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When middle-class and White residents move into working-class and poor Black neighborhoods, are there increases in the frequency of arrests of Black people? There are a handful of published articles that examine quantitatively the relationship between gentrification and policing. These studies focus almost exclusively on Los Angeles and New York City and the focus on racialized policing is limited. The present study considers racialized policing in a city that was, until very recently, majority Black and explores the extent to which gentrification and racial change in Washington, DC are associated with enhanced policing of Black residents. A spatial regression analysis which models the association between gentrification, White encroachment, and the policing of Black residents using arrest data from the D.C. Metropolitan Police Department and a gentrification score based on American Community Survey data reveals clear racialized and spatial disparities in arrest rates in Washington, DC. We hypothesized that census tracts experiencing gentrification and White encroachment would have higher drug arrest rates of Black residents. We found support for our White encroachment hypothesis but not for our gentrification hypothesis. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to explore whether avoidance and activation mediate the relationship between self-compassion and depressive symptoms. Research investigating these mechanisms may help identify potential intervention targets for preventing depression. Methods: A cross-sectional survey design was employed involving 242 non-clinical Australian adults (188 females, 54 males) ranging from 18 to 76 years (M = 24.99, SD = 9.07). Participants completed online Self-Compassion Scale, Behavioral Activation for Depression Scale, Reward Probability Index, and Depression, Anxiety, and Stress Scales. Results: Avoidance and activation were found to be significant mediators of the relationship between self-compassion and depressive symptoms. This indicates that self-compassion may influence depressive symptoms through the mechanisms suggested to operate in a behavioral model of depression, specifically avoidance and activation. Conclusions: These findings linking self-compassion to activation and avoidance with depressive symptoms are promising. Further research with larger, representative, non-clinical and clinical populations, as well as the collection of prospective data, could help establish the causality of these links. [ABSTRACT FROM AUTHOR]

The space ultraviolet (UV) is a critical astronomical observing window, where a multitude of atomic, ionic, and molecular signatures provide crucial insight into planetary, interstellar, stellar, intergalactic, and extragalactic objects. The next generation of large space telescopes require highly sensitive, moderate-to-high resolution UV spectrograph. However, sensitive observations in the UV are difficult, as UV optical performance and imaging efficiencies have lagged behind counterparts in the visible and infrared regimes. This has historically resulted in simple, low-bounce instruments to increase sensitivity. In this study, we present the design, fabrication, and calibration of a simple, high resolution, high throughput FUV spectrograph - the Colorado High-resolution Echelle Stellar Spectrograph (CHESS). CHESS is a sounding rocket payload to demonstrate the instrument design for the next-generation UV space telescopes. We present tests and results on the performance of several state-of-the-art diffraction grating and detector technologies for FUV astronomical applications that were flown aboard the first two iterations of CHESS. The CHESS spectrograph was used to study the atomic-to-molecular transitions within translucent cloud regions in the interstellar medium (ISM) through absorption spectroscopy. The first two flights looked at the sightlines towards α Virgo and 𝜖 Persei and flight results are presented. [ABSTRACT FROM AUTHOR]

Objectives: Striving to avoid inferiority, fear of compassion from others, and self-criticism are all factors that have been linked to increased depressive symptoms. However, less is known about the mechanisms of their relationship with depression, and even less about their relationship and potential interaction with each other. This study aimed to investigate the potential moderating role of fear of compassion on the relationship between self-criticism and depression, and insecure striving and depression. Methods: A longitudinal survey design with non-probability sampling was employed. Participants were surveyed at two time points (time 1 and time 2) separated by a 2-week interval. Participants completed measures of depressive symptoms, self-criticism, insecure striving, and fear of compassion from others. The final sample was comprised of 93 individuals aged 19 to 60 years (M = 29.86, SD = 10.87). Results: Using prospective data, this study replicated previous cross-sectional findings that high fear of compassion strengthens the relationship between self-criticism and depression. Fear of compassion was also found to be a significant moderator of the relationship between insecure striving at time 1 and depression at time 2, with low fear of compassion strengthening the relationship between insecure striving and depression. Conclusions: These findings may have important implications for how we understand and treat depression. They suggest that targeting both an individual's fear of, and ability to effectively communicate needs for, compassion from others may be important in reducing depressive symptoms, particularly in individuals who are high in self-criticism and insecure striving beliefs. [ABSTRACT FROM AUTHOR]

We aimed to clarify whether relationships of behavioural activation, avoidance, and response-contingent positive reinforcement with subjective wellbeing components supported a behavioural subjective wellbeing model. We used a correlational, cross-sectional design, and collected data online from a convenience and snowball sample of 224 participants aged 18-72 years using an anonymous survey. We conducted hierarchical multiple regression analyses and structural equation modelling. Behavioural activation positively predicted significant unique variance in (a) positive affect, b = 0.44, 99.2% CI [0.30, 0.58], p < 0.001, ηp2 = 0.27, and (b) satisfaction with life, b = 0.19, 99.2% CI [0.07, 0.31], p < 0.001, ηp2 = 0.08. Behavioural activation negatively predicted significant unique negative affect variance, b = − 0.17, 99.2% CI [− 0.30, − 0.03], p = 0.001, ηp2 = 0.05. Avoidance positively predicted significant negative affect variance, b = 0.45, 99.2% CI [0.31, 0.58], p < 0.001, ηp2 = 0.27. Most other predictors had non-significant effects when behavioural variables were added to our models. Response-contingent positive reinforcement mediated relationships of behavioural activation with positive affect, negative affect, and satisfaction with life. Our results suggest behavioural variables may explain some affect variance often attributed to other predictors. The pattern of relationships we found supports a behavioural subjective wellbeing model focussed on response-contingent positive reinforcement. Our findings suggest these relationships may not be unique to depressed populations. Our results do not indicate causality, but suggest testing causality is warranted in the future. [ABSTRACT FROM AUTHOR]

The aim of this paper is to respond to recent discussion of, and objections to, the libertarian view of free will I have developed in many works over the past four decades. The issues discussed all have a bearing on the central question of how one might make sense of a traditional free will requiring indeterminism in the light of modern science. This task involves, among other things, avoiding all traditional libertarian appeals to unusual forms of agency or causation (uncaused causes, noumenal selves, non-event agent causes, etc.) that cannot be accounted for by ordinary modes of explanation familiar to the natural and human sciences. Doing this, I argue, requires piecing together a "complex tapestry" of ideas and arguments that involve rethinking many traditional assumptions about free will. The paper also argues that one cannot get to the heart of historical debates about free will without distinguishing different kinds of freedom, different senses of will, and different notions of control, among other distinctions. I especially focus here on different notions of freedom and control that are necessary to make sense of free will. [ABSTRACT FROM AUTHOR]

Objective: To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) in cancer survivors, and the association between oncologists' own PA behavior and PA promotion.Methods: Oncologists (n = 123) completed a survey based on the Theory of Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, attitudes, intentions, social norm, perceived behavioral control (PBC), and confidence and knowledge of exercise prescription. Structural equation modeling (SEM) evaluated these associations.Results: Less than half of oncologists reported regularly promoting PA to patients (46%), with 20% providing written information and 23% referrals. Only 26% were physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion (comparative fit index (CFI) = 0.905, standardized root mean square residual (SRMR) = 0.040). Social norm was not only the significant pathway to intention but also a significant indirect pathway to PA promotion (p = 0.007). Confidence to promote PA, PBC, and intentions were direct significant pathways to PA promotion (p < 0.05). Exploratory SEM pathways explained 19.6% of the variance of PA behavior, which in turn explained 13.1% social norm, 10.7% attitude, 10.0% confidence to recommend, and 17.8% PA promotion behavior (CFI = 0.921, SRMR = 0.076). Instrumental attitude was a direct significant pathway to PA behavior (p = 0.001). PA behavior was a direct significant pathway to social norms, attitude, confidence to recommend, and PA promotion (p < 0.05).Conclusions: Oncologists reported a modest ability to promote PA, low PA promotion rates, and limited knowledge of exercise prescription. Patient physical activity promotion may be improved through strategies that increase oncologists' PBC, confidence, and their own personal PA participation. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to determine whether a radiation therapist-led patient education intervention (RT Prepare) reduced breasts cancer patients' psychological distress (primary endpoint); anxiety, depression and concerns about radiotherapy, and increased knowledge of radiotherapy and preparedness (secondary endpoints). Patient health system usage and costs were also assessed.Methods: A multiple-baseline study across three sites. The RT Prepare intervention comprised two consultations with a radiation therapist: prior to treatment planning and on the first day of treatment. Radiation therapists focused on providing sensory and procedural information and addressing patients' pre-treatment anxiety. Usual care data were collected prior to intervention commencement. Data collection occurred: after meeting their radiation oncologist, prior to treatment planning, first day of treatment and after treatment completion. Multilevel mixed effects regression models were used.Results: In total, 218 usual care and 190 intervention patients participated. Compared with usual care, intervention participants reported lower psychological distress at treatment commencement (p = 0.01); lower concerns about radiotherapy (p < 0.01); higher patient knowledge (p < 0.001); higher preparedness for procedural concerns (p < 0.001) and higher preparedness for sensory-psychological concerns at treatment planning (p < 0.001). Mean within-trial costs per patient were estimated at $AU159 (US$120); mean ongoing costs at $AU35 (US$26).Conclusion: The RT Prepare intervention was effective in reducing breast cancer patients' psychological distress and preparing patients for treatment. This intervention provides an opportunity for radiation therapists to extend their role into providing patients with information and support prior to treatment to reduce psychological distress. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively assess the utility of transabdominal ultrasound in surveillance of known pancreatic cystic lesions (PCL) using same day MRI as reference standard.Methods: In an IRB-approved study with written informed consent, patients with known PCL underwent pancreas US on same day as surveillance MRI. US was performed blinded to same date MRI results. Transverse (TR), antero-posterior (AP), cranio-caudal (CC), and longest any plane diameter, were measured for each PCL at US and MRI. Visualization was correlated with patient (weight, abdominal diameter, thickness of abdominal fat, sex) and cyst (location, size, internal complexity) factors.Results: 252 PCLs evaluated in 57 subjects (39 females; mean age 67 (range 39-86) yrs). Mean maximum PCL diameter 8.5 (range 2-92) mm. US identified 100% (5/5) of cysts ≥3 cm; 92% (12/13) ≥2 and <3 cm; 78% (43/55) ≥1 and <2 cm; 35% (27/78) ≥5 mm and <1 cm; and 16% (16/101) <5 mm. US visualization correlated with PCL location (<0.0001), size (p < 0.0001), patient gender (p = 0.005), participation of attending radiologist (p = 0.03); inversely with patient weight (p = 0.012) and AP abdominal diameter (p = 0.01).Conclusion: Many PCLs are visualized and accurately measured at follow-up with transabdominal ultrasound. Visualization correlates with lesion size, location, patient sex, weight, and abdominal diameter. [ABSTRACT FROM AUTHOR]

Nichols' Bound presents interesting new angles on traditional debates about free will and moral responsibility, relating them to the latest empirical research in psychology, social sciences and experimental philosophy. In experimental philosophy, he cites numerous recent studies showing that there are strong incompatibilist strands in folk intuitions about free will and responsibility, taking issue with other recent studies claiming that folk intuitions are predominantly compatibilist. But he also argues that incompatibilist folk intuitions are based on faulty reasoning and cannot be realized. We are left with a choice between an eliminativism about free will and moral responsibility (free will skepticism) or revising ordinary beliefs and practices in a compatibilist direction. Though Nichols sees problems with both these positions, he ultimately opts for the latter. Despite agreeing with Nichols on many points, I argue in this paper that he takes the libertarian view of free will off the table too precipitously, leaving us with too narrow a choice of options. I argue that we can make sense of an incompatibilist view of free will and responsibility without reducing it to mere chance or mystery and that it remains an open scientific question whether we can have such a free will. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. Materials and methods: Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included. The average patient age was 57.2 ± 15.2 years, and 602 (42%) patients were women. Major procedure categories included ultrasound-guided liver biopsies, ultrasound-guided kidney biopsies, and CT-guided lung biopsies/fiducial placement. Procedure details and medical follow-up within and after 30 days of the procedure were analyzed. Results: A total of 168 (11.8%) patients were admitted to the hospital within 30 days of the procedure, with 29 of the admissions (17.3% of total admissions and 1.9% of total procedures) being procedure related. The most common procedure-related complication that required admission was hemorrhage (10/29, 34.5% of procedure-related admissions, 6.0% of total admissions, and 0.7% of total procedures), followed by pneumothorax (9/29, 31%, 5.4%, 0.6%), infection (4/29, 13.8%, 2.4%, 0.3%), and pain (3/29, 10.3%, 1.8%, 0.2%). Eighteen (62.1%) procedure-related admissions were immediately indicated. Thirty patients visited the ED and were subsequently discharged without admission with eight of the visits being procedure related (8/1512, 0.5%). All the procedure-related ED visits were due to pain. There were two deaths (2/1512, 0.1%) related to procedures, one from a thromboembolic event and another from post-biopsy hemorrhage. Conclusion: Outpatient non-vascular image-guided procedures result in a 30-day 1.9% hospital admission, 30-day 0.5% emergency room visit, and 30-day 0.1% mortality rate. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to evaluate diagnostic yield and the added value of culture results on the clinical management of patients empirically treated with antibiotics prior to CT-guided drainage. Methods: This retrospective, HIPAA-compliant, IRB-approved study reviewed records of 300 consecutive patients who underwent CT-guided aspiration or drainage for suspected infected fluid collection while on empiric antibiotics (11/2011 to 9/2013) at a single institution. Patient imaging and clinical characteristics were evaluated by an abdominal imaging fellow and culture results, and patient management were evaluated by an infectious diseases fellow. Results: After exclusion of 14/300 (4.6%) patients who were not on empiric antibiotics and 8/300 (2.6%) patients in which no culture was acquired, 278 patients (average age 55 ± 16 years; M:F ratio 54:46) constituted the final study cohort. Leukocytosis was present in 163/278 (59%), and fever in 65/278 (24%). The average collection size was 8.5 ± 4.2 cm with gas present in 140/278 (50%) of collections; median amount drained was 35 mL, and visibly purulent material was obtained in 172/278 (63%). 236/278 (85%) received drains and the remainder were aspirated only. Average time between initiation of antibiotics and start of the drainage procedure was 4.1 ± 6.4 days (median 1.7 days). Cultures were positive in 205/278 (74%) patients with a resulting change in management in 181/278 (65%) cases. The change in management included change of antibiotics in 71/278 (26%), narrowing the antibiotic regimen in 94/278 (34%), and cessation of antibiotics in 16/278 (6%). Multidrug-resistant bacteria were cultured in 53/278 (19%). Several factors were found to be statistically significant predictors of positive cultures: patient leukocytosis (sens 62%, spec 53%), gas in the collection on CT (sens 59%, spec 77%), purulent material aspiration (sens 76%, spec 76%), and presence of polymorphonuclear cells in the specimen. Conclusions: Despite predrainage antibiotic therapy, CT-guided drainage demonstrates a high yield of positive cultures and influences clinical management in the majority of patients. [ABSTRACT FROM AUTHOR]

ICD-11 (the eleventh edition of the World Health Organization International Statistical Classification of Diseases and Related Health Problems) is due for approval in 2018. For transgender health care, the most important proposals for ICD-11 are as follows: (1) the five ICD-10 diagnoses (most notably Transsexualism and Gender Identity Disorder of Childhood) currently in Chapter 5 (Mental and Behavioural Disorders) will be replaced by two Gender Incongruence diagnoses, one of Adolescence and Adulthood and the other of Childhood (GIC), and (2) these two diagnoses will be located in a new chapter provisionally named Conditions Related to Sexual Health. Debate on the GIC proposal has focused on whether there should be a diagnosis for young children exploring their identity and has drawn on a number of arguments for and against the proposal. The World Professional Association for Transgender Health conducted a survey to examine members' views concerning the GIC proposal, as well as an alternative framework employing non-pathologizing Z Codes. The survey was completed by 241 (32.6 %) out of 740 members. Findings indicated an even split among members regarding the GIC proposal (51.0 % [n = 123] opposing and 47.7 % [n = 115] supporting the proposal). However, non-US members were overall opposed to the proposal (63.9 % [n = 46] opposing, 36.1 % [n = 26] supporting). Across the sample as a whole, and among those expressing a view about Z Codes, there was substantial support for their use in healthcare provision for children with gender issues (35.7 % [n = 86] of the sample supporting vs. 8.3 % [n = 20] rejecting). [ABSTRACT FROM AUTHOR]

In his influential paper, 'Freedom and Resentment,' P. F. Strawson argued that our ordinary practices of holding persons morally responsible and related reactive attitudes (such as blame, resentment, indignation, and moral approval) were wholly 'internal' to the practices themselves and could be insulated from traditional philosophical and metaphysical concerns, including concerns about free will and determinism. This 'insulation thesis' is a controversial feature of Strawson's influential paper; and it has had numerous critics. The first purpose of this paper is to explain my own reasons for thinking that our practices of holding responsible cannot be entirely insulated from incompatibilist concerns about freedom and determinism. The second purpose is to argue that these incompatibilist concerns are in fact legitimate concerns: There are sound reasons to believe that our ordinary practices of holding persons morally responsible do require at least sometimes in our lives that we must be capable of acting freely in a manner that is not determined. I defend this thesis by spelling out why I believe various compatibilist strategies attempting to show that moral responsibility is compatible with determinism fail to show this. In the course of this critique, a general theme will emerge: In order to do full justice to our ordinary practices of holding persons responsible and the freedoms thus involved, one must distinguish between different types of freedom, and in particular, between freedom of action and freedom of will. [ABSTRACT FROM AUTHOR]

Purpose: People diagnosed with cancer from rural and remote locations may experience heightened distress because of distance from cancer treatment and support services. We examined whether remoteness and other factors are associated with psychosocial distress and explored commonly reported problems among cancer patients in Western Australia (WA).Methods: In a cross-sectional study, cancer patients newly referred to a Cancer Council WA Cancer Support Coordinator (CSC) were screened and assessed using the Distress Thermometer (DT) and Problem List (PL) and a standardized form, respectively. The index of remoteness was the Australian Standard Geographical Classification. The association between remoteness, demographic variables, and the frequency of problems endorsed on the PL was analyzed using bivariate analyses and a generalized linear mixed model (GLMM) regression.Results: Of 1032 patients referred to a CSC, 466 were screened (45.2 %) with complete data available for 441 patients. Patients from remote areas reported fewer problems than patients from urban and regional locations. Increasing remoteness was not associated with higher distress (r = -0.04, p = 0.43). Concerns reported differed by remoteness category and included worry, sadness, fears, finances, transportation, and physical symptoms. More emotional problems were independently associated with higher distress (β = 0.47, p < 0.001), explaining 17.31 % of the variance.Conclusions: There is no evidence that increasing remoteness is associated with higher distress. Emotional concerns and physical problems appear to be prevalent among cancer patients irrespective of urban or rural location. Specific concerns detected by distress screening, particularly emotional concerns, may warrant further assessment and targeted referrals. [ABSTRACT FROM AUTHOR]

The aim of this applied study was to explore the outcomes of a parent-child relationship intervention for enhancing maternal sensitivity to the infant's needs and increasing maternal emotional wellbeing in the parenting situation. Whilst there is extensive support established for interventions with high-risk and at-risk populations, there is limited evidence from programs that target low risk parents who on presentation are often identified to have symptoms of depression, anxiety, or stress. A mixed methods research design was utilised to present quantitative and qualitative outcomes at pre- and post-intervention from 14 participants in the Tuned In Parenting program at a community health organisation. Self-report measures were summarised to provide a descriptive profile of participants. Recorded mother-child semi-structured play interactions were analysed using a behaviour rating scale. Transcripts of audio recordings from semi-structured interviews were analysed using a thematic and content approach. Participants demonstrated enhanced maternal sensitive responsiveness and a reduction in symptoms of maternal depression following program completion. The preventative relationship based intervention holds considerable promise in improving maternal wellbeing and transforming relationships between mothers and their children. [ABSTRACT FROM AUTHOR]

This study investigates cognitive deficits and alterations in resting state functional connectivity in civilian mild traumatic brain injury (mTBI) participants with high and low symptoms. Forty-one mTBI participants completed a resting state fMRI scan and the Automated Neuropsychological Assessment Metrics (ANAM) during initial testing (<10 days of injury) and a 1 month follow up. Data were compared to 30 healthy control subjects. Results from the ANAM demonstrate that mTBI participants performed significantly worse than controls on the code substitution delayed subtest ( p = 0.032) and weighted throughput score ( p = 0.001). Among the mTBI patients, high symptom mTBI participants performed worse than those with low symptoms on the code substitution delayed ( p = 0.017), code substitution ( p = 0.012), repeated simple reaction time ( p = 0.031), and weighted throughput score ( p = 0.009). Imaging results reveal that during the initial visit, low symptom mTBI participants had reduced interhemispheric functional connectivity (IH-FC) within the lateral parietal lobe ( p = 0.020); however, during follow up, high symptom mTBI participants showed reduced IH-FC compared to the control group within the dorsolateral prefrontal cortex (DLPFC) ( p = 0.013). Reduced IH-FC within the DLPFC during the follow-up was associated with reduced cognitive performance. Together, these findings suggest that reduced rs-FC may contribute to the subtle cognitive deficits noted in high symptom mTBI participants compared to control subjects and low symptom mTBI participants. [ABSTRACT FROM AUTHOR]

Objectives: Despite its widespread adoption by more than two-thirds of police departments in the US, there has not been a single study examining the effects of the TASER on cognitive functioning. This inquiry is important for two reasons. First, research has consistently documented cognitive deficits following exposure to electricity (the TASER is an electrical device). Second, questions have emerged regarding whether TASER exposure impairs suspects' ability to understand and waive their Miranda rights. Methods: To explore this issue, the authors carried out a pilot study with 21 police recruits who received a TASER exposure as part of their training at the San Bernardino County (CA) Training Center. Each recruit was given a battery of cognitive tests 3-4 h before TASER exposure, within 5 min after exposure, and again 24 h after exposure. Results: Recruits experienced statistically significant reductions in several measures of cognitive functioning following TASER exposure. However, all recruits had returned to their baseline levels of functioning within 24 h. Learning effects were documented in several of the cognitive tests. Conclusions: The questions driving this study involve serious issues including constitutionally protected rights of the accused, use of force by police, and previously unexamined effects of the TASER on the human body. The pilot study represents a critical first step in exploring the effects of the TASER on cognitive functioning. Moreover, the results provided the authors with important information that will guide their larger study, a randomized controlled trial where healthy human volunteers will be randomly assigned to four groups, two of which receive a TASER exposure. [ABSTRACT FROM AUTHOR]

The author discusses aspects of free will as an open scientific problem highlighted in the book of philosopher Mark Balaguer. He mentions his agreement with Balaguer on the libertarian theory of free will along with the involvement of indeterminism in choices and process of deliberation. An overview of his comment on the centered event casual theory of colleague Randy Clarke is also presented.

Abstract: Objectives: Trial registration has a great potential to increase research transparency and public access to research results. This study examined the availability of results either in journal publications or in the trial registry from all studies registered at ClinicalTrials.gov. Methods: All 137,612 records from ClinicalTrials.gov in December 2012 were merged with all 19,158 PubMed records containing registration numbers in the indexing field or in the abstracts. A multivariate analysis was conducted to examine the association between the availability of the results with study and participant characteristics available in registration records. Results: Fewer than 10% of the registered studies and 15% of the registered and completed studies had published results. The highest publication rate of 22.4% was for randomized trials completed between 2005 (starting year for structured indexing in PubMed of study registration) and 2010. For 86% of overall and 78% of completed registered studies, no results were available in ClinicalTrials.gov or in journal publications. Studies funded by industry vs. other funding sources and drug studies vs. all studies of other interventions were published less often after adjustment for study type, subject characteristics, or posting of results in ClinicalTrials.gov. Conclusion: Existing policy does not ensure availability of results from clinical research. International policy revisions should charge principal investigators with ensuring that the approved protocols and posted data elements are aligned and that results are available from all conducted studies. [Copyright &y& Elsevier]

There is a strong link between perfectionism and eating disorders, yet little research to date has examined mediators of this relationship. The aim of this study was to investigate the mediating effect of anxiety on the relationship between perfectionism and eating pathology in a clinical sample (N = 370, M age = 25.04, 99 % female) of treatment-seeking eating disorder patients (bulimia nervosa-41 %; eating disorder not otherwise specified-41 %; anorexia nervosa-18 %). Results from structural equation modeling indicated that anxiety partially mediated the relationship between self-oriented perfectionism and eating disorder psychopathology. The findings suggest the role of anxiety and perfectionism within cognitive-behavioral models of eating pathology, and have implications for the treatment of eating disorders. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Systematic review of preventive pharmacologic treatments for community-dwelling adults with episodic migraine. DATA SOURCES: Electronic databases through May 20, 2012. ELIGIBILITY CRITERIA: English-language randomized controlled trials (RCTs) of preventive drugs compared to placebo or active treatments examining rates of ≥50 % reduction in monthly migraine frequency or improvement in quality of life. STUDY APPRAISAL AND SYNTHESIS METHODS: We assessed risk of bias and strength of evidence and conducted random effects meta-analyses of absolute risk differences and Bayesian network meta-analysis. RESULTS: Of 5,244 retrieved references, 215 publications of RCTs provided mostly low-strength evidence because of the risk of bias and imprecision. RCTs examined 59 drugs from 14 drug classes. All approved drugs, including topiramate (9 RCTs), divalproex (3 RCTs), timolol (3 RCTs), and propranolol (4 RCTs); off-label beta blockers metoprolol (4 RCTs), atenolol (1 RCT), nadolol (1 RCT), and acebutolol (1 RCT); angiotensin-converting enzyme inhibitors captopril (1 RCT) and lisinopril (1 RCT); and angiotensin II receptor blocker candesartan (1 RCT), outperformed placebo in reducing monthly migraine frequency by ≥50 % in 200-400 patients per 1,000 treated. Adverse effects leading to treatment discontinuation (68 RCTs) were greater with topiramate, off-label antiepileptics, and antidepressants than with placebo. Limited direct evidence as well as frequentist and exploratory network Bayesian meta-analysis showed no statistically significant differences in benefits between approved drugs. Off-label angiotensin-inhibiting drugs and beta-blockers were most effective and tolerable for episodic migraine prevention. LIMITATIONS: We did not quantify reporting bias or contact principal investigators regarding unpublished trials. CONCLUSIONS: Approved drugs prevented episodic migraine frequency by ≥50 % with no statistically significant difference between them. Exploratory network meta-analysis suggested that off-label angiotensin-inhibiting drugs and beta-blockers had favorable benefit-to-harm ratios. Evidence is lacking for long-term effects of drug treatments (i.e., trials of more than 3 months duration), especially for quality of life. [ABSTRACT FROM AUTHOR]

When people discuss their experiences, they can later report seeing things that they never saw, simply because they heard about those things in the discussion. One factor that may contribute to this effect is the order in which people speak; some research has investigated this issue, but it remains unclear whether a relationship exists between memory conformity and speaking order. We explored this question using data from five previous memory conformity experiments. The results provide evidence of an association between speaking order and memory conformity, such that people who spoke first in a discussion were misled less often than people who did not. These results build on previous research by demonstrating that the association could not have been caused by differences in opportunities to be misled. We could not draw conclusions about causality from the exploratory analyses, but ruled out several simple explanations of the results, and considered a variety of social and cognitive mechanisms that might account for the association. Further investigation will be required to tease apart the possible mechanisms that underlie the relationship between speaking order and memory conformity. [ABSTRACT FROM AUTHOR]

To evaluate the association between preoperative breast magnetic resonance imaging (MRI) utilization and the rate of multiple surgeries, and to investigate the extent of any variation of rates of multiple surgeries among physicians. We identified patients with stage 0, I, or II breast cancer diagnosed between 2002 and 2007 in the Surveillance, Epidemiology, and End Results-Medicare database. Using diagnosis and procedure codes, we defined that the initial treatment episode had ended when a gap in surgery occurred at least 90 days after primary surgery. Surgical procedures of partial mastectomy or mastectomy during the initial treatment period were calculated to identify patients who received multiple surgeries. Multilevel logistic regression models were used to identify patient- and physician-level predictors of multiple surgeries. Of 45,453 women with early stage breast cancer who were treated by 2,595 surgeons during the study period, 9,462 patients (20.8 %) received multiple breast surgeries; of these patients, 8,318 (87.9 %) underwent one additional surgery, 988 (10.4 %) received two additional surgeries, and 156 (1.6 %) received three or more additional surgeries. Among 2,997 (6.6 % of the entire cohort) women who underwent preoperative breast MRI evaluation, 770 received multiple breast surgeries. After we adjusted for patient and tumor characteristics associated with multiple surgeries, we found that the rate of multiple surgeries was not significantly different between the two groups with or without preoperative breast MRI. Furthermore, the median odds ratio of 2.0, corresponding with the median value of the relative odds of receiving multiple surgeries between two randomly chosen physicians after controlling for other confounders, indicated a large individual surgeon effect. Substantial variation was observed in the rates of multiple surgeries in women aged 66 and older with early stage breast cancer. Evidence does not support that preoperative breast MRI reduces the incidence of multiple surgeries. [ABSTRACT FROM AUTHOR]

While ductal carcinoma in situ (DCIS) is seldom life threatening, the management of DCIS remains a dilemma for patients and their physicians. Aggressive treatment reduces the risk of ipsilateral breast tumor recurrence (IBTR), but has never been proven to improve survival. There is interest in identifying the prognostic factors for determining low-risk DCIS patients, but a comprehensive review of high-quality evidence on tumor characteristics in predicting local recurrence has never been carried out. We examined the following tumor characteristics: biomarkers, comedonecrosis, focality, surgical margin, method of detection, tumor grade, and tumor size. For this systematic review we restricted the analyses to the results of subgroup analyses from randomized controlled trials (RCTs) and multivariate analyses from RCTs and observational studies. We identified 44 eligible articles. The pooled random-effects risk estimates for IBTR are comedonecrosis 1.71(95% CI, 1.36-2.16), focality 1.95(95% CI, 1.59-2.40), margin 2.25(95% CI, 1.77-2.86), method of detection 1.35(95% CI, 1.12-1.62), tumor grade 1.81(95% CI, 1.53-2.13), and tumor size 1.63(95% CI, 1.30-2.06). Limited evidence indicated that women whose DCIS is ER-negative, PR-negative, or HER2/neu receptor positive have an IBTR higher than those whose DCIS is ER-positive, PR-positive, and HER2/neu receptor negative. A variety of tumor characteristics are significant predictors for IBTR. These results are important for both clinicians and patients to interpret the risk of local recurrence and to decide on a course of treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the comparative effectiveness of antiviral drugs in adults with chronic hepatitis B monoinfection for evidence-based decision-making. METHODS: A systematic review of randomized controlled clinical trials (RCTs) published in English. Results after interferon and nucleos(t)ides analog therapies were synthesized with random-effects meta-analyses and number needed to treat (NNT). RESULTS: Despite sustained improvements in selected biomarkers, no one drug regimen improved all intermediate outcomes. In 16 underpowered RCTs, drug treatments did not reduce mortality, liver cancer, or cirrhosis. Sustained HBV DNA clearance was achieved in one patient when two were treated with adefovir (NNT from 1 RCT = 2 95%CI 1;2) or interferon alfa-2b (NNT from 2 RCTs = 2 95%CI 2;4), 13 with lamivudine (NNT from 1 RCT = 13 95%CI 7;1000), and 11 with peginterferon alfa-2a vs. lamivudine (NNT from 1 RCT = 11 95%CI 7;25). Sustained HBeAg seroconversion was achieved in one patient when eight were treated with interferon alfa-2b (NNT from 2 RCTs = 8 95%CI 5;33) or 10-with peginterferon alfa-2b vs. interferon alfa-2b (NNT from 1 RCT = 10 95%CI 5;1000). Greater benefits and safety after entecavir vs. lamivudine or pegylated interferon alfa-2b vs. interferon alfa-2b require future investigation of clinical outcomes. Adverse events were common and more frequent after interferon. Treatment utilization for adverse effects is unknown. CONCLUSIONS: Individual clinical decisions should rely on comparative effectiveness and absolute rates of intermediate outcomes and adverse events. Future research should clarify the relationship of intermediate and clinical outcomes and cost-effectiveness of drugs for evidence-based policy and clinical decisions. [ABSTRACT FROM AUTHOR]

To integrate margin status information into the decision to undergo radiation therapy (RT) following breast-conserving surgery (BCS) for women with ductal carcinoma in situ (DCIS). We developed a decision-analytic Markov model to project quality-adjusted life years (QALYs) for a hypothetical cohort of 55-year-old women with DCIS over a lifetime horizon treated with or without RT following BCS. We estimated the transition probabilities of local DCIS and invasive recurrences based on the margin status (free, close, or positive) from a systematic literature review. Other probability estimates and utilities were collected from the published literature. Using the conditions defined in this model, expected QALYs after BCS alone were better than those after BCS with RT under the free-margin scenario (15.72 vs. 15.58) and worse in the close-margin (15.44 vs. 15.50) and positive-margin scenarios (15.20 vs. 15.33). The probability of receiving a salvage mastectomy varied from 10 to 28%, depending on margin status and treatment. One-way sensitivity analyses showed that the optimal treatment was sensitive to patients' preferences and RT side effects. Probabilistic sensitivity analyses revealed that BCS alone would be the best strategy in 54% of the cases under the free-margin scenario, 48% under the close-margin scenario, and 44% under the positive-margin scenario. This study illustrates that margin status is able to provide supplementary information on the decision of DCIS treatment. Our analyses also highlight the importance of patients' preferences in decision making. Our findings suggest that RT is not necessary for all patients with DCIS undergoing BCS. [ABSTRACT FROM AUTHOR]

The author of the article discusses libertarianism and free will. The article examines, amongst other things, rationality, chance, moral responsibility, incompatibilism, and self-forming actions (SFAs). The author concludes that indeterminism allow for the possibility of pursuing different purposes and that self-formation is not a gift, but rather a struggle.

Hydroxyapatite (HA)-reinforced polymer biocomposites offer a robust system to engineer synthetic bone substitutes with tailored mechanical, biological, and surgical functions. The basic design rationale has been to reinforce a tough, biocompatible polymer matrix with a bioactive HA filler. A large number of studies have investigated modifications to the biocomposite structure and composition, aimed at improving the mechanical properties, often through modified or novel processing methods. In this article, the effects of the polymer composition and molecular orientation; the HA/polymer interface; and the HA-reinforcement content, morphology, preferred orientation, and size are reviewed with respect to mechanical properties, drawing frequent comparisons between various HA-reinforced polymer composites and bone tissue. [ABSTRACT FROM AUTHOR]

Background: Intraoperative ultrasonography (US) is used in many centers before oncologic liver resections to detect additional tumors and to evaluate the relationship of tumors to major vascular structures. As preoperative imaging improves, it is expected that the diagnostic yield from intraoperative US will diminish. In this study we attempt to determine if fewer unrecognized tumors were being detected and whether intraoperative US is having less impact on surgical decision making.Methods: We compared 50 consecutive cases (mean age = 57.2 +/- 10 years; 27 men) who underwent laparotomy for a planned resection of primary liver malignancies or metastases between September 2003 and July 2005 with 50 consecutive cases (mean age = 56.9 +/- 14 years; 25 men) between January 1999 and September 2003. Dedicated intraoperative liver US was performed or supervised by a gastrointestinal radiologist using a 5.0-MHz linear- or curvilinear-array transducer during each procedure.Results: The rate of detecting unrecognized tumors has not changed significantly (14% vs. 20%, p = 0.70). The use of US to establish the relationship between tumor and the vasculature has not changed (48% vs. 60%, p = 0.23). The percentage of cases where the US findings were responsible for altering surgical management was 20% for both groups. The resection rate was 72% for both groups. The negative resection margin rate has also not changed significantly (86% vs. 69%, p = 0.09).Conclusions: Despite the advances in cross-sectional imaging, the frequency of unrecognized tumors found during intraoperative liver US and its use for surgical guidance has not changed significantly. Currently routine intraoperative US alters the management of approximately one fifth of our patients undergoing attempted liver resection for primary malignancies or metastases. [ABSTRACT FROM AUTHOR]

The present study identified predictors of time to institutionalization among elderly Latinos suffering from dementia, and determined how these predictors varied when compared to Caucasians and African-Americans. The sample included 324 Latino, 701 African-American, and 7,100 Caucasian dementia patients and their caregivers recruited from eight catchment regions in the U.S. and were assessed over a 3-year period. Potential predictors considered in the event history analyses included context of care and indicators of care recipient cognitive and functional status, caregiver stress and depression, and caregiving resources. Cox proportional hazards models revealed that various indicators of sociodemographic context, caregiver well-being, and community-based service utilization influenced time to institutionalization among Latinos. Cross-ethnic/racial comparisons also identified statistical variations in site, living arrangement, intensity of informal care provision, caregiver depression, and adult day service use across the Latino, Caucasian, and African-American samples when predicting time to nursing home placement. The findings emphasize the need to explore time to institutionalization across racial and ethnic contexts, and suggest future variables to consider when analyzing nursing home placement in diverse situations. [ABSTRACT FROM AUTHOR]

In this study, the costs and cost savings associated with departmentwide implementation of a picture archiving and communication system (PACS) as compared to the projected budget at the time of inception were evaluated. An average of $214,460 was saved each year with a total savings of $1,072,300 from 1999 to 2003, which is significantly less than the $2,943,750 projected savings. This discrepancy can be attributed to four different factors: (1) overexpenditures, (2) insufficient cost savings, (3) unanticipated costs, and (4) project management issues. Although the implementation of PACS leads to cost savings, actual savings will be much lower than expected unless extraordinary care is taken when devising the budget. [ABSTRACT FROM AUTHOR]

Objective: To relate medical surveillance outcomes to uranium biomonitoring results in a group of depleted uranium (DU)-exposed, Gulf War I veterans. Methods: Thirty-two veterans of Gulf War I who were victims of ‘friendly fire’ involving DU weapons, in whom exposure assessment can accurately be measured, had urine uranium concentrations determined using ICP-MS technology. Clinical laboratory parameters were measured and related to urine uranium concentrations. Data were examined by stratifying the cohort into a low U group, <0.10 μg/g creatinine versus a high U group, ≥0.10 μg/g creatinine and assessing differences between groups. Results: Over a decade after first exposure, soldiers possessing embedded DU fragments continue to excrete elevated concentrations of uranium in urine. No clinically significant uranium related health effects were observed in blood count, blood chemistries including renal markers, neuropsychological measures, and semen quality or genotoxicity measures. Markers of early changes in renal glomerular and tubular function were not statistically different between groups; however, genotoxicity measures continue to show subtle, mixed results. Conclusion: Persistent urine uranium elevations continue to be observed more than 12 years since first exposure. Despite this, renal and other clinical abnormalities were not observed, likely due to the ‘relatively’ low uranium burden in this cohort compared to historical uranium-exposed occupational groups. Continuing surveillance is indicated, however, due to the on-going nature of the exposure. These results are an important finding in light of the on-going controversy regarding health effects observed in soldiers of the Gulf War and other conflicts, whose uranium exposure assessment is unable to be accurately determined. [ABSTRACT FROM AUTHOR]

Prevalent vertebral deformities are predictive of future clinical fractures independent of bone density. We used a Markov model with eight health states to estimate from the societal perspective the cost-effectiveness of using spine radiographs to identify postmenopausal women age 60 or older with one or more vertebral deformities and then treat them with anti-resorptive drug therapy to prevent fractures. We compared three strategies: 5 years of amino-bisphosphonate (alendronate) therapy for all, 5 years of alendronate therapy for only those with prevalent a radiographic vertebral deformity or no initial alendronate treatment. Lifetime direct medical and indirect costs, quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were tracked. For women with one or more prevalent vertebral deformities, the costs per QALY gained ranged from $5,084 (for an 80 year old with a T-score of −2.4) to $61,192 (for a 60 year old with a T-score of −1.0). For women without prevalent vertebral deformity, the costs per QALY gained ranged from $41,897 (for a 60 year old with a T-score of −2.4) to $166,219 (for an 80 year old with a T-score of −1.0). These results were modestly sensitive to reasonable changes in fracture rates, disutility, discount rates and assumptions about the accuracy of spinal radiographs for detecting vertebral deformity. Assuming a societal willingness to pay per QALY gained of $50,000, the strategy of performing spine radiographs in post-menopausal osteopenic women with T-scores at or below –1.5 and treating those with 1 or more prevalent vertebral deformities is likely to be cost-effective. However, further research on the accuracy of vertebral deformity ascertainment from routine clinical radiographs and on the efficacy of amino-bisphosphonate drugs for reducing the risk of non-vertebral fractures in osteopenic women is needed to define more precisely the subset of osteopenic post-menopausal women in whom use of spinal radiographs is most cost-effective. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Decreased physician visits for dyspepsia were predicted with the histamine-2 receptor antagonists (H2RA) release to over-the-counter (OTC) status. The aim of this study was to examine the presentation frequency for dyspeptic complaints before and after the OTC release of the H2RA and the self-reported effectiveness of OTC H2RA. METHODS: Two cross-sectional surveys were used in a community sample. The patients comprised a random age- and sex-stratified sample of 1600 ambulatory adults in 1993 and 1800 in 1997. Self-report, valid mail surveys gathered information on healthcare seeking and gastrointestinal symptoms in 1993 and 1997 and antisecretory use in 1997. RESULTS: Presentation frequency for dyspepsia was 22% in 1993 versus 23.5% in 1997. Only 16% of chronic users of the OTC H2RA obtained complete relief of symptomatic episodes. Use of an OTC H2RA was highly associated with presentation to a physician in the past year. CONCLUSIONS: OTC H2RA infrequently provided the complete relief desired by patients. Presentation frequency to physicians for dyspeptic complaints did not change with availability of H2RA OTC. [ABSTRACT FROM AUTHOR]

The article discusses research being done on the link between nurse staffing and the use of physical restraints. It references the study "Nursing Skill Mix: Nurse Staffing Level, and Physical Restraint Use in U.S. Hospitals: A Longitudinal Study," by V. Staggs et al. in the 2016 issue of the "Journal of General and Internal Medicine." The variables considered include the use of quarterly data on restraint use with hospital nurse staffing, patient demographics and the attitude of physicians.

The sulfate and glucuronide conjugation of acetaminophen (APAP) by hepatocytes cultured on Matrigel or type 1 collagen was compared to APAP metabolism in vivo. The metabolic fate of low (15 mg/kg), medium (125 mg/kg), and high (300 mg/kg) doses of APAP injected intraperitoneally were determined in male and female rats. Males excreted more APAP as the sulfate conjugate than females, which correlated with the twofold greater APAP sulfotransferase activity in the male vs. females (301±24 vs. 156±18 pmol · mg protein · min). Also, as sulfate conjugation became saturated, there was a dose-related shift in APAP metabolism from sulfate to glucuronide conjugation in both sexes. After death, the livers of the same animals were perfused with collagenase and the hepatocytes cultured in modified Waymouth's medium on either Matrigel or rat-tail collagen, with various doses of APAP (0, 0.125, 0.25, 0.5, and 1.0 m M). Sex differences in APAP sulfation and glucuronidation persisted in culture for up to 4 days, with sulfation predominating in the male similar to in vivo. With increasing APAP concentration (dose), there was a saturation of sulfate conjugation and a shift to glucuronidation as observed in vivo. Sex differences in APAP sulfation and glucuronidation were no longer significant by Day 4 in culture. Sulfation, and to a lesser extent, glucuronidation, were more stable on Matrigel than collagen. We concluded that APAP metabolism of freshly isolated hepatocytes could replicate in vivo sex differences in conjugation, and that Matrigel was superior to collagen as substrate. [ABSTRACT FROM AUTHOR]

Although substantial research has been conducted on chronic fatigue syndrome (CFS) over the past decade, the syndrome remains poorly understood. The most recent case definition describes CFS as being characterized both by disabling fatigue and by subjective reports of difficulty with concentration and 'short-term' memory. However, research into the neurocognitive and psychological functioning of individuals with CFS has provided mixed objective results. The current paper reviews studies that have examined the neurocognitive and/or psychological functioning of individuals with CFS. Changes in research design and instruments employed to study individuals with CFS are suggested. [ABSTRACT FROM AUTHOR]

This article contains detailed reviews of 13 computerized neuropsychological and performance test batteries and six stand-alone computer tests. Tasks found on these instruments are described and tables illustrate which batteries employ which measures. In addition to issues of reliability and validity, special considerations apply to computerized assessment. These issues are discussed and readers are provided information to help them assess computerized tests in relation to their particular clinical and research needs. Since many computerized tests were developed as performance assessment tools, the relationship between performance and neuropsychological assessment is examined. [ABSTRACT FROM AUTHOR]

This article summarizes current literature relevant to commonly used tests and test batteries in clinical neuropsychology. The first section contains a discussion of the philosophy and relative advantages of standardized and flexible battery approaches in neuropsychology. The second contains historical background and a literature review of the two major standardized test batteries: the Halstead-Reitan and Luria-Nebraska. The third section includes reviews of tests that are frequently used in the flexible battery approach. Various tests of intellectual functioning, attention, memory, language, and spatial analyses are critiqued in this section. Contributions of the process approach are noted. The article ends by underscoring the need for continued research into the nature of neuropsychological measures and the abilities they assess. [ABSTRACT FROM AUTHOR]