Confirmatory Factor Analysis of the Nepean Dysphoria Scale in a Clinical Sample

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. The construct of dysphoria has been described inconsistently across a broad range of psychopathology. The term has been used to refer to an irritable state of discontent, but is also thought to incorporate anger, resentment and nonspecific symptoms associated with anxiety and depression, such as tension and unhappiness. The Nepean Dysphoria Scale has been developed to allow assessment of dysphoria, but its factor structure has not yet been investigated in clinical samples. We aimed to determine the latent structure of dysphoria as reflected by the Nepean Dysphoria Scale, using a clinical sample. Adults (N = 206) seeking treatment at a range of mental health services were administered the Nepean Dysphoria Scale. Four putative factor structures were investigated using confirmatory factor analysis: a single-factor model, a hierarchical model, a bifactor model and a four-factor model as identified in previous studies. No model fit the data except for a four-factor model when a revised 22-item version of the original 24-item scale was investigated. A four-factor structure similar to that identified in non-clinical samples was supported, albeit following the removal of two items. The Nepean Dysphoria Scale appears to have utility for the assessment of dysphoria in routine clinical settings

Does emotional reasoning change during cognitive behavioural therapy for anxiety?

© 2015 Swedish Association for Behaviour Therapy. Abstract: Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies

The structure and intensity of self-reported autonomic arousal symptoms across anxiety disorders and obsessive-compulsive disorder

© 2016 Elsevier B.V. All rights reserved. Background Heightened autonomic arousal symptoms (AAS) are assumed to be a central feature of anxiety disorders. However, it is unclear whether the magnitude and profile of AAS vary across anxiety disorders and whether heightened AAS characterises obsessive-compulsive disorder (OCD). Aims We sought to determine whether the intensity and structure of AAS varied across anxiety disorders and OCD. Method A sample of 459 individuals with a primary anxiety disorder or OCD were administered the Symptom Checklist-90R. Nine items referring to prototypic AAS were included in a latent class analysis. Results A 2-class solution (high and low AAS classes) best fitted the data. Participants comprising the high AAS class scored uniformly high across all assessed AAS symptoms. Older age and the presence of panic disorder, social anxiety disorder and generalized anxiety disorder predicted membership in the high AAS class. No OCD symptom dimension was significantly associated with membership in the high AAS class. Limitation AAS were assessed using a self-report measure and replication is needed using other methodologies. Conclusions These findings suggest that OCD may be sufficiently distinct from anxiety disorders and do not support subtyping of anxiety disorders on the basis of the predominant type of AAS. Therapeutic approaches that target AAS might best be applied in the treatment of panic disorder, social anxiety disorder and generalized anxiety disorder

Academic policy advice in consensus-seeking countries: the cases of Belgium and Germany

Research on policy-advisory systems worldwide has shown that historically dominant sources of advice traditionally located in-house to the government have been increasingly supplemented by other actors and outside knowledge. However, the vast majority of research has concentrated on the anglophone context. Yet, countries with a consensus-seeking, neo-corporatist tradition provide a special case in terms of policy advice and merit more scholarly attention. What counts as evidence in these countries is the expert rationality of institutional representatives. The position and role of academic research in consensus-based systems is unclear, and is the focus of this article. Can we observe commonalities across consensus-style countries, or do differences prevail? We investigate two typical consensus-seeking countries: Belgium and Germany. To examine the supply side of policy advice, the article reviews current evidence regarding their policy-advisory systems. For the demand side, we present insights from a survey among federal ministerial officials. We find common trends between the two cases but their nature and extent are idiosyncratic. In Belgium, the supply of and demand for academic policy advice is comparatively lower, while the German case exhibits more change in the advisory landscape and institutionalisation of the supply of and demand for academic research. The politics and administration of institutional chang

Effects of Prandial Versus Fasting Glycemia on Cardiovascular Outcomes in Type 2 Diabetes: The HEART2D trial

OBJECTIVE—Hyperglycemia and Its Effect After Acute Myocardial Infarction on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (HEART2D) is a multinational, randomized, controlled trial designed to compare the effects of prandial versus fasting glycemic control on risk for cardiovascular outcomes in patients with type 2 diabetes after acute myocardial infarction (AMI)

Risk assessment in the recovery of food for social solidarity purposes: preliminary data

The most recent study, conducted by Politecnico of Milan, on food surplus management in Italy, entitled Surplus Food Management Against Food Waste, shows that in the Italian food supply chain, the food surplus is around to 5.5 million tons/year, and the amount of food wasted is around to 5.1 million tons/year. During 2015, the charitable organizations (COs) belonging to Italian Food Bank Network, active in recovering and distributing food for social solidarity\u2019s purposes, reused 381.345 tons of food from 2.292 donors. The main supplying sources of the Banco Alimentare Network are: food industries, organized large-scale retail trade and collective catering service. The aim of this study was to analyze several aspects of the food surplus recovery thanks to the collaboration with the Fondazione Banco Alimentare Onlus (FBAO) and Caritas Italiana. In particular, two main features were analyzed in the food recovery chain: i) the microbiological profiles of specific food categories recovered from catering service with the aim to evaluate their conformity in relation to food safety and process criteria. For this purpose 11 samples were analyzed in four different moments: - T0: same day of the collection; - T1: after four hours of storage at 4\ub0C; - T2: 24 hours from the collection (storage at 4\ub0C);- T3: after four days at frozen storage (-18\ub0C).For all samples several were investigated microbiological parameters: enumeration of Mesophilic aerobic bacteria (AFNOR 3M 01/1-09/89), enumeration of Enterobacteriaceae (AFNOR 3M 01/06-09/97), enumeration of E. coli (AFNOR 3M 01/08-06/01), enumeration of coagulase-positive Staphylococci AFNOR 3M 01/ 9-04/03 A), enumeration of Bacillus cereus (UNI EN ISO 7932:2005), research of Salmonella spp. (UNI EN ISO 6579 (2008b) and research of Listeria monocytogenes (AFNOR BRD 07/4-09/98 (AFNOR, 2010a)). Furthermore, ii) the volunteer\u2019s knowledge on the correct hygienic procedures during the recovery, were evaluated by the 71 questionnaires with the aim to prevent foodborne diseases. The results show that the recovery of surplus from catering service and their reuse at COs should be planned with correct procedures, and the volunteer\u2019s knowledge on the hygienic aspects appear to be a critical point. The recovery and the charitable activities require an appropriate assessment and careful risk analysis, in order to manage the complexity of no profit organization

Effects of Prandial Versus Fasting Glycemia on Cardiovascular Outcomes in Type 2 Diabetes: The HEART2D trial

OBJECTIVE—Hyperglycemia and Its Effect After Acute Myocardial Infarction on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (HEART2D) is a multinational, randomized, controlled trial designed to compare the effects of prandial versus fasting glycemic control on risk for cardiovascular outcomes in patients with type 2 diabetes after acute myocardial infarction (AMI)

Food safety in food services in lombardy : proposal for an inspection-scoring model

The purpose of this study was to elaborate a checklist with an inspection scoring system at national level in order to assess compliance with sanitary hygiene requirements of food services. The inspection scoring system was elaborated taking into account the guidelines drawn up by NYC Department of Food Safety and Mental Hygiene. Moreover the checklist was used simultaneously with the standard inspection protocol adopted by Servizio Igiene Alimenti Nutrizione (Servizio Igiene Alimenti Nutrizione - Ss. I.A.N) and defined by D.G.R 6 March 2017 \u2013 n. X/6299 Lombardy Region. Ss. I.A.N protocol consists of a qualitative response according to which we have generated a new protocol with three different grading: A, B and C. The designed checklist was divided into 17 sections. Each section corresponds to prerequisites to be verified during the inspection. Every section includes the type of conformity to check and the type of violation: critical or general. Moreover, the failure to respect the expected compliance generates 4 severity levels that correspond to score classes. A total of 7 food services were checked with the two different inspection methods. The checklist results generated a food safety score for each food service that ranged from 0.0 (no flaws observed) to 187.2, and generates three grading class: A (0.0-28.0); B (29.0 - 70.0) and C (>71.00). The results from the Ss. I. A. N grading method and the checklist show positive correlation (r=0.94, P>0.01) suggesting that the methods are comparable. Moreover, our scoring checklist is an easy and unique method compared to standard and allows also managers to perform effective surveillance programs in food service

Chagasic Thymic Atrophy Does Not Affect Negative Selection but Results in the Export of Activated CD4+CD8+ T Cells in Severe Forms of Human Disease

Extrathymic CD4+CD8+ double-positive (DP) T cells are increased in some pathophysiological conditions, including infectious diseases. In the murine model of Chagas disease, it has been shown that the protozoan parasite Trypanosoma cruzi is able to target the thymus and induce alterations of the thymic microenvironment and the lymphoid compartment. In the acute phase, this results in a severe atrophy of the organ and early release of DP cells into the periphery. To date, the effect of the changes promoted by the parasite infection on thymic central tolerance has remained elusive. Herein we show that the intrathymic key elements that are necessary to promote the negative selection of thymocytes undergoing maturation during the thymopoiesis remains functional during the acute chagasic thymic atrophy. Intrathymic expression of the autoimmune regulator factor (Aire) and tissue-restricted antigen (TRA) genes is normal. In addition, the expression of the proapoptotic Bim protein in thymocytes was not changed, revealing that the parasite infection-induced thymus atrophy has no effect on these marker genes necessary to promote clonal deletion of T cells. In a chicken egg ovalbumin (OVA)-specific T-cell receptor (TCR) transgenic system, the administration of OVA peptide into infected mice with thymic atrophy promoted OVA-specific thymocyte apoptosis, further indicating normal negative selection process during the infection. Yet, although the intrathymic checkpoints necessary for thymic negative selection are present in the acute phase of Chagas disease, we found that the DP cells released into the periphery acquire an activated phenotype similar to what is described for activated effector or memory single-positive T cells. Most interestingly, we also demonstrate that increased percentages of peripheral blood subset of DP cells exhibiting an activated HLA-DR+ phenotype are associated with severe cardiac forms of human chronic Chagas disease. These cells may contribute to the immunopathological events seen in the Chagas disease