ADHD: can reinforcement resolve the problem?

Sergeant, J.A. [Promotor]Oosterlaan, J. [Copromotor

1939 historical aerial photography of Antioch Quadrangle, Lake County, Illinois, and Kenosha County, Wisconsin

Includes text, 1 location map with index diagram, and 4 ancillary remote-sensing image

Impact of methodological "shortcuts" in conducting public health surveys: Results from a vaccination coverage survey

Abstract Background Lack of methodological rigor can cause survey error, leading to biased results and suboptimal public health response. This study focused on the potential impact of 3 methodological "shortcuts" pertaining to field surveys: relying on a single source for critical data, failing to repeatedly visit households to improve response rates, and excluding remote areas. Methods In a vaccination coverage survey of young children conducted in the Commonwealth of the Northern Mariana Islands in July 2005, 3 sources of vaccination information were used, multiple follow-up visits were made, and all inhabited areas were included in the sampling frame. Results are calculated with and without these strategies. Results Most children had at least 2 sources of data; vaccination coverage estimated from any single source was substantially lower than from all sources combined. Eligibility was ascertained for 79% of households after the initial visit and for 94% of households after follow-up visits; vaccination coverage rates were similar with and without follow-up. Coverage among children on remote islands differed substantially from that of their counterparts on the main island indicating a programmatic need for locality-specific information; excluding remote islands from the survey would have had little effect on overall estimates due to small populations and divergent results. Conclusion Strategies to reduce sources of survey error should be maximized in public health surveys. The impact of the 3 strategies illustrated here will vary depending on the primary outcomes of interest and local situations. Survey limitations such as potential for error should be well-documented, and the likely direction and magnitude of bias should be considered.</p

Serum levels and removal by haemodialysis and haemodiafiltration of tryptophan-derived uremic toxins in ESKD patients

Tryptophan is an essential dietary amino acid that originates uremic toxins that contribute to end-stage kidney disease (ESKD) patient outcomes. We evaluated serum levels and removal during haemodialysis and haemodiafiltration of tryptophan and tryptophan-derived uremic toxins, indoxyl sulfate (IS) and indole acetic acid (IAA), in ESKD patients in different dialysis treatment settings. This prospective multicentre study in four European dialysis centres enrolled 78 patients with ESKD. Blood and spent dialysate samples obtained during dialysis were analysed with high-performance liquid chromatography to assess uremic solutes, their reduction ratio (RR) and total removed solute (TRS). Mean free serum tryptophan and IS concentrations increased, and concentration of IAA decreased over pre-dialysis levels (67%, 49%, -0.8%, respectively) during the first hour of dialysis. While mean serum total urea, IS and IAA concentrations decreased during dialysis (-72%, -39%, -43%, respectively), serum tryptophan levels increased, resulting in negative RR (-8%) towards the end of the dialysis session (p < 0.001), despite remarkable Trp losses in dialysate. RR and TRS values based on serum (total, free) and dialysate solute concentrations were lower for conventional low-flux dialysis (p < 0.001). High-efficiency haemodiafiltration resulted in 80% higher Trp losses than conventional low-flux dialysis, despite similar neutral Trp RR values. In conclusion, serum Trp concentrations and RR behave differently from uremic solutes IS, IAA and urea and Trp RR did not reflect dialysis Trp losses. Conventional low-flux dialysis may not adequately clear Trp-related uremic toxins while high efficiency haemodiafiltration increased Trp losses

Bandit Models of Human Behavior: Reward Processing in Mental Disorders

Drawing an inspiration from behavioral studies of human decision making, we propose here a general parametric framework for multi-armed bandit problem, which extends the standard Thompson Sampling approach to incorporate reward processing biases associated with several neurological and psychiatric conditions, including Parkinson's and Alzheimer's diseases, attention-deficit/hyperactivity disorder (ADHD), addiction, and chronic pain. We demonstrate empirically that the proposed parametric approach can often outperform the baseline Thompson Sampling on a variety of datasets. Moreover, from the behavioral modeling perspective, our parametric framework can be viewed as a first step towards a unifying computational model capturing reward processing abnormalities across multiple mental conditions.Comment: Conference on Artificial General Intelligence, AGI-1

Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder?

Objective: Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components are most effective. This meta-regression analysis investigated which specific behavioral techniques that parents learn in parent training are associated with effects on parental outcomes. Method: A search was performed for randomized controlled trials on parent training for children with ADHD, with positive parenting, negative parenting, parenting sense of competence, parent–child relationship quality, and parental mental health as outcome measures. After screening 23,026 publications, 29 studies contributing 138 effect sizes were included (N = 2,345). For each study, the dosage of 39 behavioral techniques was derived from intervention manuals, and meta-regression determined which techniques were related to outcomes. Results: Parent training had robust small- to medium-sized positive effects on all parental outcomes relative to control conditions, both for unblinded and probably blinded measures. A higher dosage of techniques focusing on the manipulation of antecedents of behavior was associated with better outcomes on parenting sense of competence and parental mental health, and a higher dosage of techniques focusing on reinforcement of desired behaviors was related to larger decreases in negative parenting. Higher dosages of psychoeducation were negatively related to parental outcomes. Conclusion: Although techniques were not investigated in isolation, the results suggested that manipulation of antecedents of behavior and reinforcement techniques are key components of parent training for children with ADHD in relation to parental outcomes. These exploratory findings may help to strengthen and tailor parent training interventions for children with ADHD

Overcoming the Metaphysics of Consciousness: Being/Artaud

Some recent theories of the mind have invoked the theatre as a metaphor to explain consciousness. This paper suggests that there is something irreducible to consciousness and that theatre can be an invaluable tool for exploring such subject matter. Rather than explain the mind through theory, performance practices can use immediate experience to investigate consciousness. Of course, Antonin Artaud’s ‘Theatre of Cruelty’ articulates the hope of apprehending consciousness through immediate experience, overcoming ‘literature’ and the alienating ossification of language. For Artaud, the ‘self’ has always been stolen at birth yet he suggests it can be returned through the theatre. The Theatre of Cruelty is an overcoming of the metaphysical obstructions of ‘being’. Martin Heidegger’s Being and Time also seeks to reveal the concept of 'Being' by destroying the historical misunderstanding of the term. Heidegger' claims that 'Dasein' (Being-there), the human subject, is maintained by a radical continuity with the world in which it exists. Because human subjects are 'absorbed' in the world of practical activity, projects and tasks, they tend to misrecognise themselves as a ‘thing’. But consciousness is not a ‘thing’ like other entities in the world. Such misrecognition is the fundamental error in what Heidegger calls metaphysics. My contention is that the Theatre of Cruelty is Artaud’s attempt at articulating a practical investigation of consciousness, resisting the metaphysical structures of language and logic and calling for the priority of ‘experience’. Cruelty is a return of the pre-theoretical, unspeakable words needed to explore the Being of consciousness. Such is an attempt to overcome the metaphysics of consciousness onstage.The conference was sponsored by A.D.S.A., the Department of Performance Studies, the School of Letters, Arts and Media, and the Faculty of Arts of the University of Sydney