Holistic and mechanical combination in psychological assessment:Why algorithms are underutilized and what is needed to increase their use

Although mechanical combination results in more valid judgments and decisions than holistic combination, existing publications suggest that mechanical combination is rarely used in practice. Yet, these publications are either descriptions of anecdotal experiences or outdated surveys. Therefore, in several Western countries, we conducted two surveys (total N = 323) and two focus groups to investigate (1) how decision makers in psychological and HR practice combine information, (2) why they do (not) use mechanical combination, and (3) what may be needed to increase its use in practice. Many participants reported mostly using holistic combination, usually in teams. The most common reasons for not using mechanical combination were that algorithms are unavailable in practice and that stakeholders do not accept their use. Furthermore, decision makers do not quantify information, do not believe in research findings on evidence-based decision making, and think that combining holistic and mechanical combination results in the best decisions. The most important reason why mechanical combination is used was to increase predictive validity. To stimulate the use of mechanical combination in practice, our results suggest that decision makers should receive more training on evidence-based decision making, and decision aids supporting the use of mechanical combination should be developed

Age-related improvement in complex language comprehension: Results of a cross-sectional study with 361 children aged 5 to 15

We investigated age-related improvement in speed and accuracy of complex language comprehension with 361 children attending kindergarten and the 2nd, 4th, 6th, 7th, and 8th grades. Language comprehension was measured using both the neuropsychological procedure proposed by Luria (1966, 1980) and an adapted version of the Token Test. Levels of short-term memory and verbal intelligence were controlled for in the evaluation of language comprehension. The findings show that the accuracy of language comprehension continued to develop until the 6th grade, whereas the speed of language comprehension continued to improve up until the 7th grade. We thus conclude that the complex language comprehension of children is not fully developed until early adolescence. We further contend that the speed of complex language comprehension appears to be more sensitive than accuracy with respect to measuring developmental differences

Association of transcription-coupled repair but not global genome repair with ultraviolet-B-induced Langerhans cell depletion and local immunosuppression.

Exposure to ultraviolet-B radiation impairs cellular immune responses. This immunosuppression seems to be associated with Langerhans cell migration. DNA damage appears to play a key role because enhanced nucleotide excision repair, a pathway essential for elimination of ultraviolet-B-induced DNA lesions, strongly counteracts immunosuppression. To determine the effect of DNA repair on ultraviolet-B-induced local immunosuppression and Langerhans cell disappearance, three mouse strains carrying different defects in nucleotide excision repair were compared. XPC mice, which were defective in global genome repair, were as sensitive to ultraviolet-B-induced local suppression of contact hypersensitivity to picryl chloride as their wild-type littermates. CSB mice, defective in transcription-coupled repair, were far more sensitive for immunosuppression as were XPA mice, defective in both transcription-coupled repair and global genome repair. Only a moderate depletion of Langerhans cells was observed in XPC mice and wild-type littermates. Ultraviolet-B-induced Langerhans cell depletion was enhanced in CSB and XPA mice. Hence, the major conclusion is that local immunosuppression is only affected when transcription-coupled DNA repair is impaired. Furthermore, a defect in transcription-coupled repair was linked to enhanced ultraviolet-B-induced Langerhans cell depletion. In combination with earlier experiments, it can be concluded that Langerhans cell disappearance is related to ultraviolet-B-induced local but not to systemic immunosuppression

Response time variability and response inhibition predict affective problems in adolescent girls, not in boys: the TRAILS study

The present study examines the relationship between neurocognitive functioning and affective problems through adolescence, in a cross-sectional and longitudinal perspective. Baseline response speed, response speed variability, response inhibition, attentional flexibility and working memory were assessed in a cohort of 2,179 adolescents (age 10–12 years) from the TRacking Adolescents’ Individual Lives Survey (TRAILS). Affective problems were measured with the DSM-oriented Affective Problems scale of the Youth Self Report at wave 1 (baseline assessment), wave 2 (after 2.5 years) and wave 3 (after 5 years). Cross-sectionally, baseline response speed, response time variability, response inhibition and working memory were associated with baseline affective problems in girls, but not in boys. Longitudinally, enhanced response time variability predicted affective problems after 2.5 and 5 years in girls, but not in boys. Decreased response inhibition predicted affective problems after 5 years follow-up in girls, and again not in boys. The results are discussed in light of recent insights in gender differences in adolescence and state–trait issues in depression

Discrepancies in abdominal aortic aneurysm expressions and repair

Abdominal Aortic Aneurysm (AAA) disease is a growing healthcare burden. Besides theassociated cardiovascular comorbidities, the AAA itself poses a risk for the patient in two fashions. First, it could rupture, which is associated with high mortality and morbidity. This thesis focused on the second, more indirect, hazard the patient with an AAA is exposed to: the operative risk. Our aim was to improve patient outcome by seeking discrepancies in AAA expressions and repair. Variance and variants in AAA Screening for patients at risk for adverse events due to aneurysmal disease is currently based on traditional risk factors, which does not allow individual risk stratification. The instability of the vessel wall was previously shown to be a part a systemic process, and we show that local proteins predict postoperative cardiovascular adverse events. Currently no differences among AAAs have been established. In this thesis we demonstrate that half of the AAA had only very low amounts of wall inflammation, more pronounced intimal atherosclerosis, more atherosclerotic risk factors and more postoperative events, when compared to the AAA with moderate to severe inflammation. The low-inflammatory AAAs appeared more closely related to atherosclerosis, and might need a different therapeutic approach. Furthermore, we report that there is a regional variance in wall composition inside the AAA. Inflammation and proteases were more pronounced at the lateral sides of the AAA, suggesting decreased local wall strength. This location coincides with the most frequent site of rupture, and merits a prominent focus of (medication-related) research on the lateral wall. Improving outcome after repair Endovascular aneurysm repair (EVAR) comprises the majority of AAA repairs, and various access types exist, which influence outcome. We compared percutaneous access (pEVAR) and femoral cutdown access (cEVAR) both in a tertiary university center and in a more national database, both in the USA. We found that in our hospital pEVAR is associated with an improved (local) outcome and lower operative time and lower hospital stay. However, these results could not be generalized to a national level as this mixture of centers demonstrated only minimal or absent advantages of pEVAR versus cEVAR. When zooming in on physician specialty and experience in a national database in the USA, we noted that vascular surgeons repaired an increasing proportion of AAA overall from 2001 to 2009. Mortality was higher with lower surgeon volumes, especially for open repair. Medium and high volumes decreased over time, suggesting that it will be increasingly hard to deliver good quality treatment. For EVAR, more physicians had medium or large volumes, thereby significantly improving outcome. Current and future advances in knowledge should lead to an individual approach with a tailored cut off for intervention and management of co-existing diseases. Ultimately, if AAAs are better understood, patients who need treatment because of a higher rupture risk can be identified better. Also, the AAA repair of patients who are at high-risk for postoperative mortality and morbidity should be postponed as long as possible to delay the burden of repair, ideally to be repaired just before AAA rupture