4. The Validity of ComputerBased Test Interpretations of the MMPI

With advances in computer technology, computer-based test interpretations (CBTI), first developed in the early 1960s (Fowler, 1985), have proliferated (Eyde & Kowal, 1987). CBTIs have been developed and marketed for a variety of tests used in clinical, counseling, educational, and employment settings. The largest number of commercial CBTI systems are available for the Minnesota Multiphasic Personality Inventory (MMPI; Krug, 1987), the most widely used inventory of its kind in the world, which has a continuously growing literature of more than 8,000 books and articles (Holden, 1986; Lanyon, 1984). According to Harris: CBTI refers to the automation of a set of pre-specified rules for use in analyzing, interpreting and assigning certain qualities to a response or response pattern (e .g., test score, profile pattern). The discrete rules are used to form an algorithm that guides the activity of the computer to interpret specific input data. (1987, p. 239) Consumers of CBTIs have very little information available on the development of the algorithm or the validity of the CBTI systems. Companies selling CBTIs often do not provide a user\u27s guide. The algorithms used in generating the computer interpretations are not available to CBTI users nor are they provided for scholarly review purposes. Notable exceptions to these business practices include Lachar\u27s (1974) presentation of all the rules and interpretive statements for the WPS Test Report, the MMPI CBTI sold by Western Psychological Services. National Computer Systems provided the algorithms for the Minnesota Report:Personnel Selection System, for scholarly review purposes, and gave an independent evaluation of the extent to which the interpretive statements were based on the MMPI\u27s research literature or on the clinical judgment of the CBTI\u27s author (Eyde, 1985). Numerous critics have pointed out serious problems arising from the growth of CBTIs. Mitchell (1984) observed that the advent of CBTIs presents the field of psychology with its most serious and consequential challenge of the next decade. Lanyon (1984) called attention to the exponential growth of available CBTI systems, noting that Meehl\u27s cookbook approach to MMPI interpretation (however carefully designed) has been used to justify and market many inadequate systems. Eyde and Kowal (1987) commented that the scientific basis for the C.B.T.I., namely the decision rules which codify the rationale and the evidence used to produce the computer interpretations, may wind up locked in a black box, inaccessible to test users (p. 402). Also, Matarazzo (1986) decried the lack of validity evidence for CBTIs. The problems associated with CBTIs have to do not only with the lack of validity data, but also with the problem of how to establish the validity of a computer interpretive report (Mitchell, 1984; Moreland, 1985, 1987; O\u27Dell, 1972). Mitchell (1984) notes that purists who want to do the job properly, are faced with the task of a conducting a statement-by-statement validation involving statements generated by decision rules and decision trees of almost incomprehensible complexity. Critics of prevailing practices in developing, marketing, and validating computerized applications of knowledge-based systems, may choose, as Eyde and Kowal (1985) have, to do some of the developmental work that should have been done before a computerized test product is sold. The intent of this chapter is to describe a methodology for studying the validity of the output of CBTI systems . The research focuses on a variety of CBTI systems developed as tools for interpreting the MMPI. The MMPI is the most widely used psychodiagnostic instrument with active-duty military populations (Parkison & Fishburne, 1984). Our methodology is designed so that it may be adapted to CBTIs for other tests or self-report inventories. The study involves a comparative analysis of the accuracy, relevancy, and usefulness of the output of seven CBTI systems for patients in a military hospital which draws its patients from a wide geographical area. The research design allows us to make some inferences about the relative accuracy of CBTI systems for different profile types. A secondary objective of the research was to identify racial differences, if any, in the accuracy of the CBTIs. This chapter will describe the study, provide basic data, and describe the results. Other chapters will cover (a) the Black/white differences in the accuracy of the CBTIs, which are minimal (Eyde, Kowal, & Fishburne, 1987); and (b) neuropsychological cases vs. non neuropsychological cases (Fishburne, Eyde, & Kowal, 1988)

Turbulence and the formation of filaments, loops and shock fronts in NGC 1275 in the Perseus Galaxy Cluster

NGC1275, the central galaxy in the Perseus cluster, is the host of gigantic hot bipolar bubbles inflated by AGN jets observed in the radio as Perseus A. It presents a spectacular $H{\alpha}$-emitting nebulosity surrounding NGC1275, with loops and filaments of gas extending to over 50 kpc. The origin of the filaments is still unknown, but probably correlates with the mechanism responsible for the giant buoyant bubbles. We present 2.5 and 3-dimensional MHD simulations of the central region of the cluster in which turbulent energy, possibly triggered by star formation and supernovae (SNe) explosions is introduced. The simulations reveal that the turbulence injected by massive stars could be responsible for the nearly isotropic distribution of filaments and loops that drag magnetic fields upward as indicated by recent observations. Weak shell-like shock fronts propagating into the ICM with velocities of 100-500 km/s are found, also resembling the observations. The isotropic outflow momentum of the turbulence slows the infall of the intracluster medium, thus limiting further starburst activity in NGC1275. As the turbulence is subsonic over most of the simulated volume, the turbulent kinetic energy is not efficiently converted into heat and additional heating is required to suppress the cooling flow at the core of the cluster. Simulations combining the MHD turbulence with the AGN outflow can reproduce the temperature radial profile observed around NGC1275. While the AGN mechanism is the main heating source, the supernovae are crucial to isotropize the energy distribution.Comment: accepted by ApJ Letter

Expression analysis of asthma candidate genes during human and murine lung development

<p>Abstract</p> <p>Background</p> <p>Little is known about the role of most asthma susceptibility genes during human lung development. Genetic determinants for normal lung development are not only important early in life, but also for later lung function.</p> <p>Objective</p> <p>To investigate the role of expression patterns of well-defined asthma susceptibility genes during human and murine lung development. We hypothesized that genes influencing normal airways development would be over-represented by genes associated with asthma.</p> <p>Methods</p> <p>Asthma genes were first identified via comprehensive search of the current literature. Next, we analyzed their expression patterns in the developing human lung during the pseudoglandular (gestational age, 7-16 weeks) and canalicular (17-26 weeks) stages of development, and in the complete developing lung time series of 3 mouse strains: A/J, SW, C57BL6.</p> <p>Results</p> <p>In total, 96 genes with association to asthma in at least two human populations were identified in the literature. Overall, there was no significant over-representation of the asthma genes among genes differentially expressed during lung development, although trends were seen in the human (Odds ratio, OR 1.22, confidence interval, CI 0.90-1.62) and C57BL6 mouse (OR 1.41, CI 0.92-2.11) data. However, differential expression of some asthma genes was consistent in both developing human and murine lung, e.g. <it>NOD1, EDN1, CCL5, RORA </it>and <it>HLA-G</it>. Among the asthma genes identified in genome wide association studies, <it>ROBO1</it>, <it>RORA, HLA-DQB1, IL2RB </it>and <it>PDE10A </it>were differentially expressed during human lung development.</p> <p>Conclusions</p> <p>Our data provide insight about the role of asthma susceptibility genes during lung development and suggest common mechanisms underlying lung morphogenesis and pathogenesis of respiratory diseases.</p

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Vision-related functioning outcomes of dexamethasone intravitreal implant in noninfectious intermediate or posterior uveitis,”

PURPOSE. To evaluate the effect of a single treatment with dexamethasone intravitreal implant (DEX implant) on patient-reported visual functioning in patients with noninfectious intermediate or posterior uveitis. METHODS. Patient eyes with noninfectious intermediate or posterior uveitis were randomized to a single treatment with DEX implant 0.70 mg (n ¼ 77), DEX implant 0.35 mg (n ¼ 76), or a sham procedure (n ¼ 76) and followed for 26 weeks. Vision-related functioning was measured using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) assessed at baseline and at weeks 8, 16, and 26 or early exit. Analysis of covariance and mixed model analysis of covariance were used to compare vision-related functioning between the DEX implant 0.70 and 0.35 mg groups and the sham group. RESULTS. By 8 weeks, the DEX implant 0.70 mg group demonstrated significant improvements in NEI VFQ-25 subscales near vision (P ¼ 0.031), distance vision (P ¼ 0.023), peripheral vision (P ¼ 0.045), vision-specific social functioning (P ¼ 0.019), and the NEI VFQ-25 composite score (P ¼ 0.007) compared with sham. After 26 weeks, the DEX implant 0.70 mg group reported significant improvements in NEI VFQ-25 subscales distance vision (P ¼ 0.003), vision-specific role difficulties (P ¼ 0.038), vision-specific dependency (P ¼ 0.017), vision-specific social functioning (P ¼ 0.009), vision-specific mental health (P ¼ 0.036), and the composite score (P ¼ 0.001) compared with sham. CONCLUSIONS. In patients with noninfectious intermediate or posterior uveitis receiving a single treatment of DEX implant 0.70 mg, significant and clinically meaningful improvements in patient-reported visual functioning were observed as early as week 8 and were maintained over 26 weeks. (ClinicalTrials.gov number, NCT00333814.) Keywords: dexamethasone intravitreal implant, quality of life, treatment outcomes U veitis refers to a group of diverse diseases not only affecting the uvea but also involving adjacent tissues including the retina, optic nerve, and vitreous. Patients with uveitis are at significant risk of developing substantial and sometimes permanent loss of vision, and uveitis is estimated to account for 10% to 15% of all cases of total blindness in the United States and the developed world. 1-3 The risk of severe vision loss is higher in patients with intermediate and posterior uveitis, characterized by inflammation of the vitreous and the retina. Vision loss in patients with uveitis is most commonly due to cystoid macular edema (CME), inflammatory vitreous haze and debris, and cataracts. 5 Corticosteroids are most often used to treat uveitis, despite the availability of immunosuppressive therapies

Military training and musculoskeletal disorders

Objectives: This study examined the extent to which musculoskeletal disorders [MSD] affect military populations, as well as intrinsic and extrinsic factors associated with MSD and the relative contribution of training, sports, and manual handling. A search of published literature was conducted using PubMed-listed articles published up to February 2006.\ud \ud Findings: Although physical conditioning represents an important facet of military preparedness, up to half of all recruits may suffer an injury during their basic military training. Musculoskeletal disorders are a common occurrence for soldiers and represent an important source of morbidity for the military as a whole. Intrinsic risk factors linked to military training injuries include a diverse range of inherent variables such as the level of prior physical conditioning, psychological make up, age, height, weight, and gender. Extrinsic risk factors for military MSD include training surface, exercise when fatigued, progressive training in place of cyclical training, and the type of footwear usually worn. Other military-specific variables may also include drill methods, the arrangement of platoons, training technique, and the actual training distance.\ud \ud Conclusions: Overall, this review suggests that MSD are a common occurrence for military personnel and represent an important source of morbidity for the military as a whole. In meeting this problem, there is clearly an urgent need to target effective preventive measures, especially those involving military-specific training and sports activities

Finding my voice: A qualitative exploration into the perceived impact of person‐centred counsellor training upon counsellors who were adopted as a baby

From Crossref journal articles via Jisc Publications RouterHistory: epub 2021-05-10, issued 2021-05-10Article version: VoRPublication status: Publishe