Canonical Representations Related to Hyperbolic Spaces

AbstractWe extend the notion of canonical representation, introduced by A. M. Vershik, I. M. Gel'fand and M. I. Graev (1982, in “Representation Theory,” Cambridge Univ. Press, Cambridge, U.K.), to all (classical) rank one semisimple Lie groups. We determine the spectral decomposition of the canonical representations in detail

Aged Arteries and B-vitamins

__Abstract__ Cardiovascular disease is a very common condition, especially among elderly. Cardiovascular risk prediction via the Framingham risk score is the most commonly used risk prediction. However, the Framingham risk score has only been validated until the age of 75 and the power of the classical risk factors have been shown to decline with advancing age. A strong predictor of cardiovascular disease in older populations is arterial stiffness. Arterial stiffness is involved in the pathogenesis of cardiovascular disease, with pulse wave velocity being the major marker for cardiovascular risk. Over the years, arterial stiffness have been shown to be an important pre-clinical stage of cardiovascular disease of interest for research, mainly based on preventive strategies. Arterial stiffness is associated with many lifestyle factors and disorders, among others smoking, vitamin D deficiency, physical functioning, renal failure, diabetes and constructive obstructive pulmonary disease (COPD)

Using virtual reality to treat aggressive behavior problems in children: A feasibility study

Evidence-based cognitive behavioral therapies (CBTs) for children with aggressive behavior problems have only modest effects. Research is needed into new methods to enhance CBT effectiveness. The aims of the present study were to (1) examine whether interactive virtual reality is a feasible treatment method for children with aggressive behavior problems; (2) investigate children’s appreciation of the method; and (3) explore whether children’s aggression decreased during the ten-session treatment. Six boys (8–12 years) participated at two clinical centers in the Netherlands. Newly developed weekly reports were collected on treatment feasibility (therapist-report), treatment appreciation (child report), and children’s aggression (child/parent report). Results supported treatment feasibility: therapists delivered on average 98% of the session content, provided more than the recommended practice time in virtual reality, experienced few technical issues, and were satisfied with their treatment delivery. Children highly appreciated the treatment. Parents reported decreases in children’s aggression over the treatment period (i.e., between week 1 and week 10), but children did not. The promising findings of this feasibility study warrant randomized controlled trials to determine whether interactive virtual reality enhances CBT effectiveness for children with aggressive behavior problems

Capturing mechanisms of change: Weekly covariation in anger regulation, hostile intent attribution, and children's aggression

Interventions for children's aggression typically target assumed underlying mechanisms, such as anger regulation and hostile intent attribution. The expectation here is that targeting these mechanisms will result in within-person changes in aggression. However, evidence for these mechanisms is mostly based on between-person analyses. We, therefore, examined whether within-person changes in adaptive anger regulation and hostile intent attribution covaried with within-person changes in children's aggression. Children (N = 223; age 7–12; 46% boys) filled out four weekly report measures to assess adaptive anger regulation, hostile intent attribution, and aggression. The psychometric properties of these novel measures were adequate. Results of multi-level analyses revealed within-person effects: weekly changes in adaptive anger regulation and hostile intent attribution covaried with changes in children's aggression. This corresponded with between-person findings on the same data: children with lower levels of adaptive anger regulation and higher levels of hostile intent attribution reported more aggression than other children. These findings support the idea that targeting anger regulation and hostile intent attribution in interventions may lead to changes in individual children's aggression

Impact of Comorbid Personality Disorders on Depression Treatment in Routine Outpatient Care

Item does not contain fulltextObjective: The impact of personality disorder on treatment effectiveness for depression has been debated, and study results have been inconsistent. However, studies that report a negative impact of personality disorders on depression treatment outcomes are often characterized by uncontrolled treatment designs. Within such contexts, individuals with depression and personality disorders are at risk to receive suboptimal treatment. The aim of this retrospective observational study was to investigate whether and to what extent comorbid personality disorders were associated with the type and amount of depression treatment received in routine outpatient care. Methods: Retrospectively extracted data from electronic records of 1,455 outpatients treated for depression at several sites of a nationwide mental health provider in the Netherlands were included. The type and number of treatment sessions and visits were analyzed by using regression models. Results: Individuals with depression and comorbid personality disorders received more psychotherapy sessions than individuals without personality disorders, irrespective of depression severity. The number of pharmacotherapy sessions and supportive and crisis visits did not differ between individuals with and without comorbid personality disorders. Conclusions: Individuals with depression and personality disorders received more intensive treatment than individuals without comorbid personality disorders. These results conflict with treatment guidelines and recommendations from high-quality studies and may be indicative of overtreatment among this large group of patients.7 p

Exploring the Relationship Between Morphine Concentration and Oversedation in Children After Cardiac Surgery

Titrating analgesic and sedative drugs in pediatric intensive care remains a challenge for caregivers due to the lack of pharmacodynamic knowledge in this population. The aim of the current study is to explore the concentration-effect relationship for morphine-associated oversedation after cardiac surgery in children aged 3 months to 3 years. Data on morphine dosing, as well as morphine plasma concentrations, were available from a previous study on the pharmacokinetics of morphine after cardiac surgery in children. Oversedation was defined as scores below 11 on the validated COMFORT-behavioral scale. Population pharmacokinetic-pharmacodynamic modeling was performed in NONMEM 7.3. The probability of oversedation as a function of morphine concentration was best described using a step function in which the EC50 was 46.3 ng/mL. At morphine concentrations below the EC50, the probability of oversedation was 2.9% (0.4& to 18%), whereas above the EC50 percentages were 13% (1.9% to 52%) (median value [95% prediction interval from interindividual variability]). Additionally, the risk of oversedation was found to be increased during the first hours after surgery (

Belang van ondersteunende netwerken voor ouderen

__Abstract__ ‘Even Buurten’ is een Rotterdams initiatief. Hierin proberen professionals uit zorg en welzijn via een integrale wijkaanpak de sociale netwerken rondom thuiswonende ouderen te verstevigen. Doel van dit sociale netwerk is (vroeg) signalering en het bieden van concrete hulp en ondersteuning aan kwetsbare ouderen. Uit onderzoek naar het ‘Even Buurten’-initiatief komt het belang van een sterk sociaal buurtnetwerk duidelijk naar voren. Het succes van een integrale wijkaanpak hangt in sterke mate af van een integraal formeel e´n informeel ondersteunend netwerk in de buurt. Formele en informele netwerken werken echter nog niet goed samen. En ook binnen het formele netwerk (bijv. tussen zorg en welzijn) wordt nog onvoldoende samengewerkt om kwetsbare ouderen optimale ondersteuning te bieden. Deze klinische les beschrijft hoe integrale, wijkgerichte ondersteuning beter tegemoetkomt aan de behoeften en wensen van kwetsbare ouderen