The diagnostic validity and reliability of an internet-based clinical assessment program for mental disorders

BACKGROUND: Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. OBJECTIVE: The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. METHODS: Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. RESULTS: With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: &kappa;=.37) to strong (eg, panic disorder: &kappa;=.62). Although the e-PASS\u27 sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: &kappa;=.54) to substantial (eg, bulimia nervosa: &kappa;=.87). CONCLUSIONS: The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. <br /

Amino acid sequence of β-galactoside-binding bovine heart lectin Member of a novel class of vertebrate proteins

AbstractA variety of animal tissues contain β-galactoside-binding lectins with molecular masses in the range 13–17 kDa. There is evidence that these lectins may constitute a new protein family although their function in vivo is not yet clear. In this work the major part of the amino acid sequence of the 13 kDa lectin from bovine heart muscle has been determined. Comparison of this sequence with the cDNA-deduced sequence published for the chick embryo skin lectin showed 58% homology. Comparison of the bovine lectin sequence with partial sequences from two cDNA clones from a human hepatoma library and partial amino acid sequences of human lung lectin showed 70, 40 and 85% homology, respectively. The sequences of these vertebrate lectins are thus clearly related, supporting earlier results of immunological cross-reactivity within this group of proteins. Computer searching of protein sequence databases did not detect significant homologies between the bovine lectin sequence and other known proteins

Intraoperative determinants of infrainguinal bypass graft patency: A prospective study

Objectives:To evaluate a number of currently available methods for intraoperative assessment of infrainguinal bypass grafts (IBG) in terms of detecting technical errors and predicting graft failure.Design:Prospective open clinical study.Methods:Forty-nine patients undergoing 54 consecutive IBG were studied. Intraoperatively, the following measurements were performed: distal pulse palpation (DPP), continuous wave Doppler (CWD), pulse volume recording (PVR), and ultrasonic volume flowmetry (UVF), followed by intraoperative angiography of the entire graft and runoff vessels. The outflow resistance was graded according to the guidelines of the Society for Vascular Surgery and International Society for Cardiovascular Surgery (SVS/ISCVS runoff score). Graft patency was determined noninvasively (PVR, colour Duplex) up to 12 months following surgery. Predictive values and likelihood ratios for the intraoperative tests in detecting a technical problem during the bypass procedure and in predicting early graft failure were calculated.Results:There were five immediate revisions for problems detected intraoperatively. Angiography did not identify any additional problems but assisted in the correct location of the problems detected by the other tests. DPP and CWD were highly significant indicators of the need for revision with likelihood ratios for a positive test of 14.7 (p < 0.01) and 12.3 (p < 0.01) respectively. PVR did not achieve statistical significance in this respect. None of the intraoperative tests was a statistically significant predictor of early graft failure. The SVS/ISCVS runoff score, on the other hand, predicted early failure with a PPV of 33% (likelihood ratio for a positive test of 4.9, p < 0.05). None of the grafts with a perfect SVS/ISCVS runoff score (n = 39) failed in the first postoperative month.Conclusions:Simple CWD insonation of graft and anastomoses is the best intraoperative indicator for technical inadequacies after IBG. Routine intraoperative angiography is not necessary and intraoperative anatomical imaging may be reserved for situations in which noninvasive documentation of technical success is absent. Contrary to the intraoperative haemodynamic test results, the SVS/ISCVS runoff score is a good predictor of early graft failure

Evaluation of a community-based participatory physical activity promotion project: effect on cardiovascular disease risk profiles of school employees

<p>Abstract</p> <p>Background</p> <p>The efficacy of physical activity in improving cardiovascular disease (CVD) risk profiles has been well established. However, the effectiveness of health promotion programs implemented at the community level remains controversial. This study evaluated a school-based work-site physical activity program.</p> <p>Methods</p> <p>Using a community-based participatory research model, a work-site wellness intervention was implemented in a rural public school system in Southwestern Oklahoma. During the 2005-2006 school year, 187 participants (mean age 45 years) completed a pre intervention screening for CVD risk factors followed by a physical activity promotion program. Post intervention screening was conducted after a 6 month period. During both screening sessions, body composition, blood pressure, lipids, glucose and self-reported physical activity levels were assessed. The focus of the intervention was on promoting physical activity. Opportunities for in school physical activity were created by marking hallways, adding a treadmill in each school, and allowing teachers to use planning periods for physical activity.</p> <p>Results</p> <p>During the post intervention screening, compared to pre intervention levels, participants had lower total, low, and high density lipoprotein-cholesterol (t = 5.9, p < 0.0001, t = 2.6, p = 0.01, and t = 13.2, p < 0.0001 respectively), lower systolic blood pressure (t = 2.9, p = 0.004), and higher self-reported physical activity levels (Sign t = -1.901, p = 0.06).</p> <p>Conclusions</p> <p>A successful participatory program was associated with improvements in several CVD risk factors among school employees. Limitations of this study such as seasonal variation in the outcome variables and lack of a control group limit our ability to draw solid conclusions about the effectiveness of the intervention.</p

Phase II Investigations at Prehistoric and Rock Art Sites, Justiceburg Reservoir, Garza and Kent Counties, Texas Volume I

Phase II cultural resources investigations at the proposed Justiceburg Reservoir in Garza and Kent counties, Texas, were conducted by Prewitt and Associates, Inc. in 19881989. This report documents the archeological work at 62 prehistoric and aboriginal rock art sites and the geoarcheological study conducted as part of the Phase II work. Investigations at 48 prehistoric sites, including open campsites, rockshelters, lithic procurement sites, faunal localities, and rock art sites, resulted in complete National Register assessments; 9 campsites, the 2 rockshelters, and 6 rock art sites are considered to be eligible for listing on the National Register of Historic Places. Less-intensive investigations at 14 prehistoric sites yielded insufficient data for full National Register assessments. The geoarcheological study resulted in the formulation of a model of the geomorphic history of the project area. Of considerable importance is the recognition of a period of catastrophic flushing of alluvial sediments Within the Double Mountain ~ork valley during the middle Holocene, followed by late Holocene sedimentation and stabilization. This supports the concept of a dry middle Holocene Altitherrnal period and helps explain the biased archeological record in the project area. The prehistoric site investigations indicate that most of the archeological remains present at Justiceburg Reservoir date to the late Archaic and Late Prehistoric periods, a phenomenon noted in similar settings elsewhere in the Lower Plains. Of the open campsites assessed as eligible for listing on the National Register, four are classified as late Archaic (4500-2000 B.P.), two are classified as Late Prehistoric I (2000-1000 8.P.), and three are classified as Late Prehistoric II (1000 B.P. to evidence of European contact). The two investigated rockshelters contain evidence of Late Prehistoric I and II occupations. Due to the paucity of regional archeological data and the lack of a well-defined cultural chronology, only two of these sites can be assigned tentatively to recognized cultural complexes. Site 4lGR291 yielded ceramics and arrow points indicating a Palo Duro Complex occupation, ca. A.D. 500, while ceramics and a distinctive hearth associated with the upper component at 41KTS3 suggest a Garza Complex occupation, ca. A.D. 1600-1700. No evidence of European contact was found at any of the habitation sites, but three of the rock art sites contain historic Plains Indian iconography. The investigations at the prehistoric sites resulted in the formulation of a late Holocene cuItural sequence for the project area. Analyses of the various classes of archeological evidence (e.g., artifacts, features, faunal remains) revealed broad cultural patterns that appear to reflect significant changes in subsistence strategies through time. It is suggested that these changes are related to late Holocene environmental conditions and corresponding shifts in the resource base. It is further suggested that bison were the most important resource controlling late Holocene human adaptations in the Texas Lower Plains

Phase II Investigations at Prehistoric and Rock Art Sites, Justiceburg Reservoir, Garza and Kent Counties, Texas Volume I

Phase II cultural resources investigations at the proposed Justiceburg Reservoir in Garza and Kent counties, Texas, were conducted by Prewitt and Associates, Inc. in 19881989. This report documents the archeological work at 62 prehistoric and aboriginal rock art sites and the geoarcheological study conducted as part of the Phase II work. Investigations at 48 prehistoric sites, including open campsites, rockshelters, lithic procurement sites, faunal localities, and rock art sites, resulted in complete National Register assessments; 9 campsites, the 2 rockshelters, and 6 rock art sites are considered to be eligible for listing on the National Register of Historic Places. Less-intensive investigations at 14 prehistoric sites yielded insufficient data for full National Register assessments. The geoarcheological study resulted in the formulation of a model of the geomorphic history of the project area. Of considerable importance is the recognition of a period of catastrophic flushing of alluvial sediments Within the Double Mountain ~ork valley during the middle Holocene, followed by late Holocene sedimentation and stabilization. This supports the concept of a dry middle Holocene Altitherrnal period and helps explain the biased archeological record in the project area. The prehistoric site investigations indicate that most of the archeological remains present at Justiceburg Reservoir date to the late Archaic and Late Prehistoric periods, a phenomenon noted in similar settings elsewhere in the Lower Plains. Of the open campsites assessed as eligible for listing on the National Register, four are classified as late Archaic (4500-2000 B.P.), two are classified as Late Prehistoric I (2000-1000 8.P.), and three are classified as Late Prehistoric II (1000 B.P. to evidence of European contact). The two investigated rockshelters contain evidence of Late Prehistoric I and II occupations. Due to the paucity of regional archeological data and the lack of a well-defined cultural chronology, only two of these sites can be assigned tentatively to recognized cultural complexes. Site 4lGR291 yielded ceramics and arrow points indicating a Palo Duro Complex occupation, ca. A.D. 500, while ceramics and a distinctive hearth associated with the upper component at 41KTS3 suggest a Garza Complex occupation, ca. A.D. 1600-1700. No evidence of European contact was found at any of the habitation sites, but three of the rock art sites contain historic Plains Indian iconography. The investigations at the prehistoric sites resulted in the formulation of a late Holocene cuItural sequence for the project area. Analyses of the various classes of archeological evidence (e.g., artifacts, features, faunal remains) revealed broad cultural patterns that appear to reflect significant changes in subsistence strategies through time. It is suggested that these changes are related to late Holocene environmental conditions and corresponding shifts in the resource base. It is further suggested that bison were the most important resource controlling late Holocene human adaptations in the Texas Lower Plains

Airborne Evaluation and Demonstration of a Time-Based Airborne Inter-Arrival Spacing Tool

An airborne tool has been developed that allows an aircraft to obtain a precise inter-arrival time-based spacing interval from the preceding aircraft. The Advanced Terminal Area Approach Spacing (ATAAS) tool uses Automatic Dependent Surveillance-Broadcast (ADS-B) data to compute speed commands for the ATAAS-equipped aircraft to obtain this inter-arrival spacing behind another aircraft. The tool was evaluated in an operational environment at the Chicago O'Hare International Airport and in the surrounding terminal area with three participating aircraft flying fixed route area navigation (RNAV) paths and vector scenarios. Both manual and autothrottle speed management were included in the scenarios to demonstrate the ability to use ATAAS with either method of speed management. The results on the overall delivery precision of the tool, based on a target spacing of 90 seconds, were a mean of 90.8 seconds with a standard deviation of 7.7 seconds. The results for the RNAV and vector cases were, respectively, M=89.3, SD=4.9 and M=91.7, SD=9.0

Phase II Investigations at Prehistoric and Rock Art Sites, Justiceburg Reservoir, Garza and Kent Counties, Texas Volume I

Phase II cultural resources investigations at the proposed Justiceburg Reservoir in Garza and Kent counties, Texas, were conducted by Prewitt and Associates, Inc. in 19881989. This report documents the archeological work at 62 prehistoric and aboriginal rock art sites and the geoarcheological study conducted as part of the Phase II work. Investigations at 48 prehistoric sites, including open campsites, rockshelters, lithic procurement sites, faunal localities, and rock art sites, resulted in complete National Register assessments; 9 campsites, the 2 rockshelters, and 6 rock art sites are considered to be eligible for listing on the National Register of Historic Places. Less-intensive investigations at 14 prehistoric sites yielded insufficient data for full National Register assessments. The geoarcheological study resulted in the formulation of a model of the geomorphic history of the project area. Of considerable importance is the recognition of a period of catastrophic flushing of alluvial sediments Within the Double Mountain ~ork valley during the middle Holocene, followed by late Holocene sedimentation and stabilization. This supports the concept of a dry middle Holocene Altitherrnal period and helps explain the biased archeological record in the project area. The prehistoric site investigations indicate that most of the archeological remains present at Justiceburg Reservoir date to the late Archaic and Late Prehistoric periods, a phenomenon noted in similar settings elsewhere in the Lower Plains. Of the open campsites assessed as eligible for listing on the National Register, four are classified as late Archaic (4500-2000 B.P.), two are classified as Late Prehistoric I (2000-1000 8.P.), and three are classified as Late Prehistoric II (1000 B.P. to evidence of European contact). The two investigated rockshelters contain evidence of Late Prehistoric I and II occupations. Due to the paucity of regional archeological data and the lack of a well-defined cultural chronology, only two of these sites can be assigned tentatively to recognized cultural complexes. Site 4lGR291 yielded ceramics and arrow points indicating a Palo Duro Complex occupation, ca. A.D. 500, while ceramics and a distinctive hearth associated with the upper component at 41KTS3 suggest a Garza Complex occupation, ca. A.D. 1600-1700. No evidence of European contact was found at any of the habitation sites, but three of the rock art sites contain historic Plains Indian iconography. The investigations at the prehistoric sites resulted in the formulation of a late Holocene cuItural sequence for the project area. Analyses of the various classes of archeological evidence (e.g., artifacts, features, faunal remains) revealed broad cultural patterns that appear to reflect significant changes in subsistence strategies through time. It is suggested that these changes are related to late Holocene environmental conditions and corresponding shifts in the resource base. It is further suggested that bison were the most important resource controlling late Holocene human adaptations in the Texas Lower Plains