Psychomotor therapy and aggression regulation in eating disorders:Evidence-based treatment and performance-based measurement

Uit onderzoek naar eetstoornissen blijkt onder meer dat overmatige regulatie van woede en agressie een belangrijke rol speelt. Dit proefschrift presenteert een nieuwe behandeling die hierop is gericht, ontwikkeld vanuit de psychomotorische therapie (PMT). De resultaten van gerandomiseerd en gecontroleerd onderzoek op een poliklinisch centrum en op twee dagbehandelingscentra voor eetstoornissen leveren het eerste bewijs van de toegevoegde waarde van PMT als een lichaams- en bewegingsgerichte therapie voor het reduceren van onderdrukte en op zichzelf gerichte woede. In het poliklinisch onderzoek was daarbij in de interventiegroep ook sprake van een afname in eetstoornis pathologie. Gebaseerd op deze bevindingen is de module opgenomen in de nieuwe landelijke Zorgstandaard voor Eetstoornissen. Als bijdrage aan meetprocedures voor woede en agressie introduceert het proefschrift ook een nieuwe psychomotorische gedragsmaat, genaamd de Methode voor Stamp Stoot Stem (MSSS). De MSSS meet de fysieke kracht waarmee iemand stampt op een krachtplaat, stoot tegen een bokszak en roept in een microfoon. De veronderstelling is dat deze krachtuitoefening samenhangt met de drang tot lichaamsexpressie die bij woede hoort. De MSSS is bedoeld als aanvulling op zelfrapportage-lijsten voor agressie en dient tevens als feedback-instrument voor het gecontroleerd leren uiten van agressie. De resultaten van een eerste exploratieve studie onder studenten laten zien dat de MSSS een betrouwbaar instrument is waarbij verbanden worden gevonden tussen krachtuitoefening enerzijds en het vasthouden, loslaten en controleren van woede anderzijds. Dit geldt met name bij het onderdeel Stem uitgevoerd door vrouwen. De trend is dat deelnemers die geneigd zijn woede te onderdrukken minder kracht gebruiken dan deelnemers die neigen tot expressie van woede

Моделирование изменения цен финансовых активов

В работе представлена модель процесса изменения цен финансовых активов на рынке. Описан путь построения модели, ее экономическая интерпретация, найдены моменты процесса и исследовано его поведение в предельном случае. Для сравнения с данной моделью приведены примеры некоторых других существующих моделей.У рoботi представлена модель процесу змiни цiн фiнансових активiв на ринку. Описано шлях побудови моделi, її економiчна iнтерпретацiя, знайдено моменти процесу, дослiджено його поведiнку у граничному випадку. Для порiвняння з даною моделлю наведено приклади деяких iнших моделей, що iснують.A model of process for financial assets — prices changing on market is presented. The way of the model’s construction is described, its economic interpretation, a moments of the process are obtained, its behavior in limit case is investigated. For comparison with the given model examples of other models are presented

Effect of Aggression Regulation on Eating Disorder Pathology:RCT of a Brief Body and Movement Oriented Intervention

ObjectiveThe objective of the study is to evaluate the effect of a brief body and movement oriented intervention on aggression regulation and eating disorder pathology for individuals with eating disorders. MethodIn a first randomized controlled trial, 40 women were allocated to either the aggression regulation intervention plus supportive contact or a control condition of supportive contact only. The intervention was delivered by a psychomotor therapist. Participants completed questionnaires on anger coping and eating disorder pathology. Independent samples t-tests were performed on the difference between pre-treatment and post-treatment scores. ResultsTwenty-nine participants completed questionnaires at pre-intervention and post-intervention. The intervention resulted in a significantly greater improvement of anger coping, as well as of eating disorder pathology. DiscussionResults indicate that body and movement-oriented aggression regulation may be a viable add-on for treating eating disorders. It tackles a difficult to treat emotion which may have a role in blocking the entire process of treating eating disorders. Copyright (c) 2015 John Wiley & Sons, Ltd and Eating Disorders Association

Practical Approach for Angina and Non-Obstructive Coronary Arteries: A State-of-the-Art Review

Anginal symptoms are frequently encountered in patients without the presence of significant obstructive coronary artery disease (CAD). It is increasingly recognized that vasomotor disorders, such as an abnormal vasodilatory capacity of the coronary microcirculation or coronary vasospasm, are the dominant pathophysiological substrate in these patients. Although the evidence with respect to angina in patients with non-obstructive coronary arteries is accumulating, the diagnosis and treatment of these patients remains challenging. In this review, we aimed to provide a comprehensive overview regarding the pathophysiological origins of angina with non-obstructive coronary arteries disorders and its diagnostic and therapeutic considerations. Hereby, we provide a practical approach for the management of patents with angina and non-obstructive CAD

Pharmacotherapy in patients with vasomotor disorders

BACKGROUND: Anginal symptoms in patients with non-obstructive coronary artery disease are frequently related to vasomotor disorders of the coronary circulation. Although frequently overlooked, a distinct diagnosis of different vasomotor disorders can be made by intracoronary function testing. Early detection and treatment seems beneficial, but little evidence is available for the medical treatment of these disorders. Nevertheless, there are several pharmacotherapeutic options available to treat these patients and improve quality of life. METHODS & FINDINGS: We performed an extensive yet non-systematic literature search to explore available pharmacotherapeutic strategies for addressing vasomotor disorders in individuals experiencing angina and non-obstructive coronary artery disease. This article presents a comprehensive overview of therapeutic possibilities for patients exhibiting abnormal vasoconstriction (such as spasm) and abnormal vasodilation (like coronary microvascular dysfunction). CONCLUSION: Treatment of vasomotor disorders can be very challenging, but a general treatment algorithm based on the existing evidence and the best available current practice is feasible

A cognitive remediation training for young adults with psychotic disorders to support their participation in education - study protocol for a pilot randomized controlled trial

Background: Most severe mental disorders have their onset between the age of 17 and 27, a time when many young adults begin participating in secondary or post-secondary education. The cognitive deficits typically associated with psychiatric disorders, especially psychotic disorders, increase the risk of leaving school early, which can lead to a reduction in employment opportunities later on in life and, in turn, a poorer long-term prognosis. Therefore, specific interventions aiming to improve these cognitive functions are needed. Cognitive remediation (CR) aims to improve cognitive functioning and may increase real-world functioning in educational performance. This study aims to examine the feasibility and applicability of a CR training named Mindset for students with psychotic disorders in the Netherlands. Methods/design: Sixty students diagnosed with a psychotic disorder and currently reporting cognitive deficits will be included from four Dutch Mental Health Care institutes. Half of the participants (N = 30) will be randomly assigned to the CR training consisting of twelve, individual, weekly 1-h meetings. The other half will be assigned to an active control condition consisting of twelve weekly assignments that will be sent by email aiming to improve school performance. Students will be evaluated at baseline (T0), directly after finishing the CR training or control intervention (T1), and 6 months later (T2). Treatment feasibility will be the primary outcome, using evaluation forms, interviews with trainers and participants, number of study drop outs, and patient eligibility and recruitment rates. School functioning, cognitive functioning, and strategy use will also be assessed to get a preliminary idea of the potential effectiveness of the intervention. Discussion: The CR training in this study will provide real-world examples and exercises aimed to teach useful strategies to cope with the cognitive deficits experienced by students with psychotic disorders. Furthermore, since students with other psychiatric disorders might also experience cognitive deficits, the results of this study may also provide some further implications for future studies on the effect of this CR training for students with these disorders. Trial registration: The study was registered with Trialregister.nl, no. NL6590 (NTR6764), date registered: September 7, 2017. Register name: Mindset. A cognitive rehabilitation training for young adults with psychotic spectrum disorder in an educational setting: A pilot study.Protocol version: 3, date December 23, 2019

Presence and utility of electrocardiographic abnormalities in long-term childhood cancer survivors

Background: We assessed the prevalence and diagnostic value of ECG abnormalities for cardiomyopathy surveillance in childhood cancer survivors. Methods: In this cross-sectional study, 1381 survivors (≥5 years) from the Dutch Childhood Cancer Survivor Study part 2 and 272 siblings underwent a long-term follow-up ECG and echocardiography. We compared ECG abnormality prevalences using the Minnesota Code between survivors and siblings, and within biplane left ventricular ejection fraction (LVEF) categories. Among 880 survivors who received anthracycline, mitoxantrone or heart radiotherapy, logistic regression models using least absolute shrinkage and selection operator identified ECG abnormalities associated with three abnormal LVEF categories (&lt;52% in male/&lt;54% in female, &lt;50% and &lt;45%). We assessed the overall contribution of these ECG abnormalities to clinical regression models predicting abnormal LVEF, assuming an absence of systolic dysfunction with a &lt;1% threshold probability. Results: 16% of survivors (52% female, mean age 34.7 years) and 14% of siblings had major ECG abnormalities. ECG abnormalities increased with decreasing LVEF. Integrating selected ECG data into the baseline model significantly improved prediction of sex-specific abnormal LVEF (c-statistic 0.66 vs 0.71), LVEF &lt;50% (0.66 vs 0.76) and LVEF &lt;45% (0.80 vs 0.86). While no survivor met the preset probability threshold in the first two models, the third model used five ECG variables to predict LVEF &lt;45% and was applicable for ruling out (sensitivity 93%, specificity 56%, negative predictive value 99.6%). Calibration and internal validation tests performed well. Conclusion: A clinical prediction model with ECG data (left bundle branch block, left atrial enlargement, left heart axis, Cornell's criteria for left ventricular hypertrophy and heart rate) may aid in ruling out LVEF &lt;45%.</p