Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis

Variations within and between observer-judges reduce the accuracy of clinical research. Judgement Analysis allows strategies to be developed and applied which reduce variation in judgement. The prediction that the removal of important sources of error variance by this means would reduce the likelihood of committing a Type 2 Error was supported by the application of Judgement Analysis to assessments by 15 psychiatrists of 92 patients in a clinical trial of 2 antidepressive treatments. The statistical significance of differences between the effect of the treatments on the severity of depression was increased, and significant differences appeared earlier. Ten stimulated patient profiles were also converted into narrative case histories, enacted by experienced psychiatrists or psychologists and videotaped. The participants' judgements of the overall severity of the depression were in good agreement with those they had made on the original cases. Videotapes so prepared help training to reduce variation in observation, just as Judgement Analysis can lead to reductions in the variation of judgemen

Direct and correlated effects of various selection strategies in performance tests of bulls

International audienc

Capturing the Essence of Developing Endovascular Expertise for the Construction of a Global Assessment Instrument

AbstractObjectivesTo explore what characterises the development of endovascular expertise and to construct a novel global assessment instrument.DesignLiterature review and an experimental study.Materials and methodsThe literature was searched for information regarding available global rating scales (GRSs); scientific societies’ official statements on endovascular competence; and task analyses of endovascular procedures. In the experimental study, clinicians performed a video-recorded simulated iliac-artery stenting procedure. Subsequently, by using the method of retrospective verbalisation, the clinicians were interviewed while watching their performance on video commenting on key issues of the construct. Data from all sources were analysed, categorised and synthesised into a novel rating scale.ResultsAvailable GRSs primarily included technical aspects of performance, whereas the competence statements, task analyses and clinicians’ perceptions added a range of non-technical aspects. The novel rating scale SAVE (Structured Assessment of endoVascular Expertise) differs from prior scales by including issues of pre-planning; prediction of challenges; preparation of tools; management of imaging presentation; distinction of technical skills into external and internal control according to operator focus of visual attention; adaptation of strategy; clinical decision making; use of assistant; complications; inter-personal skills; and post-procedural planning.ConclusionsThe essence of developing endovascular expertise goes far beyond mere technical aspects

Quality of life and well-being of carers of people with dementia: are there differences between working and nonworking carers? Results from the IDEAL program

The aim of this study was to identify the differences in quality of life (QoL) and well-being between working and nonworking dementia carers and the relative contribution of psychological characteristics, caregiving experience, and social support. Multiple regressions modeled the contribution of working status, caregiver experiences, and psychological and social resources to carer QoL (EQ-5D) and well-being (WHO-5). After controlling for age, gender, carer–dyad relationship, and severity of dementia, working status contributed significant variance to EQ-5D (2%) but not to WHO-5 scores. Independent of working status, higher self-esteem and reduced stress contributed to variance in both models. Self-efficacy, social support, and positive perceptions of caregiving additionally contributed to higher WHO-5 scores. Working status associated with higher EQ-5D QoL; this may reflect the sustained sense of independence associated with supported work opportunities for carers. Outside of working status, the findings support the importance of psychological and social factors as targets to improved mental health for dementia carers

Rotated stripe order and its competition with superconductivity in La1.88_{1.88}Sr0.12_{0.12}CuO4_4

We report the observation of a bulk charge modulation in La$_{1.88}$Sr$_{0.12}$CuO$_4$ (LSCO) with a characteristic in-plane wave-vector of (0.236, $\pm \delta$), with $\delta$=0.011 r.l.u. The transverse shift of the ordering wave-vector indicates the presence of rotated charge-stripe ordering, demonstrating that the charge ordering is not pinned to the Cu-O bond direction. On cooling through the superconducting transition, we find an abrupt change in the growth of the charge correlations and a suppression of the charge order parameter indicating competition between the two orderings. Orthorhombic LSCO thus helps bridge the apparent disparities between the behavior previously observed in the tetragonal "214" cuprates and the orthorhombic yttrium and bismuth-based cuprates and thus lends strong support to the idea that there is a common motif to charge order in all cuprate families.Comment: 6 pages, 4 figue

Infection kinetics and host specificity of Methicillin-resistant Staphylococcus aureus (MRSA) in pigs

In this study, we investigated the colonisation kinetics and host specificity of three different clonal lines of MRSA (ST8, ST9 and ST398). MRSA prevalence on skin, nasal mucosa, conjunctiva, feacal shedding and distribution patterns of MRSA in internal organs in weaning piglets are studied

On the Phenomenology of Hydrodynamic Shear Turbulence

The question of a purely hydrodynamic origin of turbulence in accretion disks is reexamined, on the basis of a large body of experimental and numerical evidence on various subcritical (i.e., linearly stable) hydrodynamic flows. One of the main points of this paper is that the length scale and velocity fluctuation amplitude which are characteristic of turbulent transport in these flows scale like $Re_m^{-1/2}$, where $Re_m$ is the minimal Reynolds number for the onset of fully developed turbulence. From this scaling, a simple explanation of the dependence of $Re_m$ with relative gap width in subcritical Couette-Taylor flows is developed. It is also argued that flows in the shearing sheet limit should be turbulent, and that the lack of turbulence in all such simulations performed to date is most likely due to a lack of resolution, as a consequence of the effect of the Coriolis force on the large scale fluctuations of turbulent flows. These results imply that accretion flows should be turbulent through hydrodynamic processes. If this is the case, the Shakura-Sunyaev $\alpha$ parameter is constrained to lie in the range $10^{-3}-10^{-1}$ in accretion disks, depending on unknown features of the mechanism which sustains turbulence. Whether the hydrodynamic source of turbulence is more efficient than the MHD one where present is an open question.Comment: 31 pages, 3 figures. Accepted for publication in Ap

Multiple characteristics of precipitation inferred from wind profiler radar Doppler spectra

A methodology to process radar wind profiler Doppler spectra is presented and implemented for an UHF Degreane PCL1300 system. First, double peak signal detection is conducted at each height level and, then, vertical continuity checks for each radar beam ensure physically consistent measurements. Second, horizontal and vertical wind, kinetic energy flux components, Doppler moments, and different precipitation-related variables are computed. The latter include a new precipitation type estimate, which considers rain, snow, and mixed types, and, finally, specific variables for liquid precipitation, including drop size distribution parameters, liquid water content and rainfall rate. The methodology is illustrated with a 48 h precipitation event, recorded during the Cerdanya-2017 field campaign, carried out in the Eastern Pyrenees. Verification is performed with a previously existing process for wind profiler data regarding wind components, plus precipitation estimates derived from Micro Rain Radar and disdrometer observations. The results indicated that the new methodology produced comparable estimates of wind components to the previous methodology (Bias < 0.1 m/s, RMSE ˜ 1.1 m/s), and was skilled in determining precipitation type when comparing the lowest estimate of disdrometer data for snow and rain, but did not correctly identify mixed precipitation cases. The proposed methodology, called UBWPP, is available at the GitHub repository.Peer ReviewedPostprint (published version