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Karst geology is characterized by the presence of sinkholes and voids, which may pose significant risk to existing infrastructure. Sinkhole formation is often observed near active quarries, where dewatering operations can alter regional groundwater flow patterns leading to subsidence and increased void formation. In these areas, identifying locations which may be susceptible to sinkhole formation requires an ability to map dissolution features within the rock. Traditional geotechnical explorations alone are not well-suited to this effort as they only provide subsurface information at discrete points and therefore may miss voids within the rock. Geophysical methods offer a means to produce continuous profiles of the rock surface and possible locations for voids but interpreting the results of these tests in karstic geology can be challenging. This study uses 2D electrical resistivity and seismic surveys at a site with previous sinkhole activity along an interstate in central Alabama. The site is adjacent to a limestone quarry. Resistivity data is collected using 2D dipole-dipole and strong-gradient arrays. The seismic data is processed using a full waveform inversion (FWI) technique. Subsurface profiles interpreted from the geophysical surveys are then compared to borehole data from previous site investigations. Results from the geophysical surveys are found to be consistent with borehole data regarding variation of bedrock depth and identification of possible sinkhole features. Potential limitations and sources of error pertaining to each survey type are considered.

There has been increased use of self-report prospective memory (PM) scales in recent years, despite uncertainty about their validity. This study reviewed how self-and informant-report PM questionnaires have been used in the assessment of PM. We evaluated relationships between self-report, informant-report, and performance-based PM measures, and the validity of using self-report measures in detecting PM impairments and monitoring intervention outcomes. The scoping review methodology of Arksey and O'Malley (2005. Scoping studies: Towards a methodological framework.

Intracranial hemorrhage (ICH) in patients with left ventricular assist devices (LVAD) is a devastating complication. Demographic risk factors for ICH in LVAD patients are defined, however anatomic predispositions to ICH are unknown. We sought to interrogate intracranial radiographic risk factors for ICH in LVAD patients.We reviewed 440 patients who received an LVAD from 2008-2021. We selected patients with CT scans of the head either before or after LVAD placement, but typically within 5 years. 288 patients (21 ICH, 267 Control) with imaging were included. A detailed chart review was performed on demographics, radiographic features, and management.The incidence of ICH in our total cohort was 8.6% (38/440). The presence of pump thrombosis (p=0.001), driveline infection (p=0.034), other hemorrhage (p=0.001), or previous placement of a cardio-defibrillator (p=.003) was associated with increased risk for ICH. An analysis of imaging revealed that the presence of a mass (p=0.006), vascular pathology (p=0.001), and microangiopathy (p=0.04) was significantly associated with ICH in LVAD patients. These radiographic features were validated with a multivariate logistic regression which confirmed presence of a mass (aOR 332.1, 95% CI: 14.7-7485.1, p0.001), vascular pathology (aOR 69.7, 95% CI: 1.8-2658.8, p=0.022), and microangiopathy (aOR 6.5, 95% CI: 1.1-37.6, p=0.035) were independently associated with ICH.Radiographic evidence of microangiopathy, intracranial mass, and vascular pathology are independent risk factors for ICH which are readily identified by imaging. We advocate that CT imaging be used to further stratify patients at highest risk of ICH during treatment with an LVAD.

Cyclic softening of fine-grained soils poses a significant hazard to geotechnical infrastructure in many parts of the world. Methods to numerically evaluate the cyclic softening and subsequ...

Cognitive behavioral therapy for psychosis (CBTp) has enjoyed a steep rise in popularity over the past 15 years; however, recent systematic reviews and meta-analyses have concluded that CBTp has only modest effects on psychotic syndrome outcomes and that empirical evidence of its superiority over other psychosocial treatments is poor. And although it has been argued by some prominent authors that CBTp is not designed to alleviate the “psychotic syndrome,” there is little empirical evidence linking CBTp change mechanisms with syndrome versus single-symptom outcome measures. This study investigated the relationship between CBTp change processes, beliefs about voices, and thought control strategies, with a range of outcome measures including global positive psychotic symptoms in a sample of 40 voice hearers with established diagnosis of psychotic disorder. Consistent with the assertions of Birchwood and Trower (2006), global positive symptoms were found to be generally poorly related to CBTp change processes. Conversely, these CBTp change processes were found to be generally strongly related to measures of emotional distress and some measures of single psychotic symptoms. The implications for past and future CBTp treatment outcome studies are discussed.

Objective: Following acquired brain injury (ABI), young people may experience increased anxiety as well as difficulties with their psychosocial functioning. This study examined trait mindfulness as a mediator of the relationship between anxiety and psychosocial domains of School and Leisure Activities (SLA), Interpersonal Relationships (IR) and Daily Living Skills (DLS).Method: Participants were adolescents with ABI (aged 12-19 years, N = 38). Standardised measures were used to assess anxiety, trait mindfulness, and psychosocial functioning.Results: Higher levels of anxiety were found to be associated with reduced IR (p < .05) and DLS (p < .05). Increased trait mindfulness was found to be associated with lowered anxiety (p < .01), as well as with better IR (p < .05) and DLS (p

Background Early right heart failure (RHF) occurs commonly in left ventricular assist device (LVAD) recipients, and increased right ventricular (RV) afterload may contribute. Selective pulmonary vasodilators, like phosphodiesterase-5 inhibitors (PDE5i), are used off-label to reduce RV afterload before LVAD implantation, but the association between preoperative PDE5i use and early RHF after LVAD is unknown. Methods and Results We analyzed adult patients from the INTERMACS registry (Interagency Registry for Mechanically Assisted Circulatory Support) who received a continuous flow LVAD after 2012. Patients on PDE5i were propensity-matched 1:1 to controls. The primary outcome was the incidence of severe early RHF, defined as the composite of death from RHF within 30 days, need for RV assist device support within 30 days, or use of inotropes beyond 14 days. Of 11 544 continuous flow LVAD recipients, 1199 (10.4%) received preoperative PDE5i. Compared to controls, patients on PDE5i had higher pulmonary artery systolic pressure (53.4 mm Hg versus 49.5 mm Hg) and pulmonary vascular resistance (2.6 WU versus 2.3 WU; P0.001 for both). Before propensity matching, the incidence of severe early RHF was higher among patients on PDE5i than in controls (29.4% versus 23.1%; unadjusted odds ratio (OR), 1.32; 95% CI, 1.17-1.50). This association persisted after propensity matching (PDE5i, 28.9% versus control 23.7%; OR, 1.31; 95% CI, 1.09-1.57), driven by a higher incidence of prolonged inotropic support. Similar results were observed across a wide range of subgroups stratified by markers of pulmonary vascular disease and RV dysfunction. Conclusions Patients treated with preoperative PDE5i had markers of increased RV afterload and HF severity compared to unmatched controls. Even after propensity matching, patients receiving preimplant PDE5i therapy had higher rates of post-LVAD RHF.

Background— The cause of idiopathic dilated cardiomyopathy (DCM) is unknown by definition, but its familial subtype is considered to have a genetic component. We hypothesize that most idiopathic DCM, whether familial or nonfamilial, has a genetic basis, in which case a genetics-driven approach to identifying at-risk family members for clinical screening and early intervention could reduce morbidity and mortality. Methods— On the basis of this hypothesis, we have launched the National Heart, Lung, and Blood Institute- and National Human Genome Research Institute-funded DCM Precision Medicine Study, which aims to enroll 1300 individuals (600 non-Hispanic African ancestry, 600 non-Hispanic European ancestry, and 100 Hispanic) who meet rigorous clinical criteria for idiopathic DCM along with 2600 of their relatives. Enrolled relatives will undergo clinical cardiovascular screening to identify asymptomatic disease, and all individuals with idiopathic DCM will undergo exome sequencing to identify relevant variants in genes previously implicated in DCM. Results will be returned by genetic counselors 12 to 14 months after enrollment. The data obtained will be used to describe the prevalence of familial DCM among idiopathic DCM cases and the genetic architecture of idiopathic DCM in multiple ethnicity–ancestry groups. We will also conduct a randomized controlled trial to test the effectiveness of Family Heart Talk , an intervention to aid family communication, for improving uptake of preventive screening and surveillance in at-risk first-degree relatives. Conclusions— We anticipate that this study will demonstrate that idiopathic DCM has a genetic basis and guide best practices for a genetics-driven approach to early intervention in at-risk relatives. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT03037632.

Despite a steep rise in the evidence base for third-wave cognitive and behavioural therapy approaches over the past decade, a scarcity of change measures relevant to these therapies as applied to psychosis is arguably slowing empirical progress in the area. The Voices Acceptance and Action Scale (VAAS), a measure of acceptance of voice experiences, is a notable exception. However, there are no published data on its psychometric properties outside of that provided by the scale developers. The current study explored the psychometric properties of two brief versions of the VAAS in a sample of psychotic voice hearers in a routine outpatient mental health service. Evidence from the current study suggests that both brief versions are robust measures of acceptance of voice experiences. Some limited support for the shortened VAAS-9 as being a marginally improved scale over the original brief VAAS-12 was also found. The current study found acceptance of voices to be highly related to depression, anxiety, stress and general negative affect and to predict unique variance in depression and general negative affect beyond that attributable to negative beliefs about voices and thought suppression. It was also found that acceptance was positively related to the use of reappraisal, indicating that the distinctiveness of acceptance from appraisal processes may be less pronounced in this context than what was has been reported previously. Implications for future research, as well as the practice of second-wave and third-wave cognitive and behavioural approaches to psychosis, are discussed. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Two brief versions of the VAAS instrument were found to be robust measures of acceptance of psychotic voice experiences. The construct of acceptance of voices is highly related to indices of well-being and negative appraisal processes in psychosis and appears to offer an alternative route to therapeutically addressing the toxic effects of negative beliefs about voices. The recent focus on acceptance-based techniques within cognitive and behavioural approaches to psychosis was supported.

This study examined the explanatory models of bulimia nervosa (BN) held by members of professionals in the medical, psychological, and allied health fields; the general public; and female universit...

Objective: Suicide bereavement research can help facilitate greater understanding of the impact of suicide and potential risks for others. As there is limited research on the experience of young people who lose a friend to suicide, the aim of this exploratory study was to consider specific psychological factors for such bereaved young people. Methods: Ten young people who had experienced the suicide death of a friend completed self-report measures to assess levels of depression, anxiety, coping and prolonged grief. Results: Participants reported increased levels of stress, depression, reduced coping capacity and prolonged grief symptoms that have continued considerably beyond the death of their friend. Conclusions: Psychological distress for young people bereaved by a friend’s suicide is of concern given the developmental changes and life transitions associated with this age group. Implications include the significant health and wellbeing challenges associated with suicide bereavement for young people. The outcomes support a more proactive response from mental health and support services.

Background: While the research literature exploring suicide bereavement has expanded in recent years, this has been primarily quantitative and has focused more on the bereavement experience of parents and siblings. The bereavement experience of young people affected through the suicide death of a friend remains under-conceptualized and not well understood. Aims: To develop an understanding of the experiences of young people bereaved by the suicide of a friend. Method: Ten young people participated in a pilot study with in-depth interviews to explore their suicide bereavement experiences. Narrative inquiry methodology was utilized to analyze the qualitative data. Results: The findings indicated multiple grief experiences caused by suicide. Four themes reported are meaning making, feeling guilt, risky coping behavior, and relating to friends following suicide loss. Conclusions: Implications include the need for increased awareness that friends of young people who die by suicide may have significant health and well-being challenges associated with bereavement, and that friends in these circumstances may not readily present at services for assistance.

Purpose Young adult males (YAMs) are understudied with respect to lifestyle interventions to address overweight and obesity in this group. This study reports on the participatory design of the structure and delivery of the Fit4YAMs text message–based lifestyle intervention for 18- to 25-year-old rural YAMs in Australia. Methods Two semi-structured focus group discussions were held with six overweight or obese YAMs. Sessions explored their preferences for the structure and delivery of a weight loss intervention. Focus groups were recorded, and the contents transcribed verbatim for thematic analysis. Results The YAMs were unanimous in their preference for a highly personalized intervention program, complete with personalized goal setting, personalized motivation and engagement strategies, and personalized text message content. A text message frequency of three–four messages per week was deemed optimal for this group. Minimal direct contact by the intervention team was requested, but with clear guidelines and reminders of key contacts whom they could contact should they require help and guidance. The YAMs also agreed that a comprehensive goal setting session and personalization session prior to commencement of the intervention would be best. Conclusions To engage rural YAMs in lifestyle interventions, a high degree of personalization of the program appears important. Although initially more time and resource intensive than a less personalized approach, it is essential to identify strategies to prevent and reverse weight gain in this hard to engage group. Maximizing their engagement using a more personalized approach could be the key to promoting long-term health outcomes in this group.

For psychology to truly embrace reconciliation, a greater representation of Indigenous Australian psychology professionals is required. A model for increasing Indigenous participation in psychology...

To elucidate potential relationships between personality and intelligence it is necessary to move beyond the ad hoc reporting of correlation coefficients and focus instead on testing deductions from well-established theories. To this end the present paper references Eysenck’s (1995) theoretical work linking the dimension of psychoticism to both psychosis and creative genius. Drawing on this theory it was argued that the relationship between psychoticism and crystallized ability will be conditional on the level of fluid intelligence. Participants (N = 100) completed the Eysenck Personality Questionnaire-Revised (EPQ-R) and the Kaufman Brief Intelligence Test (K-BIT). Moderated multiple regression revealed a significant interaction effect. Crystallized ability (K-BIT vocabulary) was negatively related to psychoticism at low levels of fluid ability (K-BIT matrices) and positively related to psychoticism at high levels of fluid ability. These findings highlight the potential importance of psychoticism within GfGc investment theory.

Problem-based learning (PBL) is a pedagogical approach to professional training that emphasises the development of clinical reasoning skills and self-directed learning. In contrast to more traditional lecture-based approaches that focus upon the linear acquisition of course content, PBL is undertaken in the context of actual case presentations. Although PBL has been adopted widely in the professional training of medical practitioners and nurses, it is only just beginning to be used in the professional education of psychologists. This paper examines the nature and benefits of PBL for education in clinical and forensic psychology by outlining its implementation and development at Charles Sturt University, located in a rural area of Australia. Although a full and independent evaluation of PBL for education in clinical or forensic psychology is yet to be undertaken, this paper argues that PBL can make a significant contribution to professional training in psychology.

Several recent trials have examined the clinical utility of intraaortic balloon counterpulsation pumps (IABPs) in cardiogenic shock and acute coronary syndromes. More recently, a larger-capacity 50 cc IABP was introduced into practice. No data comparing the hemodynamic effects of the 40 cc vs 50 cc IABP exist. Our aim was to explore the hemodynamic effects of the 50 cc IABP in real-world clinical practice.Demographic, hemodynamic, and laboratory data were retrospectively examined in 26 consecutive subjects treated with a 50 cc IABP and compared with 26 patients receiving a 40 cc IABP between 2012 and 2013. IABP tracings were analyzed within 24 hours of implantation in all patients. Pulmonary artery catheter data were available before and after IABP implantation in 20 subjects.Baseline demographics, including body surface area, were similar between groups. Compared with the 40 cc IABP group, 50 cc IABP recipients showed higher augmented diastolic blood pressure, greater systolic unloading, and a larger reduction in pulmonary capillary occlusion pressure (PCOP). Percent diastolic augmentation was higher among 50 cc IABP recipients. Only 58% of subjects achieved10 mm Hg of systolic unloading in the 40 cc group compared with 27% in the 50 cc group. For both the 40 cc and 50 cc IABPs, the magnitude of systolic unloading correlated inversely with PCOP and directly with the magnitude of diastolic augmentation.In real-world practice, greater systolic unloading and diastolic augmentation were observed among 50 cc vs 40 cc IABP recipients. Future trials evaluating the clinical utility of the 50 cc IABP are required.

Current best practice guidelines advocate a multidisciplinary approach to the diagnosis and management of attention-deficit hyperactivity disorder (ADHD). However, no research has yet examined whether parents and professionals share common beliefs about ADHD. This study examined the implicit beliefs about the characteristics and causes of ADHD held by parents and professionals in the psychological, educational, medical, and allied health fields. A total of 670 participants rated 46 characteristics and 29 causal explanations for ADHD. Principal component analyses identified five characteristic factors and six causal factors. There was a high degree of concordance between the groups in their beliefs about the characteristics and causes of ADHD. However, several important differences were also found. The implications of the overlap and differences between professional and nonprofessional groups, and the scientific literature are considered.

Blood pressure (BP) is one of the key modifiable risk factors for cardiovascular disease (CVD) both in primary and secondary prevention of disease. In this review, we discuss BP treatment in prevalent CVD and heart failure. Evidence for specific agents based on their neurohormonal effects and evidence for target values for systolic or diastolic BP are covered. The potential adverse effects of overtreatment of BP are also discussed. BP targets for those with CVD should generally be less than 140/90 mm Hg but require individualization of therapy for any further reduction based on the clinical setting.

This report presents a cognitive measure of drinking expectancies based on semantic priming methodologies, and it investigates differences between high and low drinking restraint undergraduates. Reaction time to an emotion name (e.g., sociable) was measured when that word was preceded by a drinking-related word (e.g., beer) and when preceded by a neutral word (e.g., book). One hundred and four undergraduate students were administered the “differentiated” Restrained Drinking Scale (Ruderman & McKiman, 1984; Collins, George, & Lapp, 1989), a drinking behaviour questionnaire, and completed the priming task. High and low-restraint drinkers were found to differ significantly in the extent and direction of priming to positive and negative emotional-word targets, with the high-restraint drinkers taking longer to recognise positive words. The results suggest that, in the absence of an alcohol pre-load, highly restrained drinkers have weaker positive drinking expectancies than their less restrained peers....

Objective The factor structure of the Bulimic Investigatory Test (BITE) was examined in adolescent girls and boys. Method Seven hundred and seventy seven adolescents (427 girls and 350 boys) completed the BITE. Results Consistent with the original scale, one factor describing overall bulimic symptoms was found for the girls. However, two factors were required to summarize the boys' symptoms: “Emotional and Rigid/Disruptive Eating Style” and “Food Preoccupation and Binging.” Discussion The results are discussed in relation to Fairburn's (Fairburn. (1995). Overcoming Binge Eating. New York: Guilford) distinction which separates problem from nonproblem binge eating. Further studies are now needed to examine the mechanisms underlying the development of bulimic eating in boys and young men. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 26: 217–221, 1999.

Background: Despite the availability of effective therapies, heart failure (HF) remains a highly prevalent, morbid and costly disease. Few data are available, however, describing long-term trends in the medical management and outcomes of patients hospitalized with acute decompensated heart failure (ADHF). Methods: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all 11 central Massachusetts medical centers from 1995 to 2004, and abstracted information on patient’s demographic, clinical, and treatment characteristics. Mortality was calculated in-hospital and at 30 days and 1, 2, and 5 years after discharge. Results: Between 1995 and 2004 respectively, the use of recommended discharge medications including beta-blockers (26%; 74%), angiotensin pathway inhibitors (50%; 61%), statins (6%; 45%), and aspirin (40%; 63%) increased markedly, while the use of digoxin (55%; 33%), nitrates (68%; 47%), and calcium channel blockers (40%; 30%) declined significantly; nearly all patients received diuretics. Females, the elderly, and patients with chronic lung disease, anemia, incident HF, and multiple comorbidities were less likely to receive recommended medications than respective comparison groups. Between 1995 and 2004, in-hospital mortality decreased from 8.5% to 6.8%; 5-year survival increased from 19% to 28%, a relative improvement of 47%. Conclusion: The use of effective HF therapies increased markedly following the issuance of ACC-AHA guidelines for HF in 1995, with a concomitant increase in survival. Nonetheless, the prognosis for patients hospitalized with HF remains poor, as fewer than 1 in 3 patients survives 5 years. Opportunities exist to further improve the use of HF therapeutics.

Objective: This study examined parental and professional beliefs about the efficacy of various treatment strategies for ADHD. Method: Parents of children with and without ADHD and seven medical and nonmedical professional groups ( N = 673) completed a questionnaire examining their beliefs about the efficacy of various treatment regimes. Results: Principle component analysis identified four factors—school-based interventions, medical and allied health interventions, parent interventions, and nontraditional interventions. Although there were some group differences in the level of endorsement for these factors, there was a high degree of concordance between the groups. The school-based interventions factor was the most highly endorsed, whereas the nontraditional interventions factor was the least endorsed by the sample as a whole. Conclusion: The results suggest that the low level of interdisciplinary interaction that has been reported in the literature is not due to differences in beliefs about the efficacy of various treatment strategies for ADHD.

With the increasing number of Black mothers participating in the labor force, rearing children without fathers present, and relying on extended family for support the question of the nature of role-flexibility and sharing in the family is raised. Sixty-four families participated in an examination of the relative influence of one- and two-parent Black families and the proximity of the grandmother on self-report measures of (a) household maintenance duties, (b) childcare duties, and (c) parental punishment behaviors. Parents, grandmothers, and at least one child between the ages of 7 and 14 years completed three types of self-report measures. Although the results indicated that mothers, fathers, and grandmothers were nominated as consistently participating in childcare and household maintenance duties, mothers were nominated for more than 60% of the childcare and household tasks. Moreover mothers and not fathers used the full range of discipline practices including corporal punishment. The hypothesis regarding role-sharing in Black household was not supported. Black mothers, like mothers in general, are primarily responsible for the maintenance of the house and the care of children.

Purpose Studies in on-call residents have shown that mood is worsened by fatigue as indicated by increased scores on measures of depression, anxiety, confusion, and anger using the Profile of Mood States (POMS). In prior sleep deprivation studies, mood has been shown to be more affected than either cognitive or motor performances. The purpose of this study was to examine the effect of the 80-hour work week regulations on resident mood in general and in a post-call period (PC). Methods Institutional Review Board approval was obtained to survey the residents and publish the results. POMS is a 65-item adjective questionnaire that includes subscales for measuring tension-anxiety, anger-hostility, depression-dejection, vigor-activity, fatigue-inertia, and confusion-bewilderment, with the summation of the scales forming a total mood disturbance score. Surgical residents were tested at a 9 am didactic curriculum session (9 am has been shown to correlate with the nadir of performance). Residents were tested after nights off call (NOC) or after PC. Time asleep in the preceding 24 hours and other demographic data were also collected. Acute fatigue (AF) was defined as t -test and linear regression were used to assess differences between groups. Results A total of 123 standardized POMS mood questionnaires were administered on 4 occasions to 51 surgical residents, 35 men and 16 women at levels PGY-1 through PGY-5. Overall, 33 tests (27%) were taken after PC and 90 (73%) were taken after NOC. Acute fatigue residents had a mean sleep time of 2.2 (+/−1.5) hours, whereas rested (R) residents had a mean sleep time of 6.7 (+/−2.2) hours (whether PC or NOC). No statistical differences in mean values of vigor, anger, depression, concentration, fatigue, tension, or total score were observed between PC and NOC or between AF and R residents. There was no significant relationship between acute sleep deprivation and total mood disturbance, whether PC or NOC. In linear relationships, NOC total score and hours slept had r 2 = 0.01 ( p = 0.44), whereas PC total score and hours slept had r 2 = 0.07 (p = 0.14). Conclusion Although POMS was given 4 times, only 27% were PC, which reflects our 1 in 4 night in-house coverage. In contrast to earlier studies, resident mood, as measured by POMS, is no longer related to PC/NOC or acute fatigue. Previous studies have shown that loss of sleep was associated with declining mood. The lack of such a relationship in this study may be related to the new regulations. It has been assumed that people can adapt to chronic sleep loss but have a harder time coping with the effects of acute sleep deprivation. If, however, the new regulations have relieved chronic sleep deprivation, then a well-rested resident can periodically cope with the effects of acute sleep deprivation. Perhaps by eliminating chronic sleep debt, work hour restrictions seem to have removed the negative impact of PC seen in the prior era. Further studies should increase the number of residents studied, have numerous repeat NOC and PC pairs in same subjects, compare different services with different workloads, junior and senior residents, and in-house and at-home call schedules.