Predictors of Inappropriate Antibiotic Prescribing in Australian General Practice / Primary Care Settings

The objective of this thesis was to identify Guideline non-conforming prescribing of systemic antibiotics in Western Australian general practice for initial presentations of acute upper respiratory tract infection and urinary tract infection. Using quantitative methods, large-scale, longitudinal datasets were utilised to ascertain predictors of inappropriate prescribing, and to determine trends in inappropriate antibiotic prescribing over time. Significant inappropriate prescribing was detected and multiple predictors of inappropriate prescribing were identified, which can assist with antibiotic stewardship

The Association Between Depressive Symptoms, Relationship Satisfaction, and Self- and Partner-Attributions

Attributions of partners have been examined in the depressive symptom-relationship satisfaction literature, while attributions of self have not been adequately addressed. In the present study, attributions of self and partner were investigated as mediators of the association between depressive symptoms and relationship satisfaction. A student and community sample of 270 adults in heterosexual romantic relationships completed an online survey consisting of depressive symptom, relationship satisfaction, and relationship attribution inventories. Pearson\u27s product-moment correlation and multiple regression analyses were utilized to assess meditational pathways. Depressive symptoms were significantly negatively correlated with relationship satisfaction. Self- and partner-attributions were significantly positively correlated with relationship satisfaction. Self- and partner-attributions did not mediate the relationship between depressive symptoms and relationship satisfaction. Rather, results indicated that depressive symptoms and partner-attributions were significant predictors of relationship satisfaction, but self-attributions were not. Partner-attributions were found to partially mediate the depressive symptom-relationship satisfaction link for the student subsample. Clinical implications, limitations of the present study and considerations for future research are also discussed

The effect of colour and size on attentional bias to alcohol-related pictures

"Attentional bias plays an important role in the development and maintenance of alcohol addiction, and has often been measured with a visual probe task, where reaction times are compared for probes replacing either a substance related cue or a neutral cue. Systematic low-level differences between image classes are a potential cause of low internal reliability of the probe task (Ataya et al., 2012). Moreover, it is unclear whether automatic attentional capture by low-level properties such as size and colour in the non-substance related image could reduce attentional bias to the alcohol-related cue. Here, alcohol-related attentional bias was assessed in moderate social drinkers by measuring reaction times to targets that replaced either an alcohol related or a non-alcohol related (i.e., neutral) picture. All alcohol-related images were greyscale, and the neutral stimulus could be either greyscale (‘control’), in colour (‘colour’), or greyscale and 25% larger in size (‘25% larger size’). We found attentional bias towards the alcohol-related stimuli in the control and 25% larger size conditions, but not in the colour condition. The magnitude of attentional bias was significantly reduced in the colour condition compared to the control and 25% larger size conditions. These findings indicate that salient low-level features in the non-substance related cue, in particular colour, can reduce the effect of alcohol-related content on the allocation of alcohol drinkers’ attention. Further, the results highlight the need for image pairs in visual probe tasks to be closely matched on basic perceptual dimensions.

Advocating for Reproducibility

As guest editors, we are excited to publish this special double issue ofIASSIST Quarterly. The topics of reproducibility, replicability, and transparency have been addressed in past issues of IASSIST Quarterly and at the IASSIST conference, but this double issue is entirely focused on these issues

SpaceOAR to improve dosimetric outcomes for monotherapy high-dose-rate prostate implantation in a patient with ulcerative colitis.

High-dose-rate (HDR) brachytherapy is an attractive option for patients receiving definitive radiation therapy for prostate cancer with decreased overall dose to the pelvis. However, ulcerative colitis increases rectal toxicity risk and may be a contraindication. A synthetic hydrogel, SpaceOAR (Augmentix Inc., Waltham, MA, USA), can facilitate the use of HDR brachytherapy for patients where rectal toxicity is a limiting factor. SpaceOAR gel (13.19 cc) was utilized in a monotherapy HDR prostate treatment with Ir-192 under transrectal ultrasound guidance, with the intention of decreasing rectal dose. SpaceOAR gel was inserted transperineally into the patient 18 days prior to the procedure. The HDR brachytherapy procedure was tolerated without incident. All planning constraints were met, and the following dosimetry was achieved: Prostate – V100% = 97.3%, V150% = 35%, V200% = 14.5%; Urethra – V118% = 0%; Rectum – D2 cc = 51.6%, V75% = 0 cc. The rectum-catheter spacing was on average between 6-8 mm. Average spacing for our 10 most recent patients without SpaceOAR was 3 mm. SpaceOAR did not hinder or distort ultrasound imaging or increase treatment time. SpaceOAR successfully increases catheter-rectal wall spacing and decreases rectal dose due to improved planning capabilities, while decreasing the likelihood of rectal perforation. One application of this tool is presented to mitigate potential toxicities associated with ulcerative colitis. At five months, one week, and one day follow-up, the patient reported no bowel issues following HDR brachytherapy. © 2018 Termedia Publishing House Ltd. All Rights Reserved

Citations, Justifications, and the Troubled State of Legal Scholarship: An Empirical Study

Recent pedagogical, economic, and technological changes require law schools to reevaluate their resource allocations. Although typically viewed in terms of curricular changes, it is important also to focus on the very significant investment in legal scholarship and its impact. Typically, this has been determined by some version of citation counting with little regard for what it means to be cited. This Article discusses why this is a deeply flawed measure of impact. Much of that discussion is based on an empirical study the Authors conducted. The investigation found that citation by other authors is highly influenced by the rank of the review in which a work is published and the school from which the author graduated. Courts, on the other hand, are less sensitive to these markers of institutional authority. Perhaps more importantly, when the purpose of the citation is examined, a very small handful of those citing a work do so for anything related to the ideas, reasoning, methodology, or conclusions found in the cited work. This is slightly less true for judicial citation compared to citations by other authors. Given the level of current investment in legal scholarship and findings that reliance on it is far lower than citation counts would suggest, the Authors offer a number of recommendations designed to increase accountability of legal scholars and the utility of what they produce

Does decision-making at age 11 predict prodromal eating pathology at ages 14 and 17? A prospective, observational, UK population-based cohort study

OBJECTIVES: We examined whether decision-making at age 11 and 14 is associated with prodromal eating pathology at age 14 and whether it would persist across adolescence and also be present at age 17. DESIGN: This prospective, observational, population-based cohort study used a longitudinal design. SETTING: Data from the Millennium Cohort Study (MCS), a UK longitudinal cohort study involving 19 244 families from England, Scotland, Wales and Northern Ireland, were analysed. PARTICIPANTS: We modelled data from 8922 boys and girls aged 11, 14 and 17 (MCS sweeps 5, 6 and 7). PRIMARY AND SECONDARY OUTCOMES: We investigated decision-making using the risk-taking, quality of decision-making, deliberation time, delay aversion and risk adjustment subscales of the Cambridge Gambling Task and prodromal eating pathology through binary response items measuring: body dissatisfaction (whether the participant perceived their body as being too overweight); intention to lose weight (whether participants reported a strong desire to lose weight); dietary restriction (whether participants reported actively eating less to influence their shape/weight) and excessive exercise (whether participants reported exercising in a driven way in order to influence weight/shape). Data were analysed using latent class analysis and logistic regression. RESULTS: Lower scores on quality of decision-making (OR=0.46) and deliberation time (OR=0.99) at age 14 were associated with prodromal eating pathology at both ages 14 and 17 (all p<0.05), indicating an association between less frequently opting to bet on the most likely outcome and taking less time to decide on which bet to choose and the persistence of prodromal eating pathology over adolescence. Lower deliberation time (OR=0.99) and delay aversion (OR=0.62) at 11 and lower risk-taking scores at 14 (OR=0.43) were associated with the absence of prodromal eating pathology at 14 and 17 (all p<0.05), indicating that a moderate approach under conditions of risk in childhood and mid-adolescence is associated with reduced eating pathology across adolescence. CONCLUSIONS: Training advantageous decision-making might protect from later prodromal eating pathology

Decision-making difficulties mediate the association between poor emotion regulation and eating disorder symptoms in adolescence

BACKGROUND: The emergence of eating problems during childhood increases the risk for eating disorders (EDs) during young adulthood. Previous studies highlight a relationship between poor self-regulation and onset of eating pathology. In this study, we investigated whether this association is mediated by decision-making difficulties. METHODS: To test this hypothesis, we used data from the Millennium Cohort Study. Decision-making performance was assessed with the Cambridge Gambling Task at age 11. Principal components analysis was used to derive an index of ED symptoms at age 14. The trajectories of scores of two subscales of the Child Social Behaviour Questionnaire, Independence and Self-Regulation (ISR) and Emotional Dysregulation (EmotDy), were modelled from ages 3 to 7 years in a latent growth curve analysis. The individual predicted values of the intercept (set at baseline, 3 years) and the slope (rate of annual change) were then used in the mediation analysis. RESULTS: In our sample of 11 303 individuals, there was evidence for mediation by three measures of decision-making at age 11 (poor quality of decision-making, delay aversion and low risk-adjustment) in the association between EmotDy across ages 3–7 and ED symptoms at age 14 even after the adjustment for relevant covariates. We found no evidence of association between ISR and ED symptoms. CONCLUSION: Our findings suggest that emotion regulation processes during childhood may be relevant for the future onset of ED symptoms via their association with decision-making skills. These findings, obtained from a large, representative, sample, shed light on the relationship between self-regulation, decision-making and symptoms of EDs

Jean-Luc Godard and Critical Legal Studies (Because We Need the Eggs)

The New Wave in filmmaking is now thirty years old. Critical Legal Studies (CLS) has been around in one form or another for approximately a third of that time. We believe that by examining the avant-garde movement in film we may be able to anticipate what is in store for the avant-garde movement in law. Our conclusion is that just as New Wave film methodology has had only a limited impact on the film industry generally, CLS is likely to have a limited - perhaps only stylistic - effect on jurisprudential development. The reason for the shortfall is that Godard and the crits, in their respective ways, present a version of reality that we are unable - in a literal sense - to incorporate into our lives. Their message is, simply, that precious little in our existence is truly ordered or governed by identifiable principles. At a fundamental level, however, our psychological well-being may depend on our ability to avoid their version of reality by assuming (or imposing) an ordered reality. In the pages that follow, we more fully discuss ~he methods and aims of both Godard and the CLS movement. The similarities between Godard and his jurisprudential counterparts will be obvious but we devote a short section to highlighting the overlap. We elaborate on the need for order - even if contrived - and the failure of the modern film world to assimilate fully the contributions of Godard. We conclude by speculating about what that failure may tell us about the eventual impact of CLS

Decision-Making in Childhood Predicts Prodromal Eating Pathology in Adolescence

OBJECTIVE: Differences in decision-making under conditions of risk have been observed cross-sectionally in clinical groups of people with eating disorders but have never been studied longitudinally or in large cohorts. We investigated whether responses on the Cambridge Gambling Task (CGT), measured in the Millennium Cohort Study in childhood, would predict prodromal eating pathology in adolescence. METHOD: Regression models were built to explore relationships between CGT variables at age 11 years and prodromal eating pathology (body dissatisfaction, intention to lose weight, dietary restriction, significant under/overweight, and excessive exercise) at 14 years. RESULTS: In 11,303 boys and girls, those with better quality decision-making were 34% less likely to show an intention to lose weight (b = -0.40, odds ratio [OR] = 0.66, p < 0.05) and 34% less likely to be overweight (b = -0.41, relative risk ratio [RRR] = 0.66, p < 0.05). Those with higher risk-taking were 58% more likely to report dietary restriction (b = 0.45, OR = 1.58, p < 0.05) and 46% more likely to report excessive exercise (b = 0.38, OR = 1.46, p < 0.05). In the complete-cases sample, higher risk-adjustment scores were associated with a 47% increased risk of underweight (b = 0.39, RRR = 1.47, p < 0.05), and better quality of decision-making was associated with a 46% lower risk of overweight (b = -0.60, RRR = 0.54, p < 0.05). CONCLUSION: Disadvantageous decision-making in childhood may predict prodromal eating pathology in adolescence and might represent a prevention target