Development of a menu of performance tests self-administered on a portable microcomputer

Eighteen cognitive, motor, and information processing performance subtests were screened for self-administration over 10 trials by 16 subjects. When altered presentation forms of the same test were collectively considered, the battery composition was reduced to 10 distinctly different measures. A fully automated microbased testing system was employed in presenting the battery of subtests. Successful self-administration of the battery provided for the field testing of the automated system and facilitated convenient data collection. Total test administration time was 47.2 minutes for each session. Results indicated that nine of the tests stabilized, but for a short battery of tests only five are recommended for use in repeated-measures research. The five recommended tests include: the Tapping series, Number Comparison, Short-term Memory, Grammatical Reasoning, and 4-Choice Reaction Time. These tests can be expected to reveal three factors: (1) cognition, (2) processing quickness, and (3) motor. All the tests stabilized in 24 minutes, or approximately two 12-minute sessions

Preliminary evaluation of a micro-based repeated measures testing system

A need exists for an automated performance test system to study the effects of various treatments which are of interest to the aerospace medical community, i.e., the effects of drugs and environmental stress. The ethics and pragmatics of such assessment demand that repeated measures in small groups of subjects be the customary research paradigm. Test stability, reliability-efficiency and factor structure take on extreme significance; in a program of study by the U.S. Navy, 80 percent of 150 tests failed to meet minimum metric requirements. The best is being programmed on a portable microprocessor and administered along with tests in their original formats in order to examine their metric properties in the computerized mode. Twenty subjects have been tested over four replications on a 6.0 minute computerized battery (six tests) and which compared with five paper and pencil marker tests. All tests achieved stability within the four test sessions, reliability-efficiencies were high (r greater than .707 for three minutes testing), and the computerized tests were largely comparable to the paper and pencil version from which they were derived. This computerized performance test system is portable, inexpensive and rugged

A menu of self-administered microcomputer-based neurotoxicology tests

This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests. Researchers developed this battery to be used to screen the fitness for duty of persons in at-risk occupations (astronauts, race car drivers), or those who may be exposed to environmental stress, toxic agents, or disease. The menu under study contained cognitive and motor tests implemented on a portable microcomputer including: a five-test core battery, lasting six minutes, which had demonstrable reliabilities and stability from several previous repeated-measures studies, and also 13 new tests, lasting 42 minutes, which had appeared in other batteries but had not yet been evaluated for repeated-measures implementation in this medium. Sixteen subjects self-administered the battery over 10 repeated sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the test from the core battery were comparable to those obtained previously under more controlled experimental conditions. Analyses of metric properties of the remaining 13 tests produced eight additional tests with satisfactory properties. Although the average retest reliability was high, cross-correlations between tests were low, indicating factorial richness. The menu can be used to form batteries of flexible total testing time which are likely to tap different mental processes and functions

Microcomputer-based tests for repeated-measures: Metric properties and predictive validities

A menu of psychomotor and mental acuity tests were refined. Field applications of such a battery are, for example, a study of the effects of toxic agents or exotic environments on performance readiness, or the determination of fitness for duty. The key requirement of these tasks is that they be suitable for repeated-measures applications, and so questions of stability and reliability are a continuing, central focus of this work. After the initial (practice) session, seven replications of 14 microcomputer-based performance tests (32 measures) were completed by 37 subjects. Each test in the battery had previously been shown to stabilize in less than five 90-second administrations and to possess retest reliabilities greater than r = 0.707 for three minutes of testing. However, all the tests had never been administered together as a battery and they had never been self-administered. In order to provide predictive validity for intelligence measurement, the Wechsler Adult Intelligence Scale-Revised and the Wonderlic Personnel Test were obtained on the same subjects

The Chandra Multi-Wavelength Project: Optical Spectroscopy and the Broadband Spectral Energy Distributions of X-ray Selected AGN

From optical spectroscopy of X-ray sources observed as part of ChaMP, we present redshifts and classifications for a total of 1569 Chandra sources from our targeted spectroscopic follow up using the FLWO, SAAO, WIYN, CTIO, KPNO, Magellan, MMT and Gemini telescopes, and from archival SDSS spectroscopy. We classify the optical counterparts as 50% BLAGN, 16% NELG, 14% ALG, and 20% stars. We detect QSOs out to z~5.5 and galaxies out to z~3. We have compiled extensive photometry from X-ray to radio bands. Together with our spectroscopic information, this enables us to derive detailed SEDs for our extragalactic sources. We fit a variety of templates to determine bolometric luminosities, and to constrain AGN and starburst components where both are present. While ~58% of X-ray Seyferts require a starburst event to fit observed photometry only 26% of the X-ray QSO population appear to have some kind of star formation contribution. This is significantly lower than for the Seyferts, especially if we take into account torus contamination at z>1 where the majority of our X-ray QSOs lie. In addition, we observe a rapid drop of the percentage of starburst contribution as X-ray luminosity increases. This is consistent with the quenching of star formation by powerful QSOs, as predicted by the merger model, or with a time lag between the peak of star formation and QSO activity. We have tested the hypothesis that there should be a strong connection between X-ray obscuration and star-formation but we do not find any association between X-ray column density and star formation rate both in the general population or the star-forming X-ray Seyferts. Our large compilation also allows us to report here the identification of 81 XBONG, 78 z>3 X-ray sources and 8 Type-2 QSO candidates. Also we have identified the highest redshift (z=5.4135) X-ray selected QSO with optical spectroscopy.Comment: 17 pages, 16 figures, accepted for publication in ApJS. Full data table and README file can be found online at http://hea-www.harvard.edu/~pgreen/Papers.htm

Broad Absorption Line Variability in Repeat Quasar Observations from the Sloan Digital Sky Survey

We present a time-variability analysis of 29 broad absorption line quasars (BALQSOs) observed in two epochs by the Sloan Digital Sky Survey (SDSS). These spectra are selected from a larger sample of BALQSOs with multiple observations by virtue of exhibiting a broad CIV $\lambda$1549 absorption trough separated from the rest frame of the associated emission peak by more than 3600 km s$^{-1}$. Detached troughs facilitate higher precision variability measurements, since the measurement of the absorption in these objects is not complicated by variation in the emission line flux. We have undertaken a statistical analysis of these detached-trough BALQSO spectra to explore the relationships between BAL features that are seen to vary and the dynamics of emission from the quasar central engine. We have measured variability within our sample, which includes three strongly variable BALs. We have also verified that the statistical behavior of the overall sample agrees with current model predictions and previous studies of BAL variability. Specifically, we observe that the strongest BAL variability occurs among the smallest equivalent width features and at velocities exceeding 12,000 km s$^{-1}$, as predicted by recent disk-wind modeling.Comment: 11 pages, 7 figures. Accepted for publication in Ap

A Randomised Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention Deficit Hyperactivity Disorder (ADHD).

There is a need for effective interventions to address the social difficulties of children with ADHD. This randomised controlled trial examined the effectiveness of a play-based intervention for improving the social play skills of children with ADHD in peer-to-peer interactions. Children with ADHD (5 to 11 years) were randomised to an intervention-first (n = 15) or waitlist control-first group (n = 14). Participants allocated to the control-first group received the intervention after a 10-week wait period. Children invited a typically-developing playmate and parents of children with ADHD participated. The intervention involved: six clinic play-sessions, weekly home-modules and a one-month home follow up. The Test of Playfulness (ToP) was scored by a blinded rater. Parent reported treatment adherence was used to assess treatment fidelity. Between group statistics were used to compare the change of the intervention-first (10-week intervention period) and control-first (10-week wait period) groups. Once all children had received the intervention, repeated measures ANOVA, post hoc Least Significance Difference tests and Cohen's-d were used to measure effect. Changes in ToP social items were analysed using Friedman's ANOVA. Linear regression analyses were used to identify variables that predicted change. The control-first group did not change during the wait period. The change in the intervention-first group was significantly greater than the change in the control-first group (during the wait period). When the data from the two groups were combined, the mean ToP scores of the children with ADHD (n = 29) improved significantly following the intervention, with a large effect from pre to post intervention and from pre intervention to follow up. Children maintained treatment gains at follow up. All ToP social items improved significantly following the intervention. The findings support the use of play involving parent and peer mediated components to enhance the social play skills of children with ADHD. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000973617

Increasing confidence and changing behaviors in primary care providers engaged in genetic counselling.

BackgroundScreening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics. This study explored whether an interactive, web-based genetics curriculum directed at PCPs in non-academic primary care settings was superior at changing practice knowledge, attitudes, and behaviors when compared to a traditional educational approach, particularly when discussing common genetic conditions.MethodsOne hundred twenty one PCPs in California and Pennsylvania physician practices were randomized to either an Intervention Group (IG) or Control Group (CG). IG physicians completed a 6 h interactive web-based curriculum covering communication skills, basics of genetic testing, risk assessment, ELSI issues and practice behaviors. CG physicians were provided with a traditional approach to Continuing Medical Education (CME) (clinical review articles) offering equivalent information.ResultsPCPs in the Intervention Group showed greater increases in knowledge compared to the Control Group. Intervention PCPs were also more satisfied with the educational materials, and more confident in their genetics knowledge and skills compared to those receiving traditional CME materials. Intervention PCPs felt that the web-based curriculum covered medical management, genetics, and ELSI issues significantly better than did the Control Group, and in comparison with traditional curricula. The Intervention Group felt the online tools offered several advantages, and engaged in better shared decision making with standardized patients, however, there was no difference in behavior change between groups with regard to increases in ELSI discussions between PCPs and patients.ConclusionWhile our intervention was deemed more enjoyable, demonstrated significant factual learning and retention, and increased shared decision making practices, there were few differences in behavior changes around ELSI discussions. Unfortunately, barriers to implementing behavior change in clinical genetics is not unique to our intervention. Perhaps the missing element is that busy physicians need systems-level support to engage in meaningful discussions around genetics issues. The next step in promoting active engagement between doctors and patients may be to put into place the tools needed for PCPs to easily access the materials they need at the point-of-care to engage in joint discussions around clinical genetics

Beyond Simple AGN Unification with Chandra-observed 3CRR Sources at 0.5 < z < 1

Low-frequency radio selection finds radio-bright galaxies regardless of the amount of obscuration by gas and dust. We report \chandra\ observations of a complete 178~MHz-selected, and so orientation unbiased, sample of 44 $0.5<z<1$ 3CRR sources. The sample is comprised of quasars and narrow-line radio galaxies (NLRGs) with similar radio luminosities, and the radio structure serves as both an age and an orientation indicator. Consistent with Unification, intrinsic obscuration (measured by \nh, X-ray hardness ratio, and X-ray luminosity) generally increases with inclination. However, the sample includes a population not seen in high-$z$ 3CRR sources: NLRGs viewed at intermediate inclination angles with \nh~$<10^{22}$~cm$^{-2}$. Multiwavelength analysis suggests these objects have lower $L/L_{\rm Edd}$ than typical NLRGs at similar orientation. Thus both orientation and $L/L_{\rm Edd}$ are important, and a "radiation-regulated Unification" provides a better explanation of the sample's observed properties. In comparison with the 3CRR sample at $1<z<2$, our lower-redshift sample shows a higher fraction of Compton-thin NLRGs (45\% vs.\ 29\%) but similar Compton-thick fraction (20\%), implying a larger covering factor of Compton-thin material at intermediate viewing angles and so a more "puffed-up" torus atmosphere. We posit that this is due to a range of $L/L_{\rm Edd}$ extending to lower values in this sample. In contrast, at high redshifts the narrower range and high $L/L_{\rm Edd}$ values allowed orientation (and so simple Unification) to dominate the sample's observed properties

Role of Complement Activation in Obliterative Bronchiolitis Post Lung Transplantation

Obliterative bronchiolitis (OB) post lung transplantation involves IL-17 regulated autoimmunity to type V collagen and alloimmunity, which could be enhanced by complement activation. However, the specific role of complement activation in lung allograft pathology, IL-17 production, and OB are unknown. The current study examines the role of complement activation in OB. Complement regulatory protein (CRP) (CD55, CD46, Crry/CD46) expression was down regulated in human and murine OB; and C3a, a marker of complement activation, was up regulated locally. IL-17 differentially suppressed Crry expression in airway epithelial cells in vitro. Neutralizing IL-17 recovered CRP expression in murine lung allografts and decreased local C3a production. Exogenous C3a enhanced IL-17 production from alloantigen or autoantigen (type V collagen) reactive lymphocytes. Systemically neutralizing C5 abrogated the development of OB, reduced acute rejection severity, lowered systemic and local levels of C3a and C5a, recovered CRP expression, and diminished systemic IL-17 and IL-6 levels. These data indicated that OB induction is in part complement dependent due to IL-17 mediated down regulation of CRPs on airway epithelium. C3a and IL-17 are part of a feed forward loop that may enhance CRP down regulation, suggesting that complement blockade could be a therapeutic strategy for OB