Effects of differing types of information upon clinical judgments.

Three groups of ten professional psychologists were provided with differing types of information about an actual counseling client: one group received minimal, or stereotype, information about the client (Stereotype Group); a second group received minimal information and viewed videotaped excerpts from a counseling session with the client (Stereotype-Video Group); and a third received both of these types of information plus test protocols from a standard test battery administered to the client (Stereotype-Video-Diagnostics Group). All subjects then made a number of clinical judgments about the client. These included: (1) predicting how the client described herself on a personality checklist (Predictive Task), (2) evaluating the client on a number of clinical dimensions (Evaluative Task), and (3) diagnosis of the client. Judges were also asked to rate their confidence in the accuracy of each judgment made.It was concluded that type of information may have complex differential effects upon different types of clinical judgments.No significant effect of type of information upon accuracy in performance of either the Predictive or Evaluative Tasks was obtained. Type of information did appear to have an effect upon diagnosis of the client and upon confidence in judgments. Type of information was found to have a significant effect upon the extent to which judges relied upon assumed similarity in predicting how the client saw herself

Rethinking ‘fieldwork’: ethics and identity in globally unequal structures of research

Racial, gender and material inequalities are increasingly understood to be deeply entangled and reproduced in the process of doing fieldwork. Our new blog series, ‘Rethinking ethics and identity in fieldwork’, uses an innovative lens based on the experiences of researchers of conflict on Africa to address the limitations and ethics of conducting research, and challenge how the nature of ‘fieldwork’ is understood

Urban sprawl in Vlaanderen : ruimtelijke én financiële winsten door het investeren in anti urban sprawl maatregelen

Begin 2019 werd het onderzoek over monetarisering van urban sprawl in Vlaanderen afgerond. Dit onderzoek, geeft nieuwe inzichten in het voorkomen en de kostprijs van urban sprawl in Vlaanderen. De resultaten zijn niet verrassend, maar toch wel confronterend. 95% van de Vlamingen woont in een omgeving die wordt getypeerd als ‘urban sprawl’. Dit verspreid wonen heeft een kostprijs, zowel voor de individuele burger als voor de maatschappij. Deze kostprijs zal aanzienlijk toenemen indien we er niet in slagen om in de toekomst een beleid uit te rollen dat inzet op het verminderen van urban sprawl. In dit artikel worden de belangrijkste resultaten uit vergelijkende internationale onderzoeken over urban sprawl toegelicht. De situatie in Nederland en Vlaanderen (België) is voor heel wat indicatoren vergelijkbaar, maar op terrein toch verschillend. Voor Vlaanderen werd een ruimtelijke en monetaire analyse uitgevoerd naar het fenomeen van urban sprawl. Hierbij werden drie kostenposten in beeld gebracht: infrastructuur, mobiliteit en verlies aan ecosysteemdiensten. Als we in Vlaanderen doorgaan zoals vandaag zal dit onvermijdelijk leiden tot meer sprawl met meer kosten. Een anti-sprawlbeleid kan in totaal (doorrekening tot 2050) 25,6 miljard euro kosten besparen. De analyse kadert in de huidige discourshift die naar aanleiding van het klimaatdebat prominent is. Het oude maatschappelijk discours van “wat gaat dat allemaal kosten, wie gaat dat betalen en hebben we daar wel budget voor” maakt langzaam plaats voor een discours dat meer aandacht heeft voor een langetermijnperspectief en kan worden begrepen als “we moeten nu investeren om in de toekomst winst te maken of op zijn minst de verliezen te beperken.

Transcutaneous vagus nerve stimulation does not affect verbal memory performance in healthy volunteers

Introduction: Invasive vagus nerve stimulation (VNS) improves word recognition memory in patients with epilepsy. Recent studies with transcutaneous VNS (tVNS) have also shown positive effects on various subdomains of cognitive functioning in healthy volunteers. In this randomized, controlled, crossover study, we investigated the effect of tVNS on a word recognition memory paradigm in healthy volunteers to further investigate the potential of tVNS in the treatment of cognitive disorders. Methods: We included 41 healthy participants aged between 18 and 30 years (young age group) and 24 healthy participants aged between 45 and 80 years (older age group). Each participant completed a word recognition memory paradigm during three different conditions: true tVNS, sham, and control. During true tVNS, stimulation was delivered at the cymba conchae. Sham stimulation was delivered by stimulating the earlobe. In the control condition, no stimulation was given. In each condition, participants were asked to remember highlighted words from three test paragraphs. Accuracy scores were calculated for immediate recall after each test paragraph and for delayed recognition at the end of the paradigm. We hypothesized that highlighted words from paragraphs in the true tVNS condition would be more accurately recalled and/or recognized compared to highlighted words from paragraphs in the sham or control condition. Results: In this randomized study, tVNS did not affect the accuracy scores for immediate recall or delayed recognition in both age groups. The younger group showed significantly higher accuracy scores than the older group. The accuracy scores improved over time, and the most recently learned words were better recognized. Participants rated true tVNS as significantly more painful; however, pain was not found to affect accuracy scores. Conclusion: In this study, tVNS did not affect verbal memory performance in healthy volunteers. Our results could not replicate the positive effects of invasive VNS on word recognition memory in epilepsy patients. Future research with the aim of improving cognitive function should focus on the rational identification of optimized and individualized stimulation settings primarily in patients with cognitive deficits

Neurostimulation for drug-resistant epilepsy : a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response

Purpose of review: Neurostimulation is becoming an increasingly accepted treatment alternative for patients with drug-resistant epilepsy (DRE) who are unsuitable surgery candidates. Standardized guidelines on when or how to use the various neurostimulation modalities are lacking. We conducted a systematic review on the currently available neurostimulation modalities primarily with regard to effectiveness and safety. Recent findings: For vagus nerve stimulation (VNS), there is moderate-quality evidence for its effectiveness in adults with drug-resistant partial epilepsies. Moderate-to-low-quality evidence supports the efficacy and safety of deep brain stimulation (DBS) and responsive neurostimulation (RNS) in patients with DRE. There is moderate-to-very low-quality evidence that transcranial direct current stimulation (tDCS) is effective or well tolerated. For transcutaneous vagus nerve stimulation (tVNS), transcranial magnetic stimulation (TMS) and trigeminal nerve stimulation (TNS), there are insufficient data to support the efficacy of any of these modalities for DRE. These treatment modalities, nevertheless, appear well tolerated, with no severe adverse events reported. Summary: Head-to-head comparison of treatment modalities such as VNS, DBS and RNS across different epileptic syndromes are required to decide which treatment modality is the most effective for a given patient scenario. Such studies are challenging and it is unlikely that data will be available in the near future. Additional data collection on potentially promising noninvasive neurostimulation modalities like tVNS, TMS, TNS and tDCS is warranted to get a more precise estimate of their therapeutic benefit and long-term safety

Providers’ Perspectives on Addressing Health Risk Behaviors and Mental Health among Young Adult Survivors of Childhood Cance

Objectives: We examined healthcare providers’ perspectives on how childhood cancer impacts young adult health behaviors and psychosocial functioning, how healthy lifestyle and psychosocial issues are addressed in this population, challenges related to addressing these issues, and potential resources for addressing them.Methods: In 2012, we recruited 21 healthcare providers (e.g., oncologists, nurses, social workers) who treat young adult survivors of childhood cancer from a children’s hospital and a cancer center in the Southeastern U.S. to complete telephone-based semi-structured interviews.Results: Our sample was an average of 45.95 (SD=7.57) years old, 52.4% female, and 81.0% MDs. Most mentioned that the impact of cancer on health risk behaviors and psychosocial functioning depended on several things including social support and other environmental factors. Participants indicated several general activities and approaches aimed at addressing healthy lifestyles among this population. Participants reported a range of health education, from minimal education to continuous education throughout treatment and survivorship. Providers indicated a team-oriented approach to addressing psychosocial issues and that the survivorship program addressed the complications of obtaining insurance, education and employment, and reproductive health within this population. A major factor was the involvement of the family in addressing these issues. Providers’ challenges in intervening included limited time, resources, financial support, and referral options. Participants suggested resources to address these challenges.Conclusions: Several resources are needed to address the challenges faced by practitioners in addressing young adult survivors’ issues, including physical resources, social support resources, education for patients and healthcare providers, and programs to provide financial support

Oligosaccharide recognition and binding to the carbohydrate binding module of AMP-activated protein kinase

AbstractThe AMP-activated protein kinase (AMPK) contains a carbohydrate-binding module (β1-CBM) that is conserved from yeast to mammals. β1-CBM has been shown to localize AMPK to glycogen in intact cells and in vitro. Here we use Nuclear Magnetic Resonance spectroscopy to investigate oligosaccharide binding to 15N labelled β1-CBM. We find that β1-CBM shows greatest affinity to carbohydrates of greater than five glucose units joined via α,1→4 glycosidic linkages with a single, but not multiple, glucose units in an α,1→6 branch. The near identical chemical shift profile for all oligosaccharides whether cyclic or linear suggest a similar binding conformation and confirms the presence of a single carbohydrate-binding site

Neurophysiological investigations of drug resistant epilepsy patients treated with vagus nerve stimulation to differentiate responders from non-responders

Background and purpose In patients treated with vagus nerve stimulation (VNS) for drug resistant epilepsy (DRE), up to a third of patients will eventually not respond to the therapy. As VNS therapy requires surgery for device implantation, prediction of response prior to surgery is desirable. It is hypothesized that neurophysiological investigations related to the mechanisms of action of VNS may help to differentiate VNS responders from non-responders prior to the initiation of therapy. Methods In a prospective series of DRE patients, polysomnography, heart rate variability (HRV) and cognitive event related potentials were recorded. Polysomnography and HRV were repeated after 1 year of treatment with VNS. Polysomnography, HRV and cognitive event related potentials were compared between VNS responders (>= 50% reduction in seizure frequency) and non-responders. Results Fifteen out of 30 patients became VNS responders after 1 year of VNS treatment. Prior to treatment with VNS, the amount of deep sleep (NREM 3), the HRV high frequency (HF) power and the P3b amplitude were significantly different in responders compared to non-responders (P = 0.007; P = 0.001; P = 0.03). Conclusion Three neurophysiological parameters, NREM 3, HRV HF and P3b amplitude, were found to be significantly different in DRE patients who became responders to VNS treatment prior to initiation of their treatment with VNS. These non-invasive recordings may be used as characteristics for response in future studies and help avoid unsuccessful implantations. Mechanistically these findings may be related to changes in brain regions involved in the so-called vagal afferent network