The Cultural Formulation Interview as a clinical tool in the assessment of eating disorders: a pilot study

BackgroundThe Cultural Formulation Interview (CFI) in the DSM-5 is a person-centered instrument for systematically appraising the impact of sociocultural factors in psychiatric assessment. The CFI has been shown to be feasible, acceptable, and useful in various clinical contexts. However, to this date there is only one published report describing the use of the CFI with patients with eating disorders.AimsTo explore the potential benefits and challenges of utilizing the CFI in the assessment of eating disorders.MethodsAs an addendum to an ongoing qualitative study about barriers to treatment for eating disorders for individuals with a migration background in Sweden, we utilized the CFI in the assessment of adult patients (n=8) in specialist eating disorder treatment. Interview data were analyzed employing a thematic analysis framework. Participants provided feedback using a standard form for evaluation of the CFI.ResultsCertain CFI questions proved especially meaningful in this context. In response to the CFI question about patient explanatory models, previously unrecognized ideas about causation emerged. These included perfectionism—a known risk factor for eating disorders—based on immigrant parents’ career expectations and experiences of strict family control over life choices. In response to the CFI questions on cultural identity and its impact, the participants provided rich descriptions including important themes such as religion, racism, and ambiguities associated with being a second-generation immigrant. The final CFI question, eliciting concern about the patient-clinician relationship, revealed numerous examples of prejudice and unfamiliarity with migrant groups among healthcare providers.ImplicationsThe CFI can be useful in the assessment of patients with eating disorders and should be further explored as a standard tool in specialist eating disorder services

Advanced predictive-analysis-based decision support for collaborative logistics networks

Purpose – The purpose of this paper is to examine challenges and potential of big data in heterogeneous business networks and relate these to an implemented logistics solution. Design/methodology/approach – The paper establishes an overview of challenges and opportunities of current significance in the area of big data, specifically in the context of transparency and processes in heterogeneous enterprise networks. Within this context, the paper presents how existing components and purpose-driven research were combined for a solution implemented in a nationwide network for less-than-truckload consignments. Findings – Aside from providing an extended overview of today’s big data situation, the findings have shown that technical means and methods available today can comprise a feasible process transparency solution in a large heterogeneous network where legacy practices, reporting lags and incomplete data exist, yet processes are sensitive to inadequate policy changes. Practical implications – The means introduced in the paper were found to be of utility value in improving process efficiency, transparency and planning in logistics networks. The particular system design choices in the presented solution allow an incremental introduction or evolution of resource handling practices, incorporating existing fragmentary, unstructured or tacit knowledge of experienced personnel into the theoretically founded overall concept. Originality/value – The paper extends previous high-level view on the potential of big data, and presents new applied research and development results in a logistics application

Anorexia Nervosa, Major Depression, and Suicide Attempts: Shared Genetic Factors

We evaluated the extent to which genetic and environmental factors influenced anorexia nervosa (AN), major depressive disorder (MDD), and suicide attempts (SA). Participants were 6,899 women from the Swedish Twin study of Adults Genes and Environment. A Cholesky decomposition assessed independent and overlapping genetic and environmental contributions to AN, MDD, and SA. Genetic factors accounted for a substantial amount of liability to all three traits; unique environmental factors accounted for most of the remaining liability. Shared genetic factors may underlie the co-expression of these traits. Results underscore the importance of assessing for signs of suicide among individuals with AN

The International Trans-Arctic Scientific Expedition (ITASE): An Overview

From its original formulation in 1990 the International Trans-Antarctic Scientific Expedition (ITASE) has had as its primary aim the collection and interpretation of a continent-wide array of environmental parameters assembled through the coordinated efforts of scientists from several nations. ITASE offers the ground-based opportunities of traditional-style traverse travel coupled with the modern technology of GPS, crevasse detecting radar, satellite communications and multidisciplinary research. By operating predominantly in the mode of an oversnow traverse, ITASE offers scientists the opportunity to experience the dynamic range of the Antarctic environment. ITASE also offers an important interactive venue for research similar to that afforded by oceanographic research vessels and large polar field camps, without the cost of the former or the lack of mobility of the latter. More importantly, the combination of disciplines represented by ITASE provides a unique, multidimensional (space and time) view of the ice sheet and its history. ITASE has now collected \u3e20 000km of snow radar, recovered more than 240 firn/ice cores (total length 7000 m), remotely penetrated to ~4000m into the ice sheet, and sampled the atmosphere to heights of \u3e20 km

Multiple antimicrobial resistance in plague: An emerging public health risk

Antimicrobial resistance in Yersinia pestis is rare, yet constitutes a significant international public health and biodefense threat. In 1995, the first multidrug resistant (MDR) isolate of Y. pestis (strain IP275) was identified, and was shown to contain a self-transmissible plasmid (pIP1202) that conferred resistance to many of the antimicrobials recommended for plague treatment and prophylaxis. Comparative analysis of the DNA sequence of Y. pestis plasmid pIP1202 revealed a near identical IncA/C plasmid backbone that is shared by MDR plasmids isolated from Salmonella enterica serotype Newport SL254 and the fish pathogen Yersinia ruckeri YR71. The high degree of sequence identity and gene synteny between the plasmid backbones suggests recent acquisition of these plasmids from a common ancestor. In addition, the Y. pestis pIP1202-like plasmid backbone was detected in numerous MDR enterobacterial pathogens isolated from retail meat samples collected between 2002 and 2005 in the United States. Plasmid-positive strains were isolated from beef, chicken, turkey and pork, and were found in samples from the following states: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York and Oregon. Our studies reveal that this common plasmid backbone is broadly disseminated among MDR zoonotic pathogens associated with agriculture. This reservoir of mobile resistance determinants has the potential to disseminate to Y. pestis and other human and zoonotic bacterial pathogens and therefore represents a significant public health concern

Treatment-seeking patients with binge-eating disorder in the Swedish national registers: clinical course and psychiatric comorbidity

Abstract Background We linked extensive longitudinal data from the Swedish national eating disorders quality registers and patient registers to explore clinical characteristics at diagnosis, diagnostic flux, psychiatric comorbidity, and suicide attempts in 850 individuals diagnosed with binge-eating disorder (BED). Method Cases were all individuals who met criteria for BED in the quality registers (N = 850). We identified 10 controls for each identified case from the Multi-Generation Register matched on sex, and year, month, and county of birth. We evaluated characteristics of individuals with BED at evaluation and explored diagnostic flux across eating disorders presentations between evaluation and one-year follow-up. We applied conditional logistic regression models to assess the association of BED with each comorbid psychiatric disorder and with suicide attempts and explored whether risk for depression and suicide were differentially elevated in individuals with BED with or without comorbid obesity. Results BED shows considerable diagnostic flux with other eating disorders over time, carries high psychiatric comorbidity burden with other eating disorders (OR 85.8; 95 % CI: 61.6, 119.4), major depressive disorder (OR 7.6; 95 % CI: 6.2, 9.3), bipolar disorder (OR 7.5; 95 % CI: 4.8, 11.9), anxiety disorders (OR 5.2; 95 % CI: 4.2, 6.4), and post-traumatic stress disorder (OR 4.3; 95 % CI: 3.2, 5.7) and is associated with elevated risk for suicide attempts (OR 1.8; 95 % CI: 1.2, 2.7). Depression and suicide attempt risk were elevated in individuals with BED with and without comorbid obesity. Conclusions Considerable flux occurs across BED and other eating disorder diagnoses. The high psychiatric comorbidity and suicide risk underscore the severity and clinical complexity of BED

Plague: past, present and future

[Introduction] Recent experience with SARS (severe acute respiratory syndrome) [1] and avian flu shows that the public and political response to threats from new anthropozoonoses can be near-hysteria. This can readily make us forget more classical animal-borne diseases, such as plague (Box 1). Three recent international meetings on plague (Box 2) concluded that: (1) it should be re-emphasised that the plague bacillus (Yersinia pestis) still causes several thousand human cases per year [2,3] (Figure 1); (2) locally perceived risks far outstrip the objective risk based purely on the number of cases [2]; (3) climate change might increase the risk of plague outbreaks where plague is currently endemic and new plague areas might arise [2,4]; (4) remarkably little is known about the dynamics of plague in its natural reservoirs and hence about changing risks for humans [5]; and, therefore, (5) plague should be taken much more seriously by the international community than appears to be the case

Developing a Personality Model for Speech-based Conversational Agents Using the Psycholexical Approach

We present the first systematic analysis of personality dimensions developed specifically to describe the personality of speech-based conversational agents. Following the psycholexical approach from psychology, we first report on a new multi-method approach to collect potentially descriptive adjectives from 1) a free description task in an online survey (228 unique descriptors), 2) an interaction task in the lab (176 unique descriptors), and 3) a text analysis of 30,000 online reviews of conversational agents (Alexa, Google Assistant, Cortana) (383 unique descriptors). We aggregate the results into a set of 349 adjectives, which are then rated by 744 people in an online survey. A factor analysis reveals that the commonly used Big Five model for human personality does not adequately describe agent personality. As an initial step to developing a personality model, we propose alternative dimensions and discuss implications for the design of agent personalities, personality-aware personalisation, and future research.Comment: 14 pages, 2 figures, 3 tables, CHI'2