The mediating roles of disgust sensitivity and danger expectancy in relation to hand washing behaviour

Copyright © 2010 British Association for Behavioural and Cognitive PsychotherapiesBackground: Recent interest in the role of vulnerability factors in obsessional washing has suggested that disgust sensitivity, danger expectancy and health anxiety may be of interest. Aims: This study explores the differential impact of these factors on both behavioural and cognitive measures of washing behaviour and is based on a replication of the Jones and Menzies (1997) experiment, during which participants immersed their hands in a noxious compound while rating themselves on a range of measures: the time they subsequently took to wash their hands was measured and danger expectancies were found to be the best predictor of this. Method: The present study added measures of disgust sensitivity and health anxiety to this experimental methodology while removing factors they found to be of little import to compulsive washing. Thirty non-clinical participants took part. Results: Results confirmed that disgust sensitivity was related to the behavioural measure of washing time, but that this relationship was almost entirely mediated by the danger expectancy concerning judgements of severity of consequent disease. However, a different pattern emerged when the outcome measure was questionnaire based: danger expectancy was not at all related to this. Disgust sensitivity mediated the relationship between health anxiety and scores on a questionnaire measure of washing compulsions. Interestingly, these scores were not related to the behavioural measure of washing time. Conclusions: The implications of these relationships to the further development of subtypes of Obsessive Compulsive Disorder (OCD) are discussed

Case 1 : Deciding Value for Money: Improving Prenatal Genetic Screening in Ontario

Since 1993, the Ontario Ministry of Health and Long-Term Care (MOHLTC) has financed prenatal genetic screening through its provincial health insurance plan. In 2013, a new technology became available. Non-invasive prenatal testing (NIPT) promises improved accuracy and screening safety at a higher cost than other screening tests. Since 2013, pregnant women in Ontario have been paying for the test themselves. In March 2014, the Ministry appointed a Prenatal Genetic Screening Group (PGSG), to make recommendations on making NIPT available through the provincial health insurance plan. The Ministry requested an economic evaluation, appraising the value of NIPT

A multi-agent system approach in evaluating human spatio-temporal vulnerability to seismic risk using social attachment

International audienceSocial attachment theory states that individuals seek the proximity of attachment figures (e.g. family members, friends, colleagues, familiar places or objects) when faced with threat. During disasters, this means that family members may seek each other before evacuating, gather personal property before heading to familiar exits and places, or follow groups/crowds, etc. This hard-wired human tendency should be considered in the assessment of risk and the creation of disaster management plans. Doing so may result in more realistic evacuation procedures and may minimise the number of casualties and injuries. In this context, a dynamic spatio-temporal analysis of seismic risk is presented using SOLACE, a multi-agent model of pedestrian behaviour based on social attachment theory implemented using the Belief-Desire-Intention approach. The model focuses on the influence of human, social, physical and temporal factors on successful evacuation. Human factors considered include perception and mobility defined by age. Social factors are defined by attachment bonds, social groups, population distribution, and cultural norms. Physical factors refer to the location of the epicentre of the earthquake, spatial distribution/layout and attributes of environmental objects such as buildings, roads, barriers (cars), placement of safe areas, evacuation routes, and the resulting debris/damage from the earthquake. Experiments tested the influence of time of the day, presence of disabled persons and earthquake intensity. Initial results show that factors that influence arrivals in safe areas include (a) human factors (age, disability, speed), (b) pre-evacuation behaviours, (c) perception distance (social attachment, time of day), (d) social interaction during evacuation, and (e) physical and spatial aspects, such as limitations imposed by debris (damage), and the distance to safe areas. To validate the results, scenarios will be designed with stakeholders, who will also take part in the definition of a serious game. The recommendation of this research is that both social and physical aspects should be considered when defining vulnerability in the analysis of risk

Developing a model of evacuation after an earthquake in Lebanon

This article describes the development of an agent-based model (AMEL, Agent-based Model for Earthquake evacuation in Lebanon) that aims at simulating the movement of pedestrians shortly after an earthquake. The GAMA platform was chosen to implement the model. AMEL is applied to a real case study, a district of the city of Beirut, Lebanon, which potentially could be stricken by a M7 earthquake. The objective of the model is to reproduce real life mobility behaviours that have been gathered through a survey in Beirut and to test different future scenarios, which may help the local authorities to target information campaigns.Comment: 8 pages, 11 figures, ISCRAM Vietnam Conference, November 201

Aligning Medical Student Curriculum with Practice Quality Goals: Impacts on Quality Metrics and Practice Capacity for Students

The practice of medicine occurs primarily in the ambulatory environment where providers have many competing demands, including health record documentation and patient volume expectations. Subsequently, medical student education has not been a priority for providers, health systems, or community practices. Yet, accrediting and professional organizations, such as the Association of American Medical Colleges, American Academy of Family Physicians, Ambulatory Pediatric Association, Society of General Internal Medicine, and the Liaison Committee on Medical Education, recommend education in ambulatory settings

Students Adding Value: Improving Patient Care Measures While Learning Valuable Population Health Skills

Medical students are potential resources for ambulatory primary care practices if learning goals can align with clinical needs. The authors introduced a quality improvement (QI) curriculum in the ambulatory clinical rotation that matched student learning expectations with practice needs. In 2016-2017, 128 students were assigned to academic, university affiliated, community health, and private practices. Student project measures were matched with appropriate outcome measures on monthly practice dashboards. Binomial mixed effects models were used to model QI measures. For university collaborative practices with student involvement, the estimated odds of a patient being screened for breast cancer in March 2017 was approximately 2 times greater than in 2016. This odds ratio was 36.2% greater than the comparable odds ratio for collaborative practices without student involvement (95% confidence interval = 22.7% to 51.2% greater). When student curriculum and assignments align with practice needs, practice metrics improve and students contribute to improvements in real-world settings

Efficacy of sediment remediation efforts on PAH contaminant flux via porewater advection at the sediment-surface water interface

Groundwater advection at the sediment-surface water interface is an important biogeochemical mechanism controlling the transport and bioavailability of contaminants in estuaries. At sites along the Elizabeth River (VA, USA) where the subterranean environment is heavily contaminated with polycyclic aromatic hydrocarbon (PAH)-rich dense non-aqueous phase liquid (DNAPL), consideration of groundwater-surface water dynamics and associated chemical exchange is critical for effective remediation. Preliminary data suggest that porewater advection in permeable sediments at this location is controlled by a host of physical forcing mechanisms that correspond with total flow estimates of up to 15,000 centimeters/year. Here, the efficacy of sediment remediation strategies, including dredging and capping DNAPL-laden sediments as well as implantation of a groundwater-blocking sheet pile wall, was evaluated with respect to groundwater and contaminant fluxes using naturally-occurring radionuclide tracers and a PAH antibody-based biosensor. Comparison of these data with results from similar analyses conducted at neighboring sites targeted for future remediation was provided to environmental managers to help guide future remediation efforts. Preliminary results revealed total PAH concentrations of up to \u3e400 μg/L in groundwater at subsurface depths up to 80 centimeters in the unremediated zone and corresponding salinity measurements of 5 –8 ppt, compared with a surface water salinity of 18 ppt. Groundwater samples from sediment depths reaching 120 centimeters at the recently remediated location had comparably low salinities and elevated PAH concentrations. These data provided strong evidence for the role of fresh groundwater contaminated with DNAPL as a major mode of PAH transport and suggest the need to devise additional, innovative strategies to mitigate porewater-associated contaminant flux