An imagery-based road map to tackle maladaptive motivation in clinical disorders

There is now a widespread recognition of the importance of mental imagery in a range of clinical disorders (1). This provides the potential for a transdiagnostic route to integrate some aspects of these disorders and their treatment within a common framework. This opinion piece argues that we need to understand why imagery is such a central and recurring feature, if we are to progress theories of the origin and maintenance of disorders. This will aid us in identifying therapeutic techniques that are not simply targeting imagery as a symptom, but as a manifestation of an underlying problem. As papers in this issue highlight, imagery is a central feature across many clinical disorders, but has been ascribed varying roles. For example, the involuntary occurrence of traumatic memories is a diagnostic criterion for PTSD (2), and it has been suggested that multisensory imagery of traumatic events normally serves a functional role in allowing the individual to reappraise the situation (3), but that this re-appraisal is disabled by extreme affective responses. In contrast to the disabling flashbacks associated with PTSD, depressed adults who experience suicidal ideation often report “flash forward” imagery related to suicidal acts (4), motivating them to self-harm. Socially anxious individuals who engage in visual imagery about giving a talk in public become more anxious and make more negative predictions about future performance than others who engage in more abstract, semantic processing of the past event (5). People with Obsessive Compulsive Disorder (OCD) frequently report imagery of past adverse events, and imagery seems to be associated with severity (6). The content of intrusive imagery has been related to psychotic symptoms (7), including visual images of the catastrophic fears associated with paranoia and persecution. Imagery has been argued (8) to play a role in the maintenance of psychosis through negative appraisals of imagined voices, misattribution of sensations to external sources, by the induction of negative mood states that trigger voices, and through maintenance of negative schemas. In addiction and substance dependence, Elaborated Intrusion (EI) Theory (9, 10) emphasizes the causal role that imagery plays in substance use, through its role in motivating an individual to pursue goals directed toward achieving the pleasurable outcomes associated with substance use...

Frailty: A key indicator to minimize inappropriate medication in older people

Older populations are more likely to have multiple co-morbid diseases that require multiple treatments, which make them a large consumer of medications. As a person grows older, their ability to tolerate medications becomes less due to age-related changes in pharmacokinetics and pharmacodynamics often heading along a path that leads to frailty. Frail older persons often have multiple co-morbidities with signs of impairment in activities of daily living. Prescribing drugs for these vulnerable individuals is difficult and is a potentially unsafe activity. Inappropriate prescribing in older population can be detected using explicit (criterion-based) or implicit (judgment-based) criteria. Unfortunately, most current therapeutic guidelines are applicable only to healthy older adults and cannot be generalized to frail patients. These discrepancies should be addressed either by developing new criteria or by refining the existing tools for frail older people. The first and foremost step is to identify the frail patient in clinical practice by applying clinically validated tools. Once the frail patient has been identified, there is a need for specific measures or criteria to assess appropriateness of therapy that consider such factors as quality of life, functional status and remaining life expectancy and thus modified goals of care.

Reliability and validity of objective measures of physical activity in youth with cerebral palsy who are ambulatory

BACKGROUND Physical therapy for youth with cerebral palsy (CP) who are ambulatory includes interventions to increase functional mobility and participation in physical activity (PA). Thus, reliable and valid measures are needed to document PA in youth with CP. OBJECTIVE The purpose of this study was to evaluate the inter-instrument reliability and concurrent validity of 3 accelerometer-based motion sensors with indirect calorimetry as the criterion for measuring PA intensity in youth with CP. METHODS Fifty-seven youth with CP (mean age=12.5 years, SD=3.3; 51% female; 49.1% with spastic hemiplegia) participated. Inclusion criteria were: aged 6 to 20 years, ambulatory, Gross Motor Function Classification System (GMFCS) levels I through III, able to follow directions, and able to complete the full PA protocol. Protocol activities included standardized activity trials with increasing PA intensity (resting, writing, household chores, active video games, and walking at 3 self-selected speeds), as measured by weight-relative oxygen uptake (in mL/kg/min). During each trial, participants wore bilateral accelerometers on the upper arms, waist/hip, and ankle and a portable indirect calorimeter. Intraclass coefficient correlations (ICCs) were calculated to evaluate inter-instrument reliability (left-to-right accelerometer placement). Spearman correlations were used to examine concurrent validity between accelerometer output (activity and step counts) and indirect calorimetry. Friedman analyses of variance with post hoc pair-wise analyses were conducted to examine the validity of accelerometers to discriminate PA intensity across activity trials. RESULTS All accelerometers exhibited excellent inter-instrument reliability (ICC=.94-.99) and good concurrent validity (rho=.70-.85). All accelerometers discriminated PA intensity across most activity trials. LIMITATIONS This PA protocol consisted of controlled activity trials. CONCLUSIONS Accelerometers provide valid and reliable measures of PA intensity among youth with CP.

Past-day recall of sedentary time: Validity of a self-reported measure of sedentary time in a university population

Background Sedentary behaviour is associated with several deleterious health consequences. Although device-based measures of sedentary time are available, they are costly and do not provide a measure of domain specific sedentary time. High quality self-report measures are necessary to accurately capture domain specific sedentary time, and to provide an alternative to devices when cost is an issue. In this study, the Past-day Adults’ Sedentary Time (PAST) questionnaire, previously shown to have acceptable validity and reliability in a sample of breast cancer survivors, was modified for a university sample and validity of the modified questionnaire was examined compared with activPAL. Methods Participants (n = 58, age = 18–55 years, 48% female, 66% students) were recruited from the University of Queensland (students and staff). They answered the PAST questionnaire, which asked about time spent sitting or lying down for work, study, travel, television viewing, leisure-time computer use, reading, eating, socialising and other purposes, during the previous day. Time reported for these questions was summed to provide a measure of total sedentary time. Participants also wore an activPAL device for the full day prior to completing the questionnaire and recorded their wake and sleep times in an activity log. Total waking sedentary time derived from the activPAL was used as the criterion measure. Correlation (Pearson's r) and agreement (Bland–Altman plots) between PAST and activPAL sedentary time were examined. Results Participants were sedentary (activPAL-determined) for approximately 66% of waking hours. The correlation between PAST and activPAL sedentary time for the whole sample was r = 0.50 [95% confidence interval (CI) = 0.28–0.67]; and higher for non-students (r = 0.63, 95% CI = 0.26–0.84) than students (r = 0.46, 95% CI = 0.16–0.68). Bland–Altman plots revealed that the mean difference between the two measures was 19 min although limits of agreement were wide (95% limits of agreement −4.1 to 4.7 h). Discussion The PAST questionnaire provides an acceptable measure of sedentary time in this population, which included students and adults with high workplace sitting. These findings support earlier research that questionnaires employing past-day recall of sedentary time provide a viable alternative to existing sedentary behaviour questionnaires.

Indigenous cultural landscapes: Equitably defining the 'authenticity' of the intangible

Over hundreds of generations, indigenous groups around the world have passed down their traditional landscape associations, a number of which are intangible and therefore unquantifiable. Yet, these associative relationships with nature have been, and continue to be, pivotal in cultural evolution. Determining the authenticity of intangible landscape associations has caused much controversy, and in recent decades, indigenous groups have begun seeking protection of their places of significance. In response, the United Nations Educational, Scientific and Cultural Organisation (UNESCO) World Heritage Committee (WHC) developed a criterion that intended to assist in the identification and protection of cultural landscapes. The WHC has therefore become the global authority responsible for determining the authenticity of cultural landscapes, including those with intangible associations rather than material cultural evidence. However, even with the support of the United Nations, UNESCO and the WHC, it is unlikely that every tangible cultural landscape will be sufficiently recognised and protected. Therefore, this research paper explores the effectiveness of current approaches to gauging authenticity in instances where multiple landscapes are valued according to similar characteristics. Further, this work studies the inherent relationship between the indigenous Maori population of the South Island of New Zealand, in particular Kai Tahi peoples, and their significant landscape features, as a means of considering the breadth and depth of historic intangible associations. In light of these findings, this research challenges the appropriateness of the term 'authenticity' when analysing not only the subjective, but more pressingly, the intangible. It therefore questions the role of empirical data in demonstrating authenticity, while recognising that a prolific list of such intangible cultural landscapes has the potential to diminish integrity. This, this paper addresses an urgent need for increased social research in this area, namely in identifying cultural landscape protection methods that empower all local indigenous communities, not just those which are the most critically acclaimed.

Contemplating Whitehead's freedom and discipline

This paper extends the previous application of Alfred Whitehead's educational ideas to the domain of enterprise education. In doing so, a unique approach to enterprise education is illustrated that links students to their reality whilst also connecting the curriculum to contemporary entrepreneurship theory. The paper reports upon past cycles of reflective practice related to the developing hic et nunc teaching and learning framework. Two specific findings of note have emerged. First, that student' learning outcomes are enhanced through the oscillating influence of freedom and discipline. However, in the absence of either factor, sub-optimal outcomes are seen to occur. That is, an imbalance between freedom and discipline has resulted in sub-optimal outcomes from either a lack of student interest or an inability to adequately apply acquired knowledge. Where gains have been made, the most obvious process has been through consultation with students. Second, that the students also play an important role in shaping the nature of the learning environments within which they interact. Both findings are of significant importance to all academics charged with the responsibility of developing enterprise education curriculum. The main implication of the paper is that in the absence of sound pedagogical practises, it is possible that enterprise programs may develop a tendency to reinforce past practises. The processes of constructive alignment and criterion-based assessment are argued to offer avenues through which students can influence the educational process. They also provide the educator with a reflective pathway through which continual improvements are constantly possible. This paper provides other academics with a window through which to view the ongoing development of a process that has been recognised nationally for teaching excellence and influenced many fine young entrepreneurs. The paper also draws attention to a set of core educational philosophies that have transferable value to any academic setting. It is noted that the task of developing a learner-centred curriculum for enterprise education has been an entrepreneurial endeavour in itself. Many mistakes have been made and many memorable achievements have been celebrated.

Career Adapt-Abilities Scale—Iran Form: Psychometric properties and relationships with career satisfaction and entrepreneurial intentions

This study examined the psychometric properties of a Persian translation of the Career Adapt-Abilities Scale (CAAS—Iran Form) and its relationships with career satisfaction, business opportunity identification, and entrepreneurial intentions. It was hypothesized that career adaptability relates positively to these three outcomes, even when controlling for demographic and employment characteristics. Data were provided by 204 workers from Iran. Results showed that the overall CAAS score and sub-dimension scores (concern, control, curiosity, and confidence) were highly reliable. Moreover, confirmatory factor analyses indicated that the CAAS—Iran Form measures four distinct dimensions that can be combined into a higher-order career adaptability factor. Findings also demonstrated criterion-related validity of the scale with regard to career satisfaction and entrepreneurial intentions. In contrast, overall career adaptability was not significantly related to opportunity identification, while concern related positively, and control related negatively to opportunity identification. Overall, the CAAS—Iran Form has very good psychometric properties and predicts important career outcomes, suggesting that it can be used for career counseling and future research with Persian-speaking workers.

Bringing nature to schools to promote children’s physical activity

Physical activity (PA) is essential for human health and wellbeing across all age, socioeconomic and ethnic groups. Engagement with the natural world is a new defining criterion for enhancing the benefits of PA particularly for children and young people. Interacting with nature benefits children’s social and emotional wellbeing, develops resilience and reduces the risk of obesity and type 2 diabetes across all population groups. Governments around the world are now recognising the importance of children spending more active time outdoors. However, children’s outdoor activities, free play and nature-related exploration are often structured and supervised by adults due to safety concerns and risks. In this context schools become more accessible and safe options for children to engage in PA outdoors with the presence of nature features. Research on school designs involving young children has revealed that children prefer nature-related features in school environments. Affordances in nature may increase children’s interest in physically active behaviours. Given that present school campuses are designed for operational efficiency and economic reasons there is a need to re-design schools responding to the positive role of nature on human health. If schools were re-designed to incorporate diverse natural features children’s PA and consequent health and wellbeing would likely improve markedly.

Effect of temperature and precipitation on salmonellosis cases in South-East Queensland, Australia: An observational study

Objective Foodborne illnesses in Australia, including salmonellosis, are estimated to cost over $A1.25 billion annually. The weather has been identified as being influential on salmonellosis incidence, as cases increase during summer, however time series modelling of salmonellosis is challenging because outbreaks cause strong autocorrelation. This study assesses whether switching models is an improved method of estimating weather–salmonellosis associations. Design We analysed weather and salmonellosis in South-East Queensland between 2004 and 2013 using 2 common regression models and a switching model, each with 21-day lags for temperature and precipitation. Results The switching model best fit the data, as judged by its substantial improvement in deviance information criterion over the regression models, less autocorrelated residuals and control of seasonality. The switching model estimated a 5°C increase in mean temperature and 10 mm precipitation were associated with increases in salmonellosis cases of 45.4% (95% CrI 40.4%, 50.5%) and 24.1% (95% CrI 17.0%, 31.6%), respectively. Conclusions Switching models improve on traditional time series models in quantifying weather–salmonellosis associations. A better understanding of how temperature and precipitation influence salmonellosis may identify where interventions can be made to lower the health and economic costs of salmonellosis.

Toward principles of construct clarity: Exploring the usefulness of facet theory in guiding conceptualization

Conceptualization in theory development has received limited consideration despite its frequently stressed importance in Information Systems research. This paper focuses on the role of construct clarity in conceptualization, arguing that construct clarity should be considered an essential criterion for evaluating conceptualization and that a focus on construct clarity can advance conceptualization methodology. Drawing from Facet Theory literature, we formulate a set of principles for assessing construct clarity, particularly regarding a construct’s relationships to its extant related constructs. Conscious and targeted attention to this criterion can promote a research ecosystem more supportive of knowledge accumulation.

Forecasting day-ahead electricity load using a multiple equation time series approach

The quality of short-term electricity load forecasting is crucial to the operation and trading activities of market participants in an electricity market. In this paper, it is shown that a multiple equation time-series model, which is estimated by repeated application of ordinary least squares, has the potential to match or even outperform more complex nonlinear and nonparametric forecasting models. The key ingredient of the success of this simple model is the effective use of lagged information by allowing for interaction between seasonal patterns and intra-day dependencies. Although the model is built using data for the Queensland region of Australia, the method is completely generic and applicable to any load forecasting problem. The model’s forecasting ability is assessed by means of the mean absolute percentage error (MAPE). For day-ahead forecast, the MAPE returned by the model over a period of 11 years is an impressive 1.36%. The forecast accuracy of the model is compared with a number of benchmarks including three popular alternatives and one industrial standard reported by the Australia Energy Market Operator (AEMO). The performance of the model developed in this paper is superior to all benchmarks and outperforms the AEMO forecasts by about a third in terms of the MAPE criterion.

Automated Discovery of Structured Process Models: Discover Structured vs. Discover and Structure

This paper addresses the problem of discovering business process models from event logs. Existing approaches to this problem strike various tradeoffs between accuracy and understandability of the discovered models. With respect to the second criterion, empirical studies have shown that block-structured process models are generally more understandable and less error-prone than unstructured ones. Accordingly, several automated process discovery methods generate block-structured models by construction. These approaches however intertwine the concern of producing accurate models with that of ensuring their structuredness, sometimes sacrificing the former to ensure the latter. In this paper we propose an alternative approach that separates these two concerns. Instead of directly discovering a structured process model, we first apply a well-known heuristic technique that discovers more accurate but sometimes unstructured (and even unsound) process models, and then transform the resulting model into a structured one. An experimental evaluation shows that our “discover and structure” approach outperforms traditional “discover structured” approaches with respect to a range of accuracy and complexity measures.