Biological And Symptom Changes In Posttraumatic Stress Disorder Treatment: A Randomized Clinical Trial

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110764/1/da22331.pd

A framework for automated anomaly detection in high frequency water-quality data from in situ sensors

River water-quality monitoring is increasingly conducted using automated in situ sensors, enabling timelier identification of unexpected values. However, anomalies caused by technical issues confound these data, while the volume and velocity of data prevent manual detection. We present a framework for automated anomaly detection in high-frequency water-quality data from in situ sensors, using turbidity, conductivity and river level data. After identifying end-user needs and defining anomalies, we ranked their importance and selected suitable detection methods. High priority anomalies included sudden isolated spikes and level shifts, most of which were classified correctly by regression-based methods such as autoregressive integrated moving average models. However, using other water-quality variables as covariates reduced performance due to complex relationships among variables. Classification of drift and periods of anomalously low or high variability improved when we applied replaced anomalous measurements with forecasts, but this inflated false positive rates. Feature-based methods also performed well on high priority anomalies, but were also less proficient at detecting lower priority anomalies, resulting in high false negative rates. Unlike regression-based methods, all feature-based methods produced low false positive rates, but did not and require training or optimization. Rule-based methods successfully detected impossible values and missing observations. Thus, we recommend using a combination of methods to improve anomaly detection performance, whilst minimizing false detection rates. Furthermore, our framework emphasizes the importance of communication between end-users and analysts for optimal outcomes with respect to both detection performance and end-user needs. Our framework is applicable to other types of high frequency time-series data and anomaly detection applications

Reducing Poverty in California…Permanently

If California were to seriously commit to equalizing opportunity and reducing poverty, how might that commitment best be realized? This is of course a hypothetical question, as there is no evidence that California is poised to make such a serious commitment, nor have many other states gone much beyond the usual lip-service proclamations. There are many reasons for California’s complacency, but an important one is that most people think that poverty is intractable and that viable solutions to it simply don’t exist. When Californians know what needs to be done, they tend to go forward and get it done. When, for example, the state’s roads are in disrepair, there are rarely paralyzing debates about exactly how to go about fixing them; instead we proceed with the needed repairs as soon as the funds to do so are appropriated. The same type of sure and certain prescription might appear to be unavailable when it comes to reducing poverty. It is hard not to be overwhelmed by the cacophony of voices yielding a thick stream of narrow-gauge interventions, new evaluations, and piecemeal proposals.1 Although the research literature on poverty is indeed large and may seem confusing, recent advances have in fact been so fundamental that it is now possible to develop a science-based response to poverty. In the past, the causes of poverty were not well understood, and major interventions, such as the War on Poverty, had to be built more on hunch than science. It is an altogether different matter now. The causes of poverty are well established, and the effects of many possible policy responses to poverty are likewise well established. The simple purpose of this essay is to assemble these advances into a coherent plan that would, if implemented, reduce poverty in California substantially

An Integrative, Multilevel, and Transdisciplinary Research Approach to Challenges of Work, Family, and Health

Recognizing a need for rigorous, experimental research to support the efforts of workplaces and policymakers in improving the health and wellbeing of employees and their families, the National Institutes of Health and the Centers for Disease Control and Prevention formed the Work, Family & Health Network (WFHN). The WFHN is implementing an innovative multisite study with a rigorous experimental design (adaptive randomization, control groups), comprehensive multilevel measures, a novel and theoretically based intervention targeting the psychosocial work environment, and translational activities. This paper describes challenges and benefits of designing a multilevel and transdisciplinary research network that includes an effectiveness study to assess intervention effects on employees, families, and managers; a daily diary study to examine effects on family functioning and daily stress; a process study to understand intervention implementation; and translational research to understand and inform diffusion of innovation. Challenges were both conceptual and logistical, spanning all aspects of study design and implementation. In dealing with these challenges, however, the WFHN developed innovative, transdisciplinary, multi-method approaches to conducting workplace research that will benefit both the research and business communities

Workplace Traumatic Stress and Mental Health Sequelae among Public Safety Telecommunications Officers in Florida

Background: Public safety telecommunications officers (PSTCOs), aka emergency “dispatchers,” are exposed to workplace traumatic stress and can experience situations characterized by uncertainty, communication difficulties, and a lack of resources. Traumatic stress experienced by emergency dispatchers has led to mental health symptoms. Purpose: This paper aims to describe the results of a study examining the patterns of workplace traumatic stress and the relationship between workplace traumatic stress and mental health concerns among a sample of PSTCOs. Methods: PSTCOs (n=54) participated in a cross-sectional, anonymous survey including screeners for depression, anxiety, post-traumatic stress disorder (PTSD), suicidal thoughts, and harmful alcohol use. Respondents also completed the Life Events Checklist (LEC) to screen for exposure to emergency calls identified as having the potential to induce traumatic stress. Results: 18.4% of respondents reported experiencing moderate to severe levels of depression, and 12% reported moderate to severe anxiety. Of the sample, 14% met the criteria for a provisional diagnosis of PTSD, 40% reported hazardous drinking levels, and 10% met the criteria of being at risk for suicide. Overall, 72.2% of PSTCOs experienced at least one form of job-related trauma and varied significantly by marital status. Poisson regression revealed statistically significant relationships between exposure to job-related traumatic events and screener scale scores. For example, those exposed to assault with a weapon had depression scores 2.29 points higher compared to those who were not exposed (p≤0.05). Discussion: Employing organizations of PSTCOs should strive to incorporate comprehensive wellness programs emphasizing education, prevention, early intervention, and recognition of traumatic stress among dispatchers. These programs should emphasize peer support and non-punitive policies to encourage help-seeking. In addition, given that findings in this study indicate exposure to traumatic emergency calls predicts PTSD symptomology, legislation could consider including PSTCOs in Florida Statute 118.1215

Readability of COVID-19 Parental Guidance Documents

The purpose of this study is to examine the readability levels of the state departments of education guidance documents regarding COVID-19 protocols for families of students receiving special education services. The authors searched the 50 states and the District of Columbia’s departments of education websites for their COVID-19, special education, parental guidance documents for the 2020-2021 school year. Parental guidance documents were available from 90% (46/51) of the department of education websites with 61% (31/51) of those documents specifically designed for parents of children receiving special education services. The researchers used the Flesch Reading Ease (FRES) to analyze the reading level of the 31 documents that the departments of education websites created for families of individuals receiving special education services. The FRES score was 43.05, indicating that the average reading difficulty was “difficult” with a “college reading level.” The Flesch-Kincaid Grade Level (FKGL) average score for the reviewed documents revealed an average U.S. grade level of 12.34. Thus, documents produced during the COVID-19 pandemic significantly exceeded the appropriate reading level recommended by the current research (Nagro & Stein, 2016). To improve communication and provide caregivers with the necessary information to make informed decisions regarding their children’s educational need during the COVID-19 pandemic, it is essential for parental guidance documents to be written at lower reading levels to accommodate the general population

Acute thrombus formation on phosphorilcholine surface modified flow diverters

PURPOSE: Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED). METHODS: Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10/group). Angioplasty was performed to enhance apposition and create intimal injury for a pro-thrombotic environment. Both before and after angioplasty, the flow diverter was imaged with intravascular optical coherence tomography. The outcome measure was the number of predefined segments along the implant relative to the location of the aneurysm with a minimum of 0 (no clot formation) and maximum of 3 (all segments with thrombus). Clot formation over the device at ostia of branch arteries was assessed as either present or absent. RESULTS: Following angioplasty, the number of flow diverter segments with clots was significantly associated with the flow diverter (p \u3c 0.0001), but not with DAPT (p=0.3872) or aneurysm neck size (p=0.8555). The incidence rate for clots with cPED was 1.72 times more than with sPED. The clots on the flow diverter at the location corresponding to side branch ostia was significantly lower with sPED than with cPED (OR 0.180; 95% CI 0.044 to 0.734; p=0.0168), but was not associated with DAPT (p=0.3198). CONCLUSION: In the rabbit model, phosphorilcholine surface modified flow diverters are associated with less thrombus formation on the surface of the device

Putting the “Sensory” Into Sensorimotor Control: The Role of Sensorimotor Integration in Goal-Directed Hand Movements After Stroke

Integration of sensory and motor information is one-step, among others, that underlies the successful production of goal-directed hand movements necessary for interacting with our environment. Disruption of sensorimotor integration is prevalent in many neurologic disorders, including stroke. In most stroke survivors, persistent paresis of the hand reduces function and overall quality of life. Current rehabilitative methods are based on neuroplastic principles to promote motor learning that focuses on regaining motor function lost due to paresis, but the sensory contributions to motor control and learning are often overlooked and currently understudied. There is a need to evaluate and understand the contribution of both sensory and motor function in the rehabilitation of skilled hand movements after stroke. Here, we will highlight the importance of integration of sensory and motor information to produce skilled hand movements in healthy individuals and individuals after stroke. We will then discuss how compromised sensorimotor integration influences relearning of skilled hand movements after stroke. Finally, we will propose an approach to target sensorimotor integration through manipulation of sensory input and motor output that may have therapeutic implications

Longitudinal Assessment of Gray and White Matter in Chronic Schizophrenia: A Combined Diffusion-Tensor and Structural Magnetic Resonance Imaging Study

Previous studies have reported continued focal gray matter loss after the clinical onset of schizophrenia. Longitudinal assessments in chronic illness, of white matter in particular, have been less conclusive

Why is there so much Poverty in California? The Causes of California’s Sky-High Poverty and the Evidence Behind the Equal Opportunity Plan for Reducing It

The purpose of this report is to describe the current state of poverty in California, to discuss concrete steps that could be taken to reduce poverty in California, and to present the best available evidence on the likely effects of those steps. We take on an important but infrequently-posed question: If California were to seriously commit to reducing poverty, how might that commitment best be realized? This is of course a hypothetical question, as there is no evidence that California is poised to make such a serious commitment, nor have many other states gone much beyond the usual lip service proclamations. It is nonetheless especially striking that California, the highest-poverty state in the country, has not rushed in to rectify the matter.1 There are many reasons for this seeming complacency, but an especially important one is that most people think that poverty is intractable and that viable solutions to it simply don’t exist. When Californians know what needs to be done, they tend to go forward and get it done. When, for example, the state’s roads are in disrepair, there are rarely paralyzing debates about exactly how to go about fixing them; and instead we proceed with the needed repairs as soon as the funds to do so are appropriated. The same type of sure and certain prescription might appear to be unavailable when it comes to fixing poverty. It is hard not to be overwhelmed by the cacaphony of voices yielding a thick stream of narrow-gauge interventions, new evaluations, and piecemeal proposals.