Screening for eating disorders: false negatives and eating disorders not otherwise specified

OBJECTIVE: To study the problem of false negatives in the screening for eating disorders. SUBJECTS AND METHODS: We administered the Eating Attitudes Test (EAT40) and the Eating Disorder Inventory (EDI) to 186 Italian female students (age 17.68 ± 0.9; BMI 20.84 ± 2.69). Then we submitted not only high-scorers but also all the subjects to a semi-structured diagnostic interview (Eating Disorder Examination - EDE 12.0D). The diagnosis of eating disorders not otherwise specified (EDNOS) was applied to cases which met all the DSM-IV criteria for AN and/or BN with one exception. RESULTS: 17 girls (9.1%) fulfilled diagnostic criteria for eating disorders: 1 bulimia nervosa full-syndrome and 16 EDNOS. Of the 17 girls 11 were EAT low-scorers (< 30) and 8 were EDI low-scorers (< 50); 5 subjects scored below the cutoff on both instruments. We calculated sensitivity (35.3%), specificity (88.8%), positive predictive value (PPV, 24.0%) and negative predictive value (NPV, 93.2%) of the EAT40; the respective values for the EDI were 52.9% (sensitivity), 85.2% (specificity), 26.4% (PPV) and 94.7% (NPV). DISCUSSION AND CONCLUSION: Our data show that the introduction of the EDNOS diagnoses increases the PPV of the two questionnaires but lowers their sensitivity. We conclude that using a two stage screening approach leads to a very high rate of false negatives with a significant underestimation of the prevalence of eating disorders, particularly of EDNOS

Interaction between clients and physiotherapists in group exercise classes in geriatric rehabilitation

The aim of this paper is to explore how older people construct their interaction in group exercise classes in geriatric rehabilitation and what is their contribution to the interaction. Discourse analysis was employed and data, consisting of seven videotaped group-based exercise sessions, were collected from 52 older people (aged 66–93 years) and nine rehabilitation professionals in seven rehabilitation centres. Four discourse categories were found. In “taciturn exercising”, older people remained verbally silent but physically active. In “submissive disagreeing”, older people opposed the professionals’ agenda by displaying reluctant consent to proposals. In “resilient endeavouring”, older adults persisted on their course of action, regardless of the disapproval of the professionals. In “lay helping”, older people initiated spontaneous encouragement, but also gave verbal and physical assistance to their peers. Older people's meaningful contribution to interaction, whilst it may challenge the institutional flow of activities, can constitute an integral part of the re-ablement process of rehabilitation

Searching for music: understanding the discovery, acquisition, processing and organization of music in a domestic setting for design

This series of studies make it clear that a wide range of both physical and digital resources are involved in domestic music consumption. The selection of digital resources is particularly evident, and it can be observed that domestic music consumption is a fragmented business, taking advantage of many different "channels'' for getting, using and preparing music. While there are not a series of common channels, each home displayed a variety of methods in respect to using metadata in multiple different modalities: regardless, the activities involved in getting, using and preparing music cohere through a noticeable, emergent set of workflows. We find that not only does metadata support searching, as one might expect, but also it pervades all parts of the workflow and is used in real-time as a reflexive artifact and in terms of its future perceived/prescribed use. The findings of the research raise a series of possibilities and issues that form the basis for understanding and designing for metadata use

The influence of ‘topic and resource’ on some aspects of social theorising

Developments in sociological theory since the 1960s have been responses to disciplinary problems rather than changes in fashion. The problem of topic and resource—where sociology has to use everyday understandings and practices as study resources even though they are legitimate topics of enquiry—has been an important and sometimes neglected spur to many of these developments. The turn to discourse, conversation analysis and the rise of Bourdieu's reflexivity are all attempts to address the problem, but each is shown to be unsatisfactory in different ways. In summary, they seek to address the issue as requiring either a principled methodological or a principled theoretical solution, and neither approach is capable of comprehensively addressing the matter. It is argued that these ‘solutions’ depend, in turn, on one of two particular construals of what the ‘problem’ consists in, neither of which is necessary or coherent. Each, it is argued, depends on a philosophical trick: making language out to need formal improvement (the Bertrand Russell trick) or introducing inappropriate scepticism to everyday life (the René Descartes trick). It is suggested that treating topic and resource not as a problem but as something which opens up new areas of investigation successfully deflates the issue and avoids unnecessary theoretical and methodological contortions

Neural Network Model for Apparent Deterministic Chaos in Spontaneously Bursting Hippocampal Slices

A neural network model that exhibits stochastic population bursting is studied by simulation. First return maps of inter-burst intervals exhibit recurrent unstable periodic orbit (UPO)-like trajectories similar to those found in experiments on hippocampal slices. Applications of various control methods and surrogate analysis for UPO-detection also yield results similar to those of experiments. Our results question the interpretation of the experimental data as evidence for deterministic chaos and suggest caution in the use of UPO-based methods for detecting determinism in time-series data.Comment: 4 pages, 5 .eps figures (included), requires psfrag.sty (included

Size-Dependent Transition to High-Dimensional Chaotic Dynamics in a Two-Dimensional Excitable Medium

The spatiotemporal dynamics of an excitable medium with multiple spiral defects is shown to vary smoothly with system size from short-lived transients for small systems to extensive chaos for large systems. A comparison of the Lyapunov dimension density with the average spiral defect density suggests an average dimension per spiral defect varying between three and seven. We discuss some implications of these results for experimental studies of excitable media.Comment: 5 pages, Latex, 4 figure

Prenatal Insecticide Exposures and Birth Weight and Length among an Urban Minority Cohort

We reported previously that insecticide exposures were widespread among minority women in New York City during pregnancy and that levels of the organophosphate chlorpyrifos in umbilical cord plasma were inversely associated with birth weight and length. Here we expand analyses to include additional insecticides (the organophosphate diazinon and the carbamate propoxur), a larger sample size (n = 314 mother–newborn pairs), and insecticide measurements in maternal personal air during pregnancy as well as in umbilical cord plasma at delivery. Controlling for potential confounders, we found no association between maternal personal air insecticide levels and birth weight, length, or head circumference. For each log unit increase in cord plasma chlorpyrifos levels, birth weight decreased by 42.6 g [95% confidence interval (CI), −81.8 to −3.8, p = 0.03] and birth length decreased by 0.24 cm (95% CI, −0.47 to −0.01, p = 0.04). Combined measures of (ln)cord plasma chlorpyrifos and diazinon (adjusted for relative potency) were also inversely associated with birth weight and length (p < 0.05). Birth weight averaged 186.3 g less (95% CI, −375.2 to −45.5) among newborns with the highest compared with lowest 26% of exposure levels (p = 0.01). Further, the associations between birth weight and length and cord plasma chlorpyrifos and diazinon were highly significant (p ≤ 0.007) among newborns born before the 2000–2001 U.S. Environmental Protection Agency’s regulatory actions to phase out residential use of these insecticides. Among newborns born after January 2001, exposure levels were substantially lower, and no association with fetal growth was apparent (p > 0.8). The propoxur metabolite 2-isopropoxyphenol in cord plasma was inversely associated with birth length, a finding of borderline significance (p = 0.05) after controlling for chlorpyrifos and diazinon. Results indicate that prenatal chlorpyrifos exposures have impaired fetal growth among this minority cohort and that diazinon exposures may have contributed to the effects. Findings support recent regulatory action to phase out residential uses of the insecticides

The Claims Culture: A Taxonomy of Industry Attitudes

This paper presents an analysis of a familiar aspect of construction industry culture that we have dubbed 'the claims culture'. This is a culture of contract administration that lays a strong emphasis on the planning and management of claims. The principal elements of the analysis are two sets of distinctions. The first comprises economic and occupational orders, referring to two kinds of control that are exercised over the construction process; predicated respectively on economic ownership and occupational competence. The second refers to contrasting attitudes towards relationships and problem solving within these orders: respectively 'distributive' and 'integrative'. The concepts of economic and occupational order entail further sub-categories. The various attitudes associated with these categories and sub-categories are described. They are assessed as to their consequences for change initiatives in the industry