental and investigational as science and the novelist as scientist who objectively and methodologically observes and tests the actions and reactions of representative fictional characters under controlled conditions.  On the contrary, the writings of the opponents of naturalism like those of A. Plantinga (2010, H. Putnam (2000, J. Kim (2008, J. Spencer (2010, R. Bush (2003, and R. Gerhardt (2010 criticize naturalistic literature for focusing on the negative side instead of the bright side of life, attaching violence and threatening behaviors to the low class people, and representing a pessimistic view of life and human progress. Our paper seeks to recapitulate the epistemological premises of naturalism and the views of its proponents and opponents who debate over the materialism, atheism and sensationism of naturalism. The paper further analyzes the predominant correlation between environment and man, fate and man and biology and man from the perspective of naturalists. The study finds out that the actions and reactions of the fictional characters of Busayna el Sayed and Zaki el Dessouki in Al Aswany’s The Yacoubian Building (2003 are not self-determined; rather, they are predetermined by the triad of environment, fate and biology. In addition, the study observes that the absence of hope pervading the characters’ lives gives rise to their pessimistic worldviews and stoic behaviors. The study’s analysis and findings are based on Al Aswany’s text because it, on one hand, epitomizes the naturalistic poetics of classism, fatalism and predeterminism in the Egyptian society. On the other

  14. Investigating gaze of children with ASD in naturalistic settings.

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    Basilio Noris

    Full Text Available BACKGROUND: Visual behavior is known to be atypical in Autism Spectrum Disorders (ASD. Monitor-based eye-tracking studies have measured several of these atypicalities in individuals with Autism. While atypical behaviors are known to be accentuated during natural interactions, few studies have been made on gaze behavior in natural interactions. In this study we focused on i whether the findings done in laboratory settings are also visible in a naturalistic interaction; ii whether new atypical elements appear when studying visual behavior across the whole field of view. METHODOLOGY/PRINCIPAL FINDINGS: Ten children with ASD and ten typically developing children participated in a dyadic interaction with an experimenter administering items from the Early Social Communication Scale (ESCS. The children wore a novel head-mounted eye-tracker, measuring gaze direction and presence of faces across the child's field of view. The analysis of gaze episodes to faces revealed that children with ASD looked significantly less and for shorter lapses of time at the experimenter. The analysis of gaze patterns across the child's field of view revealed that children with ASD looked downwards and made more extensive use of their lateral field of view when exploring the environment. CONCLUSIONS/SIGNIFICANCE: The data gathered in naturalistic settings confirm findings previously obtained only in monitor-based studies. Moreover, the study allowed to observe a generalized strategy of lateral gaze in children with ASD when they were looking at the objects in their environment.

  15. Investigating Gaze of Children with ASD in Naturalistic Settings

    Science.gov (United States)

    Noris, Basilio; Nadel, Jacqueline; Barker, Mandy; Hadjikhani, Nouchine; Billard, Aude

    2012-01-01

    Background Visual behavior is known to be atypical in Autism Spectrum Disorders (ASD). Monitor-based eye-tracking studies have measured several of these atypicalities in individuals with Autism. While atypical behaviors are known to be accentuated during natural interactions, few studies have been made on gaze behavior in natural interactions. In this study we focused on i) whether the findings done in laboratory settings are also visible in a naturalistic interaction; ii) whether new atypical elements appear when studying visual behavior across the whole field of view. Methodology/Principal Findings Ten children with ASD and ten typically developing children participated in a dyadic interaction with an experimenter administering items from the Early Social Communication Scale (ESCS). The children wore a novel head-mounted eye-tracker, measuring gaze direction and presence of faces across the child's field of view. The analysis of gaze episodes to faces revealed that children with ASD looked significantly less and for shorter lapses of time at the experimenter. The analysis of gaze patterns across the child's field of view revealed that children with ASD looked downwards and made more extensive use of their lateral field of view when exploring the environment. Conclusions/Significance The data gathered in naturalistic settings confirm findings previously obtained only in monitor-based studies. Moreover, the study allowed to observe a generalized strategy of lateral gaze in children with ASD when they were looking at the objects in their environment. PMID:23028494

  16. Recording and automated analysis of naturalistic bioptic driving.

    Science.gov (United States)

    Luo, Gang; Peli, Eli

    2011-05-01

    People with moderate central vision loss are legally permitted to drive with a bioptic telescope in 39 US states and the Netherlands, but the safety of bioptic driving remains highly controversial. There is no scientific evidence about bioptic use and its impact on safety. We propose searching for evidence by recording naturalistic driving activities in patients' cars. In a pilot study we used an analogue video system to record two bioptic drivers' daily driving activities for 10 and 5 days, respectively. In this technical report, we also describe our novel digital system that collects vehicle manoeuvre information and enables recording over more extended periods, and discuss our approach to analyzing the vast amount of data. Our observations of telescope use by the pilot subjects were quite different from their reports in a previous survey. One subject used the telescope only seven times in nearly 6 h of driving. For the other subject, the average interval between telescope use was about 2 min, and Mobile (cell) phone use in one trip extended the interval to almost 5 min. We demonstrate that computerized analysis of lengthy recordings based on video, GPS, acceleration, and black box data can be used to select informative segments for efficient off-line review of naturalistic driving behaviours. The inconsistency between self reports and objective data as well as infrequent telescope use underscores the importance of recording bioptic driving behaviours in naturalistic conditions over extended periods. We argue that the new recording system is important for understanding bioptic use behaviours and bioptic driving safety. © 2011 The College of Optometrists.

  17. Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study.

    Science.gov (United States)

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Crawford, Scott M; Simpson, Cathy A

    2015-09-01

    Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use. Cross-sectional, naturalistic field study. Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling. During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information. Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States. © 2015 Society for the Study of Addiction.

  18. Optical imaging during toddlerhood: brain responses during naturalistic social interactions.

    Science.gov (United States)

    Hakuno, Yoko; Pirazzoli, Laura; Blasi, Anna; Johnson, Mark H; Lloyd-Fox, Sarah

    2018-01-01

    Despite the importance of our ability to interact and communicate with others, the early development of the social brain network remains poorly understood. We examined brain activity in 12- to 14-month-old infants while they were interacting live with an adult in two different naturalistic social scenarios (i.e., reading a picture book versus singing nursery rhymes with gestures), as compared to baseline (i.e., showing infants a toy without eye contact or speech). We used functional near-infrared spectroscopy (fNIRS) recorded over the right temporal lobe of infants to assess the role of the superior temporal sulcus-temporoparietal junction (STS-TPJ) region during naturalistic social interactions. We observed increased cortical activation in the STS-TPJ region to live social stimuli in both socially engaging conditions compared to baseline during real life interaction, with greater activation evident for the joint attention (reading book) condition relative to the social nursery rhymes. These results supported the view that the STS-TPJ region, engaged in the cortical social brain network, is already specialized in infants for processing social signals and is sensitive to communicative situations. This study also highlighted the potential of fNIRS for studying brain function in infants entering toddlerhood during live social interaction.

  19. What Have We Learned about Naturalistic Evaluation?

    Science.gov (United States)

    Guba, Egon G.

    1987-01-01

    Definitions of and approaches to naturalistic evaluation are discussed. The qualitative aspects of the discipline are reviewed; and use of naturalistic evaluation in descriptions, illustrations, explications, hypothesis testing, and assessment of public spending are defined. A new paradigm for naturalistic evaluation is proposed. (TJH)

  20. Added value of 18F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study.

    Science.gov (United States)

    Ceccaldi, Mathieu; Jonveaux, Thérèse; Verger, Antoine; Krolak-Salmon, Pierre; Houzard, Claire; Godefroy, Olivier; Shields, Trevor; Perrotin, Audrey; Gismondi, Rossella; Bullich, Santiago; Jovalekic, Aleksandar; Raffa, Nicola; Pasquier, Florence; Semah, Franck; Dubois, Bruno; Habert, Marie-Odile; Wallon, David; Chastan, Mathieu; Payoux, Pierre; Stephens, Andrew; Guedj, Eric

    2018-03-01

    Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting. This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172). Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases. High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Effectiveness of a psychosomatic day hospital treatment for the elderly: a naturalistic longitudinal study with waiting time before treatment as control condition.

    Science.gov (United States)

    Wunner, Christina; Reichhart, Corinne; Strauss, Bernhard; Söllner, Wolfgang

    2014-02-01

    In 2006 the psychosomatic day hospital for the treatment of acute mental illness of elderly people opened as the first clinic of its kind in Germany. The aim of this study was to determine treatment effectiveness and identify possible effects on health care utilization. Designed as a naturalistic study with waiting time before admission as a control condition, the primary outcome was the level of depressive symptoms as measured by the hospital anxiety and depression scale. Secondary outcomes were depressive and somatoform symptoms and syndromes as measured with the patient health questionnaire, patient perception of interpersonal problems and health care use before and after treatment. After treatment significant improvement (ppsychosomatic treatment a reduction in medical service usage was visible. Number of consultations (pre: 13, post: 9), number and length of hospital stays (pre: 1, 7 weeks, post: 0, 3 weeks) were both significantly (ppsychosomatic day hospital treatment of the elderly is successful. Reduced usage of health care and the lower costs for day hospital treatment compared to inpatient treatment point to a positive cost-effect-ratio. Expanding this psychosomatic intervention would be useful in reducing the current gap in mental health care for the elderly. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Psychiatric and physical comorbidities and their impact on the course of bipolar disorder: A prospective, naturalistic 4-year follow-up study.

    Science.gov (United States)

    Amann, Benedikt L; Radua, Joaquim; Wunsch, Christian; König, Barbara; Simhandl, Christian

    2017-05-01

    The aim of the present study was to increase the available evidence on how physical and psychiatric comorbidities influence the long-term outcome in bipolar I and II disorder. We examined the prevalence of comorbid physical (metabolic, cardiovascular, thyroid, and neurological) diseases and psychiatric (neurotic, stress-related, somatoform, and personality) disorders and their impact on the risk of relapse in bipolar disorder. A total of 284 consecutively admitted patients with ICD-10 bipolar I (n=161) and II (n=123) disorder were followed up naturalistically over a period of 4 years. Globally, 22.0% patients had metabolic, 18.8% cardiovascular, 18.8% thyroid, and 7.6% neurological diseases; 15.5% had neurotic, stress-related, and somatoform disorders; 12.0% had personality disorders; and 52.9% had nicotine dependence. We did not find any effect of comorbid metabolic, cardiovascular or neurological diseases or psychiatric disorders on the relapse risk. However, the presence of thyroid diseases, and especially hypothyroidism, was associated with an increased risk of manic relapse in bipolar disorder I (thyroid disease: hazard ratio [HR]=2.7; P=.003; hypothyroidism: HR=3.7;, Pbipolar disorder with more manic episodes, and the importance of its detection and treatment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Naturalistic inquiry in practice.

    Science.gov (United States)

    Luczun, M E

    1990-04-01

    We have the setting and the instrument, both of which exist naturally and without any prearranged orchestration. The implications of these two factors is clear, yet they deserve conscious assessment. Think about it. Think about what comes naturally in light of the technology that seeks to replace and repress human observations. It is worth pondering and requires the desire to get back to basics. Even laboratory animals are afforded a near natural habitat. The study of human behavior demands the same consideration, more so in fact, since people can and will perceive an unnatural atmosphere and respond to it defensively. Nurses have the power to use all five senses and, possibly, the sixth sense of intuition to transform assessments into realistic research proposals. We diagnose and treat human responses to illness. Let us, then, refuse to ignore this very vital function of our profession, the one function that keeps us in touch with our patients as fellow human beings.

  4.  ALLOMATERNAL CARE AND THE SIGNIFICANCE OF NATURALISTIC OBSERVATIONS AMONG CONTEMPORARY FORAGERS: A COMMENTARY ON DENHAM’S “ALYAWARRA KINSHIP, INFANT CARRYING, AND ALLOPARENTING”

    OpenAIRE

    Helosky, Kristen N; Broaden, Elizabeth M; Franco, Carol Y; Crittenden, Alyssa N

    2015-01-01

    In this substantive work, Denham presents quantitative data on approximately 200 hours of observational research on infant and child carrying among the Alyawarra of Australia. His aim was to “demonstrate ways in which observational data collected with a hunter-gatherer society almost half a century ago can contribute to an understanding of our species”. He does just this. While his data, at first sight, may appear to be out of date (being collected from 1971-1972), that interpretation would b...

  5. Predictors of antipsychotic monotherapy with olanzapine during a 1-year naturalistic study of schizophrenia patients in Japan

    Directory of Open Access Journals (Sweden)

    Ye W

    2012-01-01

    Full Text Available Wenyu Ye1, Haya Ascher-Svanum2, Jennifer A Flynn3, Yuka Tanji3, Michihiro Takahashi3,41Lilly Suzhou Pharmaceutical Co, Shanghai, People's Republic of China; 2Eli Lilly and Company, Indianapolis, IN, USA; 3Lilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, 4Terauchi-Takahashi Psychiatric Clinic, Ashiya, JapanPurpose: Although expert guidelines for the treatment of schizophrenia recommend antipsychotic monotherapy, the use of antipsychotic polypharmacy is common. This study identified characteristics that differentiate patients with schizophrenia who are treated with olanzapine monotherapy versus polypharmacy in usual care in Japan.Patients and methods: In a large (N = 1850 prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Consistent with past research, antipsychotic polypharmacy was defined as the concurrent use of olanzapine and another antipsychotic for at least 60 days. Switching was defined as discontinuing a prior antipsychotic therapy rather than augmenting the medication regimen. Predictors of antipsychotic monotherapy were based on information available at the time of olanzapine initiation. Baseline characteristics were compared using t-tests and Χ2 tests. Stepwise logistic regression was used to identify independent predictors of monotherapy.Results: Patients treated with olanzapine monotherapy (43.2% differed from those treated with antipsychotic polypharmacy (56.8% on demographics, treatment history, baseline symptom levels, functional levels, and treatment-emergent adverse events. Stepwise logistic regression identified multiple variables that significantly predicted monotherapy: older age, shorter duration of schizophrenia, outpatient status, comorbid medical conditions, lower body mass index, no prior anticholinergic use, no prior mood stabilizer use, and switching from a previous antipsychotic (typical or atypical

  6. A prospective, naturalistic follow-up study of treatment outcomes with clonazepam in rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    Li, Shirley Xin; Lam, Siu Ping; Zhang, Jihui; Yu, Mandy Wai Man; Chan, Joey Wing Yin; Liu, Yaping; Lam, Venny Kwai Ho; Ho, Crover Kwok Wah; Zhou, Junying; Wing, Yun Kwok

    2016-05-01

    Rapid eye movement sleep behavior disorder (RBD) is characterized by prominent dream-enacting behaviors, often resulting in sleep-related injuries. This study aimed to prospectively examine the treatment response of people with RBD treated with clonazepam, by quantitatively delineating the characteristic changes in the clinical and polysomnographic features, and to explore the factors associated with this response. Patients diagnosed with idiopathic RBD (iRBD) were consecutively recruited and invited to complete clinical and polysomnographic (PSG) assessments and self-administered questionnaires (including the modified REM Sleep Behavior Questionnaire, RBDQ-3M) before and after the initiation of treatment with clonazepam. Thirty-nine iRBD patients (male: 74.4%, mean age at diagnosis: 68.3 ± 7.8 years) were recruited with a follow-up duration of 28.8 ± 13.3 months. Clonazepam was offered as the first-line treatment (starting dose: 0.43 ± 0.16 mg, range: 0.125-1.00; dose at follow-up: 0.98 ± 0.63 mg, range: 0.125-3). Treatment response, as defined by a complete elimination of sleep-related injuries and potentially injurious behaviors to self and/or to bed partner, at follow-up was reported in 66.7% of the overall study subjects. Frequency of disturbing dreams with violent and frightening content and vigorous behavioral RBD symptoms was significantly reduced, while residual nocturnal symptoms and an increase in REM-related EMG activities were observed at follow-up. Less optimal treatment outcomes were found to be associated with the presence of comorbid obstructive sleep apnea and earlier onset of RBD. Clonazepam differentially changes dream affect and content, as well as reduces vigorous verbal and motor behaviors. Residual RBD symptoms are common, despite treatment. Other more effective alternative or adjunctive interventions are needed for better clinical management of RBD. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Validity of remission and recovery criteria for schizophrenia and major depression: comparison of the results of two one-year follow-up naturalistic studies.

    Science.gov (United States)

    Spellmann, Ilja; Schennach, Rebecca; Seemüller, Florian; Meyer, Sebastian; Musil, Richard; Jäger, Markus; Schmauß, Max; Laux, Gerd; Pfeiffer, Herbert; Naber, Dieter; Schmidt, Lutz G; Gaebel, Wolfgang; Klosterkötter, Joachim; Heuser, Isabella; Bauer, Michael; Adli, Mazda; Zeiler, Joachim; Bender, Wolfram; Kronmüller, Klaus-Thomas; Ising, Marcus; Brieger, Peter; Maier, Wolfgang; Lemke, Matthias R; Rüther, Eckart; Klingberg, Stefan; Gastpar, Markus; Riedel, Michael; Möller, Hans-Jürgen

    2017-06-01

    The objective of the present study was the application and comparison of common remission and recovery criteria between patients with the diagnosis of schizophrenia and major depressive disorder (MDD) under inclusion of other outcome parameters. Patients with schizophrenia and MDD who were treated as inpatients at the beginning of the study were examined within two naturalistic follow-up trials from admission to discharge of an inpatient treatment period and the one-year follow-up assessment. PANSS criteria of the Remission in Schizophrenia Working Group (RSWG) for schizophrenia and HAMD criteria of the ACNP Task Force in MDD for depressive patients as well as the Clinical Global Impression-Severity Scale (CGI-S) were applied as symptomatic outcome measures additionally to functional outcome parameters. Data of 153 schizophrenia patients and 231 patients with a MDD episode have been included in the analysis. More depressive than schizophrenia patients reached a threshold score of ≤3 on the CGI-S, indicating symptomatic remission at discharge and at the one-year follow-up. In contrast similar proportions of patients reaching symptomatic remission at discharge from inpatient treatment and at the one-year follow-up in the schizophrenia and in the MDD group were found when disease-related consensus criteria (RSWG vs. ACNP Task Force) were used. Functional remission and recovery rates were significantly lower in schizophrenia than in depressive patients at the one-year follow-up visit. Common outcome criteria for remission and recovery in schizophrenia and major depression were not directly comparable. However, our results indicated a significantly poorer outcome in schizophrenia than in depressive patients according to terms of remission and recovery.

  8. Implication of Integrative Treatment Strategies for Real-Life Geriatric Patients with Multiple, Chronic Illnesses: A 60-Month Follow-Up of a Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Gjumrakch Aliev

    2015-03-01

    Full Text Available Neurodegeneration [Stroke and Alzheimer disease (AD] is fastly becoming one of the leading causes of age-associated disability, dementia, and death. In addition, the Centers for Disease Control and Prevention (CDC and the National Center for Health Statistics recently reported that AD has surpassed diabetes as a leading cause of death and is now considered the sixth-leading cause of death in the United States. Unfortunately, currently no effective treatments are available against this devastating disease. In the past we have shown the preservation and improvement of cognitive tasks in depressed and demented patients after 24 and 36 months of combined pharmacological and non- pharmacological treatment. Here we present the results of our ongoing, naturalistic study, in the same outpatient setting, at the 60 month follow up. The study group consisted of 156 medically ill, physically-disabled patients with mild to moderate dementia and depression. Patients were treated with antidepressants, cholinesterase inhibitors, and NMDA antagonists, along with their regular medication regimen. Non-pharmacological intervention was centered on a home-based program of physical and cognitive exercises as well as with vitamins and supplements (multivitamins, vitamin E, L-methylfolate, alpha-lipoic acid, acetyl-l-carnitine, omega-3, and coenzyme Q-10 and diet modification. Cognitive assessments were performed yearly. After 60 months of treatment, performance of all tasks remained at or above baseline. The MMSE, Cognistat–Attention, Cognistat–Judgment, and RFFT - Total Unique Designs demonstrated significant improvement. Our results, for the first time, demonstrate arrest in cognitive decline in demented/depressed patients with multiple medical co-morbidities for 60 months. Future investigations addressing the application of a combined, integrative treatment models in clinical practices are warranted.

  9. Mobile Phone-Based Measures of Activity, Step Count, and Gait Speed: Results From a Study of Older Ambulatory Adults in a Naturalistic Setting.

    Science.gov (United States)

    Rye Hanton, Cassia; Kwon, Yong-Jun; Aung, Thawda; Whittington, Jackie; High, Robin R; Goulding, Evan H; Schenk, A Katrin; Bonasera, Stephen J

    2017-10-03

    Cellular mobile telephone technology shows much promise for delivering and evaluating healthcare interventions in cost-effective manners with minimal barriers to access. There is little data demonstrating that these devices can accurately measure clinically important aspects of individual functional status in naturalistic environments outside of the laboratory. The objective of this study was to demonstrate that data derived from ubiquitous mobile phone technology, using algorithms developed and previously validated by our lab in a controlled setting, can be employed to continuously and noninvasively measure aspects of participant (subject) health status including step counts, gait speed, and activity level, in a naturalistic community setting. A second objective was to compare our mobile phone-based data against current standard survey-based gait instruments and clinical physical performance measures in order to determine whether they measured similar or independent constructs. A total of 43 ambulatory, independently dwelling older adults were recruited from Nebraska Medicine, including 25 (58%, 25/43) healthy control individuals from our Engage Wellness Center and 18 (42%, 18/43) functionally impaired, cognitively intact individuals (who met at least 3 of 5 criteria for frailty) from our ambulatory Geriatrics Clinic. The following previously-validated surveys were obtained on study day 1: (1) Late Life Function and Disability Instrument (LLFDI); (2) Survey of Activities and Fear of Falling in the Elderly (SAFFE); (3) Patient Reported Outcomes Measurement Information System (PROMIS), short form version 1.0 Physical Function 10a (PROMIS-PF); and (4) PROMIS Global Health, short form version 1.1 (PROMIS-GH). In addition, clinical physical performance measurements of frailty (10 foot Get up and Go, 4 Meter walk, and Figure-of-8 Walk [F8W]) were also obtained. These metrics were compared to our mobile phone-based metrics collected from the participants in the community

  10. Rapid improvement of tardive dyskinesia with tetrabenazine, clonazepam and clozapine combined: a naturalistic long-term follow-up study.

    Science.gov (United States)

    Kimiagar, Itzhak; Dobronevsky, Evgenia; Prokhorov, Tatiana; Miniovitz, Ala; Rabey, Jose M

    2012-04-01

    Tardive dyskinesia (TD) is a complex involuntary movement disorder affecting about 23% of neuroleptic-treated patients. Our objective was to retrospectively analyze a combination of tetrabenazine (TBZ), clonazepam (CLONAZ) and clozapine (CLOZ) used simultaneously for TD in psychotic patients. Six patients with severe, unsuccessfully controlled TD were referred for treatment (mean age 51.5 years; three male; four schizophrenics; one bipolar disease; one borderline personality disorder). They were being treated with neuroleptics (classic, three; risperidone, two; olanzapine, one) and developed severe neck and buccolingual dyskinesias. At our clinic, all of them were treated simultaneously with TBZ (mean dose 141.6 mg); CLONAZ (mean dose 4.3 mg); and CLOZ (mean dose 125 mg). In parallel, we stopped the offending medication. With 1 week, we observed a very impressive improvement in symptoms and within 1 month all the patients were free of symptoms. The mean observation period was 4 years. The combination of TBZ, CLONAZ and CLOZ is a rapid and beneficial option for the management of TD. An augmentation effect probably played a role in the rapid alleviation of symptomatology.

  11. Naturalistic Driving: A Framework and Advances in Using Big Data

    Directory of Open Access Journals (Sweden)

    Frank Knoefel

    2018-03-01

    Full Text Available Driving is an activity that facilitates physical, cognitive, and social stimulation in older adults, ultimately leading to better physical and cognitive health. However, aging is associated with declines in vision, physical health, and cognitive health, all of which can affect driving ability. One way of assessing driving ability is with the use of sensors in the older adult’s own vehicle. This paper provides a framework for driving assessment and addresses how naturalistic driving studies can assist in such assessments. The framework includes driving characteristics (how much driving, speed, position, type of road, actions and reactions (lane changes, intersections, passing, merging, traffic lights, pedestrians, other vehicles, destinations (variety and distance, sequencing and route planning, and driving conditions (time of day and season. Data from a subset of Ottawa drivers from the Candrive study is used to illustrate the use of naturalistic driving data. Challenges in using naturalistic driving big data and the changing technology in vehicles are discussed.

  12. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information : A Multivariate Pattern Recognition Study

    NARCIS (Netherlands)

    Schmaal, Lianne; Marquand, Andre F.; Rhebergen, Didi; van Tol, Marie-Jose; Ruhe, Henricus G.; van der Wee, Nic J. A.; Veltman, Dick J.; Penninx, Brenda W. J. H.

    2015-01-01

    BACKGROUND: A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the

  13. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study

    NARCIS (Netherlands)

    Schmaal, L.; Marquand, A.F.; Rhebergen, D.; van Tol, M.J.; Ruhe, H.G.; van der Wee, N.J.A.; Veltman, D.J.; Penninx, B.W.J.H.

    2015-01-01

    Background A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the

  14. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study

    NARCIS (Netherlands)

    Schmaal, L.; Marquand, A.F.; Rhebergen, D.; Tol, M.J. van; Ruhé, H.G.; Wee, N.J.A. van der; Veltman, D.J.; Penninx, B.W.J.H.

    2015-01-01

    AbstractBackground A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated

  15. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study

    NARCIS (Netherlands)

    Schmaal, Lianne; Marquand, Andre F.; Rhebergen, Didi; van Tol, Marie-José; Ruhé, Henricus G.; van der Wee, Nic J. A.; Veltman, Dick J.; Penninx, Brenda W. J. H.

    2015-01-01

    A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the prognostic value

  16. Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study

    NARCIS (Netherlands)

    Schmaal, L.; Marquand, A.F.; Rhebergen, D.; Tol, M.J. van; Ruhe, H.G.; Wee, N.J. van der; Veltman, D.J.; Penninx, B.W.

    2015-01-01

    BACKGROUND: A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the

  17. Short- and long-term neurocognitive functioning after electroconvulsive therapy in depressed elderly: a prospective naturalistic study

    NARCIS (Netherlands)

    Verwijk, E.; Comijs, H.C.; Kok, R.M.; Spaans, H.P.; Tielkes, C.E.M.; Scherder, E.J.A.; Stek, M.L.

    2014-01-01

    Background: It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressed patients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning

  18. Predicting Dropout from Intensive Outpatient Cognitive Behavioural Therapy for Binge Eating Disorder Using Pre-treatment Characteristics: A Naturalistic Study.

    Science.gov (United States)

    Vroling, Maartje S; Wiersma, Femke E; Lammers, Mirjam W; Noorthoorn, Eric O

    2016-11-01

    Dropout rates in binge eating disorder (BED) treatment are high (17-30%), and predictors of dropout are unknown. Participants were 376 patients following an intensive outpatient cognitive behavioural therapy programme for BED, 82 of whom (21.8%) dropped out of treatment. An exploratory logistic regression was performed using eating disorder variables, general psychopathology, personality and demographics to identify predictors of dropout. Binge eating pathology, preoccupations with eating, shape and weight, social adjustment, agreeableness, and social embedding appeared to be significant predictors of dropout. Also, education showed an association to dropout. This is one of the first studies investigating pre-treatment predictors for dropout in BED treatment. The total explained variance of the prediction model was low, yet the model correctly classified 80.6% of cases, which is comparable to other dropout studies in eating disorders. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. Side effects of antidepressants during long-term use in a naturalistic setting

    NARCIS (Netherlands)

    Bet, Pierre M.; Hugtenburg, Jacqueline G.; Penninx, Brenda W. J. H.; Hoogendijk, Witte J. G.

    2013-01-01

    Side effects of antidepressants are usually underreported in clinical trials and large scale naturalistic studies are restricted to six months of use. We examined the prevalence and nature of patient-perceived side effects and their determinants during long-term antidepressant use in a naturalistic

  20. Clinical effectiveness of aripiprazole in short-term treatment of tic disorder in children and adolescents: a naturalistic study.

    Science.gov (United States)

    Ho, Che-Sheng; Chiu, Nan-Chang; Tseng, Chih-Fan; Huang, Yuan-Ling

    2014-02-01

    The purpose of this study was to evaluate the effectiveness and tolerability of aripiprazole in short-term treatment of children and adolescents with tic disorder (TD). This was a 14-week, prospective, open-label flexible dose trial of aripiprazole. We enrolled patients with TD aged between 4 years and 18 years. They received aripiprazole (dose: 2.5 mg/day) initially, which was then adjusted according to clinical response. The severity was assessed by the Yale Global Tic Severity Score (YGTSS) at 0, 2, 6, 10, and 14 weeks. The linear mixed models were used for evaluation of the YGTSSs at each follow-up, which were compared with baseline scores. Eighty-one patients were enrolled in this study. Nine patients withdrew from the study with complaints of adverse side effects. Of the remaining 72 patients, 15 patients discontinued medications prematurely due to being free of symptoms for over 2 weeks. Two patients discontinued medications due to no significant improvement. The mean scores had significantly decreased since the 2nd week (p tic scores, 67.1% in the vocal tic scores, and 70.0% in the total YGTSSs. The common adverse effects were sedation (32.1%) and increased appetite (22.2%). A slight increase in average body weight was noted, from 32.7 to 33.7 kg (+1.0 kg, p tics, in children and adolescents with mild adverse effects. However, further double-blind trials against placebo or other medications are needed to verify the efficacy of aripiprazole in the pharmacotherapy of TD. Copyright © 2013. Published by Elsevier B.V.

  1. The association between mood state and chronobiological characteristics in bipolar I disorder: a naturalistic, variable cluster analysis-based study.

    Science.gov (United States)

    Gonzalez, Robert; Suppes, Trisha; Zeitzer, Jamie; McClung, Colleen; Tamminga, Carol; Tohen, Mauricio; Forero, Angelica; Dwivedi, Alok; Alvarado, Andres

    2018-02-19

    Multiple types of chronobiological disturbances have been reported in bipolar disorder, including characteristics associated with general activity levels, sleep, and rhythmicity. Previous studies have focused on examining the individual relationships between affective state and chronobiological characteristics. The aim of this study was to conduct a variable cluster analysis in order to ascertain how mood states are associated with chronobiological traits in bipolar I disorder (BDI). We hypothesized that manic symptomatology would be associated with disturbances of rhythm. Variable cluster analysis identified five chronobiological clusters in 105 BDI subjects. Cluster 1, comprising subjective sleep quality was associated with both mania and depression. Cluster 2, which comprised variables describing the degree of rhythmicity, was associated with mania. Significant associations between mood state and cluster analysis-identified chronobiological variables were noted. Disturbances of mood were associated with subjectively assessed sleep disturbances as opposed to objectively determined, actigraphy-based sleep variables. No associations with general activity variables were noted. Relationships between gender and medication classes in use and cluster analysis-identified chronobiological characteristics were noted. Exploratory analyses noted that medication class had a larger impact on these relationships than the number of psychiatric medications in use. In a BDI sample, variable cluster analysis was able to group related chronobiological variables. The results support our primary hypothesis that mood state, particularly mania, is associated with chronobiological disturbances. Further research is required in order to define these relationships and to determine the directionality of the associations between mood state and chronobiological characteristics.

  2. A 36 month naturalistic retrospective study of clinic-treated youth with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Hong, Minha; Lee, Won Hye; Moon, Duk Soo; Lee, Sang Min; Chung, Un-Sun; Bahn, Geon Ho

    2014-08-01

    The purpose of this study was to investigate factors for pharmacotherapy adherence in patients with attention-deficit/hyperactivity disorder (ADHD), with an emphasis on medication possession ratio (MPR). The medical records of 300 clinic-treated youth diagnosed with ADHD were retrospectively reviewed. Patients from March 2005 through January 2009 were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4(th) ed., Text Revision (DSM-IV-TR) and psychological tests. Patients were classified based on the time period from the initial visit to the last visit. We selectively compared the early dropout group within 6 months and the long-term medication group over 36 months (LMed) to identify long-term follow-up characteristics. The short-term follow-up group was divided into an early dropout group without pharmacotherapy commencement (EDO) and a short-term medication group (SMed). Sociodemographic data, psychological test scores, and average MPR of the EDO, SMed, and LMed groups were compared. The number of EDO patients was 69 (23.0%) out of the 300 total patients who were studied, and there were 59 SMed patients (19.3%), and 60 LMed patients (20.0%). Compared with other groups, the EDO group included significantly more younger patients, younger parents, higher maternal education level, lower Short Form Korean-Conners' Parent Rating Scale (K-CPRS) score, and higher full scale and performance intelligence quotient (IQ). There was no significant correlation between the average MPR and the treatment duration. Within the first 6 months of visiting the hospital, >40% of the patients dropped out of treatment regardless of methylphenidate (MPH) use. Twenty percent of the subjects showed adherence to MPH medication after 36 months.

  3. The life and viper of Dr Patrick Russell MD FRS (1727-1805): physician and naturalist.

    Science.gov (United States)

    Hawgood, B J

    1994-11-01

    It is nearly two hundred years since the publication in 1796 of An Account of Indian Serpents collected on the Coast of Coromandel by Patrick Russell. Within the folio is a drawing and description of the venomous snake called Katuka Rekula Poda in the local Telugu language, whose venom was shown experimentally by Dr Russell to be nearly as lethal as that of Cobra de Capello. The snake is now known as Vipera russelli or Russell's viper. Dr Russell was representative of the naturalistic tendency of British medicine in the late 18th century. He was a keen observer and skilled doctor in clinical practice, particularly in Aleppo, Syria, during an outbreak of the plague, and indefatigable in his study of plant and animal life both in Aleppo and later in the Madras Province of India. As a physician as well as Naturalist to the East India Company in the Carnatic he was concerned with the problem of snakebite. His first aim was to find a means whereby the non-specialist could distinguish between poisonous and harmless snakes and so combat the terrible notion that all bites were mortal. His writing, encompassing social and natural histories and climaxed by a study of snakes, has left a rich legacy. Dr Patrick Russell was a man of the highest integrity and ability, a physician and naturalist par excellence.

  4. Stress: a naturalistic proposal

    Directory of Open Access Journals (Sweden)

    María de Lourdes Rodríguez Campuzano

    2013-08-01

    Full Text Available Some of the stress related topics, especially from the conceptual framework of Lazarus and Folkman are reviewed on this work. It is sustained that this approach is dualistic and that the research made from this view is made on the basis of morphological criteria that don’t allow studying important elements of this kind of behavior. From an interbehavioral approach three functional criteria are proposed to study this phenomenon: the functional nature of situations, aptitude levels of behavior, and its three dimensions. Emphasis is made on the singular and individual nature of stress reactions. Finally it is suggested to take into account these functional criteria to develop a generic situational taxonomy to study these reactions as parts of complex behavioral patterns.

  5. Noninvasive brain stimulation by radioelectric asymmetric conveyor in the treatment of agoraphobia: open-label, naturalistic study

    Directory of Open Access Journals (Sweden)

    Mannu P

    2011-11-01

    Full Text Available Piero Mannu, Salvatore Rinaldi, Vania Fontani, Alessandro Castagna, Matteo Lotti MargottiDepartment of Neuro Psycho Physio Pathology, Rinaldi Fontani Institute, Florence, ItalyBackground: Agoraphobia is considered to be the most serious complication of panic disorder. It involves progressive development of debilitating anxiety symptoms related to being in situations where one would be extremely embarrassed and could not be rescued in the case of a panic attack. This study aimed to investigate the efficacy of noninvasive brain stimulation using a radioelectric asymmetric conveyor (REAC for agoraphobia.Patients and methods: Twenty-three patients (3 males and 20 females suffering from agoraphobia and without a history of panic disorder were evaluated by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and the Agoraphobia Scale (AS. The patients were subjected to two 18-session cycles of noninvasive brain stimulation with the REAC, according to an established therapeutic protocol called neuro-psycho-physical optimization.Results: Analyzing the anxiety and avoidance parameters of the AS after the first and second cycles of REAC treatment revealed variation in levels of response to treatment, including weak (AS item 7, moderate (AS items 10 and 13, and good responses (AS items 1–6, 8, 9, 11, 12, and 14–20.Conclusion: These results highlight the potential of the REAC to treat complex clinical situations such as agoraphobia, which is typically resistant to pharmacologic treatments. Furthermore, these data show the advantages of REAC treatment, even compared with modern cognitive behavioral therapy, including a relatively rapid and “stable” clinical response (just over 6 months and economic cost.Keywords: anxiety, avoidance, fear, REAC

  6. Asymmetric Drug-Induced Parkinsonism and Psychopathology: A Prospective Naturalistic Study in Long-Stay Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    Lydia E. Pieters

    2018-02-01

    Full Text Available BackgroundDrug-induced parkinsonism (DIP is the most common movement disorder induced by antipsychotics. Although DIP is mostly symmetric, asymmetric DIP is reported in a substantial part of the patients. We investigated the frequency of motor asymmetry in DIP and its relationship to the severity of psychopathology in long-stay psychiatric patients.MethodsWe obtained data from a cohort study of 207 long-stay psychiatric patients on the frequency and risk factors of tardive dyskinesia, akathisia, tardive dystonia, and DIP. From July 2003 to May 2007 (mean follow-up, 1.1 year drug-induced movement disorders were assessed at least two times in each patient, with a frequency of persistent DIP of 56.2%. All patients who had at least one time parkinsonism in the upper/lower limb(s were included for analyses (190 patients, 79 women; mean age, 48.0 ± 12.9 years. The Unified Parkinson Disease Rating Scale motor scale was used to calculate the frequency of asymmetric parkinsonism. Multilevel mixed models were built to explore the relationship between asymmetry in parkinsonism and the severity of psychopathology, measured on the Clinical Global Impression-Schizophrenia scale severity index (CGI-SCH SI.ResultsThe frequency of asymmetric parkinsonism was 20.8%. Asymmetry in parkinsonism was associated with symptom severity on all CGI-SCH SI scales (β range, 0.37–3.74 and significantly associated with the positive symptom scale (β, 3.74; 95% CI, 0.35–7.31.ConclusionDIP is asymmetric in a substantial part of patients. Asymmetric presentation of DIP is of clinical relevance as it is related to the severity of psychopathology and may alert the clinician of more severe psychopathology. Future research is recommended to provide insight into the neuropsychopathology and clinical value of asymmetric parkinsonism for psychiatric patients.

  7. A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD.

    Science.gov (United States)

    Melin, Karin; Skarphedinsson, Gudmundur; Skärsäter, Ingela; Haugland, Bente Storm Mowatt; Ivarsson, Tord

    2018-03-03

    This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score ≤ 15, and remission was defined as CY-BOCS total score ≤ 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms.

  8. Naturalistic Bicycling Behavior Pilot Study.

    Science.gov (United States)

    2017-11-01

    Bicyclists experience disproportionate rates of injuries and fatalities compared to other road users. The safety for bicyclists is of particular concern in Florida, where bicyclist fatality rates were nearly triple the national average in 2015. This ...

  9. Naturalistic assessment of demand for cigarettes, snus, and nicotine gum.

    Science.gov (United States)

    Stein, Jeffrey S; Wilson, A George; Koffarnus, Mikhail N; Judd, Michael C; Bickel, Warren K

    2017-01-01

    Behavioral economic measures of demand provide estimates of tobacco product abuse liability and may predict effects of policy-related price regulation on consumption of existing and emerging tobacco products. In the present study, we examined demand for snus, a smokeless tobacco product, in comparison to both cigarettes and medicinal nicotine. We used both a naturalistic method in which participants purchased these products for use outside the laboratory, as well as laboratory-based self-administration procedures. Cigarette smokers (N = 42) used an experimental income to purchase their usual brand of cigarettes and either snus or gum (only one product available per session) across a range of prices, while receiving all products they purchased from one randomly selected price. In a separate portion of the study, participants self-administered these products during laboratory-based, progressive ratio sessions. Demand elasticity (sensitivity of purchasing to price) was significantly greater for snus than cigarettes. Elasticity for gum was intermediate between snus and cigarettes but was not significantly different than either. Demand intensity (purchasing unconstrained by price) was significantly lower for gum compared to cigarettes, with no significant difference observed between snus and cigarettes. Results of the laboratory-based, progressive ratio sessions were generally discordant with measures of demand elasticity, with significantly higher "breakpoints" for cigarettes compared to gum and no significant differences between other study products. Moreover, breakpoints and product purchasing were generally uncorrelated across tasks. Under naturalistic conditions, snus appears more sensitive to price manipulation than either cigarettes or nicotine gum in existing smokers.

  10. Cocaine behavioral economics: from the naturalistic environment to the controlled laboratory setting.

    Science.gov (United States)

    Greenwald, Mark K; Steinmiller, Caren L

    2014-08-01

    We previously observed that behavioral economic factors predict naturalistic heroin seeking behavior that correlates with opioid seeking in the experimental laboratory. The present study sought to replicate and extend these prior findings with regular cocaine users. Participants (N=83) completed a semi-structured interview to establish income-generating and cocaine-purchasing/use repertoire during the past month. Questions addressed sources/amounts of income and expenditures; price (money and time) per purchase; and frequency/amounts of cocaine purchased and consumed. Naturalistic cocaine purchasing and use patterns were: (1) analyzed as a function of income quartile, (2) perturbed by hypothetical changes in cost factors to assess changes in purchasing/use habits, and (3) correlated with experimental cocaine seeking. Income was positively related to naturalistic cocaine seeking/use pattern (i.e., income elastic), and behaviors were cost-efficient and sensitive to supply chain. Income was unrelated to proportional expenditure on cocaine (≈55%) but inversely related to food expenditure. In all hypothetical scenarios (changes in income or dealer, loss of income assistance from government or family/friends, and increasing arrest risk when purchasing), the high-income group reported they would continue to use more cocaine daily than other groups. Number of laboratory cocaine choices significantly correlated with cocaine purchase time (positively) and purity of cocaine (negatively) in the naturalistic setting. These results replicate and extend findings with regular heroin users, demonstrate the importance of income, cost-efficiency and supply-mindedness in cocaine seeking/use, and suggest that this interview-based approach has good external validity. Copyright © 2014. Published by Elsevier Ireland Ltd.

  11. Couples' Reports of Relationship Problems in a Naturalistic Therapy Setting

    Science.gov (United States)

    Boisvert, Marie-Michele; Wright, John; Tremblay, Nadine; McDuff, Pierre

    2011-01-01

    Understanding couples' relationship problems is fundamental to couple therapy. Although research has documented common relationship problems, no study has used open-ended questions to explore problems in couples seeking therapy in naturalistic settings. The present study used a reliable coding system to explore the relationship problems reported…

  12. The use of navigation systems in naturalistic driving

    NARCIS (Netherlands)

    Knapper, A.S.; Nes, Nicole Van; Christoph, Michiel; Hagenzieker, M.P.; Brookhuis, K.A.

    2016-01-01

    Objective: In this study, we assessed the use of portable navigation systems in everyday driving by applying in-vehicle naturalistic driving. Method: Experienced users of navigation systems, 7 females and 14 males, were provided with a specially equipped vehicle for approximately 1 month. Their

  13. Interpretive signs designed to trigger naturalist intelligence at two American zoos

    Science.gov (United States)

    Bryant, Martha

    An investigation of interpretive graphics was conducted in 2005 at two mid-sized AZA-accredited zoos, Lowry Park Zoo, Tampa, Florida and Knoxville Zoo, Knoxville, Tennessee. The Lowry Park Zoo study investigated signs at a red-tailed hawk and sandhill crane exhibit. Combination signs and wordless signs were more effective helping visitors see animals, increasing holding time, and number of engagements than treatments of no signs, or signs with words only. A second study, at Knoxville Zoo, tested combination and wordless signs in a children's zoo, investigating 31 signs at a 3.5-acre exhibit. Comparisons of visitors seeing the animals/using interactive exhibit elements, holding time, and engagement activities, showed wordless signs were more effective than combination signs. Differences in gender ratio, age, group size, and other demographics were not significant. Visit motivation differed between zoos, with visitors from Lowry Park Zoo more often articulating reason for a visit as wanting to see animals. Visitors at Knoxville Zoo most often said they wanted to spend time with family and friends. Differences in potential for naturalist intelligence were probably related to local practices rather than to innate differences in naturalist intelligence. The number of communities in Florida that regulate pet ownership and provide lawn service could account for the lower number of people who have pets and plants. At both institutions, behaviors supported educational theories. The importance of signs as advanced organizers was shown where signs were removed at the bird exhibit at Lowry Park Zoo, with fewer visitors seeing the animals. Social interaction was noted at both zoos, with intra- and inter-group conversations observed. If naturalist intelligence is necessary to see animals, visitors run a continuum. Some are unable to see animals with signs and assistance from other visitors; others see animals with little difficulty. The importance of honing naturalist

  14. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 6, Driver Behaviour Monitoring through Naturalistic Driving: Deliverable 6.3: Report on small scale naturalistic driving pilot.

    NARCIS (Netherlands)

    Pilgerstorfer, M. Runda, K. Brandstätter, C. Christoph, M. Hakkert, S. Ishaq, R. Toledo, T. & Gatscha, M.

    2012-01-01

    WP6 of DaCoTA, Driver Behaviour Monitoring through Naturalistic Driving, aims to develop an implementation plan for a large scale activity that uses Naturalistic Driving (ND) Observations to continuously monitor relevant road safety data within the framework of the European Road Safety Observatory.

  15. A card game for the treatment of delusional ideas: A naturalistic pilot trial

    Directory of Open Access Journals (Sweden)

    Benzakin Laetitia

    2006-10-01

    Full Text Available Abstract Background "Michael's game" is a card game which aims at familiarizing healthcare professionals and patients with cognitive behavioral therapy of psychotic symptoms. This naturalistic study tests the feasibility and the impact of the intervention in various naturalistic settings. Method Fifty five patients were recruited in seven centers. They were assessed in pre and post-test with the Peters Delusion Inventory – 21 items (PDI-21. Results Forty five patients completed the intervention significantly reducing their conviction and preoccupation scores on the PDI-21. Conclusion This pilot study supports the feasibility and effectiveness of "Michael's game" in naturalistic setting. Additional studies could validate the game in a controlled fashion.

  16. Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.

    Science.gov (United States)

    Murphy, Dominic; Hodgman, Georgina; Carson, Carron; Spencer-Harper, Lucy; Hinton, Mark; Wessely, Simon; Busuttil, Walter

    2015-03-20

    Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up. A within subject design. UK veterans with a diagnosis of PTSD who accessed Combat Stress. 246 veterans who received treatment between late 2012 and early 2014. An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation. Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment. We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up. In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first

  17. Temporal eye movement strategies during naturalistic viewing

    Science.gov (United States)

    Wang, Helena X.; Freeman, Jeremy; Merriam, Elisha P.; Hasson, Uri; Heeger, David J.

    2011-01-01

    The deployment of eye movements to complex spatiotemporal stimuli likely involves a variety of cognitive factors. However, eye movements to movies are surprisingly reliable both within and across observers. We exploited and manipulated that reliability to characterize observers’ temporal viewing strategies. Introducing cuts and scrambling the temporal order of the resulting clips systematically changed eye movement reliability. We developed a computational model that exhibited this behavior and provided an excellent fit to the measured eye movement reliability. The model assumed that observers searched for, found, and tracked a point-of-interest, and that this process reset when there was a cut. The model did not require that eye movements depend on temporal context in any other way, and it managed to describe eye movements consistently across different observers and two movie sequences. Thus, we found no evidence for the integration of information over long time scales (greater than a second). The results are consistent with the idea that observers employ a simple tracking strategy even while viewing complex, engaging naturalistic stimuli. PMID:22262911

  18. The Networked Naturalist - Mobile devices for Citizen Science

    Science.gov (United States)

    Estrin, D.; Graham, E. A.

    2010-12-01

    Citizen science projects engage individual volunteers or groups to observe, measure, and contribute data to scientific studies. CENS is developing mobile phone and web-based tools for formal and informal observation of ecosystems. We are collaborating with national environmental education campaigns, such as Project BudBurst, and with the National Park Service to increase participation in citizen scientist campaigns and to support park service personnel in day to day data gathering. The overarching goals of the Networked Naturalist set of projects are to enhance participatory learning experiences through citizen science campaigns and to facilitate scientific and environmental data collection. Our experience with volunteers at UCLA and at the National Park Service has demonstrated that mobile phones are an efficient, effective and engaging method for collecting environmental and location data and hold great potential for both raising public awareness of environmental issues and collecting data that is valuable for both ecosystem management and research. CENS is an NSF-funded Science and Technology Center and this project represents collaboration among ecologists, computer scientist, and statisticians. Our mobile applications are free for download on Android and iPhone App stores and the source code is made available through open source licenses.

  19. Naturalistic Assessment of Novice Teenage Crash Experience

    Science.gov (United States)

    Lee, Suzanne E.; Simons-Morton, Bruce G.; Klauer, Sheila E.; Ouimet, Marie Claude; Dingus, Thomas A.

    2011-01-01

    Background Crash risk is highest during the first months after licensure. Current knowledge about teenagers’ driving exposure and the factors increasing their crash risk is based on self-reported data and crash database analyses. While these research tools are useful, new developments in naturalistic technologies have allowed researchers to examine newly-licensed teenagers’ exposure and crash risk factors in greater detail. The Naturalistic Teenage Driving Study (NTDS) described in this paper is the first study to follow a group of newly-licensed teenagers continuously for 18 months after licensure. The goals of this paper are to compare the crash and near-crash experience of drivers in the NTDS to national trends, to describe the methods and lessons learned in the NTDS, and to provide initial data on driving exposure for these drivers. Methods A data acquisition system was installed in the vehicles of 42 newly-licensed teenage drivers 16 years of age during their first 18 months of independent driving. It consisted of cameras, sensors (accelerometers, GPS, yaw, front radar, lane position, and various sensors obtained via the vehicle network), and a computer with removable hard drive. Data on the driving of participating parents was also collected when they drove the instrumented vehicle. Findings The primary findings after 18 months included the following: (1) crash and near-crash rates among teenage participants were significantly higher during the first six months of the study than the final 12 months, mirroring the national trends; (2) crash and near-crash rates were significantly higher for teenage than adult (parent) participants, also reflecting national trends; (3) teenaged driving exposure averaged between 507-710 kilometers (315-441 miles) per month over the study period, but varied substantially between participants with standard errors representing 8-14 percent of the mean; and (4) crash and near-crash types were very similar for male and female

  20. Evaluating environmental education, citizen science, and stewardship through naturalist programs.

    Science.gov (United States)

    Merenlender, Adina M; Crall, Alycia W; Drill, Sabrina; Prysby, Michelle; Ballard, Heidi

    2016-12-01

    Amateur naturalists have played an important role in the study and conservation of nature since the 17th century. Today, naturalist groups make important contributions to bridge the gap between conservation science and practice around the world. We examined data from 2 regional naturalist programs to understand participant motivations, barriers, and perspectives as well as the actions they take to advance science, stewardship, and community engagement. These programs provide certification-based natural history and conservation science training for adults that is followed by volunteer service in citizen science, education, and stewardship. Studies in California and Virginia include quantitative and qualitative evaluation data collected through pre- and postcourse surveys, interviews, and long-term tracking of volunteer hours. Motivations of participants focused on learning about the local environment and plants and animals, connecting with nature, becoming certified, and spending time with people who have similar interests. Over half the participants surveyed were over 50 years old, two-thirds were women, and a majority reported household incomes of over $50,000 (60% in California, 85% in Virginia), and ecological knowledge, scientific skills, and belief in their ability to address environmental issues increased after training. Documented conservation actions taken by the participants include invasive plant management, habitat restoration, and cleanups of natural areas and streams. Long-term data from Virginia on volunteer hours dedicated to environmental citizen science show an increase from 14% in 2007 to 32% in 2014. In general, participants in the naturalist programs we examined increased their content knowledge about ecosystems, had greater confidence in conserving them, and continued to engage as citizen scientists after completing the program. © 2016 Society for Conservation Biology.

  1. Naturalistic Experimental Designs as Tools for Understanding the Role of Genes and the Environment in Prevention Research.

    Science.gov (United States)

    Leve, Leslie D; Neiderhiser, Jenae M; Harold, Gordon T; Natsuaki, Misaki N; Bohannan, Brendan J M; Cresko, William A

    2018-01-01

    Before genetic approaches were applied in experimental studies with human populations, they were used by animal and plant breeders to observe, and experimentally manipulate, the role of genes and environment on specific phenotypic or behavioral outcomes. For obvious ethical reasons, the same level of experimental control is not possible in human populations. Nonetheless, there are natural experimental designs in human populations that can serve as logical extensions of the rigorous quantitative genetic experimental designs used by animal and plant researchers. Applying concepts such as cross-fostering and common garden rearing approaches from the life science discipline, we describe human designs that can serve as naturalistic proxies for the controlled quantitative genetic experiments facilitated in life sciences research. We present the prevention relevance of three such human designs: (1) children adopted at birth by parents to whom they are not genetically related (common garden approach); (2) sibling designs where one sibling is reared from birth with unrelated adoptive parents and the other sibling is reared from birth by the biological mother of the sibling pair (cross-fostering approach); and (3) in vitro fertilization designs, including egg donation, sperm donation, embryo donation, and surrogacy (prenatal cross-fostering approach). Each of these designs allows for differentiation of the effects of the prenatal and/or postnatal rearing environment from effects of genes shared between parent and child in naturalistic ways that can inform prevention efforts. Example findings from each design type are provided and conclusions drawn about the relevance of naturalistic genetic designs to prevention science.

  2. Using naturalistic driving films as a design tool for investigating driver requirements in HMI design for ADAS.

    Science.gov (United States)

    Wang, Minjuan; Sun, Dong; Chen, Fang

    2012-01-01

    In recent years, there are many naturalistic driving projects have been conducted, such as the 100-Car Project (Naturalistic Driving study in United State), EuroFOT(European Large-Scale Field Operational Tests on Vehicle Systems), SeMi- FOT(Sweden Michigan Naturalistic Field Operational Test and etc. However, those valuable naturalistic driving data hasn't been applied into Human-machine Interaction (HMI) design for Advanced Driver Assistance Systems (ADAS), a good HMI design for ADAS requires a deep understanding of drive environment and the interactions between the driving car and other road users in different situations. The results demonstrated the benefits of using naturalistic driving films as a mean for enhancing focus group discussion for better understanding driver's needs and traffic environment constraints. It provided an efficient tool for designers to have inside knowledge about drive and the needs for information presentation; The recommendations for how to apply this method is discussed in the paper.

  3. Naturalistic and Supernaturalistic Disclosures: The Possibility of ...

    African Journals Online (AJOL)

    Naturalistic and Supernaturalistic Disclosures: The Possibility of Relational Miracles. Amy Fisher Smith. Abstract. This paper explores naturalism and supernaturalism as modes of disclosure that reveal and conceal different aspects of relationality. Naturalism is presented as a worldview or set of philosophical assumptions ...

  4. Da Costa on ontology: a naturalistic interpretation

    Directory of Open Access Journals (Sweden)

    Antonio Mariano Nogueira Coelho

    2011-06-01

    Full Text Available Da Costa's conception of being modifies that of Quine to incorporate relativization to non-classical logics. A naturalistic view of this conception is discussed. This view tries to extend to logic some ideas of Maddy's naturalism concerning mathematics.

  5. Epistemological and Methodological Bases of Naturalistic Inquiry.

    Science.gov (United States)

    Guba, Egon G.; Lincoln, Yvonna S.

    1982-01-01

    Five major differences between the rationalistic and naturalistic paradigms of inquiry are accounted for: the nature of reality; the nature of the inquirer-object relationship; the nature of truth statements; assumptions about causal relationships; and the role of values within disciplined inquiry. Thirty-one sources are appended. (EJS)

  6. The Role of Ideology in Naturalistic Research.

    Science.gov (United States)

    Lincoln, Yvonna S.

    All social science serves some agenda: social science research is a value-bound, value-determined, context-situated, and ideologically loaded enterprise. Each researcher makes choices in the following areas, whether tacitly, implicitly, or deliberately: (1) a paradigm choice, either conventional (rationalistic) or emerging (naturalistic); (2) the…

  7. The Effectiveness of Enhanced Cognitive Behavioural Therapy (CBT-E): A Naturalistic Study within an Out-Patient Eating Disorder Service.

    Science.gov (United States)

    Signorini, Rachel; Sheffield, Jeanie; Rhodes, Natalie; Fleming, Carmel; Ward, Warren

    2018-01-01

    The effectiveness of enhanced cognitive behavioural Therapy (CBT-E) for adults with a range of eating disorder presentations within routine clinical settings has been examined in only two known published studies, neither of which included a follow-up assessment period. The current study aimed to evaluate the effectiveness of CBT-E within an out-patient eating disorder service in Brisbane, Queensland, Australia, and incorporated a follow-up assessment period of approximately 20 weeks post-treatment. The study involved 114 adult females with a diagnosed eating disorder, who attended an average of 20-40 individual CBT-E sessions with a psychologist or a psychiatry registrar between 2009 and 2013. Of those who began treatment, 50% did not complete treatment, and the presence of psychosocial and environmental problems predicted drop-out. Amongst treatment completers, statistically and clinically significant improvements in eating disorder and general psychopathology were observed at post-treatment, which were generally maintained at the 20-week follow-up. Statistically significant improvements in eating disorder and general psychopathology were observed amongst the total sample. The findings, which were comparable to the previous Australian effectiveness study of CBT-E, indicate that CBT-E is an effective treatment for adults with all eating disorders within out-patient settings. Given the high attrition rate, however, minimizing drop-out appears to be an important consideration when implementing CBT-E within clinical settings.

  8. Investigating critical incidents, driver restart period, sleep quantity, and crash countermeasures in commercial vehicle operations using naturalistic data collection.

    Science.gov (United States)

    2016-11-01

    The aim of this study was to compare the Large Truck Crash Causation Study (LTCCS) and Naturalistic Driving (ND) datasets to identify discrepancies and to determine the source(s) of these discrepancies. The project included a generalized comparative ...

  9. Do phenotypic characteristics, parental psychopathology, family functioning, and environmental stressors have a role in the response to methylphenidate in children with attention-deficit/hyperactivity disorder? A naturalistic study from a developing country.

    Science.gov (United States)

    Chazan, Rodrigo; Borowski, Carolina; Pianca, Thiago; Ludwig, Henrique; Rohde, Luis Augusto; Polanczyk, Guilherme

    2011-06-01

    Little is known about the effect of clinical characteristics, parental psychopathology, family functioning, and environmental stressors in the response to methylphenidate in children with attention-deficit/hyperactivity disorder (ADHD) followed up in a naturalistic setting. Data from cultures outside the United States are extremely scarce. This is a longitudinal study using a nonrandom assignment, quasi-experimental design. One hundred twenty-five children with ADHD were treated with methylphenidate according to standard clinical procedures, and followed up for 6 months. The severity of ADHD symptoms was assessed by the Swanson, Nolan, and Pelham rating scale. In the final multivariate model, ADHD combined subtype (P < 0.001) and comorbidity with oppositional defiant disorder (P = 0.03) were both predictors of a worse clinical response. In addition, the levels of maternal ADHD symptoms were also associated with worse prognosis (P < 0.001). In the context of several adverse psychosocial factors assessed, only undesired pregnancy was associated with poorer response to methylphenidate in the final comprehensive model (P = 0.02). Our study provides evidence for the involvement of clinical characteristics, maternal psychopathology, and environmental stressors in the response to methylphenidate. Clinicians may consider adjuvant strategies when negative predictors are present to increase the chances of success with methylphenidate treatment.

  10. Observational Study of Travelers' Diarrhea.

    Science.gov (United States)

    Meuris

    1995-03-01

    Background: European air travelers returning from Algeria, Egypt, Mexico, Morocco, and Tunisia were interviewed about their experience of travelers' diseases upon arrival in Brussels. Diarrhea was mentioned by 37% of the adults and 27% of the children. These subjects were questioned about the types of measures taken, type and duration of drug treatment (if any), and about duration of diarrhea and side effects experienced. Methods: Final analysis was performed based on 2160 interviews. The largest proportion of diarrhea was reported in the age group 15-24 years (46%). Results: The majority of the 2160 subjects had opted for drug treatment (81%): 927 subjects for loperamide alone, 235 for loperamide in combination with nifuroxazide, and 178 for nifuroxazide alone. Other drugs had been used less frequently. The median time to recovery was 2.4 days with loperamide compared to 3.2 days with nifuroxazide and to 3.4 days for the no-treatment group. Conclusions: A stratification of the results by severity of the diarrhea suggests a rank of antidiarrheal potency as follows: loperamide > nifuroxazide > no-drug treatment. The side effect with the highest incidence was constipation (2.4% with loperamide). (J Travel Med 2:11-15, 1995) Travelers' diarrhea is usually defined as the passage of at least three unformed stools per day or any number of such stools when accompanied by fever, abdominal cramping, or vomiting. The definition may be broadened to include more trivial bowel disturbance.1,2 The duration of this self-limited disease generally is 3 to 5 days. Medical intervention aims at shortening the duration of disease, thus allowing the sufferer to resume his or her usual activities at an early stage. A shortened period of recovery to physical well-being has obvious favorable economic implications if the traveler is on business and may help the maintenance of a desired level of quality of life while a traveler is on holiday. An observational study of various medical

  11. Bridging naturalistic and laboratory assessment of memory: the Baycrest mask fit test.

    Science.gov (United States)

    Armson, Michael J; Abdi, Hervé; Levine, Brian

    2017-09-01

    Autobiographical memory tests provide a naturalistic counterpoint to the artificiality of laboratory research methods, yet autobiographical events are uncontrolled and, in most cases, unverifiable. In this study, we capitalised on a scripted, complex naturalistic event - the mask fit test (MFT), a standardised procedure required of hospital employees - to bridge the gap between naturalistic and laboratory memory assessment. We created a test of recognition memory for the MFT and administered it to 135 hospital employees who had undertaken the MFT at various points over the past five years. Multivariate analysis revealed two dimensions defined by accuracy and response bias. Accuracy scores showed the expected relationship to encoding-test delay, supporting the validity of this measure. Relative to younger adults, older adults' memory for this naturalistic event was better than would be predicted from the cognitive ageing literature, a result consistent with the notion that older adults' memory performance is enhanced when stimuli are naturalistic and personally relevant. These results demonstrate that testing recognition memory for a scripted event is a viable method of studying autobiographical memory.

  12. Who's Afraid of the Naturalistic Fallacy?

    Directory of Open Access Journals (Sweden)

    Oliver Curry

    2006-01-01

    Full Text Available David Hume argued that values are the projections of natural human desires, and that moral values are the projections of desires that aim at the common good of society. Recent developments in game theory, evolutionary biology, animal behaviour and neuroscience explain why humans have such desires, and hence provide support for a Humean approach to moral psychology and moral philosophy. However, few philosophers have been willing to pursue this naturalistic approach to ethics for fear that it commits something called ‘the naturalistic fallacy’. This paper reviews several versions of the fallacy, and demonstrates that none of them present an obstacle to this updated, evolutionary version of Humean ethical naturalism.

  13. Differential treatment response of subtypes of patients with borderline personality organization, as assessed with theory-driven profiles of the Dutch short form of the MMPI: a naturalistic follow-up study.

    Science.gov (United States)

    Eurelings-Bontekoe, Elisabeth H M; Peen, Jaap; Noteboom, Annemieke; Alkema, Marieke; Dekker, Jack

    2012-01-01

    We investigated the validity of different subtypes of borderline personality organization (BPO) as assessed by theory-driven profiles of the Minnesota Multiphasic Personality Disorder (MMPI; Hathaway & McKinley, 1943 ) Dutch Short Form (DSFM; Eurelings-Bontekoe, Onnink, Williams, & Snellen, 2008 ) in a naturalistic follow-up study among 2,062 psychiatric outpatients who received 6 months of ambulatory treatment. Patients were assessed at intake (T1) and 6 months later (T2). At T2, both patients and therapists rated the level of improvement, using the Global Assessment of Improvement. Patients with the high-level BPO profile showed the largest increase in well-being and the largest decrease in severity of symptomatology, whereas severity of symptomatology and well-being of patients with psychotic BPO profiles did not change over time. Agreement between patients and therapists about improvement was good for the internalizing immature BPO and high-level BPO patients, but poor for the externalizing low-level BPO and narcissistic patients.

  14. The potential benefits of naturalistic driving for road safety research : theoretical and empirical considerations and challenges for the future.

    NARCIS (Netherlands)

    Schagen, I.N.L.G. van & Sagberg, F.

    2012-01-01

    Naturalistic driving (ND) is a research method that provides insight in everyday driver behaviour. Typically, in an ND study vehicles are equipped with several small cameras and sensors, which continuously and inconspicuously register vehicle manoeuvres, driver behaviour, and external conditions.

  15. Belgian Schizophrenia Outcome Survey - results of a 2-year naturalistic study in patients stabilised on monotherapy with olanzapine, risperidone or haloperidol.

    Science.gov (United States)

    Peuskens, J; Gillain, B; De Graeve, D; Van Vleymen, B; Albert, A

    2009-04-01

    This Schizophrenia Outcome Survey compared medical costs, psychopathology and adverse events in outpatients for 2 years following hospitalisation for an acute schizophrenic episode. Adults stabilised with haloperidol, olanzapine or risperidone entered this observational study Impression (CGI), Global Assessment of Functioning and adverse events reporting. Among 323 patients (haloperidol 32, olanzapine 149, risperidone 142), baseline characteristics were similar in the olanzapine and risperidone groups, except for more first episodes in the risperidone group (p=0.01). Haloperidol patients were more often single and institutionalised, less educated, had more residual schizophrenia, were longer hospitalised in the previous year, took more corrective and psychotropic drugs and had more extrapyramidal symptoms (EPS) and gynaecomastia (all significantly). Sixty-eight percent of patients completed a 2-year follow-up. In all groups, CGI and GAF improved during the first 3 months (both pfirst year (all within group changes por=1 EPS; 69% (por=1 sexual problem (NS). Mean weight gain was 0.4 (NS), 2.6 (pbias in the interpretation of efficiency results, but olanzapine and risperidone caused less EPS than haloperidol during 2 years of outpatient follow-up.

  16. On the use of naturalistic methods to examine safety-relevant behaviours amongst children and evaluate a cycling education program.

    Science.gov (United States)

    Hatfield, J; Dozza, M; Patton, D A; Maharaj, P; Boufous, S; Eveston, T

    2017-11-01

    School-based cycling education programs aim to improve cycling safety and participation amongst children. Available research suggests that typical programs, which focus on bicycle manoeuvring skills, have limited effects on behaviour observed on a track or planned route. The current study uses theoretically more valid, naturalistic cycling data, to evaluate Safe Cycle, a program that incorporates hazard and self-awareness training. Soon after Safe Cycle was delivered at treatment schools, research bicycles instrumented with a rearward- and a forward-facing camera were loaned to six children from treatment schools and six children from (waitlist) control schools. In each group half the children were in Year 6, and half were in Year 7/8. Each child was instructed to ride the research bicycle instead of their own bicycle for the 1-2 weeks that they had a research bicycle. Video data were reduced using a purpose-designed coding scheme that identified whether participants performed specific safety-relevant behaviours in appropriate circumstances. While the participants controlled their bicycles well, gave way appropriately to traffic at intersections, and stopped at red lights, participants frequently removed one or both hands from the handlebars, and seldom signalled turns, conducted over-shoulder-checks when changing lanes, or looked in multiple directions at intersections (except when crossing a road). While aspects of design and small sample sizes limited evaluation findings, this research demonstrated the feasibility and potential of naturalistic data to support cycling education program evaluation. Further, the study substantially extended available naturalistic study of children's cycling behaviour to highlight behaviours which might be targeted by cycling safety initiatives. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. UFOs: Observations, Studies and Extrapolations

    CERN Document Server

    Baer, T; Barnes, M J; Bartmann, W; Bracco, C; Carlier, E; Cerutti, F; Dehning, B; Ducimetière, L; Ferrari, A; Ferro-Luzzi, M; Garrel, N; Gerardin, A; Goddard, B; Holzer, E B; Jackson, S; Jimenez, J M; Kain, V; Zimmermann, F; Lechner, A; Mertens, V; Misiowiec, M; Nebot Del Busto, E; Morón Ballester, R; Norderhaug Drosdal, L; Nordt, A; Papotti, G; Redaelli, S; Uythoven, J; Velghe, B; Vlachoudis, V; Wenninger, J; Zamantzas, C; Zerlauth, M; Fuster Martinez, N

    2012-01-01

    UFOs (“ Unidentified Falling Objects”) could be one of the major performance limitations for nominal LHC operation. Therefore, in 2011, the diagnostics for UFO events were significantly improved, dedicated experiments and measurements in the LHC and in the laboratory were made and complemented by FLUKA simulations and theoretical studies. The state of knowledge is summarized and extrapolations for LHC operation in 2012 and beyond are presented. Mitigation strategies are proposed and related tests and measures for 2012 are specified.

  18. Intuitions in Epistemology: Towards a Naturalistic Alternative

    Directory of Open Access Journals (Sweden)

    Kristoffer Ahlstrom

    2009-12-01

    Full Text Available The present paper revisits the main methodological problems with conceptual analysis and considers two attempts to rectify them in terms of prototypes and reflective equilibria, respectively. Finding both wanting for the purposes of epistemological analysis, a naturalistic alternative is then sketched that explores the positive implications of aforementioned problems for the demarcation of the respective roles of intuitions and empirical investigation within three epistemological domains, viz., the evaluation of epistemological hypotheses, the amelioration of epistemic practices, and the construction of a theory of epistemic value.

  19. Philosophy of biology: naturalistic or transcendental?

    Science.gov (United States)

    Kolen, Filip; Van de Vijver, Gertrudis

    2007-01-01

    The aim of this article is to clarify the meaning of a naturalistic position within philosophy of biology, against the background of an alternative view, founded on the basic insights of transcendental philosophy. It is argued that the apparently minimal and neutral constraints naturalism imposes on philosophy of science turn out to involve a quite heavily constraining metaphysics, due to the naturalism's fundamental neglect of its own perspective. Because of its intrinsic sensitivity to perspectivity and historicity, transcendental philosophy can avoid this type of hidden metaphysics.

  20. CLASSROOM TECHNIQUES USED IN THE TEACHING OF ENGLISH BASED ON CURRICULUM 2013: A NATURALISTIC STUDY AT STATE JUNIOR HIGH SCHOOL OF SAWIT 1 BOYOLALI

    Directory of Open Access Journals (Sweden)

    Umi Nur Kurniliawati

    2016-08-01

    as observer, teacher as manager, teacher as model, teacher as counselor, teacher as controller, and teacher as evaluator. The students have roles as members of group, as tutor of other learners, as negotiator, as subject, and as monitor and evaluator of their own learning progress. There are some materials used by English teachers, such as: textbook, workbook, dictionary, photocopy exercises, powerpoint on LCD, audio like song, and videos from youtube. The conclusion of this research is that English teachers at State of Junior High School of Sawit 1 Boyolali used various classroom techniques which can improve the students’ ability. Various techniques can make the students interested in English teaching-learning process. It does not make the class monotonous. The students become more active and creative. Based on the results, apparently, classroom techniques used by the teachers have important role in the teaching-learning process.

  1. Temporal integration windows for naturalistic visual sequences.

    Directory of Open Access Journals (Sweden)

    Scott L Fairhall

    Full Text Available There is increasing evidence that the brain possesses mechanisms to integrate incoming sensory information as it unfolds over time-periods of 2-3 seconds. The ubiquity of this mechanism across modalities, tasks, perception and production has led to the proposal that it may underlie our experience of the subjective present. A critical test of this claim is that this phenomenon should be apparent in naturalistic visual experiences. We tested this using movie-clips as a surrogate for our day-to-day experience, temporally scrambling them to require (re- integration within and beyond the hypothesized 2-3 second interval. Two independent experiments demonstrate a step-wise increase in the difficulty to follow stimuli at the hypothesized 2-3 second scrambling condition. Moreover, only this difference could not be accounted for by low-level visual properties. This provides the first evidence that this 2-3 second integration window extends to complex, naturalistic visual sequences more consistent with our experience of the subjective present.

  2. Efficacy of Adderall and methylphenidate in attention deficit hyperactivity disorder: a drug-placebo and drug-drug response curve analysis of a naturalistic study.

    Science.gov (United States)

    Faraone, Stephen V; Short, Elizabeth J; Biederman, Joseph; Findling, Robert L; Roe, Christine; Manos, Michael J

    2002-06-01

    Stimulant medication has, for many years, been the pharmacological treatment of choice for children and adults with attention deficit hyperactivity disorder (ADHD). Recently, several studies have documented the efficacy of a new stimulant, Adderall. Although these initial studies provide useful information for clinicians treating ADHD children, their method of data presentation has provided limited information about the clinical significance of drug effects. Thus, to address the issue of clinical significance, we completed drug-placebo response curve analyses of a blinded, placebo-controlled study of Adderall and methylphenidate (MPH). Our results show that the efficacy of Adderall and MPH to improve functioning is seen throughout the full range of improvement scores. Both drugs prevent worsening and, for a majority of patients, lead to improvements that are well into the normal range. The analyses also highlight an important subgroup of placebo responders, which suggests that future research should focus on how to predict robust placebo response in ADHD patients.

  3. Naturalistic Cognition: A Research Paradigm for Human-Centered Design

    Science.gov (United States)

    Storkerson, Peter

    2010-01-01

    Naturalistic thinking and knowing, the tacit, experiential, and intuitive reasoning of everyday interaction, have long been regarded as inferior to formal reason and labeled primitive, fallible, subjective, superstitious, and in some cases ineffable. But, naturalistic thinking is more rational and definable than it appears. It is also relevant to…

  4. Coaching Parents to Use Naturalistic Language and Communication Strategies

    Science.gov (United States)

    Akamoglu, Yusuf; Dinnebeil, Laurie

    2017-01-01

    Naturalistic language and communication strategies (i.e., naturalistic teaching strategies) refer to practices that are used to promote the child's language and communication skills either through verbal (e.g., spoken words) or nonverbal (e.g., gestures, signs) interactions between an adult (e.g., parent, teacher) and a child. Use of naturalistic…

  5. The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study.

    Science.gov (United States)

    Rickelt, Judith; Viechtbauer, Wolfgang; Lieverse, Ritsaert; Overbeek, Thea; van Balkom, Anton J; van Oppen, Patricia; van den Heuvel, Odile A; Marcelis, Machteld; Eikelenboom, Merijn; Tibi, Lee; Schruers, Koen Rj

    2016-10-01

    Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Social orienting of children with autism to facial expressions and speech: a study with a wearable eye-tracker in naturalistic settings

    Science.gov (United States)

    Magrelli, Silvia; Jermann, Patrick; Noris, Basilio; Ansermet, François; Hentsch, François; Nadel, Jacqueline; Billard, Aude

    2013-01-01

    This study investigates attention orienting to social stimuli in children with Autism Spectrum Conditions (ASC) during dyadic social interactions taking place in real-life settings. We study the effect of social cues that differ in complexity and distinguish between social cues produced by facial expressions of emotion and those produced during speech. We record the children's gazes using a head-mounted eye-tracking device and report on a detailed and quantitative analysis of the motion of the gaze in response to the social cues. The study encompasses a group of children with ASC from 2 to 11-years old (n = 14) and a group of typically developing (TD) children (n = 17) between 3 and 6-years old. While the two groups orient overtly to facial expressions, children with ASC do so to a lesser extent. Children with ASC differ importantly from TD children in the way they respond to speech cues, displaying little overt shifting of attention to speaking faces. When children with ASC orient to facial expressions, they show reaction times and first fixation lengths similar to those presented by TD children. However, children with ASC orient to speaking faces slower than TD children. These results support the hypothesis that individuals affected by ASC have difficulties processing complex social sounds and detecting intermodal correspondence between facial and vocal information. It also corroborates evidence that people with ASC show reduced overt attention toward social stimuli. PMID:24312064

  7. Tianeptine is associated with lower risk of suicidal ideation worsening during the first weeks of treatment onset compared with other antidepressants: A naturalistic study.

    Science.gov (United States)

    Nobile, B; Jaussent, I; Gorwood, Ph; Lopez Castroman, J; Olié, E; Guillaume, S; Courtet, Ph

    2018-01-01

    Worsening of suicidal ideation during the first weeks of antidepressant treatment is a poorly understood phenomenon that prompted regulatory bodies to issue specific warnings. To better understand the causes of this phenomenon, this study compared the risk of suicidal ideation worsening in patients taking different types of antidepressant medications. To this aim, 4017 depressed adult outpatients were followed by general practitioners and psychiatrists throughout France for 6 weeks after prescription of an antidepressant treatment. The main study outcomes were to monitor changes (worsening or improvement) in suicidal ideation between baseline (treatment onset) and the study end (week 6) and to determine the remission rates according to the treatment type. Depression severity was assessed with the patient-administered Hospital Anxiety and Depression Scale and suicidal ideation with the 9-item Montgomery-Asberg Depression Rating Scale and the Hopelessness Scale. Use of tianeptine, a mu-opioid receptor agonist was significantly associated with a lower risk of suicidal ideation worsening compared with other antidepressants in the first 6 weeks of treatment. Conversely, remission rates were not significantly affected by the treatment type. Our results highlight a potential interest of opioid agonists to reduce the risk of worsening of suicidal ideation at antidepressant initiation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Importance of observational studies in clinical practice.

    Science.gov (United States)

    Ligthelm, Robert J; Borzì, Vito; Gumprecht, Janusz; Kawamori, Ryuzo; Wenying, Yang; Valensi, Paul

    2007-06-01

    In this era of evidence-based medicine, clinicians require a comprehensive range of well-designed studies to support prescribing decisions and patient management. In recent years, data from observational studies have become an increasingly important source of evidence because of improvements in observational-study methods and advances in statistical analysis. This article reviews the current literature and reports some of the key studies indicating that observational studies can both complement and build on the evidence base established by randomized controlled trials (RCTs). A literature search using the MEDLINE/PubMed database (years: 1966-present) was carried out using the search terms observational or observational study(ies), historical control, nonrandomized, and postmarketing surveillance. All references comparing observational studies with randomized controlled trials were obtained and reviewed and were also hand-checked for studies not identified in the database searches. Observational studies play an important role in investigating treatment outcomes. Data from large observational studies can clarify the tolerability profile of marketed medicines. In particular, observational studies can be of benefit in the study of large, heterogeneous patient populations with complex, chronic diseases such as diabetes mellitus. Observational studies have played a key role in supporting the results of Phase III studies of insulin analogues for the treatment of patients with type 1 and type 2 diabetes. Future observational studies in the field of diabetes such as PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) and IMPROVE will further our understanding of this global pandemic. Well-designed observational studies can play a key role in supporting the evidence base for drugs and therapies. Current evidence suggests that observational studies can be conducted using the same

  9. Efficacy of a family intervention program for prevention of hospitalization in patients with schizophrenia. A naturalistic multicenter controlled and randomized study in Spain.

    Science.gov (United States)

    Mayoral, Fermín; Berrozpe, Adela; de la Higuera, Jesús; Martinez-Jambrina, Juan José; de Dios Luna, Juan; Torres-Gonzalez, Francisco

    2015-01-01

    According to most relevant guidelines, family psycho-educational interventions are considered to be one the most effective psychosocial treatments for people with schizophrenia. The main outcome measure in controlled and randomized studies has been prevention of relapses and admissions, and encouragement of compliance, although some questions remain about its applicability and results in clinical practice. The aim of study was to evaluate the efficacy and implementation of a single family psychoeducational intervention in 'real' conditions for people diagnosed with schizophrenia. A total of 88 families were randomized in two groups. The family intervention group received a 12 months psychoeducational treatment, and the other group followed normal standard treatment. Assessments were made at baseline, at 12 and at 18 months. The main outcome measure was hospitalization, and secondary outcome measures were clinical condition (BPRS-E) and social disability (DAS-II). A total of 71 patients finished the study (34 family intervention group and 37 control group). Patients who received family intervention reduced the risk of hospitalization by 40% (P = .4018; 95%CI: 0.1833-0.6204). Symptomatology improved significantly at 12 months (P = .4018; 95%CI: 0.1833-0.6204), but not at 18 months (P = .4018; 95%CI: 0.1833-0.6204). Social disability was significantly reduced in the family intervention group at 12 months and 18 months. Family psychoeducational intervention reduces hospitalization risk and improves clinical condition and social functioning of people with schizophrenia. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  10. Using naturalistic driving study data to investigate the impact of driver distraction on driver's brake reaction time in freeway rear-end events in car-following situation.

    Science.gov (United States)

    Gao, Jingru; Davis, Gary A

    2017-12-01

    The rear-end crash is one of the most common freeway crash types, and driver distraction is often cited as a leading cause of rear-end crashes. Previous research indicates that driver distraction could have negative effects on driving performance, but the specific association between driver distraction and crash risk is still not fully revealed. This study sought to understand the mechanism by which driver distraction, defined as secondary task distraction, could influence crash risk, as indicated by a driver's reaction time, in freeway car-following situations. A statistical analysis, exploring the causal model structure regarding drivers' distraction impacts on reaction times, was conducted. Distraction duration, distraction scenario, and secondary task type were chosen as distraction-related factors. Besides, exogenous factors including weather, visual obstruction, lighting condition, traffic density, and intersection presence and endogenous factors including driver age and gender were considered. There was an association between driver distraction and reaction time in the sample freeway rear-end events from SHRP 2 NDS database. Distraction duration, the distracted status when a leader braked, and secondary task type were related to reaction time, while all other factors showed no significant effect on reaction time. The analysis showed that driver distraction duration is the primary direct cause of the increase in reaction time, with other factors having indirect effects mediated by distraction duration. Longer distraction duration, the distracted status when a leader braked, and engaging in auditory-visual-manual secondary task tended to result in longer reaction times. Given drivers will be distracted occasionally, countermeasures which shorten distraction duration or avoid distraction presence while a leader vehicle brakes are worth considering. This study helps better understand the mechanism of freeway rear-end events in car-following situations, and

  11. Stress-related psycho-physiological disorders: randomized single blind placebo controlled naturalistic study of psychometric evaluation using a radio electric asymmetric treatment

    Science.gov (United States)

    2011-01-01

    Background The aim of this study is to investigate the effects of a radio electric asymmetric treatment on psycho-physiological disorders (PPD). PPD are often stress related and are under the unconscious control of the patient and cannot be traced back to any serious physical disease. The brain stimulation treatment protocol used is called Neuro Psycho Physical Optimization (NPPO) with a Radio Electric Asymmetric Conveyer (REAC) device. Methods Psychological stress and PPD were measured for a group of 888 subjects using the Psychological Stress Measure (PSM) test, a self-administered questionnaire. Data were collected immediately before and after the 4-weeks of REAC treatment cycle. Results This study showed a significant reduction in scores measuring subjective perceptions of stress for subjects treated with a cycle of NPPO REAC treatment. At the end-point the number of subjects reporting symptoms of stress-related PPD on the PSM test was significantly reduced, whereas in the placebo group the difference was not significant. Conclusion A cycle of NPPO treatment with REAC was shown to reduce subjective perceptions of stress measured by the PSM test and in particular on PPD. Trial Registration This trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with the number: ACTRN12607000463471. PMID:21771304

  12. An Analysis of Naturalistic Interventions for Increasing Spontaneous Expressive Language in Children with Autism Spectrum Disorder

    Science.gov (United States)

    Lane, Justin D.; Lieberman-Betz, Rebecca; Gast, David L.

    2016-01-01

    The purpose of this review was to identify naturalistic language interventions for increasing spontaneous expressive language (defined in this review as absence of verbal prompt or other verbalization from adults or peers) in young children with autism spectrum disorder. Also, the methodological rigor and effectiveness of each study were evaluated…

  13. Psychosocial interventions with art, music, Tai Chi and mindfulness for subsyndromal depression and anxiety in older adults: A naturalistic study in Singapore.

    Science.gov (United States)

    Rawtaer, Iris; Mahendran, Rathi; Yu, Junhong; Fam, Johnson; Feng, Lei; Kua, Ee Heok

    2015-09-01

    Subsyndromal depression (SSD) and subsyndromal anxiety (SSA) are common in the elderly and if left untreated, contributes to a lower quality of life, increased suicide risk, disability and inappropriate use of medical services. Innovative approaches are necessary to address this public health concern. We evaluate a community-based psychosocial intervention program and its effect on mental health outcomes in Singaporean older adults. Elderly participants with SSD and SSA, as assessed on the Geriatric Depression Scale and Geriatric Anxiety Inventory, were included. Intervention groups include Tai Chi exercise, Art Therapy, Mindfulness Awareness Practice and Music Reminiscence Therapy. The program was divided into a single intervention phase and a combination intervention phase. Outcomes were measured with the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) at baseline, 4 weeks, 10 weeks, 24 weeks and 52 weeks. The program had ethics board approval. A hundred and one subjects (25 males, 76 females; mean age = 71 years, SD = 5.95) participated. There were significant reductions in SDS and SAS scores in the single intervention phase (P < 0.05), and these reductions remained significant at week 52, after completion of the combination intervention phase, relative to baseline (P < 0.001). Participating in these psychosocial interventions led to a positive improvement in SSD and SSA symptoms in these elderly subjects over a year. This simple, inexpensive and culturally acceptable approach should be adequately studied and replicated in other communities. © 2015 Wiley Publishing Asia Pty Ltd.

  14. A naturalistic study of the acceptability and effectiveness of internet-delivered cognitive behavioural therapy for psychiatric disorders in older australians.

    Directory of Open Access Journals (Sweden)

    Louise Mewton

    Full Text Available The current study investigates the acceptability, effectiveness and uptake of internet-delivered cognitive behavioural therapy (iCBT amongst older individuals (>60 years seeking psychiatric treatment in general practice.The sample consisted of 2413 (mean age 39.5; range 18-83 years patients prescribed iCBT through This Way Up clinic by their primary care clinician. The intervention consisted of six fully automated, unassisted online lessons specific to four disorders major depression, generalised anxiety disorder, panic disorder or social phobia. Patients were categorised into five age groups (18-29 years, 30-39 years, 40-49 years, 50-59 years, 60 years and above. 225 (9.3% patients were aged over 60 years. Analyses were conducted across the four disorders to ensure sufficient sample sizes in the 60 years and older age group. Age differences in adherence to the six lesson courses were assessed to demonstrate acceptability. Age-based reductions in psychological distress (Kessler Psychological Distress Scale; K10 and disability (the World Health Organisation Disability Assessment Schedule; WHODAS-II were compared to demonstrate effectiveness. To evaluate the uptake of iCBT, the age distribution of those commencing iCBT was compared with the prevalence of these disorders in the 2007 Australian National Survey of Mental Health and Well-Being.Older adults were more likely to complete all six lessons when compared with their younger counterparts. Marginal model analyses indicated that there were significant reductions in the K10 and WHODAS-II from baseline to post-intervention, regardless of age (p<0.001. The measurement occasion by age interactions were not significant, indicating that individuals showed similar reductions in the K10 and WHODAS-II regardless of age. In general, the age distribution of individuals commencing the iCBT courses matched the age distribution of the four diagnoses in the Australian general population, indicating that i

  15. Intentional forgetting: note-taking as a naturalistic example.

    Science.gov (United States)

    Eskritt, Michelle; Ma, Sierra

    2014-02-01

    In the present study, we examined whether note-taking as a memory aid may provide a naturalistic example of intentional forgetting. In the first experiment, participants played Concentration, a memory card game in which the identity and location of pairs of cards need to be remembered. Before the game started, half of the participants were allowed to study the cards, and the other half made notes that were then unexpectedly taken away. No significant differences emerged between the two groups for remembering identity information, but the study group remembered significantly more location information than did the note-taking group. In a second experiment, we examined whether note-takers would show signs of proactive interference while playing Concentration repeatedly. The results indicated that they did not. The findings suggest that participants adopted an intentional-forgetting strategy when using notes to store certain types of information.

  16. Primer: challenges in randomized and observational studies

    NARCIS (Netherlands)

    Landewé, Robert; van der Heijde, Désirée

    2007-01-01

    Randomized controlled trials (RCTs) are considered superior to observational studies, and both clinicians and researchers believe that conclusions that stem from observational research are flawed. RCTs, however, have important methodological and interpretational limitations, and particular clinical

  17. Naturalistic Field Studies of Sleep and Performance

    Science.gov (United States)

    2011-05-01

    local sleep.    Hight et al. (2010) showed circadian rhythmicity in sleep regulating substances in  both somatosensory and  visual  cortex, providing...cells in the rat somatosensory or  visual  cortex.  Brain Res.1337:32‐40. PMCID:  PMC2892412    Hill, M.N., Karatsoreos, I.N., Hillard, C.J., McEwen, B.S...2010). The basic affective circuits of mammalian brains: Implications  for healthy human development and the cultural landscapes of  ADHD . In C.M

  18. Sparse coding reveals greater functional connectivity in female brains during naturalistic emotional experience.

    Science.gov (United States)

    Ren, Yudan; Lv, Jinglei; Guo, Lei; Fang, Jun; Guo, Christine Cong

    2017-01-01

    Functional neuroimaging is widely used to examine changes in brain function associated with age, gender or neuropsychiatric conditions. FMRI (functional magnetic resonance imaging) studies employ either laboratory-designed tasks that engage the brain with abstracted and repeated stimuli, or resting state paradigms with little behavioral constraint. Recently, novel neuroimaging paradigms using naturalistic stimuli are gaining increasing attraction, as they offer an ecologically-valid condition to approximate brain function in real life. Wider application of naturalistic paradigms in exploring individual differences in brain function, however, awaits further advances in statistical methods for modeling dynamic and complex dataset. Here, we developed a novel data-driven strategy that employs group sparse representation to assess gender differences in brain responses during naturalistic emotional experience. Comparing to independent component analysis (ICA), sparse coding algorithm considers the intrinsic sparsity of neural coding and thus could be more suitable in modeling dynamic whole-brain fMRI signals. An online dictionary learning and sparse coding algorithm was applied to the aggregated fMRI signals from both groups, which was subsequently factorized into a common time series signal dictionary matrix and the associated weight coefficient matrix. Our results demonstrate that group sparse representation can effectively identify gender differences in functional brain network during natural viewing, with improved sensitivity and reliability over ICA-based method. Group sparse representation hence offers a superior data-driven strategy for examining brain function during naturalistic conditions, with great potential for clinical application in neuropsychiatric disorders.

  19. Sparse coding reveals greater functional connectivity in female brains during naturalistic emotional experience.

    Directory of Open Access Journals (Sweden)

    Yudan Ren

    Full Text Available Functional neuroimaging is widely used to examine changes in brain function associated with age, gender or neuropsychiatric conditions. FMRI (functional magnetic resonance imaging studies employ either laboratory-designed tasks that engage the brain with abstracted and repeated stimuli, or resting state paradigms with little behavioral constraint. Recently, novel neuroimaging paradigms using naturalistic stimuli are gaining increasing attraction, as they offer an ecologically-valid condition to approximate brain function in real life. Wider application of naturalistic paradigms in exploring individual differences in brain function, however, awaits further advances in statistical methods for modeling dynamic and complex dataset. Here, we developed a novel data-driven strategy that employs group sparse representation to assess gender differences in brain responses during naturalistic emotional experience. Comparing to independent component analysis (ICA, sparse coding algorithm considers the intrinsic sparsity of neural coding and thus could be more suitable in modeling dynamic whole-brain fMRI signals. An online dictionary learning and sparse coding algorithm was applied to the aggregated fMRI signals from both groups, which was subsequently factorized into a common time series signal dictionary matrix and the associated weight coefficient matrix. Our results demonstrate that group sparse representation can effectively identify gender differences in functional brain network during natural viewing, with improved sensitivity and reliability over ICA-based method. Group sparse representation hence offers a superior data-driven strategy for examining brain function during naturalistic conditions, with great potential for clinical application in neuropsychiatric disorders.

  20. Confounding in publications of observational intervention studies

    NARCIS (Netherlands)

    Groenwold, Rolf H. H.; Hoes, Arno W.; Hak, Eelko

    We conducted a systematic literature search in Medline to assess the proportion of observational intervention studies appreciating confounding bias in peer-reviewed medical literature from 1985 through 2005. This study shows only 9% of all papers on observational intervention studies published in

  1. STROBE initiative: guidelines on reporting observational studies.

    Science.gov (United States)

    Malta, Monica; Cardoso, Leticia Oliveira; Bastos, Francisco Inacio; Magnanini, Monica Maria Ferreira; Silva, Cosme Marcelo Furtado Passos da

    2010-06-01

    Reporting of observational studies is often inadequate, hampering the assessment of their strengths and weaknesses and, consequently, the generalization of study results. The initiative named Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) developed a checklist of 22 items, the STROBE Statement, with recommendations about what should be included in a more accurate and complete description of observational studies. Between June and December 2008, a group of Brazilian researchers was dedicated to the translation and adaptation of the STROBE Statement into Portuguese. The present study aimed to show the translation into Portuguese, introduce the discussion on the context of use, the potential and limitations of the STROBE initiative.

  2. The clinical utility of naturalistic action test in differentiating mild cognitive impairment from early dementia in memory clinic.

    Science.gov (United States)

    Bruce, Irene; Ntlholang, Ontefetse; Crosby, Lisa; Cunningham, Conal; Lawlor, Brian

    2016-03-01

    This study aimed to examine the validity of the Naturalistic Action Test in differentiating Mild Cognitive Impairment from early dementia compared to clinical diagnosis and ascertain Naturalistic Action Test cut-off points. This was a cross-sectional study of 70 consecutive patients diagnosed with Mild Cognitive Impairment attending the memory clinic in St James's Hospital, Dublin, Ireland. Patients with a diagnosis of Mild Cognitive Impairment who attended for routine annual assessment were asked to participate in the study. The Naturalistic Action Test was carried out after the patient had completed their routine assessment in the clinic. The Area under the Curve, AUC ± SE was 0.808 ± 0.058, p Test. The difference was not related to age, sex, level of education or informant. Using the Youden index, we determined a Naturalistic Action Test cut-off score of ≥11 for Mild Cognitive Impairment in our study (PPV 50%, NPV 91%, sensitivity 78%, specificity 73% and accuracy of 74%). There was discrepancy in 18 patients using the new cut-off point (≥11 for Mild Cognitive Impairment vs ≤10 for dementia). The Naturalistic Action Test is a useful tool that can increase diagnostic accuracy in differentiating Mild Cognitive Impairment from early dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Naturalist Intelligence Among the Other Multiple Intelligences [In Bulgarian

    Directory of Open Access Journals (Sweden)

    R. Genkov

    2007-09-01

    Full Text Available The theory of multiple intelligences was presented by Gardner in 1983. The theory was revised later (1999 and among the other intelligences a naturalist intelligence was added. The criteria for distinguishing of the different types of intelligences are considered. While Gardner restricted the analysis of the naturalist intelligence with examples from the living nature only, the present paper considered this problem on wider background including objects and persons of the natural sciences.

  4. Observing Protein & Energy Nutrition (OPEN) Study

    Science.gov (United States)

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  5. STRengthening analytical thinking for observational studies

    DEFF Research Database (Denmark)

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G.

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many...

  6. Matching reality in the arts: self-referential neural processing of naturalistic compared to surrealistic images.

    Science.gov (United States)

    Silveira, Sarita; Graupmann, Verena; Frey, Dieter; Blautzik, Janusch; Meindl, Thomas; Reiser, Maximilian; Chen, Cheng; Wang, Yizhou; Bao, Yan; PöppeI, Ernst; Gutyrchik, Evgeny

    2012-01-01

    How are works of art that present scenes that match potential expectations processed in the brain, in contrast to such scenes that can never occur in real life because they would violate physical laws? Using functional magnetic resonance imaging, we investigated the processing of surrealistic and naturalistic images in visual artworks. Looking at naturalistic paintings leads to a significantly higher activation in the visual cortex and in the precuneus. Humans apparently own a sensitive mechanism even for artistic representations of the visual world to separate the impossible from what potentially matches physical reality. The observation reported here also suggests that sensory input corresponding to a realistic representation of the visual world elicits higher self-referential processing.

  7. Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study Psicoterapia psicodramática combinada ao tratamento medicamentoso no transtorno depressivo maior: um estudo aberto e naturalístico

    Directory of Open Access Journals (Sweden)

    Elisabeth Maria Sene Costa

    2006-03-01

    Full Text Available OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria, under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression, were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.OBJETIVO: A literatura recente destaca o papel das psicoterapias no tratamento do transtorno depressivo maior. A combinação de psicoterapia e farmacoterapia apresenta os melhores resultados. Vários tipos de psicoterapias têm sido estudados no tratamento dos transtornos depressivos; no entanto, existem poucos dados sobre a psicoterapia

  8. Lazzaro Spallanzani e os fósseis: das observações em viagens naturalísticas ao ensino de história natural Lazzaro Spallanzani and fossils: from a naturalist's travel observations to the teaching of natural history

    Directory of Open Access Journals (Sweden)

    Maria Elice Brzezinski Prestes

    2011-12-01

    Full Text Available Analisa opiniões do naturalista italiano Lazzaro Spallanzani sobre a origem e a constituição dos fósseis por ocasião de três de suas viagens naturalísticas, entremeadas a três cursos de mineralogia da disciplina de história natural que lecionou na Universidade de Pavia. Essas viagens, para Portovenere, ilha Cerigo e Duas Sicílias, permitiram que abordasse temas importantes, como a descoberta de conchas fósseis no interior de rochas vulcânicas, a de fósseis humanos, e a existência de fósseis de espécies que 'se perderam', incorporando conhecimentos que se desenvolviam na época, com base na química mineralógica. Sua preocupação com os fósseis testemunha o modo como, ao estilo do século XVIII, Spallanzani integrava os estudos dos três reinos da natureza.This article analyzes opinions expressed by Italian naturalist Lazzaro Spallanzani on the origin and constitution of fossils on three of his travels, which punctuated three courses in mineralogy he gave in the natural history discipline at the University of Pavia. These trips to Portovenere, the island of Cerigo and the Two Sicilies enabled him to address important topics, such as the discovery of fossilized shells inside volcanic rocks, the discovery of human fossils, and the existence of fossils of species that had 'been lost', incorporating knowledge being developed at the time that drew on mineral chemistry. His concern with fossils is demonstrative of how Spallanzani, in true eighteenth century fashion, integrated studies from the three kingdoms of nature.

  9. The Alberta smoke plume observation study

    Science.gov (United States)

    Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

    2018-02-01

    A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at datamart" target="_blank">http://cwfis.cfs.nrcan.gc.ca/datamart.

  10. The Alberta smoke plume observation study

    Directory of Open Access Journals (Sweden)

    K. Anderson

    2018-02-01

    Full Text Available A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS. Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018 at http://cwfis.cfs.nrcan.gc.ca/datamart.

  11. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed rec...

  12. Visual Sensory and Visual-Cognitive Function and Rate of Crash and Near-Crash Involvement Among Older Drivers Using Naturalistic Driving Data

    OpenAIRE

    Huisingh, Carrie; Levitan, Emily B.; Irvin, Marguerite R.; MacLennan, Paul; Wadley, Virginia; Owsley, Cynthia

    2017-01-01

    Purpose An innovative methodology using naturalistic driving data was used to examine the association between visual sensory and visual-cognitive function and rates of future crash or near-crash involvement among older drivers. Methods The Strategic Highway Research Program (SHRP2) Naturalistic Driving Study was used for this prospective analysis. The sample consisted of N = 659 drivers aged ?70 years and study participation lasted 1 or 2 years for most participants. Distance and near visual ...

  13. Religiosity and religious delusions in schizophrenia - An observational study in a Hindu population.

    Science.gov (United States)

    Mishra, Anand; Das, Basudeb; Goyal, Nishant

    2018-02-01

    Religion exerts a significant effect on the lives of many individuals including people with mental illness. As evidences keep accumulating, role of religion in mental illness is gaining importance. The study was designed to study the effects of religiosity on religious delusions, its presentation, acute course and outcome in schizophrenia. The study was a naturalistic observational study. Subjects with schizophrenia were grouped into those with religious (RG) and with non-religious delusions (NG). Their premorbid religiosity was assessed with Brief Multi-dimensional measurement of Religiosity/spirituality (BMMRS) and were rated on Scale for Assessment of Positive Symptoms (SAPS), Brown's Assessment of Belief Scale (BABS) and Positive and Negative Symptom Scale (PANSS) at baseline and 4 weeks. Scores on private religious practices, baseline scores of SAPS, BABS & PANSS and duration of untreated psychosis (DUP) were significantly higher for RG in comparison to NG. On component analysis, higher scores were seen on private praying, watching religious programs on TV, reading religious books and prayers at meals. But no significant correlation was found between the private religious practices and the baseline scores of (DUP), SAPS, BABS, PANSS and outcome measure. Also no significant difference was noted in measures of improvement between groups. Private religious practices are more prominent in patients of schizophrenia with religious delusions and this group of patient seems to present with a more severe illness, and a longer duration of untreated psychosis in comparison to those with non-religious delusions. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Statistical challenges in observational cohort studies

    NARCIS (Netherlands)

    Hof, M.H.P.

    2015-01-01

    For over a century observational cohort studies have been used to study determinants of health and disease. Within a sample from the population, we can determine the relation between health outcomes (e.g. death) and a broad range of factors as genetic markers, environmental exposures, and lifestyle

  15. Dynamics of brain activity underlying working memory for music in a naturalistic condition

    OpenAIRE

    Burunat Pérez, Iballa

    2012-01-01

    Working memory (WM) is at the core of any cognitive function as it is necessary for the integration of information over time. Despite WM’s critical role in high-level cognitive functions, its implementation in the neural tissue is poorly understood. Preliminary studies on auditory WM show differences between linguistic and musical memory, leading to the speculation of specific neural networks encoding memory for music. Moreover, in neuroscience WM has not been studied in naturalistic listenin...

  16. Antipsychotic monotherapy and polypharmacy in the naturalistic treatment of schizophrenia with atypical antipsychotics

    Directory of Open Access Journals (Sweden)

    Correll Christoph

    2005-05-01

    polypharmacy for prolonged periods is very common during the treatment of schizophrenia patients in usual care settings. In addition, in this non-randomized naturalistic observational study, the most commonly used atypical antipsychotics significantly differed on the rate and duration of antipsychotic monotherapy. Reasons for and the impact of the predominant use of polypharmacy will require further study.

  17. Using naturalistic driving data to identify variables associated with infrequent, occasional, and consistent seat belt use.

    Science.gov (United States)

    Reagan, Ian J; McClafferty, Julie A; Berlin, Sharon P; Hankey, Jonathan M

    2013-01-01

    Seat belt use is one of the most effective countermeasures to reduce traffic fatalities and injuries. The success of efforts to increase use is measured by road side observations and self-report questionnaires. These methods have shortcomings, with the former requiring a binary point estimate and the latter being subjective. The 100-car naturalistic driving study presented a unique opportunity to study seat belt use in that seat belt status was known for every trip each driver made during a 12-month period. Drivers were grouped into infrequent, occasional, or consistent seat belt users based on the frequency of belt use. Analyses were then completed to assess if these groups differed on several measures including personality, demographics, self-reported driving style variables as well as measures from the 100-car study instrumentation suite (average trip speed, trips per day). In addition, detailed analyses of the occasional belt user group were completed to identify factors that were predictive of occasional belt users wearing their belts. The analyses indicated that consistent seat belt users took fewer trips per day, and that increased average trip speed was associated with increased belt use among occasional belt users. The results of this project may help focus messaging efforts to convert occasional and inconsistent seat belt users to consistent users. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Naturalistic music and dance: Cortical phase synchrony in musicians and dancers.

    Science.gov (United States)

    Poikonen, Hanna; Toiviainen, Petri; Tervaniemi, Mari

    2018-01-01

    Expertise in music has been investigated for decades and the results have been applied not only in composition, performance and music education, but also in understanding brain plasticity in a larger context. Several studies have revealed a strong connection between auditory and motor processes and listening to and performing music, and music imagination. Recently, as a logical next step in music and movement, the cognitive and affective neurosciences have been directed towards expertise in dance. To understand the versatile and overlapping processes during artistic stimuli, such as music and dance, it is necessary to study them with continuous naturalistic stimuli. Thus, we used long excerpts from the contemporary dance piece Carmen presented with and without music to professional dancers, musicians, and laymen in an EEG laboratory. We were interested in the cortical phase synchrony within each participant group over several frequency bands during uni- and multimodal processing. Dancers had strengthened theta and gamma synchrony during music relative to silence and silent dance, whereas the presence of music decreased systematically the alpha and beta synchrony in musicians. Laymen were the only group of participants with significant results related to dance. Future studies are required to understand whether these results are related to some other factor (such as familiarity to the stimuli), or if our results reveal a new point of view to dance observation and expertise.

  19. Safety implications of infotainment system use in naturalistic driving.

    Science.gov (United States)

    Perez, Miguel A

    2012-01-01

    The use of a radio while driving has long been considered a "threshold" of distraction that is socially acceptable although it may be a factor in some crashes and near crashes. This "social acceptance" has prompted the use of radio tasks, specifically radio tuning, as "references" that should not be exceeded by other secondary and tertiary tasks that make their way into the vehicle. As new functions make their way into vehicle radios (or more advanced infotainment systems), however, it is possible that radio tasks may become distracting to a level that surpasses current driver expectations. This investigation examines the naturalistic usage of several advanced infotainment systems and examines whether usage is associated first with changes in near crash occurrence and second with changes in driving behavior. Little association was found with near crashes: 5 of 46 near crash events observed in the dataset exhibited infotainment system use. Drivers involved in infotainment system use during near crashes, however, did exhibit distinct glance behaviors, generally suggesting lower levels of awareness about their driving environment. Initial analyses of a larger dataset appear to confirm these findings.

  20. New analysis tools for observational studies

    NARCIS (Netherlands)

    Landewé, R. B. M.

    2015-01-01

    Observational studies, which are very common in rheumatology, usually follow a selected group of patients for a predetermined period of time, or infinitely, with regard to a certain outcome. Such an outcome could be a "score" reflecting an important aspect of the disease (e.g., a disease activity

  1. Accurate referential communication and its relation with private and social speech in a naturalistic context.

    Science.gov (United States)

    Girbau, Dolors; Boada, Humbert

    2004-11-01

    Research into human communication has been grouped under two traditions: referential and sociolinguistic. The study of a communication behavior simultaneously from both paradigms appears to be absent. Basically, this paper analyzes the use of private and social speech, through both a referential task (Word Pairs) and a naturalistic dyadic setting (Lego-set) administered to a sample of 64 children from grades 3 and 5. All children, of 8 and 10 years of age, used speech that was not adapted to the decoder, and thus ineffective for interpersonal communication, in both referential and sociolinguistic communication. Pairs of high-skill referential encoders used significantly more task-relevant social speech, that is, cognitively more complex, than did low-skill dyads in the naturalistic context. High-skill referential encoder dyads showed a trend to produce more inaudible private speech than did low-skill ones during spontaneous communication. Gender did not affect the results.

  2. fMRI Validation of fNIRS Measurements During a Naturalistic Task.

    Science.gov (United States)

    Noah, J Adam; Ono, Yumie; Nomoto, Yasunori; Shimada, Sotaro; Tachibana, Atsumichi; Zhang, Xian; Bronner, Shaw; Hirsch, Joy

    2015-06-15

    We present a method to compare brain activity recorded with near-infrared spectroscopy (fNIRS) in a dance video game task to that recorded in a reduced version of the task using fMRI (functional magnetic resonance imaging). Recently, it has been shown that fNIRS can accurately record functional brain activities equivalent to those concurrently recorded with functional magnetic resonance imaging for classic psychophysical tasks and simple finger tapping paradigms. However, an often quoted benefit of fNIRS is that the technique allows for studying neural mechanisms of complex, naturalistic behaviors that are not possible using the constrained environment of fMRI. Our goal was to extend the findings of previous studies that have shown high correlation between concurrently recorded fNIRS and fMRI signals to compare neural recordings obtained in fMRI procedures to those separately obtained in naturalistic fNIRS experiments. Specifically, we developed a modified version of the dance video game Dance Dance Revolution (DDR) to be compatible with both fMRI and fNIRS imaging procedures. In this methodology we explain the modifications to the software and hardware for compatibility with each technique as well as the scanning and calibration procedures used to obtain representative results. The results of the study show a task-related increase in oxyhemoglobin in both modalities and demonstrate that it is possible to replicate the findings of fMRI using fNIRS in a naturalistic task. This technique represents a methodology to compare fMRI imaging paradigms which utilize a reduced-world environment to fNIRS in closer approximation to naturalistic, full-body activities and behaviors. Further development of this technique may apply to neurodegenerative diseases, such as Parkinson's disease, late states of dementia, or those with magnetic susceptibility which are contraindicated for fMRI scanning.

  3. 'Who's a good boy?!' Dogs prefer naturalistic dog-directed speech.

    Science.gov (United States)

    Benjamin, Alex; Slocombe, Katie

    2018-05-01

    Infant-directed speech (IDS) is a special speech register thought to aid language acquisition and improve affiliation in human infants. Although IDS shares some of its properties with dog-directed speech (DDS), it is unclear whether the production of DDS is functional, or simply an overgeneralisation of IDS within Western cultures. One recent study found that, while puppies attended more to a script read with DDS compared with adult-directed speech (ADS), adult dogs displayed no preference. In contrast, using naturalistic speech and a more ecologically valid set-up, we found that adult dogs attended to and showed more affiliative behaviour towards a speaker of DDS than of ADS. To explore whether this preference for DDS was modulated by the dog-specific words typically used in DDS, the acoustic features (prosody) of DDS or a combination of the two, we conducted a second experiment. Here the stimuli from experiment 1 were produced with reversed prosody, meaning the prosody and content of ADS and DDS were mismatched. The results revealed no significant effect of speech type, or content, suggesting that it is maybe the combination of the acoustic properties and the dog-related content of DDS that modulates the preference shown for naturalistic DDS. Overall, the results of this study suggest that naturalistic DDS, comprising of both dog-directed prosody and dog-relevant content words, improves dogs' attention and may strengthen the affiliative bond between humans and their pets.

  4. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies

    OpenAIRE

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study’s generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-contro...

  5. Assessment of naturalistic use patterns of advanced infotainment systems.

    Science.gov (United States)

    Perez, Miguel A; Angell, Linda S; Hankey, Jonathan M

    2015-06-01

    The objective was to examine naturalistic usage of infotainment systems to assess use characteristics and patterns. Infotainment systems continue to evolve in terms of their capabilities and information availability, raising concerns about their distraction potential. Assessing potential distraction requires understanding how challenging different tasks are and how frequently they occur during driving. High-end infotainment system use was observed across 17 participants over a period of approximately 4 weeks each. One of two different infotainment systems was provided to participants. Audio, video, and driving performance data were collected and observed by trained reductionists. The two infotainment systems integrated iPod™, satellite radio, CD/DVD/MP3 playback, AM/FM, and, in one case, navigation functionalities. Systems differed in their vehicle integration and advanced infotainment features offered. The median participant interacted with the infotainment systems once every 4 hr (90th percentile: 6.1 interactions/hr). More than 50% of these interactions involved adjusting the volume. Although there were a few lengthy interactions, the median duration was 2.2 s (90th percentile: 24.6 s), which required measurable visual involvement when compared to a matched baseline. The median total eyes-off-road time across interactions was 1 s (90th percentile: 11.4 s) and differed significantly across type of system interaction. Longer interactions tended to occur when the vehicle was stationary. Drivers habitually interact with infotainment systems while driving; this includes advanced functions. Some self-regulation was observed. These data provide a comparison basis for use in examining driver interactions with future infotainment systems. © 2014, Human Factors and Ergonomics Society.

  6. Use of synchrotron tomography to image naturalistic anatomy in insects

    Science.gov (United States)

    Socha, John J.; De Carlo, Francesco

    2008-08-01

    Understanding the morphology of anatomical structures is a cornerstone of biology. For small animals, classical methods such as histology have provided a wealth of data, but such techniques can be problematic due to destruction of the sample. More importantly, fixation and physical slicing can cause deformation of anatomy, a critical limitation when precise three-dimensional data are required. Modern techniques such as confocal microscopy, MRI, and tabletop x-ray microCT provide effective non-invasive methods, but each of these tools each has limitations including sample size constraints, resolution limits, and difficulty visualizing soft tissue. Our research group at the Advanced Photon Source (Argonne National Laboratory) studies physiological processes in insects, focusing on the dynamics of breathing and feeding. To determine the size, shape, and relative location of internal anatomy in insects, we use synchrotron microtomography at the beamline 2-BM to image structures including tracheal tubes, muscles, and gut. Because obtaining naturalistic, undeformed anatomical information is a key component of our studies, we have developed methods to image fresh and non-fixed whole animals and tissues. Although motion artifacts remain a problem, we have successfully imaged multiple species including beetles, ants, fruit flies, and butterflies. Here we discuss advances in biological imaging and highlight key findings in insect morphology.

  7. Pathways towards different long-term outcomes after naturalistic psychotherapy.

    Science.gov (United States)

    Ekroll, Vidar Blokhus; Rønnestad, Michael Helge

    2018-03-01

    This study suggests some potential pathways leading towards maintained gains or further growth versus deterioration after naturalistic psychotherapy with experienced clinicians. This is explored in a way that transcends specific theoretical orientations. Sixteen therapies, all showing reliable improvement on Outcome Questionnaire 45.2 (OQ-45) at treatment termination but varying in later post-therapy development, were included in this study. Building on previous content and correlational analyses, individual cases were explored qualitatively in search for developmental patterns of potential relevance for long-term outcome. Patterns re-emerging across several cases were described in light of the OQ-45 trajectories of clients providing them. Six pathways, associated with different long-term outcomes, emerged. Four of these, "Reflective route towards regulation of affects," "Gaining autonomy through a secure holding relationship," "Opening up as a new relational/emotional experience," and "Lasting acceptance of «reality»," re-emerged in clients showing maintained/growing treatment effects. Two pathways, entitled "Residual problems grow and overshadow progress" and "Core problems remain beneath superficial change," seemed linked to deterioration after termination of therapy. We suggest the former pathways as some possible routes towards enduring good outcome, and the latter as some patterns to avoid when trying to secure therapy gains will not be only temporary. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Ozone Lidar Observations for Air Quality Studies

    Science.gov (United States)

    Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.; hide

    2015-01-01

    Tropospheric ozone lidars are well suited to measuring the high spatio-temporal variability of this important trace gas. Furthermore, lidar measurements in conjunction with balloon soundings, aircraft, and satellite observations provide substantial information about a variety of atmospheric chemical and physical processes. Examples of processes elucidated by ozone-lidar measurements are presented, and modeling studies using WRF-Chem, RAQMS, and DALES/LES models illustrate our current understanding and shortcomings of these processes.

  9. Language differences in the brain network for reading in naturalistic story reading and lexical decision.

    Directory of Open Access Journals (Sweden)

    Xiaojuan Wang

    Full Text Available Differences in how writing systems represent language raise important questions about whether there could be a universal functional architecture for reading across languages. In order to study potential language differences in the neural networks that support reading skill, we collected fMRI data from readers of alphabetic (English and morpho-syllabic (Chinese writing systems during two reading tasks. In one, participants read short stories under conditions that approximate natural reading, and in the other, participants decided whether individual stimuli were real words or not. Prior work comparing these two writing systems has overwhelmingly used meta-linguistic tasks, generally supporting the conclusion that the reading system is organized differently for skilled readers of Chinese and English. We observed that language differences in the reading network were greatly dependent on task. In lexical decision, a pattern consistent with prior research was observed in which the Middle Frontal Gyrus (MFG and right Fusiform Gyrus (rFFG were more active for Chinese than for English, whereas the posterior temporal sulcus was more active for English than for Chinese. We found a very different pattern of language effects in a naturalistic reading paradigm, during which significant differences were only observed in visual regions not typically considered specific to the reading network, and the middle temporal gyrus, which is thought to be important for direct mapping of orthography to semantics. Indeed, in areas that are often discussed as supporting distinct cognitive or linguistic functions between the two languages, we observed interaction. Specifically, language differences were most pronounced in MFG and rFFG during the lexical decision task, whereas no language differences were observed in these areas during silent reading of text for comprehension.

  10. Language differences in the brain network for reading in naturalistic story reading and lexical decision.

    Science.gov (United States)

    Wang, Xiaojuan; Yang, Jianfeng; Yang, Jie; Mencl, W Einar; Shu, Hua; Zevin, Jason David

    2015-01-01

    Differences in how writing systems represent language raise important questions about whether there could be a universal functional architecture for reading across languages. In order to study potential language differences in the neural networks that support reading skill, we collected fMRI data from readers of alphabetic (English) and morpho-syllabic (Chinese) writing systems during two reading tasks. In one, participants read short stories under conditions that approximate natural reading, and in the other, participants decided whether individual stimuli were real words or not. Prior work comparing these two writing systems has overwhelmingly used meta-linguistic tasks, generally supporting the conclusion that the reading system is organized differently for skilled readers of Chinese and English. We observed that language differences in the reading network were greatly dependent on task. In lexical decision, a pattern consistent with prior research was observed in which the Middle Frontal Gyrus (MFG) and right Fusiform Gyrus (rFFG) were more active for Chinese than for English, whereas the posterior temporal sulcus was more active for English than for Chinese. We found a very different pattern of language effects in a naturalistic reading paradigm, during which significant differences were only observed in visual regions not typically considered specific to the reading network, and the middle temporal gyrus, which is thought to be important for direct mapping of orthography to semantics. Indeed, in areas that are often discussed as supporting distinct cognitive or linguistic functions between the two languages, we observed interaction. Specifically, language differences were most pronounced in MFG and rFFG during the lexical decision task, whereas no language differences were observed in these areas during silent reading of text for comprehension.

  11. The effect of visual and musical suspense on brain activation and memory during naturalistic viewing.

    Science.gov (United States)

    Bezdek, Matthew A; Wenzel, William G; Schumacher, Eric H

    2017-10-01

    We tested the hypothesis that, during naturalistic viewing, moments of increasing narrative suspense narrow the scope of attentional focus. We also tested how changes in the emotional congruency of the music would affect brain responses to suspense, as well as subsequent memory for narrative events. In our study, participants viewed suspenseful film excerpts while brain activation was measured with functional magnetic resonance imaging. Results indicated that suspense produced a pattern of activation consistent with the attention-narrowing hypothesis. For example, we observed decreased activation in the anterior calcarine sulcus, which processes the visual periphery, and increased activity in nodes of the ventral attention network and decreased activity in nodes of the default mode network. Memory recall was more accurate for high suspense than low suspense moments, but did not differ by soundtrack congruency. These findings provide neural evidence that perceptual, attentional, and memory processes respond to suspense on a moment-by-moment basis. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Getting Real: A Naturalistic Methodology for Using Smartphones to Collect Mediated Communications

    Directory of Open Access Journals (Sweden)

    Chad C. Tossell

    2012-01-01

    Full Text Available This paper contributes an intentionally naturalistic methodology using smartphone logging technology to study communications in the wild. Smartphone logging can provide tremendous access to communications data from real environments. However, researchers must consider how it is employed to preserve naturalistic behaviors. Nine considerations are presented to this end. We also provide a description of a naturalistic logging approach that has been applied successfully to collecting mediated communications from iPhones. The methodology was designed to intentionally decrease reactivity and resulted in data that were more accurate than self-reports. Example analyses are also provided to show how data collected can be analyzed to establish empirical patterns and identify user differences. Smartphone logging technologies offer flexible capabilities to enhance access to real communications data, but methodologies employing these techniques must be designed appropriately to avoid provoking naturally occurring behaviors. Functionally, this methodology can be applied to establish empirical patterns and test specific hypotheses within the field of HCI research. Topically, this methodology can be applied to domains interested in understanding mediated communications such as mobile content and systems design, teamwork, and social networks.

  13. Aesthetic perception and its minimal content: a naturalistic perspective

    Directory of Open Access Journals (Sweden)

    Ioannis eXenakis

    2014-09-01

    Full Text Available Aesthetic perception is one of the most interesting topics for philosophers and scientists who investigate how it influences our interactions with objects and states of affairs. Over the last few years, several studies have attempted to determine how aesthetics is represented in an object, and how a specific feature of an object could evoke the respective feelings during perception. Despite the vast number of approaches and models, we believe that these explanations do not resolve the problem concerning the conditions under which aesthetic perception occurs, and what constitutes the content of these perceptions. Adopting a naturalistic perspective, we here view aesthetic perception as a normative process that enables agents to enhance their interactions with physical and socio-cultural environments. Considering perception as an anticipatory and preparatory process of detection and evaluation of indications of potential interactions (what we call ‘interactive affordances’, we argue that the minimal content of aesthetic perception is an emotionally valued indication of interaction potentiality. Aesthetic perception allows an agent to normatively anticipate interaction potentialities, thus increasing sense making and reducing the uncertainty of interaction. This conception of aesthetic perception is compatible with contemporary evidence from neuroscience, experimental aesthetics, and interaction design. The proposed model overcomes several problems of transcendental, art-centered, and objective aesthetics as it offers an alternative to the idea of aesthetic objects that carry inherent values by explaining ‘the aesthetic’ as emergent in perception within a context of uncertain interaction.

  14. The use of navigation systems in naturalistic driving.

    Science.gov (United States)

    Knapper, Allert; Van Nes, Nicole; Christoph, Michiel; Hagenzieker, Marjan; Brookhuis, Karel

    2016-01-01

    In this study, we assessed the use of portable navigation systems in everyday driving by applying in-vehicle naturalistic driving. Experienced users of navigation systems, 7 females and 14 males, were provided with a specially equipped vehicle for approximately 1 month. Their trips were recorded using 4 cameras, Global Positioning System (GPS) data, and other sensor data. The drivers' navigation system use data were coded from the video recordings, which showed how often and for how long the system was activated and how often and for how long a driver operated the system. The system was activated for 23% of trips, predominantly on longer and unique trips. Analyses of the percentage of time for which the speed limit was exceeded showed no evidence of differences between trips for which the navigation system was used or not used. On trips for which the navigation system was activated, participants spent about 5% of trip time interacting with the device. About 40% of interacting behavior took place in the first 10% of the trip time, and about 35% took place while the car was standing still or moving at a very low speed; that is, 0-10 km/h. These results shed light on how and when drivers use navigation systems. They suggest that although drivers regulate their use of such systems to some extent, they often perform risky tasks while driving.

  15. Naturalistic Usability Testing of Inpatient Medication Reconciliation Software.

    Science.gov (United States)

    Lesselroth, Blake; Adams, Kathleen; Tallett, Stephanie; Ong, Lindsay; Bliss, Susan; Ragland, Scott; Tran, Hanna; Church, Victoria

    2017-01-01

    Medication history errors are common at admission, but can be mitigated through the implementation of medication reconciliation (MR). We designed multi-media software to assist clinicians with collection of an admission history. This manuscript describes a naturalistic usability study conducted on the hospital wards. Our goals were to 1) estimate the impact of our workflow upon departmental productivity and 2) determine the ability of our software to detect discrepancies. We furnished clinical pharmacists with our application on a tablet PC and asked them to collect a bedside history. We used 1) time-motion analysis to estimate cycle-time and 2) chart reviews to estimate error detection rates. Our intervention detected an average of 7.7 discrepancies per admission (11.7 per pharmacy-shift). A panel rated 67% of these discrepancies as 'high' or 'very high' risk. The cycle-time per admission was slightly longer than usual care processes (20.5 min vs. 17.9 min), but included a bedside interview. In general, pharmacists agreed that the technology improved the completeness and accuracy of a medication history. However, workflow leveling strategies are important to implementing a durable process. In conclusion, a pharmacist-mediated, patient-centered technology holds promise for improving the quality of MR and overall clinical performance.

  16. iPad® Use in Children and Young Adults with Autism Spectrum Disorder: An Observational Study

    Science.gov (United States)

    King, Amie M.; Thomeczek, Melissa; Voreis, Grayce; Scott, Victoria

    2014-01-01

    This exploratory study was conducted to describe how children and young adults with autism spectrum disorder (ASD) are currently using iPads® and applications, to explore the role of education professionals on iPad® and application use, and to determine potential research needs regarding iPad® use in children with ASD. Naturalistic observations…

  17. The NOAA Satellite Observing System Architecture Study

    Science.gov (United States)

    Volz, Stephen; Maier, Mark; Di Pietro, David

    2016-01-01

    NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

  18. Quality of Childcare and Otitis Media: Relationship to Children's Language during Naturalistic Interactions at 18, 24, and 36 Months

    Science.gov (United States)

    Vernon-Feagans, Lynne; Hurley, Megan M.; Yont, Kristine M.; Wamboldt, Patricia M.; Kolak, Amy

    2007-01-01

    The purpose of this study was to examine the relationship between the quality of childcare and experience with otitis media (middle ear disease) as they relate to children's early naturalistic language development. Sixty children were followed longitudinally from childcare entry in the first year of life until three years of age. Half the children…

  19. Expert analogy use in a naturalistic setting

    Science.gov (United States)

    Kretz, Donald R.; Krawczyk, Daniel C.

    2014-01-01

    The use of analogy is an important component of human cognition. The type of analogy we produce and communicate depends heavily on a number of factors, such as the setting, the level of domain expertise present, and the speaker's goal or intent. In this observational study, we recorded economics experts during scientific discussion and examined the categorical distance and structural depth of the analogies they produced. We also sought to characterize the purpose of the analogies that were generated. Our results supported previous conclusions about the infrequency of superficial similarity in subject-generated analogs, but also showed that distance and depth characteristics were more evenly balanced than in previous observational studies. This finding was likely due to the nature of the goals of the participants, as well as the broader nature of their expertise. An analysis of analogical purpose indicated that the generation of concrete source examples of more general target concepts was most prevalent. We also noted frequent instances of analogies intended to form visual images of source concepts. Other common purposes for analogies were the addition of colorful speech, inclusion (i.e., subsumption) of a target into a source concept, or differentiation between source and target concepts. We found no association between depth and either of the other two characteristics, but our findings suggest a relationship between purpose and distance; i.e., that visual imagery typically entailed an outside-domain source whereas exemplification was most frequently accomplished using within-domain analogies. Overall, we observed a rich and diverse set of spontaneously produced analogical comparisons. The high degree of expertise within the observed group along with the richly comparative nature of the economics discipline likely contributed to this analogical abundance. PMID:25505437

  20. Expert Analogy Use in a Naturalistic Setting

    Directory of Open Access Journals (Sweden)

    Donald R Kretz

    2014-11-01

    Full Text Available The use of analogy is an important component of human cognition. The type of analogy we produce and communicate depends heavily on a number of factors, such as the setting, the level of domain expertise present, and the speaker’s goal or intent. In this observational study, we recorded economics experts during scientific discussion and examined the categorical distance and structural depth of the analogies they produced. We also sought to characterize the purpose of the analogies that were generated. Our results supported previous conclusions about the infrequency of superficial similarity in subject-generated analogs, but also showed that distance and depth characteristics were more evenly balanced than in previous observational studies. This finding was likely due to the nature of the goals of the participants, as well as the broader nature of their expertise. An analysis of analogical purpose indicated that the generation of concrete source examples of more general target concepts was most prevalent. We also noted frequent instances of analogies intended to form visual images of source concepts. Other common purposes for analogies were the addition of colorful speech, inclusion (i.e., subsumption of a target into a source concept, or differentiation between source and target concepts. We found no association between depth and either of the other two characteristics, but our findings suggest a relationship between purpose and distance; i.e., that visual imagery typically entailed an outside-domain source whereas exemplification was most frequently accomplished using within-domain analogies. Overall, we observed a rich and diverse set of spontaneously produced analogical comparisons. The high degree of expertise within the observed group along with the richly comparative nature of the economics discipline likely contributed to this analogical abundance.

  1. A three-dimensional spatiotemporal receptive field model explains responses of area MT neurons to naturalistic movies

    Science.gov (United States)

    Nishimoto, Shinji; Gallant, Jack L.

    2012-01-01

    Area MT has been an important target for studies of motion processing. However, previous neurophysiological studies of MT have used simple stimuli that do not contain many of the motion signals that occur during natural vision. In this study we sought to determine whether views of area MT neurons developed using simple stimuli can account for MT responses under more naturalistic conditions. We recorded responses from macaque area MT neurons during stimulation with naturalistic movies. We then used a quantitative modeling framework to discover which specific mechanisms best predict neuronal responses under these challenging conditions. We find that the simplest model that accurately predicts responses of MT neurons consists of a bank of V1-like filters, each followed by a compressive nonlinearity, a divisive nonlinearity and linear pooling. Inspection of the fit models shows that the excitatory receptive fields of MT neurons tend to lie on a single plane within the three-dimensional spatiotemporal frequency domain, and suppressive receptive fields lie off this plane. However, most excitatory receptive fields form a partial ring in the plane and avoid low temporal frequencies. This receptive field organization ensures that most MT neurons are tuned for velocity but do not tend to respond to ambiguous static textures that are aligned with the direction of motion. In sum, MT responses to naturalistic movies are largely consistent with predictions based on simple stimuli. However, models fit using naturalistic stimuli reveal several novel properties of MT receptive fields that had not been shown in prior experiments. PMID:21994372

  2. Naturalists in a Nutshell: 90 Minute Biographies of Eminent Scientists

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 11. Naturalists in a Nutshell: 90 Minute Biographies of Eminent Scientists ... Author Affiliations. S Mahadevan1. Department of Molecular Reproduction, Development, and Genetics, Indian Institute of Science, Bangaloft 560 012, India.

  3. Naturalistic Inquiry: Future Research Directions for the Classroom Teacher.

    Science.gov (United States)

    Enochs, Larry G.; Hortin, John A.

    1985-01-01

    If the education profession is to improve, the gap between educational research and the classroom teacher must be narrowed. Most educational theory is based on empirical research generated by logical deduction, but naturalistic research provides more innovative and flexible methods for collecting explanations of learning behavior. (MT)

  4. But is it Rigorous? Trustworthiness and Authenticity in Naturalistic Evaluation.

    Science.gov (United States)

    Lincoln, Yvonna S.; Guba, Egon G.

    1986-01-01

    The emergence of a new, naturalistic, paradigm of inquiry has led to a demand for rigorous criteria that meet traditional standards of inquiry. Two sets are suggested, one of which, the "trustworthiness" criteria, parallels conventional criteria, while the second, "authenticity" criteria, is implied directly by new paradigm…

  5. Agomelatine in the treatment of depressive disorders in clinical practice: multicenter observational CHRONOS study

    Directory of Open Access Journals (Sweden)

    Ivanov SV

    2014-04-01

    Full Text Available Stanislav V Ivanov, Marina A Samushiya Department of “Borderline” Mental Pathology and Psychosomatic Disorders, Mental Health Research Center of the Russian Academy of Medical Science, Moscow, Russian Federation Background: CHRONOS was a large naturalistic study designed to evaluate the effectiveness and safety of agomelatine in the management of patients with major depression in routine clinical practice. Methods: Patients (n=6,276 with a moderate or severe major depressive episode without psychotic symptoms were treated initially as outpatients (80.2% or in psychiatric facilities (19.8% in 54 regions of the Russian Federation. Patients received a flexible-dosing regimen of agomelatine 25 mg or 50 mg once daily for 8 weeks, with frequent study visits (weeks 1, 2, 3, 4, 6, and 8. Results: Patients (mean age 44 years, 72.6% female showed progressive improvement on the 17-item Hamilton Rating Scale for Depression (HAMD-17 total score from 22±6.9 at baseline to 4.7±4.7 at week 8 (P<0.0001. The proportion of responders (HAMD-17 decrease of ≥50% was 90.1% and the proportion of remitters (HAMD-17 <7 was 79.1% at week 8. All individual HAMD-17 item scores improved rapidly, and the change relative to baseline was significant (P<0.0001 at week 1 and at each subsequent visit in all cases. There were corresponding rapid improvements in Clinical Global Impression Severity and Improvement scores. In the subgroup of patients with more severe illness (HAMD-17 ≥21 at baseline; n=3,478, the proportions of responders and remitters were 92.4% and 72.8%, respectively, at week 8. Conclusion: Agomelatine was effective and well tolerated in a large sample of depressed patients in an observational treatment setting, and showed a rapid onset of benefit across all HAMD-17 items. Keywords: agomelatine, antidepressant, Hamilton Rating Scale for Depression, major depressive disorder, observational study

  6. Globular Cluster Tidal Streams: An Observational Study

    Science.gov (United States)

    Powell, William L.; Lauchner, A.; Wilhelm, R.; McWilliam, A.

    2006-12-01

    Globular cluster tidal streams are of interest for what they can tell us of the dynamical evolution of the clusters and of our Galaxy. Recent studies have used photometric and statistical subtraction methods to attempt to separate potential streams from the field stars that contaminate the samples. We chose instead as our primary method to use photometry to select blue stars that match the horizontal branch of the clusters. We then make spectroscopic observations of these candidates to determine their metallicity and radial velocities. Combining these results with the photometric data offers a better picture of the structure and validity of tidal streams. We present photometric and spectroscopic results for several globular clusters and their surrounding fields. Data were obtained at McDonald Observatory, Kitt Peak, and Las Campanas Observatory. SDSS data were also used. WLP acknowledges the support of a Sigma Xi Grant-In-Aid of research. RW acknowledges the support of a AAS Small Research Grant.

  7. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies

    OpenAIRE

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2007-01-01

    Poor reporting of research hampers assessment and makes it less useful. An international group of methodologists, researchers, and journal editors sets out guidelines to improve reports of observational studies

  8. Atrial fibrillation: an observational study with outpatients.

    Science.gov (United States)

    Albina, Gastón; De Luca, Julián; Conde, Diego; Giniger, Alberto

    2014-11-01

    Atrial fibrillation (AF) is the most common sustained arrhythmia with serious clinical consequences in the absence of treatment. However, there are limited data on the treatment of these patients in Argentina. The objective was to describe the therapeutic management of patients with nonacute AF by Argentinean cardiologists and to determine the incidence of clinical events after 12 months follow-up. The Atrial Fibrillation study in Argentina (FARAON) was an observational, descriptive, prospective, national, and multicentric study that included outpatients with AF, followed for 12 months. The study included 38 sites in Argentina. Each researcher included the first 10 patients who met the inclusion criteria of being over 21 and also being an AF carrier documented by electrocardiogram or Holter within 12 months prior to or at the time of enrollment. A total of 373 patients were included, mean age 70 ± 11.5 years, 40% women; 65% had AF rhythm at the time of inclusion, 57% had permanent AF, and 56% were asymptomatic. At the time of enrollment, 40% of physicians opted for rhythm control strategy. β-blockers and amiodarone were the most used drugs. Patients with rhythm control drugs had higher success rate than those with frequency control drug therapy (80% vs 57%). Cardiologists in Argentina receive patients with AF that are mostly permanent AF. More than half of the patients are asymptomatic. They opt primarily by controlling the pace. When choosing antiarrhythmic drugs, nearly half of them indicated amiodarone. © 2014 Wiley Periodicals, Inc.

  9. Fasting with diabetes: a prospective observational study

    Science.gov (United States)

    Noon, Muhammad Jawad; Khawaja, Haseeb Ahmad; Ishtiaq, Osama; Khawaja, Quratulain; Minhas, Sana; Niazi, Asfandyar Khan; Minhas, Abdul Mannan Khan; Malhi, Umar Rasool

    2016-01-01

    Objectives To determine the proportion of diabetic patients who develop adverse glycaemic events when fasting regularly. Design Prospective observational study conducted at a tertiary care hospital in South Asia. Five hundred and twenty-three patients were assessed for eligibility, and 150 were included in the final analysis. Diabetic patients over 18 years of age who were willing to fast regularly and make a chart of their daily blood sugar levels were included in the study. The main outcome measures were hypoglycaemic and hyperglycaemic events. Frequencies and percentages were calculated for quantitative variables, while mean±SD were documented for qualitative variables. Relative risk was calculated as a measure of association. Results Of a total of 150 individuals, 10% experienced hypoglycaemia, while 3.3% reported hyperglycaemic episodes. Only 8.7% of the participants discontinued one or more fasts; however, none of them required hospitalisation. There is a negative association between a visit to a physician by diabetic patients before they begin to fast regularly and the risk of developing hypoglycaemia (relative risk 0.73). Conclusions Many diabetic patients who fast regularly are at high risk of adverse glycaemic events. Most diabetics do not consult their physicians before fasting to adjust medications and lifestyle. Various strategies should be planned and implemented for the awareness and education of such patients to avoid adverse glycaemic events and subsequent complications. PMID:28588932

  10. Enhancing and Calibrating the Rakha-Pasumarthy-Adjerid Car-Following Model using Naturalistic Driving Data

    Directory of Open Access Journals (Sweden)

    John D. Sangster, PE

    2014-09-01

    Full Text Available The research presented in this paper analyzes the simplified behavioral vehicle longitudinal motion model, currently implemented in the INTEGRATION software, known as the Rakha-Pasumarthy-Adjerid (RPA model. The model utilizes a steady-state formulation along with two constraints, namely: acceleration and collision avoidance. An analysis of the model using the naturalistic driving data identified a deficiency in the model formulation, in that it predicts more conservative driving behavior compared to naturalistic driving. Much of the error in simulated car-following behavior occurs when a car-following event is initiated at a spacing that is often much shorter than is desired. The observed behavior is that, rather than the following vehicle decelerating aggressively, the following vehicle coasts until the desired headway/spacing is achieved. Consequently, the model is enhanced to reflect this empirically observed behavior. Finally, a quantitative and qualitative evaluation of the original and proposed model formulations demonstrates that the proposed modification significantly decreases the modeling error and produces car-following behavior that is consistent with empirically observed driver behavior.

  11. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  12. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  13. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE statement: guidelines for reporting observational studies.

    Directory of Open Access Journals (Sweden)

    Erik von Elm

    2007-10-01

    Full Text Available Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  15. Informal schooling and problem-solving skills in second-grade science: A naturalistic investigation

    Science.gov (United States)

    Griffin, Georgia Inez Hunt

    The influence of informal schooling on the problem solving skills of urban elementary school children is unclear. The relationship between culture and problem solving can be studied using subjective methodologies, particularly when investigating problem solving strategies that are culturally situated. Yet, little research has been conducted to investigate how informal learning of African American children are integrated as part of the problem solving used in school. This study has been designed to expand the existing literature in this area. The purpose of this study is therefore to explore how 15 African American children attending school in Southwest Philadelphia solve problems presented to them in second grade science. This was accomplished by assessing their ability to observe, classify, recall, and perceive space/time relationships. Think-aloud protocols were used for this examination. A naturalistic approach to the investigation was implemented. Individual children were selected because he or she exhibited unique and subjective characteristics associated with individual approaches to problem solving. Children responded to three tasks: interviews of their parents, an essay on community gardens, and a group diorama collaboratively designed. Content analysis was used to infer themes that were evident in the children's work and that revealed the extent to which informal schooling influenced solutions to a community garden problem. The investigations did increase the researcher's ability to understand and build upon the understanding of African American children in their indigenous community. The study also demonstrated how these same strategies can be used to involve parents in the science curriculum. Additionally, the researcher gained insight on how to bridge the gap between home, community, and school.

  16. Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder.

    Science.gov (United States)

    Berk, Lesley; Hallam, Karen T; Venugopal, Kamalesh; Lewis, Andrew James; Austin, David W; Kulkarni, Jayashri; Dodd, Seetal; de Castella, Anthony; Fitzgerald, Paul B; Berk, Michael

    2017-05-01

    Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Do improvements after inpatient dialectial behavioral therapy persist in the long term? A naturalistic follow-up in patients with borderline personality disorder.

    Science.gov (United States)

    Kleindienst, Nikolaus; Limberger, Matthias F; Schmahl, Christian; Steil, Regina; Ebner-Priemer, Ulrich W; Bohus, Martin

    2008-11-01

    Three months of inpatient dialectical behavior therapy proved to be highly effective in patients with borderline personality disorder. This study investigates whether the effects of DBT persist after the patients returned to their usual lives. Thirty-one patients with a diagnosis of borderline personality disorder (DSM-IV) were prospectively followed-up for an observation period of 21 months after discharge from the DBT program, under naturalistic conditions.Improvements as observed after discharge persisted over the full follow-up period. This is reflected in a steady rate of remitted patients and in a broad range of psychopathology showing statistically and clinically significant effect-sizes ranging from 0.70 to 1.71. Analyses of courses over time revealed a high intraindividual concordance, indicating that short term treatment response predicted remission after 2 years follow-up. The effects of inpatient dialectical behavior therapy seem to persist after patients returned to their usual lives.

  18. Multicenter observational prehospital resuscitation on helicopter study.

    Science.gov (United States)

    Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

    2017-07-01

    Earlier use of in-hospital plasma, platelets, and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. Adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers were prospectively observed from January to November 2015. Five helicopter systems had plasma and/or RBCs, whereas the other four helicopter systems used only crystalloid resuscitation. All patients meeting predetermined high-risk criteria were analyzed. Patients receiving PHT were compared with patients not receiving PHT. Our primary analysis compared mortality at 3 hours, 24 hours, and 30 days, using logistic regression to adjust for confounders and site heterogeneity to model patients who were matched on propensity scores. Twenty-five thousand one hundred eighteen trauma patients were admitted, 2,341 (9%) were transported by helicopter, of which 1,058 (45%) met the highest-risk criteria. Five hundred eighty-five of 1,058 patients were flown on helicopters carrying blood products. In the systems with blood available, prehospital median systolic blood pressure (125 vs 128) and Glasgow Coma Scale (7 vs 14) was significantly lower, whereas median Injury Severity Score was significantly higher (21 vs 14). Unadjusted mortality was significantly higher in the systems with blood products available, at 3 hours (8.4% vs 3.6%), 24 hours (12.6% vs 8.9%), and 30 days (19.3% vs 13.3%). Twenty-four percent of eligible patients received a PHT. A median of 1 unit of RBCs and plasma were transfused prehospital. Of patients receiving PHT, 24% received only plasma, 7% received only RBCs, and 69% received both. In the propensity score matching analysis (n = 109), PHT was not significantly associated with mortality

  19. Century Scale Evaporation Trend: An Observational Study

    Science.gov (United States)

    Bounoui, Lahouari

    2012-01-01

    Several climate models with different complexity indicate that under increased CO2 forcing, runoff would increase faster than precipitation overland. However, observations over large U.S watersheds indicate otherwise. This inconsistency between models and observations suggests that there may be important feedbacks between climate and land surface unaccounted for in the present generation of models. We have analyzed century-scale observed annual runoff and precipitation time-series over several United States Geological Survey hydrological units covering large forested regions of the Eastern United States not affected by irrigation. Both time-series exhibit a positive long-term trend; however, in contrast to model results, these historic data records show that the rate of precipitation increases at roughly double the rate of runoff increase. We considered several hydrological processes to close the water budget and found that none of these processes acting alone could account for the total water excess generated by the observed difference between precipitation and runoff. We conclude that evaporation has increased over the period of observations and show that the increasing trend in precipitation minus runoff is correlated to observed increase in vegetation density based on the longest available global satellite record. The increase in vegetation density has important implications for climate; it slows but does not alleviate the projected warming associated with greenhouse gases emission.

  20. Functional response to cholinesterase inhibitor therapy in a naturalistic Alzheimer’s disease cohort

    Directory of Open Access Journals (Sweden)

    Wattmo Carina

    2012-11-01

    Full Text Available Abstract Background Activities of daily living (ADL are an essential part of the diagnostic criteria for Alzheimer’s disease (AD. A decline in ADL affects independent living and has a strong negative impact on caregiver burden. Functional response to cholinesterase inhibitor (ChEI treatment and factors that might influence this response in naturalistic AD patients need investigating. The aim of this study was to identify the socio-demographic and clinical factors that affect the functional response after 6 months of ChEI therapy. Methods This prospective, non-randomised, multicentre study in a routine clinical setting included 784 AD patients treated with donepezil, rivastigmine or galantamine. At baseline and after 6 months of treatment, patients were assessed using several rating scales, including the Instrumental Activities of Daily Living (IADL scale, Physical Self-Maintenance Scale (PSMS and Mini-Mental State Examination (MMSE. Demographic and clinical characteristics were investigated at baseline. The functional response and the relationships of potential predictors were analysed using general linear models. Results After 6 months of ChEI treatment, 49% and 74% of patients showed improvement/no change in IADL and in PSMS score, respectively. The improved/unchanged patients exhibited better cognitive status at baseline; regarding improved/unchanged PSMS, patients were younger and used fewer anti-depressants. A more positive functional response to ChEI was observed in younger individuals or among those having the interaction effect of better preserved cognition and lower ADL ability. Patients with fewer concomitant medications or those using NSAIDs/acetylsalicylic acid showed a better PSMS response. Conclusions Critical characteristics that may influence the functional response to ChEI in AD were identified. Some predictors differed from those previously shown to affect cognitive response, e.g., lower cognitive ability and older age

  1. Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Swartz Marvin

    2006-02-01

    Full Text Available Abstract Background There is an ongoing debate over whether atypical antipsychotics are more effective than typical antipsychotics in the treatment of schizophrenia. This naturalistic study compares atypical and typical antipsychotics on time to all-cause medication discontinuation, a recognized index of medication effectiveness in the treatment of schizophrenia. Methods We used data from a large, 3-year, observational, non-randomized, multisite study of schizophrenia, conducted in the U.S. between 7/1997 and 9/2003. Patients who were initiated on oral atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine, or ziprasidone or oral typical antipsychotics (low, medium, or high potency were compared on time to all-cause medication discontinuation for 1 year following initiation. Treatment group comparisons were based on treatment episodes using 3 statistical approaches (Kaplan-Meier survival analysis, Cox Proportional Hazards regression model, and propensity score-adjusted bootstrap resampling methods. To further assess the robustness of the findings, sensitivity analyses were performed, including the use of (a only 1 medication episode for each patient, the one with which the patient was treated first, and (b all medication episodes, including those simultaneously initiated on more than 1 antipsychotic. Results Mean time to all-cause medication discontinuation was longer on atypical (N = 1132, 256.3 days compared to typical antipsychotics (N = 534, 197.2 days; p Conclusion In the usual care of schizophrenia patients, time to medication discontinuation for any cause appears significantly longer for atypical than typical antipsychotics regardless of the typical antipsychotic potency level. Findings were primarily driven by clozapine and olanzapine, and to a lesser extent by risperidone. Furthermore, only clozapine and olanzapine therapy showed consistently and significantly longer treatment duration compared to perphenazine, a medium

  2. Greco-Roman ethics and the naturalistic fantasy.

    Science.gov (United States)

    Holmes, Brooke

    2014-09-01

    To modern scholars, the naturalistic fallacy looks out of place in Greco-Roman antiquity owing to the robust associations between nature, especially human nature, and moral norms. Yet nature was understood by ancient authors not only as a norm but also as a form of necessity. The Greco-Roman philosophical schools grappled with how to reconcile the idea that human nature is given with the idea that it is a goal to be reached. This essay looks at the Stoic concept of oikeiōsis as one strategy for effecting such a reconciliation. Drawing on natural history, these Stoic sources used examples of animal behavior to illustrate a process whereby nature "entrusts" all animals, including humans, with the care of their own survival. Nature is thus both what is given to the animal and what the animal achieves in a powerful but also problematic synthesis here called the "naturalistic fantasy".

  3. Naturalistic perspectives of traditional Tibetan medicine and contemporary relevance

    OpenAIRE

    Chengxin ZHAO; Li TONG

    2016-01-01

    Traditional Tibetan Medicine (TTM) has unique naturalistic connotation. Understanding naturalism from the TTM helps us to increase our understanding of organic cosmology and naturalism itself. It also helps us to realize the potential of naturalism. Hopefully this will show us a broader Asian naturalism and multidimensional prospect of the international organic cosmology. This paper intends to describe and analyze the naturalism hidden in the TTM by combining the source, theory, system and pr...

  4. Human mesostriatal response tracks motivational tendencies under naturalistic goal conflict.

    Science.gov (United States)

    Gonen, Tal; Soreq, Eyal; Eldar, Eran; Ben-Simon, Eti; Raz, Gal; Hendler, Talma

    2016-06-01

    Goal conflict situations, involving the simultaneous presence of reward and punishment, occur commonly in real life, and reflect well-known individual differences in the behavioral tendency to approach or avoid. However, despite accumulating neural depiction of motivational processing, the investigation of naturalistic approach behavior and its interplay with individual tendencies is remarkably lacking. We developed a novel ecological interactive scenario which triggers motivational behavior under high or low goal conflict conditions. Fifty-five healthy subjects played the game during a functional magnetic resonance imaging scan. A machine-learning approach was applied to classify approach/avoidance behaviors during the game. To achieve an independent measure of individual tendencies, an integrative profile was composed from three established theoretical models. Results demonstrated that approach under high relative to low conflict involved increased activity in the ventral tegmental area (VTA), peri-aquaductal gray, ventral striatum (VS) and precuneus. Notably, only VS and VTA activations during high conflict discriminated between approach/avoidance personality profiles, suggesting that the relationship between individual personality and naturalistic motivational tendencies is uniquely associated with the mesostriatal pathway. VTA-VS further demonstrated stronger coupling during high vs low conflict. These findings are the first to unravel the multilevel relationship among personality profile, approach tendencies in naturalistic set-up and their underlying neural manifestation, thus enabling new avenues for investigating approach-related psychopathologies. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  5. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed......, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  6. Geomagnetic Observations for Main Field Studies

    DEFF Research Database (Denmark)

    Matzka, Jürgen; Chulliat, A.; Mandea, M.

    2010-01-01

    and the beginning of geomagnetic repeat stations surveys in the 19th century. In the second half of the 20th century, true global coverage with geomagnetic field measurements was accomplished by magnetometer payloads on low-Earth-orbiting satellites. This article describes the procedures and instruments...... for magnetic field measurements on ground and in space and covers geomagnetic observatories, repeat stations, automatic observatories, satellites and historic observations. Special emphasis is laid on the global network of geomagnetic observatories....

  7. Back to basics: a naturalistic assessment of the experience and regulation of emotion.

    Science.gov (United States)

    Heiy, Jane E; Cheavens, Jennifer S

    2014-10-01

    Emotion regulation research links regulatory responding to important outcomes in psychological well-being, physical health, and interpersonal relations, but several fundamental questions remain. As much of the previous research has addressed generalized regulatory habits, far less is known about the ways in which individuals respond to emotions in daily life. The literature is particularly sparse in explorations of positive emotion regulation. In the current study, we provide an assessment of naturalistic experiences and regulation of emotion, both positive and negative in valence. Using an electronic experience sampling methodology, participants reported on their use of 40 regulatory strategies in response to 14 emotions for 10 consecutive days. On average, participants used 15 different regulatory strategies in response to negative emotions over this time, most frequently relying on acceptance, behavioral activation, and rumination. Participants used a similarly large repertoire of strategies, approximately 16 total, in response to positive emotions, particularly savoring, future focus, and behavioral activation. Participants' mood ratings following strategy use, however, indicated that the most frequently used strategies were often not the most effective strategies. The results of this study provide estimates of the frequency and effectiveness of a large number of emotion regulation strategies in response to both negative and positive emotions. Such findings characterize naturalistic emotion regulation, and estimates of normative emotion regulation processes are imperative to determining the ways in which deviations (e.g., small emotion regulation repertoires, insufficient attention to regulation of positive emotions) impact emotional functioning. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  8. Complicated Intra-Abdominal Infections Observational European study (CIAO Study

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2011-12-01

    Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

  9. Management of rheumatic chorea: an observational study

    Directory of Open Access Journals (Sweden)

    Araújo Alexandra Prufer de Queiroz Campos

    2002-01-01

    Full Text Available BACKGROUND: Rheumatic chorea (RC has recently been linked to an antibody-mediated immune mechanism. OBJECTIVE/METHOD: To verify if this knowledge reflected in management changes we conceived a descriptive study. RESULTS: The medical charts of 20 children (13 females aged 6 to 12 years (mean 8 years, diagnosed as RC from June 1996 to June 1999, were reviewed. All patients received some medical treatment. Haloperidol was the most prescribed medication (15 patients - 75 %. Sulpiride, diazepam and valproate were also used as symptomatic treatment. Imune-modulating therapy with prednisone was prescribed for seven children. The shortest course of chorea (16 days occurred in a patient treated with prednisone. CONCLUSION: Prednisone has been prescribed for rheumatic chorea besides the traditional symptomatic approach. A great variety of antichoreic drugs are being employed.

  10. [Difficult laryngoscopy and tracheal intubation: observational study].

    Science.gov (United States)

    Andrade, Rebeca Gonelli Albanez da Cunha; Lima, Bruno Luís Soares; Lopes, Douglas Kaíque de Oliveira; Couceiro Filho, Roberto Oliveira; Lima, Luciana Cavalcanti; Couceiro, Tania Cursino de Menezes

    Since anesthesia complications associated with unexpected difficult airway are potentially catastrophic, they should be avoided. The modified Mallampati test and jaw-thrust maneuver enable the identification of difficult airway. The aim of this study was to associate the modified Mallampati test and the jaw-thrust maneuver with laryngoscopy (Cormack-Lehane) in an attempt to identify a better predictor of difficult airway in an adult population undergoing elective surgery. A cross-sectional study in which 133 adult patients undergoing elective surgery requiring tracheal intubation were analyzed. The accuracy and specificity of the modified Mallampati test and jaw-thrust maneuver were assessed by correlating them with difficult laryngoscopy (Cormack-Lehane Degrees 3 and 4). In the 133 patients evaluated the difficult intubation rate found was 0.8%; there was association between the two predictive tests proposed (p=0.012). The values of 94.5% for specificity and 95.4% for accuracy were found for the jaw-thrust maneuver and for the modified Mallampati test, the values found were 81.1% and 81.2%, respectively. Kappa agreement identified a result of 0.240 between jaw-thrust maneuver and Cormarck-Lehane, which was considered reasonable. On the other hand, a poor agreement (κ=0.06) was seen between modified Mallampati test and Cormarck-Lehane test. The jaw-thrust maneuver presented superior accuracy and agreement than the modified Mallampati test, showing the ability to identify a difficult airway. It is necessary to emphasize the association of tests in the evaluation of patients, emphasizing their complementarity to minimize the negative consequences of repeated laryngoscopies. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. How Parents Read Counting Books and Non-numerical Books to Their Preverbal Infants: An Observational Study.

    Science.gov (United States)

    Goldstein, Alison; Cole, Thomas; Cordes, Sara

    2016-01-01

    Studies have stressed the importance of counting with children to promote formal numeracy abilities; however, little work has investigated when parents begin to engage in this behavior with their young children. In the current study, we investigated whether parents elaborated on numerical information when reading a counting book to their preverbal infants and whether developmental differences in numerical input exist even in the 1st year of life. Parents and their 5-10 months old infants were asked to read, as they would at home, two books to their infants: a counting book and another book that did not have numerical content. Parents' spontaneous statements rarely focused on number and those that did consisted primarily of counting, with little emphasis on labeling the cardinality of the set. However, developmental differences were observed even in this age range, such that parents were more likely to make numerical utterances when reading to older infants. Together, results are the first to characterize naturalistic reading behaviors between parents and their preverbal infants in the context of counting books, suggesting that although counting books promote numerical language in parents, infants still receive very little in the way of numerical input before the end of the 1st year of life. While little is known regarding the impact of number talk on the cognitive development of young infants, the current results may guide future work in this area by providing the first assessment of the characteristics of parental numerical input to preverbal infants.

  12. How Parents Read Counting Books and Non-Numerical Books to Their Preverbal Infants: An Observational Study

    Directory of Open Access Journals (Sweden)

    Alison Goldstein

    2016-07-01

    Full Text Available Studies have stressed the importance of counting with children to promote formal numeracy abilities; however little work has investigated when parents begin to engage in this behavior with their young children. In the current study, we investigated whether parents elaborated on numerical information when reading a counting book to their preverbal infants and whether developmental differences in numerical input exist even in the first year of life. Parents and their 5-10 month old infants were asked to read, as they would at home, two books to their infants: a counting book and another book that did not have numerical content. Parents’ spontaneous statements rarely focused on number and those that did consisted primarily of counting, with little emphasis on labeling the cardinality of the set. However, developmental differences were observed even in this age range, such that parents were more likely to make numerical utterances when reading to older infants. Together, results are the first to characterize naturalistic reading behaviors between parents and their preverbal infants in the context of counting books, suggesting that although counting books promote numerical language in parents, infants still receive very little in the way of numerical input before the end of the first year of life. While little is known regarding the impact of number talk on the cognitive development of young infants, the current results may guide future work in this area by providing the first assessment of the characteristics of parental numerical input to preverbal infants.

  13. Constructivism: a naturalistic methodology for nursing inquiry.

    Science.gov (United States)

    Appleton, J V; King, L

    1997-12-01

    This article will explore the philosophical underpinnings of the constructivist research paradigm. Despite its increasing popularity in evaluative health research studies there is limited recognition of constructivism in popular research texts. Lincoln and Guba's original approach to constructivist methodology is outlined and a detailed framework for nursing research is offered. Fundamental issues and concerns surrounding this methodology are debated and differences between method and methodology are highlighted.

  14. TORCH screening in polyhydramnios: an observational study.

    Science.gov (United States)

    Fayyaz, Humera; Rafi, Junaid

    2012-07-01

    The aim of this study was to understand the TORCH test and to evaluate its significance in women with polyhydramnios in singleton pregnancies. Retrospective analysis of indications and results of TORCH referrals made from November 2007 to 2009 with detailed review of case notes of women with polyhydramnios who had TORCH test. The total number of deliveries during specimen time was 3004, out of which 110(3.6%) had serum TORCH screening. The main indication for this test was polyhydramnios 62 (56.36%) followed by obstetric cholestasis 20 (18.18%), Intra-uterine fetal demise 6 (5.45%), fetal anomalies 5(4.54%), and deranged liver function tests (LFTs) 2 (1.8%). 15 (13.6%) women had TORCH screening for other indications such as clinical polyhydramnios, increased nuchal translucency (>2.5 mm). cytomegalovirus (CMV) and toxoplasmosis antibodies were tested in all cases whereas, parvovirus and herpes simplex virus screen were carried out in 4 (12.7%) and 2 (1.8%) patients, respectively. One woman (0.09%) had infection with CMV who had TORCH screening carried out for deranged LFTs. None of these women had positive TORCH screening giving the p value of TORCH test in polyhydramnios, the statistical evaluation shows that this test is not beneficial in women in whom polyhydramnios is an isolated ultrasound finding, especially when it is diagnosed in third trimester.

  15. Differences in Anticipatory Behaviour between Rats (Rattus norvegicus Housed in Standard versus Semi-Naturalistic Laboratory Environments.

    Directory of Open Access Journals (Sweden)

    I Joanna Makowska

    Full Text Available Laboratory rats are usually kept in relatively small cages, but research has shown that they prefer larger and more complex environments. The physiological, neurological and health effects of standard laboratory housing are well established, but fewer studies have addressed the sustained emotional impact of a standard cage environment. One method of assessing affective states in animals is to look at the animals' anticipatory behaviour between the presentation of a cue signalling the arrival of a reward and the arrival of that reward. The primary aim of this study was to use anticipatory behaviour to assess the affective state experienced by female rats a reared and housed long-term in a standard laboratory cage versus a semi-naturalistic environment, and b before and after treatment with an antidepressant or an anxiolytic. A secondary aim was to add to the literature on anticipatory behaviour by describing and comparing the frequency and duration of individual elements of anticipatory behaviour displayed by rats reared in these two systems. In all experiments, total behavioural frequency was higher in standard-housed rats compared to rats from the semi-naturalistic condition, suggesting that standard-housed rats were more sensitive to rewards and experiencing poorer welfare than rats reared in the semi-naturalistic environment. What rats did in anticipation of the reward also differed between housing treatments, with standard-housed rats mostly rearing and rats from the semi-naturalistic condition mostly sitting facing the direction of the upcoming treat. Drug interventions had no effect on the quantity or form of anticipatory behaviour, suggesting that the poorer welfare experienced by standard-housed rats was not analogous to depression or anxiety, or alternatively that the drug interventions were ineffective. This study adds to mounting evidence that standard laboratory housing for rats compromises rat welfare, and provides further

  16. Evolutionary theory and the naturalist fallacy

    DEFF Research Database (Denmark)

    Grodal, Torben Kragh

    2008-01-01

    The article is an invited response to a target article by Joseph Carroll entitled "An evolutionary paradigm for literary study". It argues that the target article  misuse the fact that works of art are based on adaptations that were fitness-enhancing in the era of evolutionary adaptations to claim...... that great work of art are also automatically fitness-enhancing in the present day environment, at that there are simple correllations between whether a work of art has a high aesthetic value and whether it is fitness-enhancing or not.  Keywords :  Evolutionary aesthetics, film theory, literary theory...

  17. Evolutionary theory and the naturalist fallacy

    DEFF Research Database (Denmark)

    Grodal, Torben Kragh

    2008-01-01

    that great work of art are also automatically fitness-enhancing in the present day environment, at that there are simple correllations between whether a work of art has a high aesthetic value and whether it is fitness-enhancing or not.  Keywords :  Evolutionary aesthetics, film theory, literary theory......The article is an invited response to a target article by Joseph Carroll entitled "An evolutionary paradigm for literary study". It argues that the target article  misuse the fact that works of art are based on adaptations that were fitness-enhancing in the era of evolutionary adaptations to claim...

  18. [Therapeutic failure in scabies: An observational study].

    Science.gov (United States)

    De Sainte Marie, B; Mallet, S; Gaudy-Marqueste, C; Baumstarck, K; Bentaleb, N; Loundou, A; Hesse, S; Monestier, S; Grob, J-J; Richard, M-A

    2016-01-01

    Several sources suggest an escalation of scabies in France. To describe a population of patients continuing to present with scabies despite multiple treatments in order to identify factors associated with persistence of infection. A descriptive cross-sectional study in adults and children consulting for persistent scabies despite at least one previous treatment. A standardized questionnaire explored potential sources of treatment failure. Thirty-one patients were analyzed. Initial symptoms were noted to have started between two and 52 weeks earlier (mean: 19 weeks). The mean number of prior consultations with a general practitioner was 3.1 (0-10) and 1.7 with a dermatologist (0-7). The mean number of patients per household was 3.5 (1-9). At least one dose of oral ivermectin (maximum of 6 doses per household) was prescribed for 84 % of patients (29 % of whom were not fasted at the time). Further, 74 % of patients received at least one local application of esdepallethrin and piperonyl butoxide (maximum: 5 courses), four received benzyl benzoate and two received permethrin; however, 58 % did not reapply the substance after hand washing. All households bought the prescribed treatments despite the costs. Close contacts of patients were treated in 58 % of households. Decontamination of bedding and clothing was carried out properly in 90 % of households. Persistence of infection appears to be linked to: (1) insufficient treatment of close contacts; (2) absence of a second treatment between days 7 and 14; (3) insufficient efficacy of the available treatments, doubtless due to multiple factors (intrinsic resistance of Sarcoptes, failure to repeat treatment, poor explanation of methods for dosing and application, and oral intake of treatments). Access to non-reimbursed treatments was not identified as a problem and decontamination of bedding and clothing was correctly performed in most cases. Though certain fundamental aspects of scabies treatment must be better

  19. Areas activated during naturalistic reading comprehension overlap topological visual, auditory, and somatotomotor maps

    Science.gov (United States)

    2016-01-01

    Abstract Cortical mapping techniques using fMRI have been instrumental in identifying the boundaries of topological (neighbor‐preserving) maps in early sensory areas. The presence of topological maps beyond early sensory areas raises the possibility that they might play a significant role in other cognitive systems, and that topological mapping might help to delineate areas involved in higher cognitive processes. In this study, we combine surface‐based visual, auditory, and somatomotor mapping methods with a naturalistic reading comprehension task in the same group of subjects to provide a qualitative and quantitative assessment of the cortical overlap between sensory‐motor maps in all major sensory modalities, and reading processing regions. Our results suggest that cortical activation during naturalistic reading comprehension overlaps more extensively with topological sensory‐motor maps than has been heretofore appreciated. Reading activation in regions adjacent to occipital lobe and inferior parietal lobe almost completely overlaps visual maps, whereas a significant portion of frontal activation for reading in dorsolateral and ventral prefrontal cortex overlaps both visual and auditory maps. Even classical language regions in superior temporal cortex are partially overlapped by topological visual and auditory maps. By contrast, the main overlap with somatomotor maps is restricted to a small region on the anterior bank of the central sulcus near the border between the face and hand representations of M‐I. Hum Brain Mapp 37:2784–2810, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:27061771

  20. The methodological lesson of complementarity: Bohr’s naturalistic epistemology

    International Nuclear Information System (INIS)

    Folse, H J

    2014-01-01

    Bohr’s intellectual journey began with the recognition that empirical phenomena implied the breakdown of classical mechanics in the atomic domain; this, in turn, led to his adoption of the ‘quantum postulate’ that justifies the ‘stationary states’ of his atomic model of 1913. His endeavor to develop a wider conceptual framework harmonizing both classical and quantum descriptions led to his proposal of the new methodological goals and standards of complementarity. Bohr’s claim that an empirical discovery can demand methodological revision justifies regarding his epistemological lesson as supporting a naturalistic epistemology. (paper)

  1. Potential benefits of slow titration of paroxetine treatment in an elderly population: eight-week results from a naturalistic setting.

    Science.gov (United States)

    Gibiino, Sara; Mori, Elisa; De Ronchi, Diana; Serretti, Alessandro

    2013-08-01

    Late-life depression, often in association with anxiety, affects approximately 15% of individuals older than 65 years. Selective serotonin reuptake inhibitors are the first-line treatment but could be responsible of an early exacerbation of anxiety, possibly reduced by a very gradual titration of drugs. The main aim of this study is to compare gradual and rapid (standard) titration of paroxetine in an elderly population. In a naturalistic setting, 50 elderly (≥60 years old) outpatients with unipolar mood disorder or anxiety disorder were naturalistically assigned to abrupt initiation of 10 mg of paroxetine or to a gradual increase with 2.5 mg on alternate days up to 10 mg in 7 days. Then dosage could be maintained at 10 mg or increased according to clinical response. Primary outcome was efficacy as assessed by the Hamilton Depression Rating Scale (HAM-D) 21, HAM-D symptom subscales (core, psychic anxiety, somatic anxiety cluster), and Hamilton Anxiety Rating Scale changes. Secondary outcome was evaluation of overall dropouts at eighth week and evaluation of most common adverse effects through the global judgment of the Dosage Record and Treatment Emergent Symptom Scale. All data were recorded weekly for the first 8 weeks of treatment (with 1 more evaluation after 3 days from the baseline). Samples were comparable at baseline, with patients in gradual titration showing a higher level of psychic anxiety. During the first 3 days of treatment, a significant worsening in psychic anxiety was observed in patients treated abruptly with 10 mg of paroxetine (difference in HAM-D psychic anxiety subscale from baseline: 110.61% vs 89.38% with rapid and slow titration, respectively; t test P = 0.03). Overall, a significantly greater improvement in depressive and anxious symptoms favored gradual titration (HAM-D core cluster and HAM-D psychic anxiety cluster, respectively, P = 0.014 and P titration). Our results suggest that a gradual titration of paroxetine could avoid the

  2. Detection of Risky Driving Behaviors in the Naturalistic Environment in Healthy Older Adults and Mild Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Jennifer D. Davis

    2018-03-01

    Full Text Available Analyzing naturalistic driving behavior recorded with in-car cameras is an ecologically valid method for measuring driving errors, but it is time intensive and not easily applied on a large scale. This study validated a semi-automated, computerized method using archival naturalistic driving data collected for drivers with mild Alzheimer’s disease (AD; n = 44 and age-matched healthy controls (HC; n = 16. The computerized method flagged driving situations where safety concerns are most likely to occur (i.e., rapid stops, lane deviations, turns, and intersections. These driving epochs were manually reviewed and rated for error type and severity, if present. Ratings were made with a standardized scoring system adapted from DriveCam®. The top eight error types were applied as features to train a logistic model tree classifier to predict diagnostic group. The sensitivity and specificity were compared among the event-based method, on-road test, and composite ratings of two weeks of recorded driving. The logistic model derived from the event-based method had the best overall accuracy (91.7% and sensitivity (97.7% and high specificity (75.0% compared to the other methods. Review of driving situations where risk is highest appears to be a sensitive data reduction method for detecting cognitive impairment associated driving behaviors and may be a more cost-effective method for analyzing large volumes of naturalistic data.

  3. HOW TO DESCRIBE THE RESULTS OF OBSERVATIONAL EPIDEMIOLOGICAL STUDIES

    Directory of Open Access Journals (Sweden)

    S. A. Shal'nova

    2016-01-01

    Full Text Available Principles and fundamentals of proper presentation of observational epidemiological study results are focused. Principles of observational study publication developed by expert epidemiologists (STROBE statement are explained in detail.

  4. The Potential of Naturalistic Methods for Evaluating Visual Arts Education Programs.

    Science.gov (United States)

    Sherman, Ann L.; Lincoln, Yvonna S.

    An overview of four models of naturalistic evaluation of arts education is presented for visual arts education administrators: illuminative, responsive, criticism, and naturalistic. The first method is illuminative evaluation. It focuses on description and interpretation, rather than standardized measurement and control. Concentrating on the…

  5. Observational study of outpatients with schizophrenia in the Middle ...

    African Journals Online (AJOL)

    Observational study of outpatients with schizophrenia in the Middle East and Africa — 3- and 6-month efficacy and safety results. The Intercontinental Schizophrenia Outpatient Health Outcomes Study.

  6. The utility of novel outcome measures in a naturalistic evaluation of schizophrenia treatment

    Directory of Open Access Journals (Sweden)

    Tompsett T

    2018-03-01

    Full Text Available Tamara Tompsett,1 Kate Masters,1,2 Parastou Donyai1 1Department of Pharmacy, University of Reading, Reading, UK; 2Department of Pharmacy, Berkshire Healthcare NHS Foundation Trust, Reading, UK Background: A number of naturalistic studies have investigated paliperidone palmitate (PP using proxy measures of effectiveness. An unexplored option is to examine the utility of the mental health clustering tool (MHCT, which is used in UK clinical practice to measure patient well-being and is linked to allocation of resources. This study evaluated the effectiveness of PP using the MHCT, the Health of the Nation Outcome Scales (HoNOS, and, for comparison, more conventional outcome measures.Methods: This was a naturalistic, 1-year evaluation of PP (n=50 in schizophrenia as well as a comparator antipsychotic drugs group. Changes in the MHCT cluster-score cost ranking and four HoNOS-derived factors were analyzed using a mixed-model statistical analysis to explore the utility of these measures.Results: At 1 year, 30 patients (60% continued PP treatment. The mean “cluster-score cost ranking” (–1.5 and Severe Disturbance factor scores (–1.1 were significantly lower (p-value [adjusted] =0.0003, p-value [adjusted] =0.002, respectively after 1 year of antipsychotic treatment but no differences were found between PP and the comparator antipsychotic drugs group. Patients prescribed PP were 1.8 times (95% CI 1.1–3.1 more likely to be discharged from hospital than those in the comparator antipsychotic drugs group.Conclusion: PP’s continuation rate after 1 year made the study similar to the existing evaluations, and it was possible to prospectively evaluate antipsychotic effectiveness using the novel measures although these did not discriminate between PP and the comparator group. The investigation illustrates that in principle these novel measures are meaningful in naturalistic study designs. Keywords: paliperidone palmitate, antipsychotics

  7. Learning to observe mathematical learning in lesson studies

    DEFF Research Database (Denmark)

    Rasmussen, Klaus; Østergaard, Camilla Hellsten; Foss, Kristian Kildemoes

    2016-01-01

    This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which ena...... enable or hinder fruitful lesson study. While substantial research has been carried out in the general field of bserving pupils’ learning processes and teachers’ pedagogical practice, little is known about this in the particular setting of lesson study.......This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which...

  8. Split-Session Focus Group Interviews in the Naturalistic Setting of Family Medicine Offices.

    Science.gov (United States)

    Fetters, Michael D; Guetterman, Timothy C; Power, Debra; Nease, Donald E

    2016-01-01

    When recruiting health care professionals to focus group interviews, investigators encounter challenges such as busy clinic schedules, recruitment, and a desire to get candid responses from diverse participants. We sought to overcome these challenges using an innovative, office-based, split-session focus group procedure in a project that elicited feedback from family medicine practices regarding a new preventive services model. This procedure entails allocating a portion of time to the entire group and the remaining time to individual subgroups. We discuss the methodologic procedure and the implications of using this approach for data collection. We conducted split-session focus groups with physicians and staff in 4 primary care practices. The procedure entailed 3 sessions, each lasting 30 minutes: the moderator interviewed physicians and staff together, physicians alone, and staff alone. As part of the focus group interview, we elicited and analyzed participant comments about the split-session format and collected observational field notes. The split-session focus group interviews leveraged the naturalistic setting of the office for context-relevant discussion. We tested alternate formats that began in the morning and at lunchtime, to parallel each practice's workflow. The split-session approach facilitated discussion of topics primarily relevant to staff among staff, topics primarily relevant to physicians among physicians, and topics common to all among all. Qualitative feedback on this approach was uniformly positive. A split-session focus group interview provides an efficient, effective way to elicit candid qualitative information from all members of a primary care practice in the naturalistic setting where they work. © 2016 Annals of Family Medicine, Inc.

  9. Independent naturalists make matchless contributions to science and resource management (Invited)

    Science.gov (United States)

    Crimmins, T. M.; Crimmins, M.; Bertelsen, C. D.

    2013-12-01

    Much of the recent growth in PPSR, or public participation in scientific research, has been in 'contributory' or 'collaborative'-type PPSR projects, where non-scientists' roles primarily are data collection or some participation in other aspects of project design or execution. A less common PPSR model, referred to as 'collegial' in recent literature, is characterized by dedicated naturalists collecting rich and extensive data sets outside of an organized program and then working with professional scientists to analyze these data and disseminate findings. The three collaborators on this presentation represent an example of the collegial model; our team is comprised of an independent naturalist who has collected over 150,000 records of plant flowering phenology spanning three decades, a professional climatologist, and a professional plant ecologist. Together, we have documented fundamental plant-climate relationships and seasonal patterns in flowering in the Sonoran Desert region, as well as changes in flowering community composition and distribution associated with changing climate conditions in the form of seven peer-reviewed journal articles and several conference presentations and proceedings. These novel findings address critical gaps in our understanding of plant ecology in the Sky Islands region, and have been incorporated into the Southwest Climate Change and other regional planning documents. It is safe to say that the data resource amassed by a single very dedicated individual, which is far beyond what could be accomplished by probably nearly all researchers or resource managers, has been instrumental in documenting fundamental ecological relationships in the Sky Islands region as well as how these systems are changing in this period of rapidly changing climate. The research findings that have resulted from this partnership have the potential to also directly affect management decisions. The watershed under study, managed by the US Forest Service, has been

  10. A naturalistic decision making model for simulated human combatants

    International Nuclear Information System (INIS)

    HUNTER, KEITH O.; HART, WILLIAM E.; FORSYTHE, JAMES C.

    2000-01-01

    The authors describe a naturalistic behavioral model for the simulation of small unit combat. This model, Klein's recognition-primed decision making (RPD) model, is driven by situational awareness rather than a rational process of selecting from a set of action options. They argue that simulated combatants modeled with RPD will have more flexible and realistic responses to a broad range of small-scale combat scenarios. Furthermore, they note that the predictability of a simulation using an RPD framework can be easily controlled to provide multiple evaluations of a given combat scenario. Finally, they discuss computational issues for building an RPD-based behavior engine for fully automated combatants in small conflict scenarios, which are being investigated within Sandia's Next Generation Site Security project

  11. Going outside in Winter: A Qualitative Study of Preschool Dressing Routines

    Science.gov (United States)

    Hatcher, Beth; Squibb, Betsy

    2011-01-01

    The exploratory study focused on describing typical routines of preparing for winter outdoor play with preschool children and their teachers. Naturalistic observations, interviews and photographs resulted in extensive examples of children's development in cognitive understanding of winter and winter-related concepts. Observations of teachers and…

  12. The Naturalistic Fallacy - The Metaethical Source of the Controversy over the Naturalization of Epistemology

    Directory of Open Access Journals (Sweden)

    Barbara Trybulec

    2013-12-01

    Full Text Available In this paper I analyze the phenomenon known as ‘the naturalistic fallacy’. The thesis for which I argue is that the decision not to commit the ‘naturalistic fallacy’ (as taken by anti-naturalists, or to acknowledging it as an inevitable process (as in the naturalist position, forms the basis for every theory concerning the justification of normative judgments. It is this choice that determines what solutions can be proposed within the various fields of philosophy to the problems pertaining to the sources of justificational reasons and the criteria for justified judgment. To justify this thesis I draw an analogy between metaethical and epistemological versions of this ‘fallacy’. In the first part of the paper, I point to the metaethical controversy surrounding the ‘naturalistic fallacy’. In the second part, I transpose the controversy over ‘the  naturalistic fallacy’ from the sphere of metaethics into that epistemology. Firstly, I adopt and seek to justify a chosen epistemic quality that, I argue, may be regarded as analogous to the ethical quality ‘good’. In order to accomplish this, I set out to determine the relation between the truth and the justification of a judgment, arguing that this second category is, in fact, the more important one where epistemological analysis is concerned. Although the ‘naturalistic fallacy’ was initially formulated within metaethics, it might be transferred to every field of  normative consideration.

  13. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Directory of Open Access Journals (Sweden)

    Elisa De Stefani

    Full Text Available The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3. Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed when the observed (and simulated movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  14. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Science.gov (United States)

    De Stefani, Elisa; Innocenti, Alessandro; De Marco, Doriana; Gentilucci, Maurizio

    2013-01-01

    The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3). Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed) when the observed (and simulated) movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  15. Do adults with autism spectrum disorders compensate in naturalistic prospective memory tasks?

    Science.gov (United States)

    Altgassen, Mareike; Koban, Nancy; Kliegel, Matthias

    2012-10-01

    The present study is the first to directly compare event- and time-based prospective memory in Autism Spectrum Disorders (ASD) using a contextual task mirroring real life demands of prospective memory. Twenty-five individuals with ASD and 25 age- and ability-matched controls completed the Dresden Breakfast task which required participants to prepare breakfast following a set of rules and time restrictions. Overall, adults with ASD had less correct time- and event-based prospective memory responses in comparison to controls, which is consistent with previous research in children with ASD. Moreover, ASD participants completed fewer tasks, followed rules less closely, and monitored the elapsing time less closely than controls. Individuals with ASD seem not to be compensating in naturalistic prospective memory tasks.

  16. Does Joshua Greene’s Dual Process Theory of Moral Judgment Commit the Naturalistic Fallacy?

    Directory of Open Access Journals (Sweden)

    Javier Gracia Calandín

    2017-02-01

    Full Text Available In this article I analyse whether Joshua Greene’s dual process theory of moral judgment commits the naturalistic fallacy. Firstly, and against current authors such as Patricia S. Churchland, I uphold the validity of the naturalistic fallacy denounced by Moore for more than a century. Secondly, I highlight and question Greene’s naturalized way of understanding Deontologism. Thirdly, I assert the distinction between "neural basis" and "moral foundation" as the key to avoid committing the naturalistic fallacy. Finally and according to that key distinction I assess Greene’s neuroethical approach and I analyse some of its most critical aspects related to normative issues.

  17. Comparison of two simulation methods for testing of algorithms to detect cyclist and pedestrian accidents in naturalistic data

    DEFF Research Database (Denmark)

    Madsen, Tanja Kidholm Osmann; Christensen, Mads Bock; Andersen, Camilla Sloth

    Naturalistic studies can potentially be used to detect accidents of vulnerable road users and thus overcome the large degree of under-reporting in the official accident records. In this study, simulated cycling and walking accidents were performed by a stunt man and with a crash test dummy to test...... how they differ from each other and the potential implications of using simulated accidents as an alternative to real accidents. The study consisted of simulations of common accident types for cyclists and pedestrians, such as tripping over a curb or falling of the bike after hitting an obstacle...

  18. Areas activated during naturalistic reading comprehension overlap topological visual, auditory, and somatotomotor maps.

    Science.gov (United States)

    Sood, Mariam R; Sereno, Martin I

    2016-08-01

    Cortical mapping techniques using fMRI have been instrumental in identifying the boundaries of topological (neighbor-preserving) maps in early sensory areas. The presence of topological maps beyond early sensory areas raises the possibility that they might play a significant role in other cognitive systems, and that topological mapping might help to delineate areas involved in higher cognitive processes. In this study, we combine surface-based visual, auditory, and somatomotor mapping methods with a naturalistic reading comprehension task in the same group of subjects to provide a qualitative and quantitative assessment of the cortical overlap between sensory-motor maps in all major sensory modalities, and reading processing regions. Our results suggest that cortical activation during naturalistic reading comprehension overlaps more extensively with topological sensory-motor maps than has been heretofore appreciated. Reading activation in regions adjacent to occipital lobe and inferior parietal lobe almost completely overlaps visual maps, whereas a significant portion of frontal activation for reading in dorsolateral and ventral prefrontal cortex overlaps both visual and auditory maps. Even classical language regions in superior temporal cortex are partially overlapped by topological visual and auditory maps. By contrast, the main overlap with somatomotor maps is restricted to a small region on the anterior bank of the central sulcus near the border between the face and hand representations of M-I. Hum Brain Mapp 37:2784-2810, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

  19. The development of prospective memory in preschool children using naturalistic tasks.

    Science.gov (United States)

    Walsh, Stephanie J; Martin, Gerard M; Courage, Mary L

    2014-11-01

    The development of prospective memory (PM) in 3-, 4-, and 5-year-old children (N=123) was assessed in two experiments using several naturalistic game-like tasks that varied in the explicitness of the cues for retrieval that they provided. The goals of the study were to evaluate age differences in PM (a) with the effects of retrospective memory (RM) factored out and (b) as a function of increasing retrieval cue specificity. Results from Experiment 1 showed that there were age differences in PM on a simulated Shopping Trip task that favored older children after age differences attributable to RM were identified in a hierarchical regression. PM and RM components followed the same developmental trajectory. Because the Shopping Trip task provided a visual cue for retrieval, a second naturalistic PM task that was incidental to the Shopping Trip task (i.e., to ask for stickers at the end of the shopping trip) was included but provided no explicit cue other than the end of Shopping Trip task itself. A binary logistic regression showed that age did not predict children who succeeded and those who did not succeed. Because the end of the Shopping Trip task might have cued PM, two new tasks without any explicit cues for retrieval were examined in Experiment 2. Logistic regressions revealed that age predicted PM success on both tasks. With additional cues following failure to retrieve the PM intention, nearly all children succeeded, but the number of cues needed increased with age. The joint and separate contributions of PM and RM to successful task performance are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Observational studies and the difficult quest for causality

    DEFF Research Database (Denmark)

    Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

    2016-01-01

    design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed...... more robust observational study designs, challenges lie ahead for evaluating best practices for achieving robust unbiased results from observational studies. This is critical for evaluation of national and global vaccine programme effectiveness....... be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study...

  1. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)

    DEFF Research Database (Denmark)

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G

    2014-01-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical...... considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate...... to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how...

  2. Aripiprazole augmentation, antidepressant combination or switching therapy in patients with major depressive disorder who are partial- or non-responsive to current antidepressants: a multi-center, naturalistic study.

    Science.gov (United States)

    Han, Changsu; Wang, Sheng-Min; Seo, Ho-Jun; Lee, Boung Chul; Jeon, Hong Jin; Kim, Won; Kwak, Kyung-Phil; Pae, Chi-Un

    2014-02-01

    There has been no studies comparing the clinical benefits of aripiprazole augmentation (AT), antidepressant combination (AC), and switching to a different antidepressant (SW) in patients with major depressive disorder (MDD) patients partially or not responding to an initial antidepressant. AT, AC, or SW was chosen by patients. The primary efficacy measure was the proportion of patients showing an improvement in the Clinical Global Impression-Clinical Benefit (CGI-CB) score at week 8. Secondary efficacy measures included changes in CGI-CB, CGI-Severity (S) and subjective satisfaction scores. Remission and responder analysis were also employed. A total of 295 patients were enrolled. The most preferred strategy was AT (n = 156, 52.9%), followed by AC (n = 93, 31.5%) and SW (n = 46, 15.6%). The improver was significantly higher in AT (74.1%) compared with AC (48.1%; p antidepressant was ineffective in treating their depression. Among the three treatment strategies, overall AT yielded greater clinical benefit than did AC and SW. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Psychological Factors Associated with Chronic Migraine and Severe Migraine-Related Disability: an Observational Study in a Tertiary Headache Center

    Science.gov (United States)

    Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; Mayson, Sarah Jo; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.

    2016-01-01

    Objective To evaluate relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors [depressive symptoms (Patient Health Questionnaire-9), anxious symptoms (Generalized Anxiety Disorder-7), Pain Catastrophizing Scale and Headache Specific Locus of Control]. Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1,11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Conclusions Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate relationships among naturalistic

  4. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    Science.gov (United States)

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  5. Utilizing ego-centric video to conduct naturalistic bicycling studies.

    Science.gov (United States)

    2016-10-01

    Existing data collection methods are mostly designed for videos captured by stationary cameras and are not designed to follow cyclists along a : route or to integrate other sensor data. The goals of this research are: a) to develop a platform to coll...

  6. Missing outcome data in a naturalistic psychodynamic group therapy study

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2017-01-01

    might have had a reliable improvement in GSI. The SPSS standard statistical imputations procedure estimated that 48.6% of the patients reliably improved in GSI, and 50.2% when therapist evaluations were not included. It is concluded that therapist evaluations are essential in order to avoid bias...

  7. naturalistic study of olanzapine in treatment-resistant schizophrenia

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... Background: Whereas the Fiji government provides all aspects of mental health care services free of charge to its citizens, many schizophrenics have failed to respond to classical antipsychotic drugs. Objective: To assess the efficacy and safety of olanzapine among various patients with severe psychiatric ...

  8. Useful Brazilian plants listed in the field books of the French naturalist Auguste de Saint-Hilaire (1779-1853).

    Science.gov (United States)

    Brandão, Maria G L; Pignal, Marc; Romaniuc, Sergio; Grael, Cristiane F F; Fagg, Christopher W

    2012-09-28

    Information regarding the use of beneficial, native Brazilian plants was compiled by European naturalists in the 19th century. The French botanist Auguste de Saint-Hilaire (1779-1853) was one of the most important such naturalists; however, his manuscripts (field books) have not yet been studied, especially in the context of useful plants. To present data documented by Saint-Hilaire in his field book regarding the use of native plants by the Brazilians. Data on useful plants were obtained from field books (six volumes) deposited in the Muséum national d' Histoire naturelle in Paris, France. The vernacular names of the plants, registered as "N.V." or "Nom Vulg." in the field book, were carefully searched. Traditional information about these plants was translated and organised using a computer. The botanical identification of each plant was determined and updated from the original descriptions and names cited in the field books by A. de Saint-Hilaire. Correlated pharmacological studies were obtained from PubMed. A total of 283 useful plants were recorded from the field books and 165 (58.3%) could be identified to genus or species. Fifty-eight different traditional uses were registered for the identified plants; the most common were as purgatives and febrifuges. Other data recovered were related to edible fruits and plants with interesting sensorial characteristics. For the few species that have been subjected to laboratory studies, the efficacy of the recorded traditional uses was confirmed. The data recorded by the French naturalist A. de Saint-Hilaire represent a rich, unexplored source of information regarding the traditional uses of Brazilian plants. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Does Joshua Greene’s Dual Process Theory of Moral Judgment Commit the Naturalistic Fallacy?

    OpenAIRE

    Javier Gracia Calandín

    2017-01-01

    In this article I analyse whether Joshua Greene’s dual process theory of moral judgment commits the naturalistic fallacy. Firstly, and against current authors such as Patricia S. Churchland, I uphold the validity of the naturalistic fallacy denounced by Moore for more than a century. Secondly, I highlight and question Greene’s naturalized way of understanding Deontologism. Thirdly, I assert the distinction between "neural basis" and "moral foundation" as the key to avoid committing the natura...

  10. The EULAR Study Group for Registers and Observational Drug Studies

    DEFF Research Database (Denmark)

    Kearsley-Fleet, Lianne; Závada, Jakub; Hetland, Merete Lund

    2015-01-01

    OBJECTIVE: Under the auspices of the European League Against Rheumatism (EULAR), a study group of investigators representing European biologic DMARD (bDMARD) registers was convened. The purpose of this initial assessment was to collect and compare a cross section of patient characteristics...

  11. [Constant Duméril (1774-1860) anatomist doctor and naturalist, about a portrait by G. Devers].

    Science.gov (United States)

    Le Floch-Prigent, P

    2008-12-01

    André, Marie, Constant Duméril (1774-1860) served as a professor in the from 1801 to 1855. He was also chairman of herpetology and ichthyology of the in Paris. The Paris-Descartes University (department of anatomy) owns a great, framed portrait which is an oil painting by Giuseppe Devers, 1855, representing C. Duméril sat on a chair. The study of his portrait, biography and bibliography brings precisions on a noticeable scholar of the anatomical and naturalistic field in Paris in the first half of the 19th century.

  12. Cortical Activations during a Computer-Based Fraction Learning Game: Preliminary Results from a Pilot Study

    Science.gov (United States)

    Baker, Joseph M.; Martin, Taylor; Aghababyan, Ani; Armaghanyan, Armen; Gillam, Ronald

    2015-01-01

    Advances in educational neuroscience have made it possible for researchers to conduct studies that observe concurrent behavioral (i.e., task performance) and neural (i.e., brain activation) responses to naturalistic educational activities. Such studies are important because they help educators, clinicians, and researchers to better understand the…

  13. On sensitivity value of pair-matched observational studies

    OpenAIRE

    Zhao, Qingyuan

    2017-01-01

    An observational study may be biased for estimating causal effects by failing to control for unmeasured confounders. This paper proposes a new quantity called the "sensitivity value", which is defined as the minimum strength of unmeasured confounders needed to change the qualitative conclusions of a naive analysis assuming no unmeasured confounder. We establish the asymptotic normality of the sensitivity value in pair-matched observational studies. The theoretical results are then used to app...

  14. Victorian naturalists in China: science and informal empire.

    Science.gov (United States)

    Fan, Fa-ti

    2003-03-01

    This paper discusses the research of British naturalists in China during the period between the Opium War and the collapse of the Qing dynasty (1839-1911). China was defeated in the Opium War and forced to open treaty ports for trade with the Westerners. The foreign powers, particularly Britain, imposed upon the Qing government treaties, concession leases, favourable trade conditions, legal privileges and so on to reduce its political autonomy. In the shadow of the informal empire, not only did the British have more freedom to travel in China, first at the treaty ports and later in the interior, but they successively established diplomatic , commercial and missionary institutions in dozens of Chinese cities. The most important of them - the British Consular Service, the Chinese Maritime Customs and the Protestant missionary organizations - provided the talent and infrastructure for natural historical research and became networks for scientific information. The research into China's natural history epitomized the characteristics of British research on China in general: it engaged in collecting and circulating an ever-increasing amount of information and aimed at producing 'factual' and 'useful' knowledge about China. The paper modified current literature on scientific imperialism, which has dealt primarily with the colonial context, by examining the role of nineteenth-century British imperial science in the context of informal empire.

  15. As traduções de Bates: dois naturalistas no Rio Amazonas Bates's translations: two naturalists in the Amazon River

    Directory of Open Access Journals (Sweden)

    Cristina Carneiro Rodrigues

    2011-12-01

    Full Text Available Neste trabalho analisam-se duas traduções do relato da viagem do naturalista Henry Walter Bates pela Amazônia, uma publicada em 1944 na Coleção Brasiliana feita pelo naturalista Candido de Mello-Leitão, outra editada em 1979 na Coleção Reconquista do Brasil, assinada por Regina Regis Junqueira. O objetivo do artigo é problematizar a demarcação de limites nítidos entre uma ética da diferença e uma ética da igualdade, pois, em ambos os textos, tanto ocorre um movimento no sentido de preservar a alteridade do texto e do autor, quanto no de domesticar o texto. A análise busca também evidenciar que cada tradução, realizada a partir de diferentes projetos editoriais e tradutórios, acaba por suscitar diferentes imagens do naturalista e dos lugares por ele visitados.Two translations of the travel writing by the naturalist Henry Walter Bates in the Amazon are analyzed in this work: one published in 1944 in the Brasiliana Collection by the naturalist Candido de Mello-Leitão, and another edited in 1979 in the Reconquista do Brasil Collection, signed by Regina Regis Junqueira. The purpose of this study is to examine the delimitation of clear boundaries between an ethics of difference and an ethics of equality, since the two texts present a movement that both preserves the otherness of the text and the author and domesticates the text. The analysis also aims to evidence that each translation, carried out from different editorial and translational projects, ultimately projects different images of naturalist and the places visited by him.

  16. The social functional outcome of being naturalistically treated with paliperidone extended-release in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Nakagawa R

    2015-06-01

    Full Text Available Ryoko Nakagawa,1 Takashi Ohnishi,1 Hisanori Kobayashi,1 Akihide Wakamatsu,2 Ai Tanimura,3 Kazuo Morita,3 Toshio Yamaoka,3 Hideo Usui,3 Yoshimasa Ogawa,3 Akiko Fujino,3 Kazutake Yoshizawa11Evidence Generation Department, Medical Affairs Division, 2Medical Affairs Strategy Department, Medical Affairs Division, 3Drug Safety Surveillance Department, Japan Safety and Surveillance Division, Janssen Pharmaceutical K.K., Tokyo, JapanBackground: Social functioning is an important outcome for patients with schizophrenia. To evaluate the effects of paliperidone extended-release (PAL-ER on social function, symptomatology, and safety in the routine clinical practice, we conducted a 1-year post-marketing surveillance study of PAL-ER. We also explored relationships between symptomatic improvement and socially functional outcome in patients with schizophrenia.Patients and methods: Patients with an established diagnosis of schizophrenia were allowed flexible 3–12 mg/day dosing during the surveillance. Patients were assessed on social functioning using the Social and Occupational Functioning Assessment Scale (SOFAS and on symptomatology using the Clinical Global Impression–Schizophrenia scale. All adverse events (AEs were also collected.Results: A total of 1,429 patients were enrolled in the surveillance study, of whom 1,405 were evaluable for safety and 1,142 were evaluable for efficacy. The treatment discontinuation rate for any reason during the observation period was 34.66%. Significant improvements were observed on both Social and Occupational Functioning Assessment Scale and Clinical Global Impression–Schizophrenia scale during the observation period. The percentage of patients with socially functional remission (SOFAS ≥61 also increased significantly. A significant association between early improvements in positive symptoms, sex, severity of negative symptoms at baseline, and socially functional remission was observed. A total of 33.52% of patients

  17. Issues of reporting in observational studies in veterinary medicine.

    Science.gov (United States)

    Sargeant, Jan M; O'Connor, Annette M

    2014-02-15

    Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. SABRE observations of Pi2 pulsations: case studies

    Directory of Open Access Journals (Sweden)

    E. G. Bradshaw

    1997-01-01

    Full Text Available The characteristics of substorm-associated Pi2 pulsations observed by the SABRE coherent radar system during three separate case studies are presented. The SABRE field of view is well positioned to observe the differences between the auroral zone pulsation signature and that observed at mid-latitudes. During the first case study the SABRE field of view is initially in the eastward electrojet, equatorward and to the west of the substorm-enhanced electrojet current. As the interval progresses, the western, upward field-aligned current of the substorm current wedge moves westward across the longitudes of the radar field of view. The westward motion of the wedge is apparent in the spatial and temporal signatures of the associated Pi2 pulsation spectra and polarisation sense. During the second case study, the complex field-aligned and ionospheric currents associated with the pulsation generation region move equatorward into the SABRE field of view and then poleward out of it again after the third pulsation in the series. The spectral content of the four pulsations during the interval indicate different auroral zone and mid-latitude signatures. The final case study is from a period of low magnetic activity when SABRE observes a Pi2 pulsation signature from regions equatorward of the enhanced substorm currents. There is an apparent mode change between the signature observed by SABRE in the ionosphere and that on the ground by magnetometers at latitudes slightly equatorward of the radar field of view. The observations are discussed in terms of published theories of the generation mechanisms for this type of pulsation. Different signatures are observed by SABRE depending on the level of magnetic activity and the position of the SABRE field of view relative to the pulsation generation region. A twin source model for Pi2 pulsation generation provides the clearest explanation of the signatures observed.

  19. The valuable contribution of observational studies to nephrology

    NARCIS (Netherlands)

    Jager, K. J.; Stel, V. S.; Wanner, C.; Zoccali, C.; Dekker, F. W.

    2007-01-01

    In studies on the effects of therapy (or other interventions), the randomized controlled trial (RCT) is an almost unbeatable standard in clinical research. The value of RCTs leaves unabated the valuable contributions of observational studies to medicine. This paper discusses some limitations of RCTs

  20. Passive output feedback and observer based autopilots: A comparative study

    Directory of Open Access Journals (Sweden)

    Marit Paulsen

    1996-04-01

    Full Text Available Two methods for course-keeping of a ship are studied where no measurements of the yaw rate are available. The two methods are a passive output feedback controller and a controller-observer structure. A comparison with special attention to stability and wave filtering properties, is provided. Finally, a case study of a ship autopilot is included.

  1. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    NARCIS (Netherlands)

    Madsen, M.B.; Skrede, S.; Bruun, T.; Arnell, P.; Rosén, A.; Nekludov, M.; Karlsson, Y.; Bergey, F.; Saccenti, E.; Martins dos Santos, V.A.P.; Perner, A.; Norrby-Teglund, A.; Hyldegaard, O.

    2018-01-01

    Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating

  2. Maternal Sensitivity and Child Secure Base Use in Early Childhood: Studies in Different Cultural Contexts

    Science.gov (United States)

    Posada, German; Trumbell, Jill; Noblega, Magaly; Plata, Sandra; Peña, Paola; Carbonell, Olga A.; Lu, Ting

    2016-01-01

    This study tested whether maternal sensitivity and child security are related during early childhood and whether such an association is found in different cultural and social contexts. Mother-child dyads (N = 237) from four different countries (Colombia, Mexico, Peru, and the United States) were observed in naturalistic settings when children were…

  3. Assessing the quality of reporting of observational studies in cancer.

    Science.gov (United States)

    Papathanasiou, Afroditi A; Zintzaras, Elias

    2010-01-01

    The vast majority of epidemiological studies in cancer are observational. However, inadequate reporting of the published observational studies (OS) may restrict the generalizability and credibility of study results. The aim of this study was to evaluate the reporting quality of OS concerning cancer. PubMed was searched for systematic reviews (SRs) of OS involving cancer published from January 2008 through February 2009. The citations provided in the SRs were evaluated for their reporting quality according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement, a checklist of items that are considered essential for good reporting of OS. The evaluation was focused on 25 methodological items/sub-items. The effect of journals' ranking in quality of reporting was also evaluated. The search identified 244 eligible OS included in seven SRs. Nine items/sub-items were reported by more than 90% of studies and 16 items/sub-items were reported by more than 70%. Some essential methodological aspects of OS (such as matching, absolute risks, missing data and flow diagram) were underreported. Significant differences were found among the seven SRs in the majority of the items. High and lower ranked journals were different only in reporting of results estimates and precision. The quality of reporting in OS in cancer was considered satisfactory, although certain items were underreported. Further improvement of reporting may enhance the validity of observational research.

  4. A statistical study of ion frictional heating observed by EISCAT

    Directory of Open Access Journals (Sweden)

    J. A. Davies

    1997-11-01

    Full Text Available Results of a statistical survey of F-region ion frictional heating are presented, a survey which is based on over 4000 h of common programme observations taken by the European incoherent scatter (EISCAT UHF radar facility. The criterion adopted in this study for the identification of ion frictional heating was that defined by McCrea et al., requiring an enhancement in the F-region field-parallel ion temperature exceeding 100 K over two consecutive integration periods, which was itself based on a selection criterion for frictional heating derived for the study of high-latitude F-region ion temperature observations from the Atmospheric Explorer-C satellite. In the present study, the diurnal distribution of ion frictional heating observed by EISCAT is established and, furthermore, its dependence on geomagnetic activity and the orientation of the interplanetary magnetic field (IMF is investigated; results are interpreted with reference to corresponding distributions of enhanced ion velocity, again derived from the extended set of EISCAT UHF common programme observations. The radar, due to its location relative to the large-scale convection pattern, observes ion frictional heating principally during the night, although preferentially during the post-midnight hours where there is reduced coupling between the ion and neutral populations. There is an increased preponderance of frictional heating during intervals of high geomagnetic activity and for a southward z component of the IMF and, moreover, evidence of asymmetries introduced by the y component of the IMF.

  5. Creating a driving profile for older adults using GPS devices and naturalistic driving methodology [version 2; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Ganesh M. Babulal

    2016-12-01

    Full Text Available Background/Objectives: Road tests and driving simulators are most commonly used in research studies and clinical evaluations of older drivers. Our objective was to describe the process and associated challenges in adapting an existing, commercial, off-the-shelf (COTS, in-vehicle device for naturalistic, longitudinal research to better understand daily driving behavior in older drivers. Design: The Azuga G2 Tracking DeviceTM was installed in each participant’s vehicle, and we collected data over 5 months (speed, latitude/longitude every 30-seconds when the vehicle was driven.  Setting: The Knight Alzheimer’s Disease Research Center at Washington University School of Medicine. Participants: Five individuals enrolled in a larger, longitudinal study assessing preclinical Alzheimer disease and driving performance.  Participants were aged 65+ years and had normal cognition. Measurements:  Spatial components included Primary Location(s, Driving Areas, Mean Centers and Unique Destinations.  Temporal components included number of trips taken during different times of the day.  Behavioral components included number of hard braking, speeding and sudden acceleration events. Methods:  Individual 30-second observations, each comprising one breadcrumb, and trip-level data were collected and analyzed in R and ArcGIS.  Results: Primary locations were confirmed to be 100% accurate when compared to known addresses.  Based on the locations of the breadcrumbs, we were able to successfully identify frequently visited locations and general travel patterns.  Based on the reported time from the breadcrumbs, we could assess number of trips driven in daylight vs. night.  Data on additional events while driving allowed us to compute the number of adverse driving alerts over the course of the 5-month period. Conclusions: Compared to cameras and highly instrumented vehicle in other naturalistic studies, the compact COTS device was quickly installed and

  6. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting of observational studies].

    Science.gov (United States)

    von Elm, E; Altman, D G; Egger, M; Pocock, S J; Gøtzsche, P C; Vandenbroucke, J P

    2008-06-01

    Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  7. A moving story: Whole-body motor training selectively improves the appraisal of action meanings in naturalistic narratives.

    Science.gov (United States)

    Trevisan, Piergiorgio; Sedeño, Lucas; Birba, Agustina; Ibáñez, Agustín; García, Adolfo M

    2017-10-02

    This study examined whether systematic whole-body stimulation and increased attention to visuospatial motion patterns can enhance the appraisal of action meanings evoked by naturalistic texts. Participants listened to action and neutral (non-action) narratives before and after videogame-based bodily training, and responded to questions on information realized by verbs (denoting abstract and action processes) and circumstances (conveying locative or temporal details, for example). Strategically, we worked with dyslexic children, whose potential comprehension deficits could give room to post-training improvements. Results showed a selective boost in understanding of action information, even when controlling for baseline performance. Also, this effect proved uninfluenced by short-term memory skills, and it was absent when training relied on non-action videogames requiring minimal bodily engagement. Of note, the movements described in the texts did not match those performed by participants, suggesting that well-established effector- and direction-specific language embodiment effects may be accompanied by more coarse-grained sensorimotor resonance, driven by activation of motor and visuospatial sensory systems. In sum, the stimulation of movement-related mechanisms seems to selectively boost the appraisal of actions evoked by naturalistic texts. By demonstrating such links between two real-life activities, our study offers an empirical tie between embodied and situated accounts of cognition.

  8. Effect of a naturalistic prospective memory-related task on the cortisol awakening response in young children.

    Science.gov (United States)

    Bäumler, Damaris; Kliegel, Matthias; Kirschbaum, Clemens; Miller, Robert; Alexander, Nina; Stalder, Tobias

    2014-12-01

    Activation of prospective memory (PM) representations following awakening has been proposed to modulate expression of the cortisol awakening response (CAR). However, experimental testing of this hypothesis is still missing. This study examined the effect of a naturalistic PM-related manipulation on the CAR in a sample of 35 preschool-aged children. The CAR was assessed on two study days (0 and 30min post-awakening) using objective verification of awakening and sampling times. Children had to remember to perform a naturalistic PM-related task (reminding their parents about a gift) on the experimental day while there was no intervention on the control day (counterbalanced order). Results revealed an increased CAR on the experimental day (mean±SD increase: 9.97±7.05nmol/L) compared to the control day (mean±SD increase: 5.45±8.14nmol/L; p=.022). Our findings concur with the notion that expression of the CAR is modulated by post-awakening anticipatory processes involving activation of PM representations. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Contribution of infrared observations to the study of supernovae remnants

    International Nuclear Information System (INIS)

    Douvion, Thomas

    2000-01-01

    This research thesis addresses the study of dust in young supernovae remnants observed in middle infrared, mainly by means of the ISOCAM instrument installed on the ISO satellite. The author first presents the supernovae physics and the studied young remnants, describes dusts and the main sites of formation and destruction, and outlines the difficulties and benefits of observations performed in the middle infrared. Then, the author reports acquired evidences related to the formation of dusts in supernovae, and the search for a millimetre emission by cold dust contained in regions which are not yet excited by the shock, in order to better assess the overall quantities created by supernovae. He reports the use of observations of dust and neon in Cassiopeia A to perform a diagnosis on the mixture of elements during the supernovae explosion [fr

  10. general paralysis in a tropical country. study of 43 observations

    African Journals Online (AJOL)

    GENERAL PARALYSIS IN A TROPICAL COUNTRY. STUDY OF 43 OBSERVATIONS. Amara Cisse, Yves Morel, Abass Fodé Cisse, Naby Camara, Bangaly Cisse, Morifode Doukoure, Ibrahima Sory Souare, Mariam Barry, Siaka Camara, Sele Kourouma, Mohamed Mmah Diaby, L Dasilva, Amara Sylla, Hasmiou Dia ...

  11. An observational study on the relationship between plasma vitamin ...

    African Journals Online (AJOL)

    Methods. In a prospective, observational study of 25 adult septic shock patients, serial blood samples were analysed for vitamin C, thiobarbituric acid-reactive substances (TBARS) (a biomarker of oxidative stress), and soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin. (markers of endothelial dysfunction).

  12. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...

  13. An observational study of defensible space in the neighbourhood park

    Science.gov (United States)

    Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

    2018-02-01

    The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

  14. Observing position and movements in hydrotherapy: a pilot study.

    Science.gov (United States)

    Stark, Mary Ann; Rudell, Barb; Haus, George

    2008-01-01

    To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. Descriptive, observational pilot study. A rural community hospital that provided hydrotherapy in labor. Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

  15. Comparisons of Portable Sleep Monitors of Different Modalities: Potential as Naturalistic Sleep Recorders

    Directory of Open Access Journals (Sweden)

    Masahiro Matsuo

    2016-07-01

    Full Text Available Background: Humans spend more than a fourth of their life sleeping, and sleep quality has been significantly linked to health. However, the objective examination of ambulatory sleep quality remains a challenge, since sleep is a state of unconsciousness, which limits the reliability of self-reports. Therefore, a non-invasive, continuous, and objective method for the recording and analysis of naturalistic sleep is required.Objective: Portable sleep recording devices provide a suitable solution for the ambulatory analysis of sleep quality. In this study, the performance of two activity-based sleep monitors (Actiwatch and MTN-210 and a single-channel EEG-based sleep monitor (SleepScope were compared in order to examine their reliability for the assessment of sleep quality.Methods: Twenty healthy adults were recruited for this study. First, data from daily activity recorded by Actiwatch and MTN-210 were compared to determine whether MTN-210, a more affordable device, could yield data similar to Actiwatch, the de-facto standard. In addition, sleep detection ability was examined using data obtained by polysomnography as reference. One simple analysis included comparing the sleep/wake detection ability of Actiwatch, MTN-210, and SleepScope. Furthermore, the fidelity of sleep stage determination was examined using SleepScope in finer time resolution. Results: The results indicate that MTN-210 demonstrates an activity pattern comparable to that of Actiwatch, although their sensitivity preferences were not identical. Moreover, MTN-210 provides assessment of sleep duration comparable to that of the wrist-worn Actiwatch when MTN-210 was attached to the body. SleepScope featured superior overall sleep detection performance among the three methods tested. Furthermore, SleepScope was able to provide information regarding sleep architecture, although systemic bias was found. Conclusion: The present results suggest that single-channel EEG-based sleep monitors are

  16. Recognising safety critical events: can automatic video processing improve naturalistic data analyses?

    Science.gov (United States)

    Dozza, Marco; González, Nieves Pañeda

    2013-11-01

    New trends in research on traffic accidents include Naturalistic Driving Studies (NDS). NDS are based on large scale data collection of driver, vehicle, and environment information in real world. NDS data sets have proven to be extremely valuable for the analysis of safety critical events such as crashes and near crashes. However, finding safety critical events in NDS data is often difficult and time consuming. Safety critical events are currently identified using kinematic triggers, for instance searching for deceleration below a certain threshold signifying harsh braking. Due to the low sensitivity and specificity of this filtering procedure, manual review of video data is currently necessary to decide whether the events identified by the triggers are actually safety critical. Such reviewing procedure is based on subjective decisions, is expensive and time consuming, and often tedious for the analysts. Furthermore, since NDS data is exponentially growing over time, this reviewing procedure may not be viable anymore in the very near future. This study tested the hypothesis that automatic processing of driver video information could increase the correct classification of safety critical events from kinematic triggers in naturalistic driving data. Review of about 400 video sequences recorded from the events, collected by 100 Volvo cars in the euroFOT project, suggested that drivers' individual reaction may be the key to recognize safety critical events. In fact, whether an event is safety critical or not often depends on the individual driver. A few algorithms, able to automatically classify driver reaction from video data, have been compared. The results presented in this paper show that the state of the art subjective review procedures to identify safety critical events from NDS can benefit from automated objective video processing. In addition, this paper discusses the major challenges in making such video analysis viable for future NDS and new potential

  17. Association between abciximab and length of stay in intensive care for patients undergoing percutaneous coronary intervention. A 2-stage econometric model in a naturalistic setting.

    Science.gov (United States)

    Lage, M J; Barber, B L; Bala, M; McCollam, P L; Ball, D E

    2000-12-01

    To examine the effect of abciximab treatment on intensive care length of stay for patients undergoing percutaneous coronary intervention (PCI). A retrospective study conducted in a naturalistic setting. A 2-stage econometric model was used to control for the influence of possible selection bias across categories of patients and for both observable and unobservable factors correlated with each patient's treatment selection and length of stay in intensive care. Multivariate analysis was applied to control for a wide range of factors (patient demographics, insurance provider, health conditions, admission and discharge information, and hospital characteristics) that may influence intensive care length of stay. Retrospective data were obtained from HCIA's Clinical Pathways Database. Patients (n = 13,364) who were hospitalised in any of 87 hospitals across the US over the period from October 1, 1995 to December 1, 1996. After controlling for high-risk indications and selection bias, results indicated that administration of abciximab was associated with a significantly shorter length of stay in intensive care compared with not administering a GPIIb/IIIa inhibitor (0.45 fewer days; p < or = 0.0001). In a subgroup analysis of patients having an acute myocardial infarction (n = 4793), administration of abciximab was also associated with a significantly shorter intensive care stay (0.27 fewer days; p < 0.0001). Results of this study indicate that the administration of abciximab is associated with a reduction in the length of stay in intensive care. This reduction implies potential cost offsets for patients undergoing PCI who receive abciximab.

  18. Driving performance while using cell phones: an observational study.

    Science.gov (United States)

    Rosenbloom, Tova

    2006-01-01

    Through spontaneous driving observations, this study sought to examine the impact of using a hands-free cell phone while driving on speed and safe gap keeping behaviors. The study also examined the association between the measure of disturbance created by using a cell phone and the driver's awareness of the disturbance. Twenty-three male adults were observed while driving for an hour and a half each; drivers were unaware of being observed. During the session, each of the participants received a phone call, initiated by an associate of the observer. The experiment was divided into two periods during which the experimental parameters were monitored: 10 minutes during conversation on a cell phone and 10 minutes of non-conversation on a hands-free cell phone. After the experiment, the driver was questioned concerning the extent to which his/her driving was disturbed by the cell phone conversation. T-test for matched samples revealed that the gaps between the drivers' cars and those in front of them diminished when drivers were engaged in the cell phone conversations. Repeated measures ANOVA revealed that drivers that had short conversations did not change their speed, while drivers who were engaged in long (over 16 minutes) conversations drove faster. No effect of drivers' awareness toward cell phone-related disturbance on actual driving behavior monitored in the present study was found.

  19. Visual Sensory and Visual-Cognitive Function and Rate of Crash and Near-Crash Involvement Among Older Drivers Using Naturalistic Driving Data.

    Science.gov (United States)

    Huisingh, Carrie; Levitan, Emily B; Irvin, Marguerite R; MacLennan, Paul; Wadley, Virginia; Owsley, Cynthia

    2017-06-01

    An innovative methodology using naturalistic driving data was used to examine the association between visual sensory and visual-cognitive function and rates of future crash or near-crash involvement among older drivers. The Strategic Highway Research Program (SHRP2) Naturalistic Driving Study was used for this prospective analysis. The sample consisted of N = 659 drivers aged ≥70 years and study participation lasted 1 or 2 years for most participants. Distance and near visual acuity, contrast sensitivity, peripheral vision, visual processing speed, and visuospatial skills were assessed at baseline. Crash and near-crash involvement were based on video recordings and vehicle sensors. Poisson regression models were used to generate crude and adjusted rate ratios (RRs) and 95% confidence intervals, while accounting for person-miles of travel. After adjustment, severe impairment of the useful field of view (RR = 1.33) was associated with an increased rate of near-crash involvement. Crash, severe crash, and at-fault crash involvement were associated with impaired contrast sensitivity in the worse eye (RRs = 1.38, 1.54, and 1.44, respectively) and far peripheral field loss in both eyes (RRs = 1.74, 2.32, and 1.73, respectively). Naturalistic driving data suggest that contrast sensitivity in the worse eye and far peripheral field loss in both eyes elevate the rates of crash involvement, and impaired visual processing speed elevates rates of near-crash involvement among older drivers. Naturalistic driving data may ultimately be critical for understanding the relationship between vision and driving safety.

  20. Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting.

    Science.gov (United States)

    Cheon, Eun-Jin; Koo, Bon-Hoon; Seo, Wan-Seok; Lee, Jun-Yeob; Choi, Joong-Hyeon; Song, Shin-Ho

    2015-03-01

    Few well-controlled studies have considered neurofeedback treatment in adult psychiatric patients. In this regard, the present study investigates the characteristics and effects of neurofeedback on adult psychiatric patients in a naturalistic setting. A total of 77 adult patients with psychiatric disorders participated in this study. Demographic data and neurofeedback states were retrospectively analyzed, and the effects of neurofeedback were evaluated using clinical global impression (CGI) and subjective self-rating scales. Depressive disorders were the most common psychiatric disorders (19; 24.7 %), followed by anxiety disorders (18; 23.4 %). A total of 69 patients (89.6 %) took medicine, and the average frequency of neurofeedback was 17.39 ± 16.64. Neurofeedback was applied to a total of 39 patients (50.6 %) more than 10 times, and 48 patients (62.3 %) received both β/SMR and α/θ training. The discontinuation rate was 33.8 % (26 patients). There was significant difference between pretreatment and posttreatment CGI scores (neurofeedback as an effective complimentary treatment for adult patients with psychiatric disorders.

  1. Neuroleptic-induced movement disorders in a naturalistic schizophrenia population: diagnostic value of actometric movement patterns

    Directory of Open Access Journals (Sweden)

    Tuisku Katinka

    2008-04-01

    Full Text Available Abstract Background Neuroleptic-induced movement disorders (NIMDs have overlapping co-morbidity. Earlier studies have described typical clinical movement patterns for individual NIMDs. This study aimed to identify specific movement patterns for each individual NIMD using actometry. Methods A naturalistic population of 99 schizophrenia inpatients using conventional antipsychotics and clozapine was evaluated. Subjects with NIMDs were categorized using the criteria for NIMD found in the Diagnostic and Statistical Manual for Mental Disorders – Fourth Edition (DSM-IV. Two blinded raters evaluated the actometric-controlled rest activity data for activity periods, rhythmical activity, frequencies, and highest acceleration peaks. A simple subjective question was formulated to test patient-based evaluation of NIMD. Results The patterns of neuroleptic-induced akathisia (NIA and pseudoakathisia (PsA were identifiable in actometry with excellent inter-rater reliability. The answers to the subjective question about troubles with movements distinguished NIA patients from other patients rather well. Also actometry had rather good screening performances in distinguishing akathisia from other NIMD. Actometry was not able to reliably detect patterns of neuroleptic-induced parkinsonism and tardive dyskinesia. Conclusion The present study showed that pooled NIA and PsA patients had a different pattern in lower limb descriptive actometry than other patients in a non-selected sample. Careful questioning of patients is a useful method of diagnosing NIA in a clinical setting.

  2. Effects of alcohol portrayals in movies on actual alcohol consumption: an observational experimental study.

    Science.gov (United States)

    Koordeman, Renske; Anschutz, Doeschka J; van Baaren, Rick B; Engels, Rutger C M E

    2011-03-01

    This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use and identification with the movie actor/character were assessed as moderators. A two (sex) × two (movie: alcohol or no portrayal of alcohol) between-subject design was used. Participants watched a contemporary movie in a semi-naturalistic living room setting. A total of 122 same-sex, young adult dyads (ages 18-29 years) participated in the experiment. Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption. Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption. Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  3. Folic Acid Supplementation and Preterm Birth: Results from Observational Studies

    Directory of Open Access Journals (Sweden)

    Elena Mantovani

    2014-01-01

    Full Text Available Introduction. Folic acid (FA supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB, preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs has not found a beneficial role of FA in reducing the rate of PTBs. Aim of the Study. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. Materials and Methods. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. Results. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  4. Olanzapine monotherapy and olanzapine combination therapy in the treatment of mania: 12-week results from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) observational study.

    Science.gov (United States)

    Vieta, Eduard; Panicali, Francesco; Goetz, Iris; Reed, Catherine; Comes, Merce; Tohen, Mauricio

    2008-02-01

    To evaluate the 12-week outcomes (effectiveness, tolerability, and patterns of medication use) of olanzapine (either in antimanic monotherapy or in combination with other antipsychotics, anticonvulsants, and/or lithium) in patients with bipolar mania or mixed mania. EMBLEM (European Mania in Bipolar Longitudinal Evaluation of Medication) is a 24-month prospective observational study of in- and outpatients with acute mania/mixed mania conducted in 14 European countries. Primary outcome measures included Clinical Global Impressions-Bipolar Disorder scale (overall, mania, and depression); 5-item Hamilton Depression Rating Scale; and Young Mania Rating Scale. Tolerability measures included a questionnaire to assess patients' symptomatic complaints. Overall, 2004 patients received olanzapine (olanzapine monotherapy, n=673; olanzapine combination, n=1331). Concomitant therapy with antidepressants and/or anxiolytics was possible in both groups. The countries significantly differed in the use of olanzapine monotherapy versus olanzapine combination (pEMBLEM results suggest that in naturalistic settings, olanzapine (both as monotherapy and combination) may be effective in treating patients with bipolar mania. The use of olanzapine monotherapy or combination varies significantly across countries, but combination is generally the rule, rather than the exception.

  5. “An Aristocracy of Talent”: The South Carolina Physician-Naturalists and their Times

    Science.gov (United States)

    Bryan, Charles S.; Whitehead, A. Weaver

    2014-01-01

    During the natural history movement of the 18th and early 19th centuries, Charleston as a center was rivaled in the United States only by Philadelphia, New York, and Boston. Prominent physician-naturalists included Alexander Garden (for whom the gardenia is named), John Edwards Holbrook (“father of American herpetology”), and Francis Peyre Porcher (whose Resources of Southern Fields and Forests helped Confederates compensate for drug shortages). The Charleston physician-naturalists belonged to an “aristocracy of talent” as distinguished from the “aristocracy of wealth” of lowcountry planters, who probably did more than any other group to perpetuate slavery and propel the South toward a disastrous civil war. None of the physician-naturalists actively opposed slavery or secession, a reminder that we are all prisoners of the prevailing paradigms and prejudices of our times. PMID:25125748

  6. "An aristocracy of talent": the South Carolina physician-naturalists and their times.

    Science.gov (United States)

    Bryan, Charles S; Whitehead, A Weaver

    2014-01-01

    During the natural history movement of the 18th and early 19th centuries, Charleston as a center was rivaled in the United States only by Philadelphia, New York, and Boston. Prominent physician-naturalists included Alexander Garden (for whom the gardenia is named), John Edwards Holbrook ("father of American herpetology"), and Francis Peyre Porcher (whose Resources of Southern Fields and Forests helped Confederates compensate for drug shortages). The Charleston physician-naturalists belonged to an "aristocracy of talent" as distinguished from the "aristocracy of wealth" of lowcountry planters, who probably did more than any other group to perpetuate slavery and propel the South toward a disastrous civil war. None of the physician-naturalists actively opposed slavery or secession, a reminder that we are all prisoners of the prevailing paradigms and prejudices of our times.

  7. Sympathetic science: Charles Darwin, Joseph Hooker, and the passions of Victorian naturalists.

    Science.gov (United States)

    Endersby, Jim

    2009-01-01

    This essay examines the complex tangle of emotional and scientific attachments that linked Darwin and botanist Joseph Dalton Hooker. Analyzing their roles as husbands, fathers, and novel readers demonstrates that possessing and expressing sympathy was as important for Victorian naturalists as it was for Victorian husbands. Sympathy was a scientific skill that Victorian naturalists regarded as necessary to fully understand the living world; although sympathy became increasingly gendered as feminine over the course of the century, its importance to male naturalists requires us to rethink the ways gender roles were negotiated in Victorian Britain. Botany was, for men like Darwin and Hooker, an acceptably masculine pursuit that nevertheless allowed--and even required--them to be sensitive and sympathetic.

  8. Subtypes of depression and their overlap in a naturalistic inpatient sample of major depressive disorder.

    Science.gov (United States)

    Musil, Richard; Seemüller, Florian; Meyer, Sebastian; Spellmann, Ilja; Adli, Mazda; Bauer, Michael; Kronmüller, Klaus-Thomas; Brieger, Peter; Laux, Gerd; Bender, Wolfram; Heuser, Isabella; Fisher, Robert; Gaebel, Wolfgang; Schennach, Rebecca; Möller, Hans-Jürgen; Riedel, Michael

    2018-03-01

    Subtyping depression is important in order to further delineate biological causes of depressive syndromes. The aim of this study was to evaluate clinical and outcome characteristics of distinct subtypes of depression and to assess proportion and features of patients fulfilling criteria for more than one subtype. Melancholic, atypical and anxious subtypes of depression were assessed in a naturalistic sample of 833 inpatients using DSM-IV specifiers based on operationalized criteria. Baseline characteristics and outcome criteria at discharge were compared between distinct subtypes and their overlap. A substantial proportion of patients (16%) were classified with more than one subtype of depression, 28% were of the distinct anxious, 7% of the distinct atypical and 5% of the distinct melancholic subtype. Distinct melancholic patients had shortest duration of episode, highest baseline depression severity, but were more often early improvers; distinct anxious patients had higher NEO-Five Factor Inventory (NEO-FFI) neuroticism scores compared with patients with unspecific subtype. Melancholic patients with overlap of anxious features had worse treatment outcome compared to distinct melancholic and distinct anxious subtype. Distinct subtypes differed in only few variables and patients with overlap of depression subtypes may have independent clinical and outcome characteristics. Studies investigating biological causes of subtypes of depression should take influence of features of other subtypes into account. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Effects of a naturalistic sign intervention on expressive language of toddlers with Down syndrome.

    Science.gov (United States)

    Wright, Courtney A; Kaiser, Ann P; Reikowsky, Dawn I; Roberts, Megan Y

    2013-06-01

    In this study, the authors evaluated the effects of Enhanced Milieu Teaching (EMT; Hancock & Kaiser, 2006) blended with Joint Attention, Symbolic Play, and Emotional Regulation (JASPER; Kasari, Freeman, & Paparella, 2006) to teach spoken words and manual signs (Words + Signs) to young children with Down syndrome (DS). Four toddlers (ages 23-29 months) with DS were enrolled in a study with a multiple-baseline, across-participants design. Following baseline, 20 play-based treatment sessions (20-30 min each) occurred twice weekly. Spoken words and manual signs were modeled and prompted by a therapist who used EMT/JASPER teaching strategies. The authors assessed generalization to interactions with parents at home. There was a functional relation between the therapist's implementation of EMT/JASPER Words + Signs and all 4 children's use of signs during the intervention. Gradual increases in children's use of spoken words occurred, but there was not a clear functional relation. All children generalized their use of signs to their parents at home. The infusion of manual signs with verbal models within a framework of play, joint attention, and naturalistic language teaching appears to facilitate development of expressive sign and word communication in young children with DS.

  10. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 6, Driver Behaviour Monitoring through Naturalistic Driving: Deliverable 6.5: Naturalistic Driving for cross-national monitoring of SPIs and Exposure : an overview.

    NARCIS (Netherlands)

    Wegman, R.W.N. & Bos, N.M.

    2015-01-01

    WP6 of DaCoTA, Driver Behaviour Monitoring through Naturalistic Driving, focuses on the usefulness and feasibility of applying the Naturalistic Driving method for monitoring within the framework of ERSO. The aim is to continuously collect comparable information about the road safety level in EU

  11. Effective population management practices in diabetes care - an observational study

    DEFF Research Database (Denmark)

    Frølich, Anne; Bellows, Jim; Nielsen, Bo Friis

    2010-01-01

    Of fifteen diabetes care management practices, our data indicate that high performance is most associated with provider alerts and more weakly associated with action plans and with guideline distribution and training. Lack of convergence in the literature on effective care management practices su...... suggests that factors contributing to high performance may be highly context-dependent or that the factors involved may be too numerous or their implementation too nuanced to be reliably identified in observational studies....

  12. Strategies GeoCape Intelligent Observation Studies @ GSFC

    Science.gov (United States)

    Cappelaere, Pat; Frye, Stu; Moe, Karen; Mandl, Dan; LeMoigne, Jacqueline; Flatley, Tom; Geist, Alessandro

    2015-01-01

    This presentation provides information a summary of the tradeoff studies conducted for GeoCape by the GSFC team in terms of how to optimize GeoCape observation efficiency. Tradeoffs include total ground scheduling with simple priorities, ground scheduling with cloud forecast, ground scheduling with sub-area forecast, onboard scheduling with onboard cloud detection and smart onboard scheduling and onboard image processing. The tradeoffs considered optimzing cost, downlink bandwidth and total number of images acquired.

  13. Folic acid supplementation and preterm birth: results from observational studies.

    Science.gov (United States)

    Mantovani, Elena; Filippini, Francesca; Bortolus, Renata; Franchi, Massimo

    2014-01-01

    Folic acid (FA) supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB), preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs) has not found a beneficial role of FA in reducing the rate of PTBs. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  14. Targeted Maximum Likelihood Estimation for Causal Inference in Observational Studies.

    Science.gov (United States)

    Schuler, Megan S; Rose, Sherri

    2017-01-01

    Estimation of causal effects using observational data continues to grow in popularity in the epidemiologic literature. While many applications of causal effect estimation use propensity score methods or G-computation, targeted maximum likelihood estimation (TMLE) is a well-established alternative method with desirable statistical properties. TMLE is a doubly robust maximum-likelihood-based approach that includes a secondary "targeting" step that optimizes the bias-variance tradeoff for the target parameter. Under standard causal assumptions, estimates can be interpreted as causal effects. Because TMLE has not been as widely implemented in epidemiologic research, we aim to provide an accessible presentation of TMLE for applied researchers. We give step-by-step instructions for using TMLE to estimate the average treatment effect in the context of an observational study. We discuss conceptual similarities and differences between TMLE and 2 common estimation approaches (G-computation and inverse probability weighting) and present findings on their relative performance using simulated data. Our simulation study compares methods under parametric regression misspecification; our results highlight TMLE's property of double robustness. Additionally, we discuss best practices for TMLE implementation, particularly the use of ensembled machine learning algorithms. Our simulation study demonstrates all methods using super learning, highlighting that incorporation of machine learning may outperform parametric regression in observational data settings. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Research Approaches in the Study of Religion

    Directory of Open Access Journals (Sweden)

    Szocik Konrad

    2015-02-01

    Full Text Available Despite development of secular ideas and concepts in the Western world, we can observe increasing interest in the study of religion. However, this popularity of the study of religion and different research approaches has caused that in some sense scholars that were studying religion came to a dead point. Here I show that the most optimal research approach in the study of religion is pluralistic, integral paradigm which connects old traditional methods with naturalistic, cognitive and sometimes experimental approach.

  16. Predictors of continuation with olanzapine during the 1-year naturalistic treatment of patients with schizophrenia in Japan

    Directory of Open Access Journals (Sweden)

    Ye W

    2011-12-01

    Full Text Available Wenyu Ye1, Haya Ascher-Svanum2, Yuka Tanji3, Jennifer A Flynn3, Michihiro Takahashi3,41Lilly Suzhou Pharmaceutical Co, Shanghai, People’s Republic of China; 2Eli Lilly and Company, Indianapolis, IN, USA; 3Lilly Research Laboratories Japan, Eli Lilly Japan KK, Kobe, 4Terauchi-Takahashi Psychiatric Clinic, Ashiya, JapanPurpose: Treatment continuation is considered an important measure of antipsychotic effectiveness in schizophrenia, reflecting the medication’s efficacy, safety, and tolerability from both patients’ and clinicians’ perspectives. This study identified characteristics of patients with schizophrenia who continue olanzapine therapy for a 1-year period in Japan.Methods: In a large (N = 1850, prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Baseline characteristics were compared using t-tests and chi-square tests. Stepwise logistic regression was used to identify independent baseline predictors of treatment continuation.Results: Most patients (68.2% continued with olanzapine therapy for the full 1-year study period, with an average duration of 265.5 ± 119.4 days. At baseline, patients who continued were significantly more likely to be male, older, and inpatients; have longer illness duration, higher negative and cognitive symptoms, better health-related quality of life, and prior anticholinergic use. Continuers were significantly less likely to engage in social activities, live independently, work for pay, or have prior antidepressant use. Continuers showed significantly greater early (3-month improvement in global symptom severity. Logistic regression found that continuation was significantly predicted by longer illness duration, lower positive symptoms, higher negative symptoms, and better health-related quality of life.Conclusions: In this large naturalistic study in Japan, most patients with schizophrenia stayed on olanzapine therapy for

  17. A foundational observation method for studying design situations

    DEFF Research Database (Denmark)

    Cash, Philip; Hicks, Ben; Culley, Steve

    2015-01-01

    impact of individual studies is severely constrained. This paper begins to address this issue by introducing and developing a foundational method for observational design research to improve replicability, reuse, and overall comparability of empirical studies. A three-step foundational method is proposed...... that covers capture, coding, and analysis. The capture step defines overall and situational context as well as multiple capture streams, generating a broad data-set that can be examined from multiple perspectives. The coding step employs a multi-level approach that seeks to minimise workload while describing...

  18. Using data mining techniques to characterize participation in observational studies.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2016-12-01

    Data mining techniques are gaining in popularity among health researchers for an array of purposes, such as improving diagnostic accuracy, identifying high-risk patients and extracting concepts from unstructured data. In this paper, we describe how these techniques can be applied to another area in the health research domain: identifying characteristics of individuals who do and do not choose to participate in observational studies. In contrast to randomized studies where individuals have no control over their treatment assignment, participants in observational studies self-select into the treatment arm and therefore have the potential to differ in their characteristics from those who elect not to participate. These differences may explain part, or all, of the difference in the observed outcome, making it crucial to assess whether there is differential participation based on observed characteristics. As compared to traditional approaches to this assessment, data mining offers a more precise understanding of these differences. To describe and illustrate the application of data mining in this domain, we use data from a primary care-based medical home pilot programme and compare the performance of commonly used classification approaches - logistic regression, support vector machines, random forests and classification tree analysis (CTA) - in correctly classifying participants and non-participants. We find that CTA is substantially more accurate than the other models. Moreover, unlike the other models, CTA offers transparency in its computational approach, ease of interpretation via the decision rules produced and provides statistical results familiar to health researchers. Beyond their application to research, data mining techniques could help administrators to identify new candidates for participation who may most benefit from the intervention. © 2016 John Wiley & Sons, Ltd.

  19. Study of some defects observed in the hexagonal liquid crystals

    International Nuclear Information System (INIS)

    Oswald, Patrick

    1981-01-01

    A polarising microscopy study of the disclinations in an hexagonal discotic liquid crystal (hexa-pentoxy-triphenylene) allows us to confirm the theory of the developable domains and the existence of the disclinations as involute of the circle. The absence of the lines S = 1 leads us to propose a model of core in which the energetic instability of these lines is emphasized. The nature of the core is discussed: it is probably filled with hexagonal liquid crystal. Moreover the birefringence Δn is measured and a first estimate of the anchoring energies of the discotic both on the glass and in contact with the air is given. The Michelson interferometry study of the interaction between the disclinations and the free surface has allowed to observe a strong anisotropy of the interfacial tension. At last a study of the walls leads to a classification according to the matching angle and to a first estimate of the penetration distance λ. A similar study has been undertaken in an inverse middle liquid crystalline phase (Na dioctylsulfosuccinate). A strong dependence of the elastic constants with the water concentration is observed. The micellar → hexagonal transition is studied. (author) [fr

  20. Learning phonemic vowel length from naturalistic recordings of Japanese infant-directed speech.

    Directory of Open Access Journals (Sweden)

    Ricardo A H Bion

    Full Text Available In Japanese, vowel duration can distinguish the meaning of words. In order for infants to learn this phonemic contrast using simple distributional analyses, there should be reliable differences in the duration of short and long vowels, and the frequency distribution of vowels must make these differences salient enough in the input. In this study, we evaluate these requirements of phonemic learning by analyzing the duration of vowels from over 11 hours of Japanese infant-directed speech. We found that long vowels are substantially longer than short vowels in the input directed to infants, for each of the five oral vowels. However, we also found that learning phonemic length from the overall distribution of vowel duration is not going to be easy for a simple distributional learner, because of the large base-rate effect (i.e., 94% of vowels are short, and because of the many factors that influence vowel duration (e.g., intonational phrase boundaries, word boundaries, and vowel height. Therefore, a successful learner would need to take into account additional factors such as prosodic and lexical cues in order to discover that duration can contrast the meaning of words in Japanese. These findings highlight the importance of taking into account the naturalistic distributions of lexicons and acoustic cues when modeling early phonemic learning.

  1. CONTEXTUALIZING NATURALISTIC DRIVING DATA IN A RURAL STATE AMONG DRIVERS WITH AND WITHOUT OBSTRUCTIVE SLEEP APNEA.

    Science.gov (United States)

    Dawson, Jeffrey D; Bair, Elizabeth; Askan, Nazan; Sewell, Kelly; Tippin, Jon; Rizzo, Matthew

    2017-06-01

    In naturalistic studies, Global Positioning System (GPS) data and date/time stamps can link driver exposure to specific environments (e.g., road types, speed limits, night driving, etc.), providing valuable context for analyzing critical events, such as crashes, near crashes, and breaches of accelerometer limits. In previous work, we showed how to automate this contextualization, using GPS data obtained at 1 Hz and merging this with Geographic Information Systems (GIS) databases maintained by the Iowa Department of Transportation (DOT). Here we further demonstrate our methods by analyzing data from 80 drivers with obstructive sleep apnea (OSA) and 48 controls, and comparing the two groups with respect to several factors of interest. The majority of comparisons found no difference between groups, suggesting similar patterns of exposures to driving environments in OSA and control drivers. However, OSA drivers appeared to spend slightly more time on roads with annual traffic counts of 500-10,000 and less time driving on wider highways, during twilight, and on roads with 10,000-25,000 annual traffic counts.

  2. Naturalistic Decision Making in Power Grid Operations: Implications for Dispatcher Training and Usability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Greitzer, Frank L.; Podmore, Robin

    2008-11-17

    The focus of the present study is on improved training approaches to accelerate learning and improved methods for analyzing effectiveness of tools within a high-fidelity power grid simulated environment. A theory-based model has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The theoretical foundation for the method is based on the concepts of situation awareness, the methods of cognitive task analysis, and the naturalistic decision making (NDM) approach of Recognition Primed Decision Making. The method has been systematically explored and refined as part of a capability demonstration of a high-fidelity real-time power system simulator under normal and emergency conditions. To examine NDM processes, we analyzed transcripts of operator-to-operator conversations during the simulated scenario to reveal and assess NDM-based performance criteria. The results of the analysis indicate that the proposed framework can be used constructively to map or assess the Situation Awareness Level of the operators at each point in the scenario. We can also identify the mental models and mental simulations that the operators employ at different points in the scenario. This report documents the method, describes elements of the model, and provides appendices that document the simulation scenario and the associated mental models used by operators in the scenario.

  3. Neural correlates of naturalistic social cognition: brain-behavior relationships in healthy adults.

    Science.gov (United States)

    Deuse, L; Rademacher, L M; Winkler, L; Schultz, R T; Gründer, G; Lammertz, S E

    2016-11-01

    Being able to infer the thoughts, feelings and intentions of those around us is indispensable in order to function in a social world. Despite growing interest in social cognition and its neural underpinnings, the factors that contribute to successful mental state attribution remain unclear. Current knowledge is limited because the most widely used tasks suffer from two main constraints: (i) They fail to capture individual variability due to ceiling effects and (ii) they use highly simplistic, often artificial stimuli inapt to mirror real-world socio-cognitive demands. In the present study, we address these problems by employing complex depictions of naturalistic social interactions that vary in both valence (positive vs negative) and ambiguity (high vs low). Thirty-eight healthy participants (20 female) made mental state judgments while brain responses were obtained using functional magnetic resonance imaging (fMRI). Accuracy varied based on valence and ambiguity conditions and women were more accurate than men with highly ambiguous social stimuli. Activity of the orbitofrontal cortex predicted performance in the high ambiguity condition. The results shed light on subtle differences in mentalizing abilities and associated neural activity. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  4. From naturalistic neuroscience to modeling radical embodiment with narrative enactive systems.

    Science.gov (United States)

    Tikka, Pia; Kaipainen, Mauri Ylermi

    2014-01-01

    Mainstream cognitive neuroscience has begun to accept the idea of embodied mind, which assumes that the human mind is fundamentally constituted by the dynamical interactions of the brain, body, and the environment. In today's paradigm of naturalistic neurosciences, subjects are exposed to rich contexts, such as video sequences or entire films, under relatively controlled conditions, against which researchers can interpret changes in neural responses within a time window. However, from the point of view of radical embodied cognitive neuroscience, the increasing complexity alone will not suffice as the explanatory apparatus for dynamical embodiment and situatedness of the mind. We suggest that narrative enactive systems with dynamically adaptive content as stimuli, may serve better to account for the embodied mind engaged with the surrounding world. Among the ensuing challenges for neuroimaging studies is how to interpret brain data against broad temporal contexts of previous experiences that condition the unfolding experience of nowness. We propose means to tackle this issue, as well as ways to limit the exponentially growing combinatoria of narrative paths to a controllable number.

  5. A preliminary investigation of the relationships between historical crash and naturalistic driving.

    Science.gov (United States)

    Pande, Anurag; Chand, Sai; Saxena, Neeraj; Dixit, Vinayak; Loy, James; Wolshon, Brian; Kent, Joshua D

    2017-04-01

    This paper describes a project that was undertaken using naturalistic driving data collected via Global Positioning System (GPS) devices to demonstrate a proof-of-concept for proactive safety assessments of crash-prone locations. The main hypothesis for the study is that the segments where drivers have to apply hard braking (higher jerks) more frequently might be the "unsafe" segments with more crashes over a long-term. The linear referencing methodology in ArcMap was used to link the GPS data with roadway characteristic data of US Highway 101 northbound (NB) and southbound (SB) in San Luis Obispo, California. The process used to merge GPS data with quarter-mile freeway segments for traditional crash frequency analysis is also discussed in the paper. A negative binomial regression analyses showed that proportion of high magnitude jerks while decelerating on freeway segments (from the driving data) was significantly related with the long-term crash frequency of those segments. A random parameter negative binomial model with uniformly distributed parameter for ADT and a fixed parameter for jerk provided a statistically significant estimate for quarter-mile segments. The results also indicated that roadway curvature and the presence of auxiliary lane are not significantly related with crash frequency for the highway segments under consideration. The results from this exploration are promising since the data used to derive the explanatory variable(s) can be collected using most off-the-shelf GPS devices, including many smartphones. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. From naturalistic neuroscience to modeling radical embodiment with narrative enactive systems

    Science.gov (United States)

    Tikka, Pia; Kaipainen, Mauri Ylermi

    2014-01-01

    Mainstream cognitive neuroscience has begun to accept the idea of embodied mind, which assumes that the human mind is fundamentally constituted by the dynamical interactions of the brain, body, and the environment. In today’s paradigm of naturalistic neurosciences, subjects are exposed to rich contexts, such as video sequences or entire films, under relatively controlled conditions, against which researchers can interpret changes in neural responses within a time window. However, from the point of view of radical embodied cognitive neuroscience, the increasing complexity alone will not suffice as the explanatory apparatus for dynamical embodiment and situatedness of the mind. We suggest that narrative enactive systems with dynamically adaptive content as stimuli, may serve better to account for the embodied mind engaged with the surrounding world. Among the ensuing challenges for neuroimaging studies is how to interpret brain data against broad temporal contexts of previous experiences that condition the unfolding experience of nowness. We propose means to tackle this issue, as well as ways to limit the exponentially growing combinatoria of narrative paths to a controllable number. PMID:25339890

  7. Foraging in a complex naturalistic environment: capacity of spatial working memory in flower bats.

    Science.gov (United States)

    Winter, York; Stich, Kai Petra

    2005-02-01

    Memory systems have evolved under selection pressures, such as the need to remember the locations of resources or past events within spatiotemporally dynamic natural environments. The full repertoire of complex behaviours exhibited by animals in dynamic surroundings are, however, difficult to elicit within simply structured laboratory environments. We have developed a computer-controlled naturalistic environment with 64 feeders for simulating dynamic patterns of water or food resource availability (depletion and replenishment) within the laboratory. The combination of feeder and cage remote control permits the automated transfer of animals between cage and test arena and, therefore, high experimental throughput and minimal disturbance to the animals (bats and mice). In the present study, we investigated spatial working memory in nectar-feeding bats (Glossophaga soricina, Phyllostomidae) collecting food from a 64-feeder array. Feeders gave only single rewards within trials so that efficient foraging required bats to avoid depleted locations. Initially, bats tended to revisit feeders (win-stay), but within three trials changed towards a win-shift strategy. The significant avoidance of revisits could not be explained by algorithmic search guiding movement through the array nor by scent cues left by the bats themselves and, thus, the data suggest that bats remembered spatial locations depleted of food. An examination of the recency effect on spatial working memory after bats shifted to a win-shift strategy indicated that bats held more than 40 behaviour actions (feeder visits) in working memory without indication of decay. This result surpasses previous findings for other taxa.

  8. Observations of radiographer communication: An exploratory study using Transactional Analysis

    International Nuclear Information System (INIS)

    Booth, Lisa A.; Manning, David J.

    2006-01-01

    Purpose: Communication in medical imaging is a neglected area of research, despite the necessity for good communication if optimum diagnostic images are to be achieved. Methods: The present study has investigated the styles of communication used in medical imaging, using an approach known as Transactional Analysis. This approach has been demonstrated previously as having reliability and validity, using observations and supporting interviews with medical imaging staff, along with inter-rater observations of radiographer-patient interactions. Results: The results indicate that Transactional Analysis can be used effectively for identifying and naming interaction events in diagnostic radiography, with diagnostic radiographers using five styles of communication. Conclusion: Radiographers tend to use Parental styles of communicating; these styles are commonly associated with a practitioner-centred approach to dealing with patients which often result in non-adherence

  9. Linking Indigenous Knowledge and Observed Climate Change Studies

    Science.gov (United States)

    Alexander, Chief Clarence; Bynum, Nora; Johnson, Liz; King, Ursula; Mustonen, Tero; Neofotis, Peter; Oettle, Noel; Rosenzweig, Cynthia; Sakakibara, Chie; Shadrin, Chief Vyacheslav; hide

    2010-01-01

    We present indigenous knowledge narratives and explore their connections to documented temperature and other climate changes and observed climate change impact studies. We then propose a framework for enhancing integration of these indigenous narratives of observed climate change with global assessments. Our aim is to contribute to the thoughtful and respectful integration of indigenous knowledge with scientific data and analysis, so that this rich body of knowledge can inform science, and so that indigenous and traditional peoples can use the tools and methods of science for the benefit of their communities if they choose to do so. Enhancing ways of understanding such connections are critical as the Intergovernmental Panel on Climate Change Fifth Assessment process gets underway.

  10. Supplementing Oscat winds with Saral Altika observations for cyclone studies

    Science.gov (United States)

    Niharika, K.; Usha Sundari, H. S. V.; Prasad, A. V. V.; Kumari, E. V. S. Sita; Dadhwal, V. K.; Ali, M. M.

    2014-11-01

    Accurate prediction of life cycle of cyclone is very critical to the disaster management practices. Since the cyclones originate over the oceans where in situ observations are limited, we have to resort to the remote sensing techniques. Both optical and microwave sensors help studying the cyclones. While scatterometer provide wind vectors, altimeters can give only wind speed. In this paper we present how altimeter measurements can supplement the scatterometer observations in determining the radius of maximum winds (RMW). Sustained maximum winds, indicator for the intensity of the cyclone, are within the eye wall of a cyclone at a distance of RMW. This parameter is also useful in predicting right time of the storm surge. In this paper we used the wind speed estimations from AltiKa, an altimeter operating at Ka band.

  11. Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability: An Observational Study in a Tertiary Headache Center.

    Science.gov (United States)

    Seng, Elizabeth K; Buse, Dawn C; Klepper, Jaclyn E; J Mayson, Sarah; Grinberg, Amy S; Grosberg, Brian M; Pavlovic, Jelena M; Robbins, Matthew S; Vollbracht, Sarah E; Lipton, Richard B

    2017-04-01

    To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1.11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among

  12. Lifestyle, Dwelling Conditions and Daily Routine as Qualitative Indicators of Infant Development: A Study of 0-3 Years Old Children from Rural Brazilian Northeast.

    Science.gov (United States)

    Rabinovich, Elaine Pedreira

    The developing child and his/her eco-social-cultural context is the focus of study of 28 children ages 0-3 years in the rural area of Cocal, Piaui in Northeast Brazil. Ethnographic methods, naturalistic observations and semi-structured interviews were used to ascertain the physical context (the house and its surroundings), as well as maternal…

  13. Primary Trauma Triage Performed by Bystanders: An Observation Study.

    Science.gov (United States)

    Nordberg, Martin; Castrén, Maaret; Lindström, Veronica

    2016-08-01

    The aim of this study was to evaluate whether bystanders with no training in triage can correctly prioritize three injured patients by using a triage instrument. An observational study was conducted. Participants performed a primary triage on three paper-based patient cases and answered 11 questions during a public event in the center of Stockholm, Sweden. A total of 69 persons participated in the study. The success rate among all the participants for correct triage of the three patient cases was 52 percent. The female participants and younger participants (triage to a greater extent. The over-triage was 12.5 percent and under-triage was 6.3 percent. Participants with no prior knowledge of triage instruments may be capable of triaging injured patients with the help of an easy triage instrument. The over- and under-triage percentages were low, and this may indicate that the developed triage instrument is relatively easy to use. It may also indicate that bystanders can identify a severely injured patient. Nordberg M , Castrén M , Lindström V . Primary trauma triage performed by bystanders: an observation study. Prehosp Disaster Med. 2016;31(4):353-357.

  14. [The reporting of observational studies: analysis using the STROBE statement].

    Science.gov (United States)

    Galera Llorca, Jordi; Lahoz Grillo, Raquel; Roig Loscertales, Francesc

    2011-12-01

    Deficiencies detected in biomedical studies publication different Guidelines to improve. The objective of the study is to assess the communication of observational studies of Cardiovascular and Metabolism therapeutic area (CVM) published in 6 Spanish journals in 2009 using the STROBE statement. Cross-sectional analysis of articles related to CVM therapeutic area, published during 2009 in 6 Spanish journals applying the 34 items of the STROBE statement. Descriptive analysis of the results for qualitative variables was performed using a frequency analysis. Quantitative variables were analyzed by sample estimates and dispersion. A comparative analysis of journals was performed using ANOVA with a statistical significance of pSTROBE recommendations. The Methods and Results sections showed more deficiencies.

  15. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    DEFF Research Database (Denmark)

    Madsen, M. B.; Skrede, S.; Bruun, T.

    2018-01-01

    Indicator for Necrotizing Fasciitis (LRINEC) score and 90-day mortality; 90-day mortality in patients with and without acute kidney injury (AKI) and LRINEC score of six and above or below six; and association between affected body part at arrival and microbiological findings. Exploratory outcomes include......Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating...... univariate analyses of baseline characteristics associations with 90-day mortality. The statistical analyses will be conducted in accordance with the predefined statistical analysis plan. Conclusion: Necrotizing soft tissue infections result in severe morbidity and mortality. The INFECT study...

  16. Palliative care team visits. Qualitative study through participant observation

    Science.gov (United States)

    Bueno Pernias, Maria José; Hueso Montoro, César; Guardia Mancilla, Plácido; Montoya Juárez, Rafael; García Caro, Maria Paz

    2016-01-01

    Objectives: To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. Methods: A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. Results: The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. Conclusion: Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources. PMID:27226663

  17. Motorcycle helmet use in Southern China: an observational study.

    Science.gov (United States)

    Li, Gong-Li; Li, Li-Ping; Cai, Qi-En

    2008-06-01

    In China, despite national motorcycle helmet legislation and the known safety benefits of helmets, helmet use remains low. The aim of this study was to determine the rate of motorcycle helmet use and attitudes towards helmet use among drivers and passengers in two cities in Southern China to provide baseline data and scientific evidence for the formulation of an intervention aimed at strengthening road safety law enforcement. Observational sites were randomly selected from three road types (national roads, main streets, and subordinate streets). Observations were conducted during six specified time periods and uniform checklists were used to record helmet use. Motorcycle riders were randomly selected from service stations, elementary schools, and supermarket car parks to participate in a face-to-face interview to ascertain attitudes. Overall, the rate of correct helmet use among drivers was higher in Chaozhou (34.6%) than in Shantou (30.2%; P helmet use was higher among drivers in main streets, during daytime hours, and during weekdays (P helmet knowledge of motorcycle drivers was high with most reporting that helmets prevent or reduce head injury (Shantou: 78.2%; Chaozhou 70.6%). Although level of awareness of the benefits of helmets was high, observed helmet usage was low. These results suggest that there is a need to implement new interventions to increase helmet use.

  18. A Statistical Study of Interplanetary Type II Bursts: STEREO Observations

    Science.gov (United States)

    Krupar, V.; Eastwood, J. P.; Magdalenic, J.; Gopalswamy, N.; Kruparova, O.; Szabo, A.

    2017-12-01

    Coronal mass ejections (CMEs) are the primary cause of the most severe and disruptive space weather events such as solar energetic particle (SEP) events and geomagnetic storms at Earth. Interplanetary type II bursts are generated via the plasma emission mechanism by energetic electrons accelerated at CME-driven shock waves and hence identify CMEs that potentially cause space weather impact. As CMEs propagate outward from the Sun, radio emissions are generated at progressively at lower frequencies corresponding to a decreasing ambient solar wind plasma density. We have performed a statistical study of 153 interplanetary type II bursts observed by the two STEREO spacecraft between March 2008 and August 2014. These events have been correlated with manually-identified CMEs contained in the Heliospheric Cataloguing, Analysis and Techniques Service (HELCATS) catalogue. Our results confirm that faster CMEs are more likely to produce interplanetary type II radio bursts. We have compared observed frequency drifts with white-light observations to estimate angular deviations of type II burst propagation directions from radial. We have found that interplanetary type II bursts preferably arise from CME flanks. Finally, we discuss a visibility of radio emissions in relation to the CME propagation direction.

  19. How safe do teenagers behave on Facebook? An observational study.

    Directory of Open Access Journals (Sweden)

    Ellen Vanderhoven

    Full Text Available The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18 to investigate (1 what kind of information teenagers post on their profile, (2 to what extent they protect this information using privacy-settings and (3 how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  20. How safe do teenagers behave on Facebook? An observational study.

    Science.gov (United States)

    Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin; Raes, Annelies

    2014-01-01

    The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  1. A conceptual framework for evaluating data suitability for observational studies.

    Science.gov (United States)

    Shang, Ning; Weng, Chunhua; Hripcsak, George

    2017-09-08

    To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. Nursing praxis, compassionate caring and interpersonal relations: an observational study.

    Science.gov (United States)

    Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

    2013-05-01

    The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

  3. Pedestrian crossing behavior, an observational study in the city of Ushuaia, Argentina.

    Science.gov (United States)

    Poó, Fernando Martín; Ledesma, Ruben Daniel; Trujillo, Roberto

    2017-10-20

    Pedestrian crashes are a critical problem in Latin American countries. However, little research has been published about pedestrians and even less about their behaviors in a naturalistic context. The objective of the present research was to explore risky pedestrian crossing behaviors in traffic intersections in an argentine city (Ushuaia). It is focused in different stages of the crossing process, traffic code violations, and other potentially risky behaviors such as distractions. A high frequency of risky behaviors among pedestrians was expected. Moreover, according to previous findings, it was hypothesized that men and younger pedestrians would show riskier behaviors. Participants were 802 pedestrians (53.9% females) observed at several intersections (with and without traffic lights) in the city of Ushuaia. Behaviors were codified following a standardized observation protocol. Observers documented information on behavior previous to, during, and after crossing. Gender and age were also registered. Data were gathered through video recording. Frequency analyses of observed behaviors were conducted for the total sample, as well as by gender and by age group. A general crossing risk index was calculated to facilitate comparisons between the genders and age groups. We conducted an analysis of variance to evaluate gender and age differences for this index. A high proportion of risky behaviors were observed among pedestrians. The majority of pedestrian waited in the street (as opposed to on the sidewalk) before crossing, did not comply with traffic lights, or crossed outside the crosswalk. A large number of pedestrians were distracted while crossing. Men presented higher scores on risky behaviors than women. No differences were observed by age group. The high level of risk behaviors during the different stages of street crossing is worrisome and reinforces the idea that pedestrians are responsible for many of the conflicts with motorists. Many of the risky behaviors

  4. Prefrontal Cortical Activity during Discourse Processing: An Observational fNIRS Study

    Science.gov (United States)

    Cannizzaro, Michael S.; Stephens, Shaun R.; Breidenstein, Max; Crovo, Cori

    2016-01-01

    Discourse is a commonly occurring and cognitively demanding form of naturalistic communication (e.g., conversation, event narration, personal and fictional narratives, text reading/generation). Because of the prevalence of these communication acts in daily routines (e.g., educational, vocational, and social), disrupted discourse is an important…

  5. Safety Hazards During Intrahospital Transport: A Prospective Observational Study.

    Science.gov (United States)

    Bergman, Lina M; Pettersson, Monica E; Chaboyer, Wendy P; Carlström, Eric D; Ringdal, Mona L

    2017-10-01

    To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. The study was undertaken at two ICUs in one university hospital. Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians. None. Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes. Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

  6. An Observational Study of Entrainment Rate in Deep Convection

    Directory of Open Access Journals (Sweden)

    Xiaohao Guo

    2015-09-01

    Full Text Available This study estimates entrainment rate and investigates its relationships with cloud properties in 156 deep convective clouds based on in-situ aircraft observations during the TOGA-COARE (Tropical Ocean Global Atmosphere Coupled Ocean Atmosphere Response Experiment field campaign over the western Pacific. To the authors’ knowledge, this is the first study on the probability density function of entrainment rate, the relationships between entrainment rate and cloud microphysics, and the effects of dry air sources on the calculated entrainment rate in deep convection from an observational perspective. Results show that the probability density function of entrainment rate can be well fitted by lognormal, gamma or Weibull distribution, with coefficients of determination being 0.82, 0.85 and 0.80, respectively. Entrainment tends to reduce temperature, water vapor content and moist static energy in cloud due to evaporative cooling and dilution. Inspection of the relationships between entrainment rate and microphysical properties reveals a negative correlation between volume-mean radius and entrainment rate, suggesting the potential dominance of homogeneous mechanism in the clouds examined. In addition, entrainment rate and environmental water vapor content show similar tendencies of variation with the distance of the assumed environmental air to the cloud edges. Their variation tendencies are non-monotonic due to the relatively short distance between adjacent clouds.

  7. Technological aspects of hospital communication challenges: an observational study.

    Science.gov (United States)

    Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

    2015-06-01

    To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  8. Assessing the completeness of reporting of observational studies in Colombian Journal of Anesthesiology. Cross sectional study

    NARCIS (Netherlands)

    Bravo-Peña, M. (Mary); Barona-Fong, L. (Luis); Campo-López, J. (Julio); Arroyave, Y. (Yeni); J.A. Calvache (Jose Andres)

    2017-01-01

    textabstractIntroduction The STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology), consisting of 22 points, was published in 2007 with the aim of improving the reporting of observational research. Objective To determine the completeness of reporting of

  9. Linear Discriminant Analysis Achieves High Classification Accuracy for the BOLD fMRI Response to Naturalistic Movie Stimuli.

    Science.gov (United States)

    Mandelkow, Hendrik; de Zwart, Jacco A; Duyn, Jeff H

    2016-01-01

    Naturalistic stimuli like movies evoke complex perceptual processes, which are of great interest in the study of human cognition by functional MRI (fMRI). However, conventional fMRI analysis based on statistical parametric mapping (SPM) and the general linear model (GLM) is hampered by a lack of accurate parametric models of the BOLD response to complex stimuli. In this situation, statistical machine-learning methods, a.k.a. multivariate pattern analysis (MVPA), have received growing attention for their ability to generate stimulus response models in a data-driven fashion. However, machine-learning methods typically require large amounts of training data as well as computational resources. In the past, this has largely limited their application to fMRI experiments involving small sets of stimulus categories and small regions of interest in the brain. By contrast, the present study compares several classification algorithms known as Nearest Neighbor (NN), Gaussian Naïve Bayes (GNB), and (regularized) Linear Discriminant Analysis (LDA) in terms of their classification accuracy in discriminating the global fMRI response patterns evoked by a large number of naturalistic visual stimuli presented as a movie. Results show that LDA regularized by principal component analysis (PCA) achieved high classification accuracies, above 90% on average for single fMRI volumes acquired 2 s apart during a 300 s movie (chance level 0.7% = 2 s/300 s). The largest source of classification errors were autocorrelations in the BOLD signal compounded by the similarity of consecutive stimuli. All classifiers performed best when given input features from a large region of interest comprising around 25% of the voxels that responded significantly to the visual stimulus. Consistent with this, the most informative principal components represented widespread distributions of co-activated brain regions that were similar between subjects and may represent functional networks. In light of these

  10. Czy naturalistyczna etyka jest możliwa? (Is Naturalistic Ethics Possible?

    Directory of Open Access Journals (Sweden)

    Artur Szutta

    2010-12-01

    Full Text Available The paper concerns the possibility of naturalistic ethics. It seems that ethics properly understood must be described as a discipline necessarily focused on evaluation of human action, analyzed in the light of its moral value. Such evaluation, in turn, presupposes an agent who is responsible for his or her actions. The possibility of so understood agent seems not to be possible without agent’s being capable of self-determination in action. According to the naturalistic thesis, however, such freedom is impossible; all human action is causally determined, with no place for ‘sui generis’ causation, and such a thesis must be interpreted as excluding the possibility of responsibility for one’s action. If so, then the concept of naturalistic ethics seems contradictory. Nonetheless, some authors (ex. H. Frankfurt and D. Dennett try to show that the concept of moral responsibility (so crucial to ethics does not necessarily entail freedom understood as ‘sui generis’ causation, and therefore it is compatible with determinism. In this paper I analyze their argumentation with the purpose to assess its conclusiveness. The conclusion I reach is that responsibility postulated by Frankfurt or Dennett is to be understood as merely epiphenomenal, as such it must be treated more like an illusion than a real property of human beings. Therefore, the thesis that naturalistic ethics is a contradictory concept seems to maintain its soundness.

  11. Institutional Facts and the NaturalisticFallacy : Confronting Searle with Searle

    NARCIS (Netherlands)

    Hindriks, Frank

    2002-01-01

    In 1964 Searle argued against the naturalistic fallacy thesis that an ought-statement can in fact be derived from is-statements. From an analysis of this argument and of Searle’s social ontology of 1995 – which includes a full-blown theory of institutional facts – I conclude that this argument is

  12. A Collaborative Naturalistic Service Delivery Program for Enhancing Pragmatic Language and Participation in Preschoolers

    Science.gov (United States)

    Demchick, Barbara B.; Day, Karen H.

    2016-01-01

    We describe a speech-language pathology and occupational therapy service delivery program for preschoolers with developmental delays and communication and related impairments. Key features included interprofessional collaboration; parent professional partnerships; naturalistic environment; opportunities for choice and control; use of a…

  13. The Development of Intrinsic Criteria for Authenticity: A Model for Trust in Naturalistic Researches.

    Science.gov (United States)

    Lincoln, Yvonna S.

    This paper presents criteria for establishing the trustworthiness of naturalistic inquiries, and specific techniques to facilitate their achievement or determine the degree of their achievement. The following criteria are briefly described: fairness; and ontological, educative, catalytic and tactical authenticity. Explored in greater detail,…

  14. Function and coding in the blowfly H1 neuron during naturalistic optic flow

    NARCIS (Netherlands)

    Hateren, J.H. van; Kern, R.; Schwerdtfeger, G.; Egelhaaf, M.

    2005-01-01

    Naturalistic stimuli, reconstructed from measured eye movements of flying blowflies, were replayed on a panoramic stimulus device. The directional movement-sensitive H1 neuron was recorded from blowflies watching these stimuli. The response of the H1 neuron is dominated by the response to fast

  15. Population distributions of time to collision at brake application during car following from naturalistic driving data.

    Science.gov (United States)

    Kusano, Kristofer D; Chen, Rong; Montgomery, Jade; Gabler, Hampton C

    2015-09-01

    Forward collision warning (FCW) systems are designed to mitigate the effects of rear-end collisions. Driver acceptance of these systems is crucial to their success, as perceived "nuisance" alarms may cause drivers to disable the systems. In order to make customizable FCW thresholds, system designers need to quantify the variation in braking behavior in the driving population. The objective of this study was to quantify the time to collision (TTC) that drivers applied the brakes during car following scenarios from a large scale naturalistic driving study (NDS). Because of the large amount of data generated by NDS, an automated algorithm was developed to identify lead vehicles using radar data recorded as part of the study. Using the search algorithm, all trips from 64 drivers from the 100-Car NDS were analyzed. A comparison of the algorithm to 7135 brake applications where the presence of a lead vehicle was manually identified found that the algorithm agreed with the human review 90.6% of the time. This study examined 72,123 trips that resulted in 2.6 million brake applications. Population distributions of the minimum, 1st, and 10th percentiles were computed for each driver in speed ranges between 3 and 60 mph in 10 mph increments. As speed increased, so did the minimum TTC experience by drivers as well as variance in TTC. Younger drivers (18-30) had lower TTC at brake application compared to older drivers (30-51+), especially at speeds between 40 mph and 60 mph. This is one of the first studies to use large scale NDS data to quantify braking behavior during car following. The results of this study can be used to design and evaluate FCW systems and calibrate traffic simulation models. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  16. Diffusion of Bevacizumab Across Oncology Practices: An Observational Study.

    Science.gov (United States)

    Keating, Nancy L; Huskamp, Haiden A; Schrag, Deborah; McWilliams, John M; McNeil, Barbara J; Landon, Bruce E; Chernew, Michael E; Normand, Sharon-Lise T

    2018-01-01

    Technological advances can improve care and outcomes but are a primary driver of health care spending growth. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. Population-based observational study. A total of 2329 US practices providing cancer chemotherapy. Random 20% sample of 236,304 Medicare fee-for-service beneficiaries aged above 65 years in 2004-2012 undergoing infused chemotherapy for cancer. Diffusion of bevacizumab (cumulative time to first use and 10% use) in practices, variation in use across practices overall and by higher versus lower-value use. We used hierarchical models with practice random effects to estimate the between-practice variation in the probability of receiving bevacizumab and to identify factors associated with use. We observed relatively rapid diffusion of bevacizumab, particularly in independent practices and larger versus smaller practices. We observed substantial variation in use; the adjusted odds ratio (95% confidence interval) of bevacizumab use was 2.90 higher (2.73-3.08) for practices 1 SD above versus one standard deviation below the mean. Variation was less for higher-value [odds ratio=2.72 (2.56-2.89)] than lower-value uses [odds ratio=3.61 (3.21-4.06)]. Use of bevacizumab varied widely across oncology practices, particularly for lower-value indications. These findings suggest that interventions targeted to practices have potential for decreasing low-value use of high-cost cancer therapies.

  17. The clinical-familial correlates and naturalistic outcome of panic-disorder-agoraphobia with and without lifetime bipolar II comorbidity

    Directory of Open Access Journals (Sweden)

    Toni Cristina

    2008-11-01

    complexity of the clinical picture in this naturalistic study. That such complexity does not seem to translate into poorer response and outcome in those with comorbid soft bipolarity probably reflects the fact that we had brought BP-II under control with mood stabilizers. We discuss the implications of our findings as further evidence for the existence of a distinct anxious-bipolar diathesis.

  18. Yogurt and Diabetes: Overview of Recent Observational Studies.

    Science.gov (United States)

    Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Díaz-López, Andrés; Babio, Nancy

    2017-07-01

    The effects of dairy consumption on the prevention of type 2 diabetes remain controversial and depend on the dairy subtype. Yogurt intake has received special attention because its association with health benefits is more consistent than that of other types of dairy products. In the present article, we review those observational studies that evaluated the association between yogurt consumption and type 2 diabetes. We also discuss the possible mechanisms involved in these associations. We found that 13 prospective studies evaluated the association between yogurt intake and type 2 diabetes, most of which showed an inverse association between the frequency of yogurt consumption and the risk of diabetes. In addition to the scientific evidence accumulated from individual prospective studies, several meta-analyses have shown that yogurt consumption has a potential role in diabetes prevention. The most recent analysis shows a 14% lower risk of type 2 diabetes when yogurt consumption was 80-125 g/d compared with no yogurt consumption. The intake of fermented dairy products, especially yogurt, has been inversely associated with variables of glucose metabolism. Yogurt may have probiotic effects that could modulate glucose metabolism. We conclude that yogurt consumption, in the context of a healthy dietary pattern, may reduce the risk of type 2 diabetes in healthy and older adults at high cardiovascular risk. Large-scale intervention studies and randomized clinical trials are warranted to determine if yogurt consumption has beneficial effects on insulin sensitivity and reduces the risk of type 2 diabetes. © 2017 American Society for Nutrition.

  19. An observational study of foot lifts asymmetry during obstacle avoidance

    Directory of Open Access Journals (Sweden)

    Ujjawal Singh Tomar

    2012-01-01

    Full Text Available Background: Specific information regarding obstacle-clearance strategies used by community-dwelling young and elderly is scant in the literature, and physical barriers encountered in real-life situations have not been used in most of the studies. Aim: The aim of this study is to determine foot lift asymmetry during obstacle avoidance in young and elderly subjects. Settings and Design: This was an observational study. Materials and Methods: Thirty elderly and 30 young individuals were taken for the study. All the subjects were evaluated using different scales and foot lift asymmetry was measured on a walkway using three obstacles of different heights. Results: The mean and standard deviation (SD value of the asymmetric index of the young was 3.25±0.28 and the mean and SD value of the asymmetric index of the elderly was 3.53±0.47. The asymmetric index of the elderly population was found to be higher than that of the younger population. Conclusion: The asymmetric index of the elderly population was found to be higher than that of the younger population, though it is not clinically significant.

  20. Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study

    Directory of Open Access Journals (Sweden)

    Somenath Sarkar

    2012-01-01

    Full Text Available Hypoparathyroidism is a disorder of calcium and phosphorus metabolism due to decreased secretion of parathyroid hormone. Hypoparathyroidism can be hereditary and acquired. Acquired hypoparathyroidism usually occurs following neck surgery (thyroid surgery or parathyroid surgery. Along with systemic manifestations, hypoparathyroidism produces some skin manifestations. Lack of study regarding mucocutaneous manifestations of acquired hypoparathyroidism prompted us to undertake this study. To evaluate the mucocutaneous manifestations of acquired hypoparathyroidism. An observational study done in a tertiary care hospital of Kolkata by comprehensive history taking, through clinical examination and relevant laboratory investigations. Twenty-one patients were included in the study. The commonest form of acquired hypoparathyroidism was neck surgery (thyroidectomy and parathyroidectomy operation. Mucocutaneous manifestations were present in 76.19% of patients. The most frequent mucocutaneous manifestation was found in the hairs like the loss of axillary hair (61.9%, loss of pubic hair (52.38%, coarsening of body hair (47.62%, and alopecia areata (9.52%. The nail changes noted were brittle and ridged nail, followed by onycholysis, onychosezia, and onychomedesis. The most common skin features were xerotic skin in 11 patients (52.38%, followed by pellagra-like skin pigmentation, pustular psoriasis and acne form eruption, bullous impetigo, etc. Mucosa was normal in all the cases excepting the one which showed oral candidiasis.

  1. Critical Observation on Methodologies of Select Doctoral Research Studies

    Directory of Open Access Journals (Sweden)

    Dr Indrajit Goswami

    2014-12-01

    Full Text Available The present article aims to critically observe and interpret the methodological deficiencies as found in randomly selected 14 doctoral theses submitted to two different universities in India. Despite their serious deviation from the expected methodological standards, all those theses were accepted and approved by the universities and scholars concerned conferred with PhD degrees. Undoubtedly, those theses kept in the reference sections at the respective university libraries would potentially misguide and mislead the future researchers. Some of the common technical deficiencies, as have been noticed, include (1 absence of careful thoughts in framing research titles, (ii biased method of data collection, (ii absence of logical explanation in favour of sample size and sample selection process, (iii designing and execution of instrument for data collection, (iv theory formulation in terms of framing of objectives, hypotheses and operational definitions etc. The article attempts to present the critical observations on case-to-case basis so that their conceptual, instrumental and procedural deficiencies and deviations are easily understood by the academicians, researchers and students. The content of this article is divided in to three broad sections. The first section deals with an introduction to quantitative and qualitative research methods and their advantages and limitations. The next section deals with the review of the selected theses followed by conclusion and suggested remedial measures. The objective of this article is purely academic and its scope is limited to enhancement of quality of future research studies in the domains and related fields.

  2. A study of GPS ionospheric scintillations observed at Guilin

    Science.gov (United States)

    Zou, Yuhua; Wang, Dongli

    2009-12-01

    The occurrence of strong ionospheric scintillations with S4>=0.2 was studied using global positioning system (GPS) measurements at Guilin (25.29°N, 110.33°E; geomagnetic: 15.04°N, 181.98°E), a station located near the northern crest of equatorial anomaly in China. The results are presented for data collected from January 2007 to December 2008. The results show that amplitude scintillations occurred only during the first five months of the considered years. Nighttime amplitude scintillations, observed mainly in the south of Guilin, always occurred with phase scintillations, total electron content (TEC) depletions, and Rate Of change of TEC (ROT) fluctuations. However, TEC depletions and ROT fluctuations were weak during daytime amplitude scintillations, and daytime amplitude scintillations usually occurred in most of the azimuth directions. GPS scintillation/TEC observations recorded at Guilin and signal-to-noise-ratio measurements obtained from GPS-COSMIC radio occultation indicate that nighttime and daytime scintillations are very likely caused by ionospheric F region irregularities and sporadic E, respectively.

  3. An observational study towards a newer classification in child psychiatry

    Directory of Open Access Journals (Sweden)

    Shyamanta Das

    2017-01-01

    Full Text Available Background: The first manifestations of majority of mental disorders are seen in childhood and adolescence. They result in burden in this age group as well. Materials and methods: A different way of classifying psychiatric disorders in children and adolescents categorise them into emotional, disruptive, and developmental disorders. We carried out an observational study to validate such an approach towards diagnosis. Results: Sample was almost equally divided in the two age groups as well as between the sexes. The distribution of emotional, disruptive, and developmental disorders in the younger and older age groups were 4:3:2 and 5:0:1 respectively. The same for boys and girls were 4:2:1 and 4:1:2 respectively. Comorbidity was same within group and across groups. Conclusion: A simplified diagnostic approach in child psychiatry has the potential of bridging the gap among the different ‘gatekeepers’ toward psychiatric service utilisation.

  4. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  5. [Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study].

    Science.gov (United States)

    Rocha, Juliana; Brandão, Pedro; Melo, Anabela; Torres, Silvia; Mota, Lurdes; Costa, Fernanda

    2017-08-31

    The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

  6. Obesity in adolescents with chronic fatigue syndrome: an observational study.

    Science.gov (United States)

    Norris, T; Hawton, K; Hamilton-Shield, J; Crawley, E

    2017-01-01

    Identify the prevalence of obesity in patients with chronic fatigue syndrome (CFS) compared with healthy adolescents, and those identified with CFS in a population cohort. Cross-sectional analysis of multiple imputed data. Data from UK paediatric CFS/myalgic encephalomyelitis (CFS/ME) services compared with data collected at two time points in the Avon Longitudinal Study of Parents and Children (ALSPAC). 1685 adolescents who attended a CFS/ME specialist service between 2004 and 2014 and 13 978 adolescents aged approximately 13 years and 16 years participating in the ALSPAC study. Body mass index (BMI) (kg/m 2 ), sex-specific and age-specific BMI Z-scores (relative to the International Obesity Task Force cut-offs) and prevalence of obesity (%). Adolescents who had attended specialist CFS/ME services had a higher prevalence of obesity (age 13 years: 9.28%; age 16 years: 16.43%) compared with both adolescents classified as CFS/ME in ALSPAC (age 13 years: 3.72%; age 16 years: 5.46%) and those non-CFS in ALSPAC (age 13 years: 4.18%; age 16 years: 4.46%). The increased odds of obesity in those who attended specialist services (relative to non-CFS in ALSPAC) was apparent at both 13 years (OR: 2.31 (1.54 to 3.48)) and 16 years, with a greater likelihood observed at 16 years (OR: 4.07 (2.04 to 8.11)). We observed an increased prevalence of obesity in adolescents who were affected severely enough to be referred to a specialist CFS/ME service. Further longitudinal research is required in order to identify the temporal relationship between the two conditions. 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/.

  7. Splenic lesions observed in 71 splenectomized dogs: a retrospective study

    Directory of Open Access Journals (Sweden)

    Elisângela Olegário da Silva

    2016-10-01

    Full Text Available The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71 of the dogs were submitted to total splenectomy and 3% (2/71 to partial splenectomy. In 45 (63.4% of these cases, the histopathological diagnosis was non-neoplastic alterations; only 36.6% (26/71 had a splenic neoplasia. The main non-neoplastic lesions observed were nodular hyperplasia 24.4% (11/45, infarction 22.3% (10/45, and hematoma 20% (9/45. The most frequent tumors were hemangiosarcoma 50% (13/26, histiocytic sarcoma 23% (6/26, and lymphoma 11.5% (3/26. The clinical methods used to diagnose splenic lesions were ultrasonography 88% (63/71, radiography 2.8% (2/71 and exploratory laparotomy 4.2% (3/71. In 4.2% (3/71 the spleen changes were observed during the therapeutic ovariohysterectomy. The results of the present study showed a prevalence of benign disorders in the spleen of splenectomized dogs associated with a high incidence of total splenectomy performed, indicating a difficulty in recognizing the different lesions that can affect the spleen by the veterinarian medical.

  8. Observational Study of Solar Magnetic Active Phenomena Hongqi ...

    Indian Academy of Sciences (India)

    1991-06-09

    Jun 9, 1991 ... active region NOAA 6580-6619-6659 observed at Huairou Solar Observing Station of. National Astronomical Observatories of China in 1991 (Ai & Hu ... The white arrows mark the observed transverse field and the black arrows show the transverse components inferred from the calculation of magnetic ...

  9. Observational study of sleep disturbances in advanced cancer.

    Science.gov (United States)

    Davies, Andrew Neil; Patel, Shuchita D; Gregory, Amanda; Lee, Bernadette

    2017-12-01

    To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form). 174 patients completed the study. Sleep quality was poor in 70.5% participants and was worse in younger patients and in inpatients (hospital, hospice). 18% of patients reported nightmares, 8% sleep terrors and 34% vivid dreams. Nightmares were associated with poor sleep quality and greater sleep disturbance; nightmares were also associated with greater physical and psychological burden. Nightmares (and vivid dreams) were not associated with the use of opioid analgesics. Nightmares do not seem to be especially common in patients with advanced cancer, and when they do occur, there is often an association with sleep disturbance, and/or physical and psychological burden. © 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.

  10. Observational studies of X-ray binary systems

    International Nuclear Information System (INIS)

    Klis, M. van der.

    1983-01-01

    The subject of Chapter 1 is theoretical. The other chapters, Ch. 2 to 6, contain original observational data and efforts towards their interpretation. Of these, Ch. 3, 4 and 5 deal with massive X-ray binaries, Ch. 6 with low-mass systems and Ch. 2 with Cygnus X-3, which we have not yet been able to assign to any of these two classes. The X-ray observations described were made with the COS-B satellite. Work based on UV and optical observations is described in Ch. 5. The UV observations were made with the IUE satellite, the optical observations at several ground-based observatories. (Auth.)

  11. 12-Month naturalistic outcomes of depressive disorders in Hong Kong's primary care.

    Science.gov (United States)

    Chin, Weng Yee; Chan, Kit T Y; Lam, Cindy L K; Wan, Eric Y F; Lam, Tai Pong

    2015-06-01

    In Asia, the role of primary care physicians (PCPs) in mental health delivery is not clearly defined and what happens to patients following a depressive episode remains poorly understood. To examine the 12-month naturalistic outcomes of depression in primary care and the impact of PCP identification. A cohort study was conducted. A total of 10179 adults were consecutively recruited from the waiting rooms of 59 PCPs across Hong Kong to complete a survey which screened for depression. Blinded doctors provided data on their diagnosis and management; 539 screened-positive and 3819 screened-negative subjects consented to telephone follow-up at 3, 6 and 12 months. Study instruments included Patient Health Questionnaire-9, Centre for Epidemiologic Studies Depression Scale 20 and Short-Form Health Survey Version 2.0 (SF-12v2) and self-reported mental health and primary care service use. 12-month remission rate was 60.31%. PCP detection had no association with remission. Identified patients had poorer health-related quality of life (HRQOL) at baseline but a faster rate of recovery in SF-12v2 mental component scores. PCP detection was associated with greater mental health service use at 12, 26 and 52 weeks, while GP consultation rates were only increased at 12 weeks. Over 1 year, ~60% of depressed patients experience symptom resolution, while 40% continue to suffer a chronic or remitting course of illness. Identification of depression by a PCP does not appear to affect remission of mood symptoms at 12 months, but is associated with a faster rate of recovery of HRQOL. PCP detection raises GP consultation rates temporarily however appears to enable more patients to access mental health services over 12 months. © The Author 2015. Published by Oxford University Press.

  12. Examination of drivers' cell phone use behavior at intersections by using naturalistic driving data.

    Science.gov (United States)

    Xiong, Huimin; Bao, Shan; Sayer, James; Kato, Kazuma

    2015-09-01

    Many driving simulator studies have shown that cell phone use while driving greatly degraded driving performance. In terms of safety analysis, many factors including drivers, vehicles, and driving situations need to be considered. Controlled or simulated studies cannot always account for the full effects of these factors, especially situational factors such as road condition, traffic density, and weather and lighting conditions. Naturalistic driving by its nature provides a natural and realistic way to examine drivers' behaviors and associated factors for cell phone use while driving. In this study, driving speed while using a cell phone (conversation or visual/manual tasks) was compared to two baselines (baseline 1: normal driving condition, which only excludes driving while using a cell phone, baseline 2: driving-only condition, which excludes all types of secondary tasks) when traversing an intersection. The outcomes showed that drivers drove slower when using a cell for both conversation and visual/manual (VM) tasks compared to baseline conditions. With regard to cell phone conversations, drivers were more likely to drive faster during the day time compared to night time driving and drive slower under moderate traffic compared to under sparse traffic situations. With regard to VM tasks, there was a significant interaction between traffic and cell phone use conditions. The maximum speed with VM tasks was significantly lower than that with baseline conditions under sparse traffic conditions. In contrast, the maximum speed with VM tasks was slightly higher than that with baseline driving under dense traffic situations. This suggests that drivers might self-regulate their behavior based on the driving situations and demand for secondary tasks, which could provide insights on driver distraction guidelines. With the rapid development of in-vehicle technology, the findings in this research could lead the improvement of human-machine interface (HMI) design as well

  13. Satellite Observation Systems for Polar Climate Change Studies

    Science.gov (United States)

    Comiso, Josefino C.

    2012-01-01

    The key observational tools for detecting large scale changes of various parameters in the polar regions have been satellite sensors. The sensors include passive and active satellite systems in the visible, infrared and microwave frequencies. The monitoring started with Tiros and Nimbus research satellites series in the 1970s but during the period, not much data was stored digitally because of limitations and cost of the needed storage systems. Continuous global data came about starting with the launch of ocean color, passive microwave, and thermal infrared sensors on board Nimbus-7 and Synthetic Aperture Radar, Radar Altimeter and Scatterometer on board SeaSat satellite both launched in 1978. The Nimbus-7 lasted longer than expected and provided about 9 years of useful data while SeaSat quit working after 3 months but provided very useful data that became the baseline for follow-up systems with similar capabilities. Over the years, many new sensors were launched, some from Japan Aeronautics and Space Agency (JAXA), some from the European Space Agency (ESA) and more recently, from RuSSia, China, Korea, Canada and India. For polar studies, among the most useful sensors has been the passive microwave sensor which provides day/night and almost all weather observation of the surface. The sensor provide sea surface temperature, precipitation, wind, water vapor and sea ice concentration data that have been very useful in monitoring the climate of the region. More than 30 years of such data are now available, starting with the Scanning Multichannel Microwave Radiometer (SMMR) on board the Nimbus-7, the Special Scanning Microwave/Imager (SSM/I) on board a Defense Meteorological Satellite Program (DMSP) and the Advanced Microwave Scanning Radiometer on board the EOS/ Aqua satellite. The techniques that have been developed to derive geophysical parameters from data provided by these and other sensors and associated instrumental and algorithm errors and validation techniques

  14. Ions, isotopes, and metal cyanides: Observational and laboratory studies

    Science.gov (United States)

    Savage, Chandra Shannon

    2004-11-01

    Chemistry in the interstellar medium is very different from the processes which take place in terrestrial settings. Environments such as circumstellar envelopes, molecular clouds, and comets contain diverse and complex chemical networks. The low temperatures (10 50 K) and densities (1 10 6 cm-3) allow normally unstable molecules to exist in significant quantities. At these temperatures, the rotational energy levels of molecules are populated, and thus these species can be detected by millimeter-wave radio astronomy. The detection and quantification of interstellar molecules, including metal cyanides and molecular ions, is the basis of this dissertation work. While conducting observations of CN and 13CN to determine the 12C/13C ratio throughout the Galaxy, it was found that the ratios in photon- dominated regions (PDRs) were much higher than those in nearby molecular clouds. This can be explained by isotope-selective photodissociation, in which the 12CN molecules are self-shielded. However, the chemistry in these regions is poorly understood, and other processes may be occurring. In order to understand one of the chemical networks present in PDRs, observations of HCO+, HOC +, and CO+ were made toward several of these sources. Previous studies indicated that the HCO+/HOC+ ratio was much lower in PDRs, due to the presence of CO+. The new observations indicate that there is a strong correlation between CO + and HOC+ abundances, which suggests that other molecular ions which have not been detected in molecular clouds may be present in PDRs. There is a significant obstacle to the detection of new interstellar molecular ions, however. The laboratory spectra are virtually unknown for many of these species, due to their inherent instability. Thus, techniques which can selectively detect ionic spectra must be utilized. One such method is velocity modulation, which incorporates an AC electrical discharge to produce and detect ions. Previously, velocity modulation spectroscopy

  15. Oral implications of the vegan diet: observational study.

    Science.gov (United States)

    Laffranchi, L; Zotti, F; Bonetti, S; Dalessandri, D; Fontana, P

    2010-01-01

    The aim of this study was to investigate oral changes in subjects who have assumed a vegan diet for a long time (at least 18 months), that is to say, a diet completely lacking in meat and animal derivatives. A sample of 15 subjects was analyzed, all from northern Italy and aged 24 to 60 year, composed of 11 men and 4 women who had been following a vegan diet for a minimum of 18 months to a maximum of 20 years. In parallel with the study sample, a control group (15 subjects) with the same criteria of age, sex, and place of origin all following an omnivorous diet was chosen. The sample answered a questionnaire that investigated their eating habits, the frequency with which they eat meals, the main foodstuffs assumed, oral hygiene habits, and any painful symptomatology of the teeth or more general problems in the oral cavity. The sample was then subject to objective examination in which the saliva pH was measured and the teeth were checked for demineralization of the enamel, white spots, and caries (using KaVo DIAGNOdent) with particular attention being paid to the localization of these lesions, and lastly, sounding was carried out to detect any osseous defects and periodontal pockets. The study revealed greater incidence of demineralization and white spots in the vegan subjects compared to the omnivorous ones localized at the neck of the teeth and on the vestibular surfaces of dental elements (with the exception of the lower anterior group). The saliva pH, more acid in the omnivorous patients, ranged between four and six. Changes in oral conditions in both groups of subjects were observed. In order to research into the cause-effect relationship of the vegan diet on the oral cavity effectively, the sample needs to be studied for a longer period of time and the results re-evaluated.

  16. Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study.

    Science.gov (United States)

    Veerabhadrappa, Suresh Kandagal; Chandrappa, Pramod Redder; Patil, Snehal; Roodmal, Seema Yadav; Kumarswamy, Akshay; Chappi, Mounesh Kumar

    2016-09-01

    Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders. To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders. A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation. In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (pXerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had 'moderate' to 'severe' xerostomia whereas the control group had 'mild' xerostomia. Xerostomia was significantly higher in younger age group (18-49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had significantly more dryness of lip and mucosa than healthy controls. A moderate

  17. Estimation of Skin to Subarachnoid Space Depth: An Observational Study.

    Science.gov (United States)

    Hazarika, Rajib; Choudhury, Dipika; Nath, Sangeeta; Parua, Samit

    2016-10-01

    In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. To measure the skin to SSD in the Indian population and to find a formula for predicting this depth. Three hundred adult patients belonging to American Society of Anaesthesiologist class I and II, undergoing surgery using spinal anaesthesia in various surgical specialities of Gauhati Medical College were selected by systemic sampling for this prospective, observational study. Patients were divided into three groups: Group M containing male patients, Group F containing non-pregnant female patients, and Group PF containing pregnant female's patients. SSD was measured after performing lumbar puncture. The relationship between SSD and patient characteristics were studied, correlated and statistical analysis was used to find a formula for predicting the skin to SSD. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0, Chicago, IL, USA). One-way ANOVA with post-hoc(Bonferroni correction factor) analysis was applied to compare the three groups. Multivariate analysis was done for the covariates followed by a multivariate regression analysis to evaluate the covariates influencing SSD for each group separately. Mean SSD was 4.37±0.31cm in the overall population. SSD in adult males was 4.49±0.19cm which was significantly longer than that observed in female's 4.18±0.39cm which was comparable with SSD in parturient 4.43±0.19 cm. The formula for predicting the skin to SSD in the male population was 1.718+0.077×BMI+0.632×Height, in nonpregnant female population was 1.828+0.077×BMI+0.018×Height+0.007×Age and 0.748+0.209×BMI+4.703×Height-0.054×weight in parturient females, respectively. Skin to SSD correlated with the BMI in all

  18. Southeast Atmosphere Studies: learning from model-observation syntheses

    Science.gov (United States)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-02-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  19. Study of Rayleigh-Love coupling from Spatial Gradient Observation

    Science.gov (United States)

    Lin, C. J.; Hosseini, K.; Donner, S.; Vernon, F.; Wassermann, J. M.; Igel, H.

    2017-12-01

    We present a new method to study Rayleigh-Love coupling. Instead of using seismograms solely, where ground motion is recorded as function of time, we incorporate with rotation and strain, also called spatial gradient where ground is represented as function of distance. Seismic rotation and strain are intrinsic different observable wavefield so are helpful to indentify wave type and wave propagation. A Mw 7.5 earthquake on 29 March 2015 occurred in Kokopo, Papua New Guinea recorded by a dense seismic array at PFO, California are used to obtaint seismic spatial gradient. We firstly estimate time series of azimuthal direction and phase velocity of SH wave and Rayleigh wave by analyzing collocated seismograms and rotations. This result also compares with frequency wavenumber methods using a nearby ANZA seismic array. We find the direction of Rayleigh wave fits well with great-circle back azimuth during wave propagation, while the direction of Love wave deviates from that, especially when main energy of Rayleigh wave arrives. From the analysis of cross-correlation between areal strain and vertical rotation, it reveals that high coherence, either positive or negative, happens at the same time when Love wave deparate from great-circle path. We also find the observed azimuth of Love wave and polarized particle motion of Rayleigh wave fits well with the fast direction of Rayleigh wave, for the period of 50 secs. We conclude the cause of deviated azimuth of Love wave is due to Rayleigh-Love coupling, as surface wave propagates through the area with anisotropic structure.

  20. [Pregnancy-Associated Breast Cancer: An analytical observational study].

    Science.gov (United States)

    Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

    2014-03-04

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  1. Southeast Atmosphere Studies: learning from model-observation syntheses

    Directory of Open Access Journals (Sweden)

    J. Mao

    2018-02-01

    Full Text Available Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and

  2. Treatment of Crohn's disease with cannabis: an observational study.

    Science.gov (United States)

    Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

    2011-08-01

    The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use. This is the first report of cannabis use in Crohn's disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

  3. The full moon as a synchronizer of circa-monthly biological rhythms: Chronobiologic perspectives based on multidisciplinary naturalistic research.

    Science.gov (United States)

    Reinberg, Alain; Smolensky, Michael H; Touitou, Yvan

    Biological rhythmicity is presumed to be an advantageous genetic adaptation of fitness and survival value resulting from evolution of life forms in an environment that varies predictably-in-time during the 24 h, month, and year. The 24 h light/dark cycle is the prime synchronizer of circadian periodicities, and its modulation over the course of the year, in terms of daytime photoperiod length, is a prime synchronizer of circannual periodicities. Circadian and circannual rhythms have been the major research focus of most scientists. Circa-monthly rhythms triggered or synchronized by the 29.5 day lunar cycle of nighttime light intensity, or specifically the light of the full moon, although explored in waterborne and certain other species, have received far less study, perhaps because of associations with ancient mythology and/or an attitude naturalistic studies are of lesser merit than ones that entail molecular mechanisms. In this editorial, we cite our recent discovery through multidisciplinary naturalistic investigation of a highly integrated circadian, circa-monthly, and circannual time structure, synchronized by the natural ambient nyctohemeral, lunar, and annual light cycles, of the Peruvian apple cactus (C. peruvianus) flowering and reproductive processes that occur in close temporal coordination with like rhythms of the honey bee as its pollinator. This finding led us to explore the preservation of this integrated biological time structure, synchronized and/or triggered by environmental light cues and cycles, in the reproduction of other species, including Homo sapiens, and how the artificial light environment of today in which humans reside may be negatively affecting human reproduction efficiency.

  4. Antipsychotic treatment in child and adolescent first-episode psychosis: a longitudinal naturalistic approach.

    Science.gov (United States)

    Castro-Fornieles, Josefina; Parellada, Mara; Soutullo, César A; Baeza, Immaculada; Gonzalez-Pinto, Ana; Graell, Montserrat; Paya, Beatriz; Moreno, Dolores; de la Serna, Elena; Arango, Celso

    2008-08-01

    The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a naturalistic longitudinal study of early-onset first psychotic episodes. This report describes the antipsychotic treatment during the first year and compares the most frequently used agents after 6 months. Participants were 110 patients, aged 9-17 years, with a first psychotic episode attended consecutively at six different centers. The Positive and Negative Symptom Scale (PANSS), Clinical Global Impressions (CGI), Disability Assessment Schedule (DAS), and Global Assessment of Function (GAF) scales were administered at baseline and at 6 months and the Udvalg for Kliniske Undersøgelser (UKU) Side Effects Rating Scale only at 6 months. Diagnoses at baseline were 38.2% psychotic disorder not otherwise specified, 39.1% schizophrenia-type disorder, 11.8% depressive disorder with psychotic symptoms, and 10.9% bipolar disorder, manic episode with psychotic symptoms. The most frequently used antipsychotic agents were risperidone (n = 50), quetiapine (n = 18), and olanzapine (n = 16). Patients who were prescribed olanzapine or quetiapine had more negative and general symptoms. Using the baseline score as covariate, no significant differences were found in the reductions on any scale in patients treated with risperidone, quetiapine, or olanzapine for 6 months. Weight increase was greater with olanzapine than with risperidone (p = 0.020) or quetiapine (p = 0.040). More neurological side effects appeared with risperidone than with olanzapine (p = 0.022). All side effects were mild or moderate. Second-generation antipsychotics, especially risperidone, quetiapine, and olanzapine, are the most used in our context in first psychotic episodes in children and adolescents. These three obtain similar clinical improvement, but differ in their side effects.

  5. Clinical, functional, and economic ramifications of early nonresponse to antipsychotics in the naturalistic treatment of schizophrenia.

    Science.gov (United States)

    Ascher-Svanum, Haya; Nyhuis, Allen W; Faries, Douglas E; Kinon, Bruce J; Baker, Robert W; Shekhar, Anantha

    2008-11-01

    Early nonresponse to antipsychotics appears to predict subsequent nonresponse to treatment when assessed in randomized controlled trials of predominately acute inpatients treated for schizophrenia. This study assessed the predictive accuracy of early nonresponse to treatment and its clinical, functional, and economic ramifications in the naturalistic treatment of predominately chronic outpatients treated for schizophrenia. This post hoc analysis used data from a 1-year, randomized, open-label study of olanzapine, risperidone, and typical antipsychotics in the treatment of schizophrenia. If clinically warranted, patients could switch antipsychotics following 8 weeks of treatment. Patients completing 8 weeks of treatment (n = 443 of 664 enrollees) were included. Patients with early response (> or = 20% improvement from baseline on the Positive and Negative Syndrome Scale at 2 weeks) were compared with early nonresponders on symptom remission, functionality, perceptions of medication influence, and total health care costs at 8 weeks. Early response/nonresponse at 2 weeks predicted subsequent response/nonresponse at 8 weeks with a high level of accuracy (72%) and specificity (89%). After 8 weeks, early nonresponders were less likely to achieve symptom remission (P < .001), improved less on functional domains (P < .05), perceived medication as less beneficial (P = .004), and incurred total heath care costs over twice that of early responders ($4349 vs $2102, P = .010). In the usual care of schizophrenia patients, early nonresponse appears to reliably predict subsequent nonresponse to continued treatment with the same medication to be associated with poorer outcomes and higher health care costs. Identifying early nonresponders may minimize prolonging exposure to suboptimal or ineffective treatment strategies.

  6. Observational study of drug-drug interactions in oncological inpatients

    Directory of Open Access Journals (Sweden)

    María Sacramento Díaz-Carrasco

    2018-01-01

    Full Text Available Objective: To determine the prevalence of potential clinically relevant drug- drug interactions in adult oncological inpatients, as well as to describe the most frequent interactions. A standard database was used. Method: An observational, transversal, and descriptive study including patients admitted to the Oncology Service of a reference hospital. All prescriptions were collected twice a week during a month. They were analysed using Lexicomp® database, recording all interactions classified with a level of risk: C, D or X. Results: A total of 1 850 drug-drug interactions were detected in 218 treatments. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 94.5% for those at level C and 26.1% for levels D and X. The drugs most commonly involved in the interactions detected were opioid analgesics, antipsychotics (butyrophenones, benzodiazepines, pyrazolones, glucocorticoids and heparins, whereas interactions with antineoplastics were minimal, highlighting those related to paclitaxel and between metamizole and various antineoplastics. Conclusions: The prevalence of clinically relevant drug-drug interactions rate was very high, highlighting the high risk percentage of them related to level of risk X. Due to the frequency of onset and potential severity, highlighted the concomitant use of central nervous system depressants drugs with risk of respiratory depression, the risk of onset of anticholinergic symptoms when combining morphine or haloperidol with butylscopolamine, ipratropium bromide or dexchlorpheniramine and the multiple interactions involving metamizole.

  7. Young adult smoking in peer groups: an experimental observational study.

    Science.gov (United States)

    Harakeh, Zeena; Vollebergh, Wilma A M

    2013-03-01

    The aim of this experimental observational study is to examine whether, in a group setting (same-sex triads), passive peer influence (imitation) in the context of homogeneous and heterogeneous (contradictory) behavior of peer models affects young adults' smoking behavior. An experiment was conducted among 48 daily-smoking college and university students aged 17-25. Participants had to complete a 30-min music task with two same-sex confederates. We tested the following three conditions: (a) neither of the confederates is smoking, (b) one confederate is smoking and the other is not, and (c) both confederates are smoking. The primary outcome tested was the total number of cigarettes smoked during the task. Students in the condition with two smoking peer models and in the condition with one smoking peer model and one nonsmoking peer model smoked significantly more cigarettes than those in the condition with two nonsmoking peer models. However, results for the condition with two smoking peer models did not differ significantly from the condition with one smoking peer model and one nonsmoking peer model. Our findings show that in a group setting, the impact of the homogeneity of smoking peers on young adults' smoking behavior is not greater than the impact of the heterogeneity of smoking and nonsmoking peers. This would suggest that the smoking peer in the group has a greater impact on the daily-smoking young adult, thus reducing or even eliminating the protective effect of the nonsmoking peer model.

  8. iPad use during ward rounds: an observational study.

    Science.gov (United States)

    Lehnbom, Elin C; Adams, Kristian; Day, Richard O; Westbrook, Johanna I; Baysari, Melissa T

    2014-01-01

    Much clinical information is computerised and doctors' use of mobile devices such as iPad tablets to access this information is expanding rapidly. This study investigated the use of iPads during ward rounds and their usefulness in providing access to information during ward rounds. Ten teams of doctors at a large teaching hospital were given iPads for ten weeks and were observed on ward rounds for 77.3 hours as they interacted with 525 patients. Use of iPads and other information technology devices to access clinical information was recorded. The majority of clinical information was accessed using iPads (56.2%), followed by computers-on-wheels (35.8%), stationary PCs (7.9%) and smartphones (0.1%). Despite having read-only access on iPads, doctors were generally happy using iPads on ward rounds. These findings provide evidence of the value of iPads as a tool to access information at the point of care.

  9. Sensitivity of dose-finding studies to observation errors.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2009-11-01

    The purpose of Phase I designs is to estimate the MTD (maximum tolerated dose, in practice a dose with some given acceptable rate of toxicity) while, at the same time, minimizing the number of patients treated at doses too far removed from the MTD. Our purpose here is to investigate the sensitivity of conclusions from dose-finding designs to recording or observation errors. Certain toxicities may go undetected and, conversely, certain non-toxicities may be incorrectly recorded as dose-limiting toxicities. Recording inaccuracies would be expected to have an influence on final and within trial recommendations and, in this paper, we study in greater depth this question. We focus, in particular on three designs used currently; the standard '3+3' design, the grouped up-and-down design [M. Gezmu, N. Flournoy, Group up-and-down designs for dose finding. Journal of Statistical Planning and Inference 2006; 136 (6): 1749-1764.] and the continual reassessment method (CRM, [J. O'Quigley, M. Pepe, L. Fisher, Continual reassessment method: a practical design for phase 1 clinical trials in cancer. Biometrics 1990; 46 (1): 33-48.]). A non-toxicity incorrectly recorded as a toxicity (error of first kind) has a greater influence in general than the converse (error of second kind). These results are illustrated via figures which suggest that the standard '3+3' design in particular is sensitive to errors of the second kind. Such errors can have a very important impact on drug development in that, if carried through to the Phase 2 and Phase 3 studies, we can significantly increase the probability of failure to detect efficacy as a result of having delivered an inadequate dose.

  10. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Science.gov (United States)

    Colson, Pascal H; Gaudard, Philippe; Fellahi, Jean-Luc; Bertet, Héléna; Faucanie, Marie; Amour, Julien; Blanloeil, Yvonnick; Lanquetot, Hervé; Ouattara, Alexandre; Picot, Marie Christine

    2016-01-01

    To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  11. [The aggression in SPDC: an observational study. Preliminary data].

    Science.gov (United States)

    Minutolo, Giuseppe; Cannavò, Dario; Petralia, Antonino; Gandolfo, Liliana; Palermo, Filippo; Aguglia, Eugenio

    2010-01-01

    In the different psychiatric disorders the aggression often leads to uncontrolled events, taking aspects of impulsiveness and irrationality. Our research proposes the assessment of socio-demographic and clinical characteristics of patients with a psychiatric disorder, who presented an aggressive event. The observational study was conducted on a sample of 50 patients (34 men and 16 women), hospitalized following the manifestation of an aggressive event. For each patient was provided an assessment of socio-demographic and clinical variables and a psychometric investigation through: the OAS, for the analysis of aggressive episodes; the BDHI, for the hostile behavior and attitudes; the BIS-11, for the impulsiveness and the BPRS for the psychopathological aspects. Among the socio-demographic features investigated, the highest correlation with aggressive behavior was related to the concomitant substance abuse, type of admission to psychiatric hospital and the male gender. The OAS has shown a greater propensity to directed-aggression in males with schizophrenia, and self-directed in females with major depression. The BPRS has shown a positive correlation between hetero-directed aggressive behavior and positive symptomatology, and between the self-directed and depression, risk of suicide, feelings of guilt and somatic concerns. The BDHI has indicated greater suspicion in women's group. The hypothesis that aggression is otherwise related to specific socio-demographic and clinical characteristics was confirmed by our study. The data suggest that early identification and assessment of potential risk factors involved in the genesis of aggressive episodes would allow the clinician to implement a better strategy for prevention and intervention.

  12. External Validation of the HERNIAscore: An Observational Study.

    Science.gov (United States)

    Cherla, Deepa V; Moses, Maya L; Mueck, Krislynn M; Hannon, Craig; Ko, Tien C; Kao, Lillian S; Liang, Mike K

    2017-09-01

    The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH. Patients were stratified into low-risk, medium-risk, and high-risk groups based on HERNIAscore. A revised HERNIAscore was calculated with the addition of earlier abdominal operation as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Two hundred and forty-seven patents were enrolled. On Cox regression, in addition to the 3 variables of the HERNIAscore (BMI, COPD, and incision length), earlier abdominal operation was also predictive of VIH. The revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. Although the original HERNIAscore effectively stratified the risk of an incisional radiographic VIH developing, the revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. We have externally validated and improved the HERNIAscore. The revised HERNIAscore uses BMI, incision length, COPD, and earlier abdominal operation to predict risk of postoperative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Pascal H Colson

    Full Text Available To estimate the incidence of active bleeding after cardiac surgery (AB based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications.AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications.Among 4,904 patients, 129 experienced AB (2.6%, among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16% but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication.A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  14. A 1-year naturalistic follow-up of patients with compulsive shopping disorder.

    Science.gov (United States)

    Aboujaoude, Elias; Gamel, Nona; Koran, Lorrin M

    2003-08-01

    Compulsive shopping disorder is increasingly recognized as a treatable impulse-control disorder. We report the first long-term, naturalistic follow-up of patients with compulsive shopping disorder, which examined the course of illness over 1 year in a cohort that had completed up to 3 months of open-label treatment with citalopram, 20 mg/day to 60 mg/day. In that trial, 17 (71%) of 24 subjects who met McElroy and colleagues' diagnostic criteria for compulsive shopping disorder were responders (Clinical Global Impressions-Improvement scale rating of much or very much improved and Yale-Brown Obsessive Compulsive Scale-Shopping Version score decrease of >/= 50%). Follow-up interviews occurred 3, 6, 9, and 12 months after study end. Data gathered included comorbid conditions, estimated total debt, 2-week spending, whether the patient was taking citalopram, and illness versus remission status. Remission was defined as no longer meeting diagnostic criteria for compulsive shopping disorder. Data were gathered between March 2000 and January 2002. Of responders at trial end, 81% (13/16), 71% (10/14), 71% (10/14), and 73% (11/15) were in remission at 3, 6, 9, and 12 months. Mean 2-week compulsive shopping expenditures decreased from 773 US dollars (median = 500 US dollars) at baseline to 351 US dollars (median = 0 US dollars) at month 12, and mean total debt decreased from 17,833 US dollars (median = 20,000 US dollars) to 16,752 US dollars (median = 14,000 US dollars). No clear association was seen between taking citalopram and remission status (p =.55, p =.08, p =.58, and p =.60 at 3, 6, 9, and 12 months, respectively; Fisher exact test). The majority of trial nonresponders remained ill at each follow-up point. An acute response to citalopram predicts a greater likelihood of continued remission over 1 year, although the mechanisms that maintain remission require further investigation.

  15. A naturalistic examination of the temporal patterns of affect and eating disorder behaviors in anorexia nervosa.

    Science.gov (United States)

    Lavender, Jason M; Utzinger, Linsey M; Crosby, Ross D; Goldschmidt, Andrea B; Ellison, Jo; Wonderlich, Stephen A; Engel, Scott G; Mitchell, James E; Crow, Scott J; Peterson, Carol B; Le Grange, Daniel

    2016-01-01

    Evidence supports the presence of significant variability in the timing of affective experiences and eating disorder (ED) behaviors across ED populations. This study examined the naturalistic timing of affective states and ED behaviors in anorexia nervosa (AN). Women (N = 118) with full or subthreshold DSM-IV AN completed 2 weeks of ecological momentary assessment (EMA) involving self-reports of affect and ED behaviors. Patterns of positive affect, negative affect, and tension/anxiety across hours of the day and days of the week were examined using linear mixed models. Variation in ED behavior occurrence (i.e., binge eating, vomiting, exercise, meal skipping, and self-weighing) across hours of the day and days of the week was examined using general estimating equations. Results revealed significant variation in tension/anxiety across hours of the day; there were no significant associations between time of day and negative or positive affect. All affective variables significantly varied across days of the week, with both negative affect and tension/anxiety highest in the middle of the week and lowest on the weekends. The ED behaviors all significantly varied across hours of the day, with binge eating and vomiting most common in later hours, exercise and self-weighing most common in earlier hours, and meal skipping most common at times corresponding to breakfast and lunch. ED behaviors did not significantly vary across days of the week. The significant patterns of variation in the timing of affective experiences and ED behaviors may have utility in informing theories and interventions for AN. © 2015 Wiley Periodicals, Inc.

  16. Pericyazine in the treatment of cannabis dependence in general practice: a naturalistic pilot trial

    Directory of Open Access Journals (Sweden)

    Morley KC

    2012-05-01

    Full Text Available Kirsten C Morley,1 Paul S Haber,1,2 Madeleine L Morgan,3 Fares Samara3,41Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia; 2Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 3Drug and Alcohol Services, North Coast Area Health Service, Kempsey and Port Macquarie, NSW, Australia; 4Durri Aboriginal Medical Service, Kempsey, NSW, AustraliaAbstract: Cannabis is one of the most widely used illicit drugs worldwide. However, while the rates of cannabis dependence and treatment increase, there remains no medications approved for this use. Due to its sedative effects and low abuse liability, the typical antipsychotic pericyazine has been utilized in some parts of Australia for the treatment of cannabis dependence. We aimed to provide documentation of preliminary outcomes and acceptability of pericyazine treatment in a small sample. A naturalistic case series study was conducted in which 21 patients were enrolled for a 4-week course of pericyazine (up to 8 × 2.5 mg tablets daily and weekly medical review. Levels of cannabis use were reported and side effects with electrocardiography and blood tests were monitored. Measures of dependence severity, depression, anxiety, and insomnia were taken at baseline and follow-up utilizing validated psychometric tools. Significant reductions in cannabis use, depression, anxiety, and insomnia severity occurred across time. Pericyazine appeared to be well tolerated and easily administered in the community clinics. The results provide some preliminary evidence that low-dose short-term pericyazine may be an acceptable mode of treatment in this population. Given the open-label nature of the design, we cannot conclude that pharmacotherapy was uniquely responsible for the treatment effect. Nonetheless, low-dose pericyazine may be a potentially effective approach to the treatment of cannabis dependence, and further evaluation via a randomized placebo

  17. Ventilation strategies in burn intensive care: A retrospective observational study

    Directory of Open Access Journals (Sweden)

    Stefano Palazzo

    2014-01-01

    Full Text Available Consensus regarding optimal burns intensive care (BICU patient management is lacking. This study aimed to assess whether ventilation strategies, cardiovascular support and sedation in BICU patients have changed over time, and whether this affects outcome. A retrospective observational study comparing two 12-patient BICU cohorts (2005/06 and 2010/11 was undertaken. Demographic and admission characteristics, ventilation parameters, sedation, fluid resuscitation, cardiovascular support and outcome (length of stay, mortality data were collected from patient notes. Data was analysed using T-tests, Fisher's exact and Mann-Whitney U tests. In our study cohort groups were equivalent in demographic and admission parameters. There were equal ventilator-free days in the two cohorts 10 ± 12.7 vs. 13.3 ± 12.2 ventilator free days; P = 0.447. The 2005/06 cohort were mechanically ventilated more often than in 2010/11 cohort (568 ventilator days/1000 patient BICU days vs. 206 ventilator days/1000 patient BICU days; P = 0.001. The 2005/06 cohort were ventilated less commonly in tracheostomy group/endotracheal tube spontaneous (17.8% vs. 26%; P = 0.001 and volume-controlled modes (34.4% vs. 40.8%; P = 0.001. Patients in 2010/11 cohort were more heavily sedated (P = 0.001 with more long-acting sedative drug use (P = 0.001 than the 2005/06 cohort, fluid administration was equivalent. Patient outcome did not vary. Inhalational injury patients were ventilated in volume-controlled (44.5% vs. 28.1%; P = 0.001 and pressure-controlled modes (18.2% vs. 9.5%; P = 0.001 more frequently than those without. Outcome did not vary. This study showed there has been shift away from mechanical ventilation, with increased use of tracheostomy/tracheal tube airway spontaneous ventilation. Inhalation injury patients require more ventilatory support though patient outcomes do not differ. Prospective trials are required to establish which strategies confer benefit.

  18. Fatal poisonings in Oslo: a one-year observational study

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    Heyerdahl Fridtjof

    2010-06-01

    Full Text Available Abstract Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic, and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years. In 92 cases (89%, death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases, followed by ethanol (9%, tricyclic anti-depressants (TCAs (4%, benzodiazepines (4%, and zopiclone (4%. Seventy-one (69% were evaluated as accidental deaths and 32 (31% as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04. Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91, 14% (95% C.I., 0.04-0.33, and 10% (95% C.I., 0.02-0.27, respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental

  19. Modified release paracetamol overdose: a prospective observational study (ATOM-3).

    Science.gov (United States)

    Chiew, Angela L; Isbister, Geoffrey K; Page, Colin B; Kirby, Katharine A; Chan, Betty S H; Buckley, Nicholas A

    2018-02-16

    Modified-release (MR) paracetamol is available in many countries as 665 mg tablets of which 69% is MR and 31% is immediate release. There are concerns that MR paracetamol overdose has higher rates of liver injury despite standard treatment algorithms. The objective of this study was to describe the clinical characteristics and outcomes of acute MR paracetamol overdose. Prospective observational study, recruiting patients from January 2013 to June 2017, from five clinical toxicology units and calls to two Poisons Information Centres in Australia. Included were patients >14 years who ingested ≥10 g or 200 mg/kg (whichever is less) of MR paracetamol. Data collected included demographics, ingestion history, pathology results, treatments, and outcomes including hepatotoxicity (ALT >1000 U/L). In total, 116 patients were recruited, 85(73%) were female. The median dose ingested was 32 g (IQR: 20-49 g) and median time to presentation was 3 h (IQR: 2-9 h). 78(67%) had an initial paracetamol concentration above the nomogram line (150 mg/L at 4 h). A further 12(10%) crossed the nomogram after repeat paracetamol measurements, of which five crossed after two non-toxic levels 4 h apart. Six had a double paracetamol peak, in three occurring >24 h post-ingestion. 113(97%) received acetylcysteine of which 67 received prolonged treatment beyond the standard 21 h. This was because of an elevated paracetamol concentration at the completion of acetylcysteine in 39 (median paracetamol concentration 25 mg/L, IQR: 16-62 mg/L). 21 (18%) developed hepatotoxicity, including six treated within 8 h of ingestion. Activated charcoal and double doses of acetylcysteine did not significantly decrease the risk of hepatotoxicity. Drug regulatory authorities are considering restrictions on MR paracetamol preparations. Following an acute MR paracetamol overdose, this study found that many patients had a persistently elevated paracetamol concentrations, many required

  20. Fatal poisonings in Oslo: a one-year observational study.

    Science.gov (United States)

    Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

    2010-06-06

    Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

  1. Creating a driving profile for older adults using GPS devices and naturalistic driving methodology [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Ganesh M. Babulal

    2016-09-01

    Full Text Available Background/Objectives: Road tests and driving simulators are most commonly used in research studies and clinical evaluations of older drivers. We adapted an existing, commercial, off-the-shelf, in-vehicle device for naturalistic, longitudinal research to better understand daily driving behavior in older drivers. Design: The Azuga G2 Tracking DeviceTM was installed in each participant’s vehicle, and we collected data over 5 months (speed, latitude/longitude every 30-seconds when the vehicle was driven.  Setting: The Knight Alzheimer’s Disease Research Center at Washington University School of Medicine. Participants: Five individuals enrolled in a larger, longitudinal study assessing preclinical Alzheimer disease and driving performance.  Participants were aged 65+ years and had normal cognition. Measurements:  Spatial components included Primary Location(s, Driving Areas, Mean Centers and Unique Destinations.  Temporal components included number of trips taken during different times of the day.  Behavioral components included number of hard braking, speeding and sudden acceleration events. Methods:  Individual 30-second observations, each comprising one breadcrumb, and trip-level data were collected and analyzed in R and ArcGIS.  Results: Primary locations were confirmed to be 100% accurate when compared to known addresses.  Based on the locations of the breadcrumbs, we were able to successfully identify frequently visited locations and general travel patterns.  Based on the reported time from the breadcrumbs, we could assess number of trips driven in daylight vs. night.  Data on additional events while driving allowed us to compute the number of adverse driving alerts over the course of the 5-month period. Conclusions: This pilot study indicated that Driving Profiles for older adults can be created and compared month-to-month or year-to-year, allowing researchers to identify changes in driving patterns that are unavailable in

  2. Southeast Atmosphere Studies: learning from model-observation syntheses

    Data.gov (United States)

    U.S. Environmental Protection Agency — Observed and modeled data shown in figure 2b-c. This dataset is associated with the following publication: Mao, J., A. Carlton, R. Cohen, W. Brune, S. Brown, G....

  3. Pulp polyp - A periapical lesion: Radiographic observational study

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    Kandagal V Suresh

    2015-01-01

    Full Text Available Introduction: Pulp polyp (PP is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW, loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%, loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%. Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001. All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical

  4. Multicentre observational study of the Gatekeeper for faecal incontinence.

    Science.gov (United States)

    Ratto, C; Buntzen, S; Aigner, F; Altomare, D F; Heydari, A; Donisi, L; Lundby, L; Parello, A

    2016-02-01

    A variety of therapeutic approaches are available for faecal incontinence. Implantation of Gatekeeper prostheses is a new promising option. The primary endpoint of this prospective observational multicentre study was to assess the clinical efficacy of Gatekeeper implantation in patients with faecal incontinence. Secondary endpoints included the assessment of patients' quality of life, and the feasibility and safety of implantation. Patients with faecal incontinence, with either intact sphincters or internal anal sphincter lesions extending for less than 60° of the anal circumference, were selected. Intersphincteric implantation of six prostheses was performed. At baseline, and 1, 3 and 12 months after implantation, the number of faecal incontinence episodes, Cleveland Clinic Faecal Incontinence, Vaizey and American Medical Systems, Faecal Incontinence Quality of Life Scale and Short Form 36 Health Survey scores were recorded. Endoanal ultrasonography was performed at baseline and follow-up. Fifty-four patients were implanted. After Gatekeeper implantation, incontinence to gas, liquid and solid stool improved significantly, soiling was reduced, and ability to defer defaecation enhanced. All faecal incontinence severity scores were significantly reduced, and patients' quality of life improved. At 12 months, 30 patients (56 per cent) showed at least 75 per cent improvement in all faecal incontinence parameters, and seven (13 per cent) became fully continent. In three patients a single prosthesis was extruded during surgery, but was replaced immediately. After implantation, prosthesis dislodgement occurred in three patients; no replacement was required. Anal implantation of the Gatekeeper in patients with faecal incontinence was effective and safe. Clinical benefits were sustained at 1-year follow-up. © 2015 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

  5. Association between day of delivery and obstetric outcomes: observational study.

    Science.gov (United States)

    Palmer, William L; Bottle, A; Aylin, P

    2015-11-24

    What is the association between day of delivery and measures of quality and safety of maternity services, particularly comparing weekend with weekday performance? This observational study examined outcomes for maternal and neonatal records (1,332,835 deliveries and 1,349,599 births between 1 April 2010 and 31 March 2012) within the nationwide administrative dataset for English National Health Service hospitals by day of the week. Groups were defined by day of admission (for maternal indicators) or delivery (for neonatal indicators) rather than by day of complication. Logistic regression was used to adjust for case mix factors including gestational age, birth weight, and maternal age. Staffing factors were also investigated using multilevel models to evaluate the association between outcomes and level of consultant presence. The primary outcomes were perinatal mortality and-for both neonate and mother-infections, emergency readmissions, and injuries. Performance across four of the seven measures was significantly worse for women admitted, and babies born, at weekends. In particular, the perinatal mortality rate was 7.3 per 1000 babies delivered at weekends, 0.9 per 1000 higher than for weekdays (adjusted odds ratio 1.07, 95% confidence interval 1.02 to 1.13). No consistent association between outcomes and staffing was identified, although trusts that complied with recommended levels of consultant presence had a perineal tear rate of 3.0% compared with 3.3% for non-compliant services (adjusted odds ratio 1.21, 1.00 to 1.45). Limitations of the analysis include the method of categorising performance temporally, which was mitigated by using a midweek reference day (Tuesday). Further research is needed to investigate possible bias from unmeasured confounders and explore the nature of the causal relationship. This study provides an evaluation of the "weekend effect" in obstetric care, covering a range of outcomes. The results would suggest approximately 770 perinatal

  6. "My appointment received the sanction of the Admiralty": why Charles Darwin really was the naturalist on HMS Beagle.

    Science.gov (United States)

    van Wyhe, John

    2013-09-01

    For decades historians of science and science writers in general have maintained that Charles Darwin was not the 'naturalist' or 'official naturalist' during the 1831-1836 surveying voyage of HMS Beagle but instead Captain Robert FitzRoy's 'companion', 'gentleman companion' or 'dining companion'. That is, Darwin was primarily the captain's social companion and only secondarily and unofficially naturalist. Instead, it is usually maintained, the ship's surgeon Robert McCormick was the official naturalist because this was the default or official practice at the time. Although these views have been repeated in countless accounts of Darwin's life, this essay aims to show that they are incorrect. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Reduction, supervenience, emergence and naturalistic truth: reductionism, holism and the description of human nature

    Directory of Open Access Journals (Sweden)

    Carlos Castrodeza

    2013-07-01

    Full Text Available Methodological reduction is often wrongly identified with ontological reduction. For anyontology has always existential problems of its own which are absent in a methodological approach. Emergence would also be problematic unless it is also contemplated methodologically. As anyphilosophical issue, the question of emergence-reduction is used from a naturalistic stance as aplatform to promote personal ideals of survival. For example, Richard Dawkins would promote aDarwinially reduced world. On the contrary, Richard Lewontin for one would implement a holisticworld essentially Kropotkian. In this context, a contentious term is that of replicator. But this termneed not be either as reductive as Dawkins would have us believe nor as useless as Lewontin thinks.For again evolution by natural selection would always be defended naturalistically along one’s ownideological tenets.

  8. Motor-Manipulatory Behaviours and Learning: an Observational Study

    Directory of Open Access Journals (Sweden)

    Assunta Tavernise

    2008-07-01

    Full Text Available In this paper we investigated the role of motor-manipulatory behaviour in the learning modalities of thirty-five primary school children interacting with a Lego MindStorms kit. In particular, by means of an observational taxonomy of children’s behaviour, we analysed the video records of two observational sessions regarding the learning activities during the building of a small robot. Our results demonstrated that motor-manipulatory behaviours are strictly linked to cognitive processes, and that the acquisition of new knowledge can be considered as the result of a gradual experience of integration between both perceptual and manipulative behavioural routines.

  9. Fédération de botanistes, synthèse de contributions citoyennes et transfert de la connaissance naturaliste

    Directory of Open Access Journals (Sweden)

    Delphine Montagne

    2014-06-01

    Full Text Available Tela Botanica est une association dédiée à la botanique. Elle s’appuie sur Internet et les nouvelles technologies pour développer un réseau naturaliste francophone. Cette note rappelle sa construction, ses particularités techniques et organisationnelles. Ces dernières ont permis son succès et le développement de projets pluri-thématiques au service de la connaissance naturaliste.

  10. Complex Tasks Force Hand Laterality and Technological Behaviour in Naturalistically Housed Chimpanzees: Inferences in Hominin Evolution

    OpenAIRE

    Mosquera, M.; Geribàs, N.; Bargalló, A.; Llorente, M.; Riba, D.

    2012-01-01

    Clear hand laterality patterns in humans are widely accepted. However, humans only elicit a significant hand laterality pattern when performing complementary role differentiation (CRD) tasks. Meanwhile, hand laterality in chimpanzees is weaker and controversial. Here we have reevaluated our results on hand laterality in chimpanzees housed in naturalistic environments at Fundació Mona (Spain) and Chimfunshi Wild Orphanage (Zambia). Our results show that the difference between hand laterality i...

  11. Study of observed microearthquakes at Masada Deep Borehole

    Science.gov (United States)

    Hofstetter, A.; Malin, P. E.

    2017-12-01

    Seismological measurements, conducted at great depths of several hundred of meters or even a few km, can provide useful information that one cannot get while conducting the measurements on the surface. We take advantage of Masada Deep borehole (MDBI), an abandoned oil well, for the installation of a seismometer at a large depth of 1,256 m (1,516 bsl). The station is located in the near vicinity of the East Masada fault, part of the Western Boundary Fault of the Dead Sea basin. We present seismic observations of microearthquakes which occurred along the Dead Sea fault (DSF). Many of them were not recorded by the Israel Seismic Network (ISN). The quiet site of the station has an obvious advantage in detection and identification of earthquakes and explosions. For example, the station detects about 30% more quarry explosions as compared to observations of the ISN. We demonstrate that borehole seismograms are clearer than the on-surface observations of nearby seismometer. We lowered the magnitude scale of observed events down to about M≈-3. Many of the earthquakes, sometimes clusters, occurred underneath the MDBI at depths of 10-25 km, having special signature. Using the cross-correlation technique we present several series of seismic activity either underneath the station or along the DSF. Frequency-magnitude relationship, known also as Gutenberg-Richter relationship, is somewhat higher than the determined value for the whole Dead Sea Fault.

  12. An observational study of post-asymptotic-giant-branch stars

    Science.gov (United States)

    Sahin, T.

    2008-05-01

    In this thesis, we present an LTE model atmosphere analyses of a group of early B-type postasymptotic giant branch (pAGB) stars. With initial masses ≤ 9M⊙, post-AGB stars form an important group of evolved stars and provide a unique opportunity to study stellar evolution almost on a human time-scale. Post-AGB stars have spectral types ranging from K to B and luminosities between 103 and 104L⊙. These objects ended their asymptotic giant branch (AGB) evolution phase with a period of strong mass loss (10-7 - 10-4M⊙ yr-1) and have been evolving from cooler to hotter temperatures at almost constant luminosity on a timescale of ˜ 104yr. B-type pAGB stars span a wide range in effective temperature (10 000 - 30 000K). Their expected surface gravities (log g ) and effective temperatures ( Teff ) coincide with those of B stars evolving from the main sequence. Therefore systematic observational analyses are required to distinguish these two groups. Furthermore, p! ost-AGB stars may be divided into four distinct groups based on their chemical composition. In this thesis, groups I and II represent post-AGB stars which are very metal deficient with C/O ≈ 1 and metal poor with C/OTIGER. These spectra were analyzed using model atmospheres and synthetic spectra computed with the Armagh LTE stellar atmospheres software. The semiautomated spectral fitting package SFIT was used to measure the stellar surface parameters and composition. The results show that Teff of the programme stars are in the range 15 000 - 25 000 K and log g are in the range 2.5 - 3.0. In addition to being metal-poor stars, they show mostly C/O<1. Several of our programme stars, namely HD119608, LSS4331, LSS5112, and LB3116 confirm this. The majority of hot post-AGB stars can be identified with the group II, metal-poor and C-deficient post-AGB stars. The model atmosphere parameters, LTE element abundances and estimated distance obtained here support the idea that programme stars are in true post

  13. Re-evaluating concepts of biological function in clinical medicine: towards a new naturalistic theory of disease.

    Science.gov (United States)

    Chin-Yee, Benjamin; Upshur, Ross E G

    2017-08-01

    Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of disease and illness, we need not necessarily abandon naturalistic concepts of function and dysfunction in the disease debate. This article attempts to move towards a new naturalistic theory of disease that overcomes the limitations of previous definitions and offers advantages in the clinical setting. Our approach involves a re-evaluation of concepts of biological function employed by naturalistic theories. Drawing on recent insights from the philosophy of biology, we develop a contextual and evaluative account of function that is better suited to clinical medicine and remains consistent with contemporary naturalism. We also show how an updated naturalistic view shares important affinities with normativist and phenomenological positions, suggesting a possibility for consilience in the disease debate.

  14. The Pavlovian craver: Neural and experiential correlates of single trial naturalistic food conditioning in humans.

    Science.gov (United States)

    Blechert, J; Testa, G; Georgii, C; Klimesch, W; Wilhelm, F H

    2016-05-01

    Present-day environments are replete with tempting foods and the current obesity pandemic speaks to humans' inability to adjust to this. Pavlovian processes may be fundamental to such hedonic overeating. However, a lack of naturalistic Pavlovian paradigms in humans makes translational research difficult and important parameters such as implicitness and acquisition speed are unknown. Here we present a novel naturalistic conditioning task: an image of a neutral object was conditioned to marzipan taste in a single trial procedure by asking the participant to eat the 'object' (made from marzipan). Relative to control objects, results demonstrate robust pre- to post-conditioning changes of both subjective ratings and early as well as late event related brain potentials, suggesting contributions of implicit (attentional) and explicit (motivational) processes. Naturalistic single-trial taste-appetitive conditioning is potent in humans and shapes attentional and motivational neural processes that might challenge self-regulation during exposure to tempting foods. Thus, appetitive conditioning processes might contribute to overweight and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Reliability of radiographic observations recorded on a proforma measured using inter- and intra-observer variation: a preliminary study.

    Science.gov (United States)

    Saunders, M B; Gulabivala, K; Holt, R; Kahan, R S

    2000-05-01

    The aim of this preliminary study was to test the reliability of radiographic evaluation of features of endodontic interest using a newly devised data collection system. Twelve endodontic MSc postgraduate students and one specialist endodontist examined sample radiographs derived from a random selection of 42 patients seen previously on an Endodontic New Patient Clinic (EDI). Each student examined a random selection of 8-9 roots on periapical radiographs of single- and multirooted teeth, with and without previous root canal therapy and 3-4 dental panoramic tomograms (DPTs). A total of 100 roots were examined. A proforma was used to record observations on 67 radiographic features using predefined criteria. Intra-observer agreement was tested by asking the students to re-examine the radiographs. The principle investigator and the specialist endodontist examined the same radiographs and devised a Gold Standard using the same criteria. This was compared with the student assessments to determine inter-observer variation. The postgraduates then attended a revision session on the use of the form. Each student subsequently examined 8-9 different roots from the pool of radiographs. A further assessment of inter-observer variation was made by comparing these observations with the Gold Standard. Of the 67 radiographic features, only 25 had sufficient response to allow statistical analysis. Kappa values for intra- and inter-observer variation were estimated. These varied depending on the particular radiographic feature being assessed. Fifteen out of 25 intra-observer recordings showed 'good' or 'very good' Kappa agreement, but only three out of 25 inter-observer observations achieved 'good' or 'very good' values. Inter-observer variation was improved following the revision session with 16 out of 25 observations achieving 'good' or 'very good' Kappa agreement. Modification to the proforma, the criteria used, and training for radiographic assessment were considered necessary to

  16. Treatment of breast cancer during pregnancy: an observational study.

    Science.gov (United States)

    Loibl, Sibylle; Han, Sileny N; von Minckwitz, Gunter; Bontenbal, Marijke; Ring, Alistair; Giermek, Jerzy; Fehm, Tanja; Van Calsteren, Kristel; Linn, Sabine C; Schlehe, Bettina; Gziri, Mina Mhallem; Westenend, Pieter J; Müller, Volkmar; Heyns, Liesbeth; Rack, Brigitte; Van Calster, Ben; Harbeck, Nadia; Lenhard, Miriam; Halaska, Michael J; Kaufmann, Manfred; Nekljudova, Valentina; Amant, Frederic

    2012-09-01

    Little is known about the treatment of breast cancer during pregnancy. We aimed to determine whether treatment for breast cancer during pregnancy is safe for both mother and child. We recruited patients from seven European countries with a primary diagnosis of breast cancer during pregnancy; data were collected retrospectively if the patient was diagnosed before April, 2003 (when the registry began), or prospectively thereafter, irrespective of the outcome of pregnancy and the type and timing of treatment. The primary endpoint was fetal health for up to 4 weeks after delivery. The registry is ongoing. The study is registered with ClinicalTrials.gov, number NCT00196833. From April, 2003, to December, 2011, 447 patients were registered, 413 of whom had early breast cancer. Median age was 33 years (range 22-51). At the time of diagnosis, median gestational age was 24 weeks (range 5-40). 197 (48%) of 413 women received chemotherapy during pregnancy with a median of four cycles (range one to eight). 178 received an anthracycline, 15 received cyclophosphamide, methotrexate, and fluorouracil, and 14 received a taxane. Birthweight was affected by chemotherapy exposure after adjustment for gestational age (p=0·018), but not by number of chemotherapy cycles (p=0·71). No statistical difference between the two groups was observed for premature deliveries before the 37th week of gestation. 40 (10%) of 386 infants had side-effects, malformations, or new-born complications; these events were more common in infants born before the 37th week of gestation than they were in infants born in the 37th week or later (31 [16%] of 191 infants vs nine [5%] of 195 infants; p=0·0002). In infants for whom maternal treatment was known, adverse events were more common in those who received chemotherapy in utero compared with those who were not exposed (31 [15%] of 203 vs seven [4%] of 170 infants; p=0·00045). Two infants died; both were exposed to chemotherapy and delivered prematurely, but

  17. Observational and theoretical studies of the nova outburst

    Energy Technology Data Exchange (ETDEWEB)

    Starrfield, S.; Vanlandingham, K.; Schwarz, G. [Arizona State Univ., Tempe, AZ (United States). Dept. of Physics and Astronomy] [and others

    1998-04-01

    A nova outburst is one consequence of the accretion of hydrogen rich material onto a white dwarf in a close binary system. The strong electron degeneracy of a massive white dwarf drives the temperatures in the nuclear burning region to values exceeding 108K under all circumstances. As a result, a major fraction of the CNO nuclei in the envelope are transformed into e{sup +}-decay nuclei, which constrains the nuclear energy generation and yields non-solar CNO isotopic abundance ratios. In addition, the observations demonstrate that white dwarf core material is dredged up into the accreted layers and these nuclei are the catalysts for producing peak rates of energy generation that can exceed 10{sup 16} erg gm{sup -1}s{sup -1}. Observations show that there are two compositional classes of novae, one that occurs on a carbon-oxygen white dwarf and the other that occurs on an oxygen-neon-magnesium white dwarf.

  18. Comprehensive study of observables in Compton scattering on the nucleon

    Science.gov (United States)

    Grießhammer, Harald W.; McGovern, Judith A.; Phillips, Daniel R.

    2018-03-01

    We present an analysis of 13 observables in Compton scattering on the proton. Cross sections, asymmetries with polarised beam and/or targets, and polarisation-transfer observables are investigated for energies up to the Δ(1232) resonance to determine their sensitivity to the proton's dipole scalar and spin polarisabilities. The Chiral Effective Field Theory Compton amplitude we use is complete at N4LO, O(e2δ4), for photon energies ω˜ m_{π}, and so has an accuracy of a few per cent there. At photon energies in the resonance region, it is complete at NLO, O(e2δ0), and so its accuracy there is about 20%. We find that for energies from pion-production threshold to about 250 MeV, multiple asymmetries have significant sensitivity to presently ill-determined combinations of proton spin polarisabilities. We also argue that the broad outcomes of this analysis will be replicated in complementary theoretical approaches, e.g., dispersion relations. Finally, we show that below the pion-production threshold, 6 observables suffice to reconstruct the Compton amplitude, and above it 11 are required. Although not necessary for polarisability extractions, this opens the possibility to perform "complete" Compton-scattering experiments. An interactive Mathematica notebook, including results for the neutron, is available from judith.mcgovern@manchester.ac.uk.

  19. Naturalistic Follow-up of Youths Treated for Pediatric Anxiety Disorders

    Science.gov (United States)

    Ginsburg, Golda S.; Becker, Emily M.; Keeton, Courtney P.; Sakolsky, Dara; Piacentini, John; Albano, Anne Marie; Compton, Scott N.; Iyengar, Satish; Sullivan, Kevin; Caporino, Nicole; Peris, Tara; Birmaher, Boris; Rynn, Moira; March, John; Kendall, Philip C.

    2014-01-01

    IMPORTANCE Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems. Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents, particularly those treated with medication. OBJECTIVE To determine whether acute clinical improvement and treatment type (ie, cognitive behavioral therapy, medication, or their combination) predicted remission of anxiety and improvement in global functioning at a mean of 6 years after randomization and to examine predictors of outcomes at follow-up. DESIGN, SETTING, AND PARTICIPANTS This naturalistic follow-up study, as part of the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), was conducted at 6 academic sites in the United States and included 288 youths (age range, 11–26 years; mean age, 17 years). Youths were randomized to 1 of 4 interventions (cognitive behavioral therapy, medication, combination, or pill placebo) in the Child/Adolescent Anxiety Multimodal Study (CAMS) and were evaluated a mean of 6 years after randomization. Participants in this study constituted 59.0% of the original CAMS sample. EXPOSURES Participants were assessed by independent evaluators using a semistructured diagnostic interview to determine the presence of anxiety disorders, the severity of anxiety, and global functioning. Participants and their parents completed questionnaires about mental health symptoms, family functioning, life events, and mental health service use. MAIN OUTCOMES AND MEASURES Remission, defined as the absence of all study entry anxiety disorders. RESULTS Almost half of the sample (46.5%) were in remission a mean of 6 years after randomization. Responders to acute treatment were significantly more likely to be in remission (odds ratio, 1.83; 95% CI, 1.08–3.09) and had less severe anxiety symptoms and higher functioning; the assigned treatment

  20. Solar energetic particles: observational studies and magnetohydrodynamic simulation

    International Nuclear Information System (INIS)

    Masson, S.

    2010-10-01

    Solar activity manifests itself through highly dynamical events, such as flares and coronal mass ejections, which result in energy release by magnetic reconnection. This thesis focuses on two manifestations of this energy release: solar energetic particles and dynamics of magnetic reconnection. The first part of my work consists in the detailed temporal analysis of several electromagnetic signatures, produced by energetic particles in the solar atmosphere, with respect to the energetic particle flux at Earth. Using multi-instrument observations, I highlighted that particles can be accelerated by the flare to relativistic energies during a specific episode of acceleration in the impulsive phase. This showed that particles traveled a longer path length than the theoretical length generally assumed. Using in-situ measurements of magnetic field and plasma, I identified the interplanetary magnetic field for 10 particle events, and performing a velocity dispersion analysis I obtained the interplanetary length traveled by particles. I showed that the magnetic structure of the interplanetary medium play a crucial role in the association of the particle flux at Earth and the acceleration signatures of particles at the Sun. The second part of my work focuses on the dynamics of magnetic reconnection. Observationally, the best evidence for magnetic reconnection is the appearance of brightnesses at the solar surface. Performing the first data-driven 3 dimensional magneto-hydrodynamic (MHD) simulation of an observed event, I discovered that the evolution of brightnesses can be explained by the succession of two different reconnection regimes, induced by a new topological association where null-point separatrix lines are embedded in quasi-separatrix layers. This new topological association induces a change of field line connectivity, but also a continuous reconnection process, leading to an apparent slipping motion of reconnected field lines. From a MHD simulation I showed that

  1. Astronomical Observations Astronomy and the Study of Deep Space

    CERN Document Server

    2010-01-01

    Our Search for knowledge about the universe has been remarkable, heartbreaking, fantastical, and inspiring, and this search is just beginning. Astronomical Observations is part of a 7 book series that takes readers through a virtual time warp of our discovery. From the nascent space programs of the 1960's to today's space tourism and the promise of distant planet colonization, readers will be transfixed. Throughout this journey of the mind, Earth-bound explorers gain keen insight into the celestial phenomena that have fascinated humans for centuries. Thrilling narratives about indefatigable sc

  2. Echinococcus, Giardia and Cryptosporidium: observational studies challenging accepted dogma.

    Science.gov (United States)

    Thompson, R C A

    2009-10-01

    The development of in vitro culture systems that allow the maintenance, and support the development of Echinococcus, Giardia and Cryptosporidium in the laboratory have had a significant impact on their biology and taxonomy and the epidemiology of infections they cause. This short retrospective review demonstrates how radical shifts in our understanding have occurred as a result of being able to grow these organisms in culture, and how molecular tools have helped in the interpretation of such research that often reflects the observations of earlier workers.

  3. Temporal sequence in observational studies to establish causality

    Directory of Open Access Journals (Sweden)

    Luis Carlos Silva Ayçaguer, PhD

    2014-05-01

    Full Text Available The article includes a brief summary on the scope of the notions of causality and risk and considers some operational difficulties that arise when dealing with problems associated with them. It underscores the vital importance of timing and its link with the most commonly used observational research designs that address causal relationships. The article describes in detail the need to record the order in which the relevant events occur and how to consider this in the analysis. A detailed example of errors that are usually incurred in and their effect is provided.

  4. Observational and Modeling Studies of Clouds and the Hydrological Cycle

    Science.gov (United States)

    Somerville, Richard C. J.

    1997-01-01

    Our approach involved validating parameterizations directly against measurements from field programs, and using this validation to tune existing parameterizations and to guide the development of new ones. We have used a single-column model (SCM) to make the link between observations and parameterizations of clouds, including explicit cloud microphysics (e.g., prognostic cloud liquid water used to determine cloud radiative properties). Surface and satellite radiation measurements were used to provide an initial evaluation of the performance of the different parameterizations. The results of this evaluation will then used to develop improved cloud and cloud-radiation schemes, which were tested in GCM experiments.

  5. Analysis of subprotonospheric whistlers observed by DEMETER: A case study

    Science.gov (United States)

    Chum, Jaroslav; Santolik, Ondrej; Parrot, Michel

    2009-02-01

    Subprotonospheric (SP) whistlers consist of a series of low-dispersion components that result from repeated reflections between the base of the ionosphere and altitudes up to ~1000 km. We have used wave-normal angles and plasma characteristics measured by the DEMETER microsatellite as an input for a three-dimensional ray tracing technique. For several SP whistlers we have also succeeded in finding the causative lightning located at relatively large distances from the satellite footprint along the geomagnetic field line. We show that the reflections and formation of the SP whistlers take place owing to an oblique propagation, with respect to the magnetic field, in the waveguide formed by a profile of the increasing lower hybrid resonance frequency in the upper ionosphere and the base of the ionosphere. We have observed propagation across the magnetic meridian planes. We conclude that the individual components of the SP whistler propagate along different raypaths. The reflected components enter the ionosphere at relatively large distances from the satellite footprint and experience a spread of wave-normal angles during this entry. Depending on the initial wave-normal angle, these waves undergo a different number of reflections before reaching the satellite, thus arriving with different time delays. However, the first component observed of a SP whistler is formed by waves entering the ionosphere at relatively small distances from the satellite footprint and at relatively small wave-normal angles. These waves do not reflect above the satellite but propagate to the opposite hemisphere.

  6. Direct observation, study and control of molecular super rotors

    Science.gov (United States)

    Korobenko, Aleksey; Milner, Alexander; Hepburn, John; Milner, Valery

    2014-05-01

    Extremely fast rotating molecules whose rotational energy is comparable with or exceeds the molecular bond strength are known as ``super rotors''. It has been speculated that super rotors may exhibit a number of unique properties, yet only indirect evidence of these molecular objects has been reported to date. We demonstrate the first direct observation of molecular super rotors by detecting coherent unidirectional molecular rotation with extreme frequencies exceeding 10 THz. The technique of an ``optical centrifuge'' is used to control the degree of rotational excitation in an ultra-broad range of rotational quantum numbers, reaching as high as N = 95 in oxygen and N = 60 in nitrogen. State-resolved detection enables us to determine the shape of the excited rotational wave packet and quantify the effect of centrifugal distortion on the rotational spectrum. Femtosecond time resolution reveals coherent rotational dynamics with increasing coherence times at higher angular momentum. We demonstrate that molecular super rotors can be created and observed in dense samples under normal conditions where the effects of ultrafast rotation on many-body interactions, inter-molecular collisions and chemical reactions can be readily explored.

  7. Theoretical and Observational Studies of the Central Engines of AGN

    Science.gov (United States)

    Sivron, Ran

    1995-03-01

    In Active Galactic Nuclei (AGN) the luminosity is so intense that the effect of radiation pressure on a particle may exceed the gravitational attraction. It was shown that when such luminosities are reached, relatively cold (not completely ionized) thermal matter clouds may form in the central engines of AGN, where most of the luminosity originates. We show that the spectrum of emission from cold clouds embedded in hot relativistic matter is similar to the observed spectrum. We also show that within the hot relativistic matter, cold matter moves faster than the speed of sound or the Alfven speed, and shocks form. The shocks provide a mechanism by which a localized perturbation can propagate throughout the central engine. The shocked matter can emit the observed luminosity, and can explain the flux and spectral variability. It may also provide an efficient mechanism for the outward transfer of angular momentum and provide the outward flow of winds. With observations from X-ray satellites, emission features from the cold and hot matter may be revealed. Our analysis of X-ray data from the Seyfert 1 galaxy MCG - 6-30-15 over five years using detectors on the Ginga and Rosat satellites, revealed some interesting variable features. A source with hot matter emits non-thermal radiation which is Compton reflected from cold matter and then absorbed by warm (partially ionized) absorbing matter in the first model, which can be fit to the data if both the cold and warm absorbers are near the central engine. An alternative model in which the emission from the hot matter is partially covered by very warm matter (in which all elements except Iron are mostly ionized) is also successful. In this model the cold and warm matter may be at distances of up to 100 times the size of the central engine, well within the region where broad optical lines are produced. The flux variability is more naturally explained by the second model. Our results support the existence of cold matter in, or

  8. Observational study of food safety practices in retail deli departments.

    Science.gov (United States)

    Lubran, M B; Pouillot, R; Bohm, S; Calvey, E M; Meng, J; Dennis, S

    2010-10-01

    In order to improve the safety of refrigerated ready-to-eat food products prepared at retail deli departments, a better understanding of current practices in these establishments is needed. Food employees in deli departments at six chain and three independent retail establishments in Maryland and Virginia were observed, using notational analysis, as they prepared deli products for sale. The frequency of contact with objects and deli products before sale, hand washing and glove changing during preparation, and equipment, utensil, and surface cleaning and sanitizing was determined. Compliance with the U.S. Food and Drug Administration's 2005 model Food Code recommendations, which must be adopted by the individual state and local jurisdictions that are responsible for directly regulating retail establishments, was also assessed. Observations indicated there were a large number of actions for which hand washing was recommended at independent and chain stores (273 recommended of 1,098 total actions and 439 recommended of 3,073 total actions, respectively). Moreover, 67% (295 of 439) of the actions for which hand washing was recommended at the chain stores and 86% (235 of 273) of those at the independent stores resulted from employees touching non-food contact surfaces prior to handling ready-to-eat food. Compliance with hand washing recommendations was generally low and varied depending on store type with independent stores exhibiting lower compliance than chain stores (5 instances of compliance for 273 recommended actions and 73 instances of compliance for 439 recommended actions, respectively). Potential risk mitigation measures that may reduce the frequency of hand washing actions needed during ready-to-eat food preparation in retail deli departments are discussed. More research is needed to determine the impact of such measures on food safety.

  9. Communication Patterns and Stress in the Preschool: An Observational Study

    Science.gov (United States)

    Sjödin, Fredrik; Neely, Gregory

    2017-01-01

    The study included 12 preschool departments, with two teachers in six departments characterised by high levels of stress and burnout and two teachers in six departments characterised by low levels of stress and burnout. A total of 24 females with a mean age of 43.5 years participated in the study. The teachers rated stress, fatigue, work demands…

  10. Further observations on study difficulty among Nigerian students ...

    African Journals Online (AJOL)

    To investigate how study difficulty is associated with psychiatric morbidity, personality and psychosocial factors, the University College London Study Questionnaire (UCLSQ), Eysenck Personality Questionnaire (EPQ), the 30-item version of the General Health Questionnaire (GHQ-30) and a schedule on psychosocial ...

  11. Theoretical Cognitive Principles Observed in the Social Studies Classroom

    Science.gov (United States)

    Walker, Juan; Langan, Elise; Kemp, Andrew; Pagnotti, John; Russell, William

    2016-01-01

    Pre-service elementary social studies teachers in the south eastern United States participated in a mixed methods study to determine the degree to which they utilized critical thinking skills. Insight Assessments administered analysis of their reflections, critical thinking skills, and dispositions test. The researchers developed a post survey for…

  12. Adjacent segment degeneration: observations in a goat spinal fusion study

    NARCIS (Netherlands)

    Hoogendoorn, R.J.W.; Helder, M.N.; Wuisman, P.I.J.M.; Bank, R.A.; Everts, V.; Smit, T.H.

    2008-01-01

    Study Design. The adjacent discs of 13 goats, originally used in a lumbar spinal fusion model study, were analyzed for symptoms of intervertebral disc degeneration by means of magnetic resonance imaging (MRI), macroscopy, and histology. These goats were followed for 6 months and the results were

  13. 3-Dimensional Agent Representations Increase Generosity in a Naturalistic Setting

    DEFF Research Database (Denmark)

    Krátký, Jan; McGraw, John J.; Xygalatas, Dimitris

    they be our conspecifics, non-human species or supernatural beings. A number of studies have found that exposing participants to cues of agency increase prosocial or cooperative behavior. In two separate studies, we investigated the role dimensionality plays in priming inferences of agency. In contrast...

  14. Interactional Feedback in Naturalistic Interaction between L2 English Learners

    Science.gov (United States)

    Ranaweera, Mahishi

    2015-01-01

    Theoretical and empirical data support that the feedback given in small group activities promote second language acquisition. There are many studies that have examined the impact of interaction on second language acquisition in controlled language situations. This study examines the small group activity "conversation partner" in order to…

  15. Subclinical Hypothyroidism: A Prospective Observational Study from Southern India.

    Science.gov (United States)

    Sridhar, Mathrubootham; Mahadevan, Shriraam; Vishwanathan, Latha; Subbarayan, Anbezhil

    2018-03-15

    To assess the natural history and progression of subclinical hypothyroidism and to study factors which help predict evolution of subclinical hypothyroidism into overt hypothyroidism. Longitudinal study in 40 children (2-16 yrs) presenting with subclinical hypothyroidism in a tertiary care unit in Chennai, India. Patients showing evidence of overt hypothyroidism or thyroid stimulating hormone ≥15 mIU/mL during follow-up were started on thyroxine. Others were followed up with 3-monthly thyroid function tests up to one year. At the end of our study period 3 (7.5%) were overtly hypothyroid, 16 (40%) remained as subclinical hypothyroid, and 21 (52.5%) became euthyroid. Evidence of auto- immunity at baseline was a significant (Phypothyroidism. Subclinical hypothyroidism in children, with thyroid stimulating hormone upto 15 mIU/L and irrespective of thyroid autoimmunity, needs only periodic clinical and biochemical follow up. Thyroid autoimmunity may point to an increased probability of progression to overt hypothyroidism.

  16. Dialyzing women and men: does it matter? An observational study

    Science.gov (United States)

    Artan, Ayse Serra; Kircelli, Fatih; Ok, Ercan; Yilmaz, Murvet; Asci, Gulay; Dogan, Cengiz; Oto, Ozgur; Gunestepe, Kutay; Basci, Ali; Sever, Mehmet Sukru

    2016-01-01

    Background Application and consequences of hemodialysis treatment may differ between genders; focusing on these differences may be useful to optim