Sustainable transport modes, travel satisfaction, and emotions: Evidence from car-dependent compact cities

This study investigates how the use of sustainable transport modes relates to travel satisfaction (general evaluation of travel) and travel affect (emotions during travel) in car-dependent compact cities. Thereby, the study provides evidence on sustainable mobility and travel-related well-being in a context of compact urban form but inadequate provisions for public transport, walking, and cycling. A mixed-methods approach was applied comprising quantitative and qualitative analyses of data from the two major cities of Greece, i.e., Athens and Thessaloniki. Travel satisfaction and travel affect are found to be highest for those who walk for commuting, independently of travel time and other factors. Conversely, travel satisfaction and travel affect are lowest for public transport users, largely due to very long travel times but also poor public transport services in one of the two cities. Results indicate that the experience of traveling by public transport, car, and motorcycle within urban areas greatly depends on transport provision and policies. Overall, findings support the idea that to shift to pleasant, satisfying, and sustainable mobility in car-dependent compact cities, car restrictions should be accompanied by massive improvements in public transport, high-quality walking and cycling infrastructure, and an integrated coordination of different modes.Sustainable transport modes, travel satisfaction, and emotions: Evidence from car-dependent compact citiespublishedVersio

Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome

BACKGROUND AND HYPOTHESIS: Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. STUDY DESIGN: At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. STUDY RESULTS: CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). CONCLUSIONS: In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes

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Registered Australian psychologists' responses to ethical dilemmas regarding medicare funding of their services

Psychological services have been funded by the Australian government through Medicare since 2006. Medicare guidelines specify the conditions that psychologists can treat and the types of treatment that will be funded. The current study aimed to carry out an exploratory investigation of possible ethical issues raised by these guidelines. Psychologists' responses to hypothetical ethical dilemmas related to Medicare funding were examined. Two hundred and thirty-seven registered psychologists responded to an online questionnaire. Results suggest that psychologists base ethical decisions regarding Medicare-funded services on a number of factors, including the Australian Psychological Society Code of Ethics, best practice/treatment considerations, client interests, and Medicare guidelines. The characteristics of the dilemma and whether the situation can be referred to in the Code of Ethics appeared to influence psychologists' decisions. Participants were more ethically willing (they would do what they believed they should do) when the situation could be clearly related to the Code of Ethics. It was concluded that as psychologists must consider various professional values and standards, Medicare guidelines add a further level of complexity to practice decisions, and further education regarding Medicare rules is recommended

Clinical, cognitive and neuroanatomical associations of serum NMDAR autoantibodies in people at clinical high risk for psychosis

Serum neuronal autoantibodies, such as those to the NMDA receptor (NMDAR), are detectable in a subgroup of patients with psychotic disorders. It is not known if they are present before the onset of psychosis or whether they are associated with particular clinical features or outcomes. In a case–control study, sera from 254 subjects at clinical high risk (CHR) for psychosis and 116 healthy volunteers were tested for antibodies against multiple neuronal antigens implicated in CNS autoimmune disorders, using fixed and live cell-based assays (CBAs). Within the CHR group, the relationship between NMDAR antibodies and symptoms, cognitive function and clinical outcomes over 24 month follow-up was examined. CHR subjects were not more frequently seropositive for neuronal autoantibodies than controls (8.3% vs. 5.2%; OR = 1.50; 95% CI: 0.58–3.90). The NMDAR was the most common target antigen and NMDAR IgGs were more sensitively detected with live versus fixed CBAs (p < 0.001). Preliminary phenotypic analyses revealed that within the CHR sample, the NMDAR antibody seropositive subjects had higher levels of current depression, performed worse on the Rey Auditory Verbal Learning Task (p < 0.05), and had a markedly lower IQ (p < 0.01). NMDAR IgGs were not more frequent in subjects who later became psychotic than those who did not. NMDAR antibody serostatus and titre was associated with poorer levels of functioning at follow-up (p < 0.05) and the presence of a neuronal autoantibody was associated with larger amygdala volumes (p < 0.05). Altogether, these findings demonstrate that NMDAR autoantibodies are detectable in a subgroup of CHR subjects at equal rates to controls. In the CHR group, they are associated with affective psychopathology, impairments in verbal memory, and overall cognitive function: these findings are qualitatively and individually similar to core features of autoimmune encephalitis and/or animal models of NMDAR antibody-mediated CNS disease. Overall the current work supports further evaluation of NMDAR autoantibodies as a possible prognostic biomarker and aetiological factor in a subset of people already meeting CHR criteria

Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning - Results from the EU-GEI study

Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and anxiety disorders) and global functioning in patients with an at-risk mental state (ARMS) for psychosis. Methods: The sample consisted of 336 ARMS patients (159 women) from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. Results: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. Conclusions: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful. (C) 2019 Published by Elsevier Masson SAS