Catastrophic reaction in acute stroke: a reflex behavior in aphasic patients.

Twelve patients with a catastrophic reaction (CR) (an outburst of frustration, depression, and anger when confronted with a task) were identified in a prospective cohort population (n = 326) with first-ever stroke admitted within 48 hours from onset. The authors' findings suggest that CR is a rare though not exceptional phenomenon in acute stroke and is associated with nonfluent aphasias and left opercular lesions. CR, poststroke depression, and emotionalism are distinct but related disorders.

Assessing attachment cognitions and their associations with depression in youth with eating or drug misuse disorders.

The study investigates associations between attachment cognitions and depression symptoms in 71 15-25-year-olds, 26 of whom have eating disorders, and 20 of whom are drug misusers. Attachment cognitions were measured with the CaMir Q-sort, which provides indexes for secure, avoidant, and preoccupied attachment, as well as scores on 13 dimensions. The BDI-13 was used to measure depressive symptomatology. Consistent with the literature, BDI scores were associated with cognitions of preoccupied attachment. They were also related to cognitions of avoidant attachment, confirming Bowlby's theory on defensive exclusion. For participants with eating disorders, depressive symptomatology was related to preoccupation and parental interference, whereas for drug misusers, it was negatively related to security, preoccupation, parental support, and lack of parental concern. These findings help understand how attachment cognitions may participate in depressive symptomatology, namely in youth whose behavior problems may be associated with specific attachment experiences.

Technical note: Implementation of a geodatabase of published and unpublished data on the catastrophic Vaiont landslide

On 9 October 1963 a catastrophic landslide suddenly occurred on the southern slope of the Vaiont dam reservoir. A mass of approximately 270 million m3 collapsed into the reservoir generating a wave that overtopped the dam and hit the town of Longarone and other villages nearby. Several investigations and interpretations of the slope collapse have been carried out during the last 45 years, however, a comprehensive explanation of both the triggering and the dynamics of the phenomenon has yet to be provided. In order to re-evaluate the currently existing information on the slide, an electronic bibliographic database and an ESRI-geodatabase have been developed. The chronology of the collected documentation showed that most of the studies for re-evaluating the failure mechanisms were conducted in the last decade, as a consequence of knowledge, methods and techniques recently acquired. The current contents of the geodatabase will improve definition of the structural setting that influenced the slide and led to the the propagation of the displaced rock mass. The objectives, structure and contents of the e-bibliography and Geodatabase are indicated, together with a brief description on the possible use of the alphanumeric and spatial contents of the databases.

Catastrophic medical expenditure risk

Medical expenditure risk can pose a major threat to living standards. We derive decomposable measures of catastrophic medical expenditure risk from reference-dependent utility with loss aversion. We propose a quantile regression based method of estimating risk exposure from cross-section data containing information on the means of financing health payments. We estimate medical expenditure risk in seven Asian countries and find it is highest in Laos and China, and is lowest in Malaysia. Exposure to risk is generally higher for households that have less recourse to self-insurance, lower incomes, wealth and education, and suffer from chronic illness.

On Strong Citizens: A Sociological View on Cognitions and Contentious Participation

The present thesis is about cognitions of left-wing activists and the role they play to better understand contentious participation. It compares activists of three post-industrial social movement organizations in Switzerland, i.e. Solidarity across Borders defending migrant's rights, the Society of Threatened People promoting collective human rights and Greenpeace protecting the environment. It makes use of an innovative mixed methods design combining survey and interview data. The main theoretical contribution is to conceptualize an analytical tool enabling to grasp the cognitive map of these activists by putting forward the concept of strong citizen, summing up their relation to society and politics. The relation to society consists of an extensive relation to others and an interconnected vision of society. Consequently, their primary concerns include the handing of common goods and the equal treatment of individuals with regard to common goods. The relation to politics incorporates a critical and vigilant citizen. They are critical towards political authorities and they appreciate political action by organized groups of the civil society. The thesis states that only by having such worldviews activists are able to construct an injustice, agency and identity frame for the claims of their organizations. Thus, the present work delivers a parsimonious answer to the question of where an injustice, agency and identity frame comes from. It does so by a systematic analysis of four specific arguments. First, it empirically demonstrates that these activists have - at the aggregate level - specific cognitive resources compared to the general population. Second, it describes the content of this specific cognitive outlook by evaluating the appropriateness of the strong citizen concept. Third, it looks at variations between activist's communities and shows that activists of more challenging protest issues are stronger citizens than activists of more mainstream protests. Finally, cognitions are not the only part of the story if one looks at contentious participation. Other factors, i.e. social networks and biographical availability, matter too. Therefore, I test if cognitions are able to contribute in explaining differences between activists' communities if one controls for other factors. In sum, this thesis is thus a first step to demonstrate why one should be concerned about activists' cognitions. - Cette thèse s'intéresse aux cognitions des activistes de gauche et à leur rôle dans le phénomène de la participation contestataire. Des activistes de trois organisations post- industrielles en Suisse sont comparé, à savoir Solidarité sans Frontières qui défend les droits des migrants, la Société des Peuples menacés qui promeut les droits des collectivités minoritaires et Greenpeace qui oeuvre pour la protection de l'environnement. Cette recherche utilise un « mixed methods design » en combinant de manière innovant des données de sondage et d'entretiens. Ma principale contribution théorique réside dans la conceptualisation d'un outil analytique qui permet de saisir la « carte cognitive » des activistes, à travers le concept de « strong citizen » qui se réfère à la relation spécifique qu'entretiennent certains individus avec la société et la politique. Ces individus sont caractérisés par une vision inclusive et interconnectée de la société, ainsi que par une conception politique du citoyen comme critique et vigilant. Mon argument principal est celui selon lequel seuls les individus possédant ce type particulier de cognitions sont capable de construire un cadre d'injustice, d'« agency » et d'identité. Cette thèse apporte donc quelques éléments de réponse à la question de l'origine de ces cadres cognitifs qui sont cruciales pour la participation. Pour ce faire, quatre aspects spécifiques sont analysés de manière systématique. Premièrement, je démontre empiriquement, au niveau agrégé, que ces activistes possèdent effectivement des ressources cognitives spécifiques - en comparaison avec la population générale. Deuxièmement, j'analyse le contenu de ces cognitions, ce qui me permet notamment d'évaluer la pertinence et l'adéquation du concept de « strong citizen ». Troisièmement, en m'intéressant cette fois aux variations entre communautés d'activistes, je démontre que ceux réunis autour d'enjeux protestataires très revendicatifs sont, d'un point de vue cognitif, plus proches de la figure du « strong citizen » que ceux mobilisés sur des enjeux plus consensuels. Finalement, d'autres facteurs, à savoir les réseaux sociaux et la disponibilité biographique, sont intégrés à l'analyse afin de mesurer le réel pouvoir explicatif des cognitions dans l'explication des différences observées entre communautés d'activistes. A travers ces analyses, cette thèse met en avant l'importance du rôle des cognitions dans l'étude de la participation contestataire.

A measure of dysfunctional eating-related cognitions in people with psychotic disorders.

Obesity and binge eating disorder are common in individuals with psychotic disorders. Eating and weight-related cognitions are known to influence eating behaviors. The study was designed to assess the psychometric properties of the Mizes Anorectic Cognitions Questionnaire (MAC-R) in patients with psychotic disorders. Binge eating disorder (BED), body mass index (BMI), the MAC-R and the three factor eating questionnaire (TFEQ) were assessed in 125 patients with a diagnosis of schizophrenia or schizoaffective disorder. Whereas the MAC-R has not acceptable psychometric properties, a brief version of the MAC-R (BMAC) has good psychometrical properties and is correlated with TFEQ and BMI. Binge eating disorder is also correlated to the Rigid Weight Regulation and Fear of Weight Gain subscale. The BMAC is a useful brief measure to assess eating and weight related cognitions in people with psychotic disorders.

Eating and weight related cognitions in people with Schizophrenia: a case control study

ABSTRACT: BACKGROUND: Patients with antipsychotic-induced weight gain (WG) regularly report on unsuccessful dietary trials, which suggests strong biological weight gain drive that is extremely hard to overcome with thoughts, such that behaviour doesn't change despite some intent to change. The purpose of the present study was to assess cognitions specifically related to restrained eating in severely overweight patients with schizophrenia treated with antipsychotic drugs. METHODS: Forty outpatients with schizophrenia and 40 controls without psychiatric disability were included. Both groups were composed of one subgroup severely overweight (defined as a BMI > 28), and a comparison sample (BMI<28). The revised version of the Mizes Anorectic cognitive questionnaire (MAC-R) was used in this cross-sectional case-control study. RESULTS: Gender was significantly related to eating disorders cognition, women scoring higher than men. Patients with schizophrenia in general scored higher on the MAC-R total scale and on the MAC-R subscale 2, the latter score representing rigid weight regulation and fear of weight gain. When comparing the two groups of subjects with BMI < 28, it appeared that patients with schizophrenia also scored higher on MAC-R total scale, the subscales 2 and 3, the latter subscale 3, indicating altered self control and self-esteem. CONCLUSION: As is the case in weight gain of subjects without schizophrenia, the present results suggest that the cognitive distortions, as assessed by the MAC-R, may play an important role in weight gain also in patients with schizophrenia, and in weight gain associated with antipsychotic pharmacotherapy. Particular attention to these processes may help to improve the management of antipsychotic drugs induced weight gain

Reversible behavioural autistic-like regression: A manifestation of a special (new?) epileptic syndrome in a 28-month-old child. A 2-year longitudinal study .

A 28-month-old boy was referred for acute onset of abnormal head movements. History revealed an insidious progressive regression in behaviour and communication over several months. Head and shoulder 'spasms' with alteration of consciousness and on one occasion ictal laughter were seen. The electroencephalograph (EEG) showed repeated bursts of brief generalized polyspikes and spike-wave during the 'spasms', followed by flattening, a special pattern which never recurred after treatment. Review of family videos showed a single 'minor' identical seizure 6 months previously. Magnetic resonance imaging was normal. Clonazepam brought immediate cessation of seizures, normalization of the EEG and a parallel spectacular improvement in communication, mood and language. Follow-up over the next 10 months showed a new regression unaccompained by recognized seizures, although numerous seizures were discovered during the videotaped neuropsychological examination, when stereotyped subtle brief paroxysmal changes in posture and behaviour could be studied in slow motion and compared with the 'prototypical' initial ones. The EEG showed predominant rare left-sided fronto-temporal discharges. Clonazepam was changed to carbamazepin with marked improvement in behaviour, language and cognition which has been sustained up to the last control at 51 months. Videotaped home observations allowed the documentation of striking qualitative and quantitative variations in social interaction and play of autistic type in relation to the epileptic activity. We conclude that this child has a special characteristic epileptic syndrome with subtle motor and vegetative symptomatology associated with an insidious catastrophic 'autistic-like' regression which could be overlooked. The methods used to document such fluctuating epileptic behavioural manifestations are discussed.

L'exploitation des eaux souterraines en Syrie centrale : construction de diagnostics et politiques d'intervention

Syrian dry areas have been for several millennia a place of interaction between human populations and the environment. If environmental constraints and heterogeneity condition the human occupation and exploitation of resources, socio-political, economic and historical elements play a fundamental role. Since the late 1980s, Syrian dry areas are viewed as suffering a serious water crisis, due to groundwater overdraft. The Syrian administration and international development agencies believe that groundwater overexploitation is also leading to a decline of agricultural activities and to poverty increase. Action is thus required to address these problems.However, the overexploitation diagnosis needs to be reviewed. The overexploitation discourse appears in the context of Syria's opening to international organizations and to the market economy. It echoes the international discourse of "global water crisis". The diagnosis is based on national indicators recycling old Soviet data that has not been updated. In the post-Soviet era, the Syrian national water policy seems to abandon large surface water irrigation projects in favor of a strategy of water use rationalization and groundwater conservation in crisis regions, especially in the district of Salamieh.This groundwater conservation policy has a number of inconsistencies. It is justified for the administration and also probably for international donors, since it responds to an indisputable environmental emergency. However, efforts to conserve water are anecdotal or even counterproductive. The water conservation policy appears a posteriori as an extension of the national policy of food self-sufficiency. The dominant interpretation of overexploitation, and more generally of the water crisis, prevents any controversary approach of the status of resources and of the agricultural system in general and thus destroys any attempt to discuss alternatives with respect to groundwater management, allocation, and their inclusion in development programs.A revisited diagnosis of the situation needs to take into account spatial and temporal dimensions of the groundwater exploitation and to analyze the co-evolution of hydrogeological and agricultural systems. It should highlight the adjustments adopted to cope with environmental and economic variability, changes of water availability and regulatory measures enforcements. These elements play an important role for water availability and for the spatial, temporal, sectoral allocation of water resource. The groundwater exploitation in the last century has obviously had an impact on the environment, but the changes are not necessarily catastrophic.The current groundwater use in central Syria increases the uncertainty by reducing the ability of aquifers to buffer climatic changes. However, the climatic factor is not the only source of uncertainty. The high volatility of commodity prices, fuel, land and water, depending on the market but also on the will (and capacity) of the Syrian State to preserve social peace is a strong source of uncertainty. The research should consider the whole range of possibilities and propose alternatives that take into consideration the risks they imply for the water users, the political will to support or not the local access to water - thus involving a redefinition of the economic and social objectives - and finally the ability of international organizations to reconsider pre-established diagnoses.

Stratigraphic significance of siliceous microfossils collected during Nautiperc dives (Off Peru, 5°-6° S)

The geological evolution of the northern Peru convergent margin can be traced using samples collected during deep-sea dives of the submersible Nautile. In the Paita area (5 degrees-6 degrees S), the sedimentary sequence was intensively sampled along the main scarp of the middle slope area. It consists of Upper Miocene (7-9 Ma) to Pleistocene siltstone, sandstone and rare dolostone. The age distribution of these samples is the basis for a new geologic interpretation of the multichannel seismic line CDP3. Siliceous microfossils (both diatoms and radiolarians) show influence of both cold and temperate waters (local species mixed with upwelling ones). Diatom assemblages studied from the NP1-13 and NP1-15 dives bear a strong resemblance to assemblages from the Pisco Formation of southern Peru. Micropaleontological data from siliceous microfossils, provide evidence for two main unconformities, one is at the base of the Quaternary sequence and the other corresponds to a hiatus of 1 Myr, separating the Upper Miocene (7-8 Ma) sediments from uppermost Miocene (5-6 Ma) sediments. During the past 400 kyr, a wide rollover fold developed in the middle slope area associated with a major seaward dipping detachment fault. A catastrophic debris avalanche occurred as the result of an oversteepening of the landward flank of the rollover fold. The gravity failure of the slope, recognized by SeaBEAM and hydrosweep mapping, displaced enough material to produce a destructive tsunami which occurred 13.8 +/- 2.7 kyr ago.

Impact of severe epilepsy on development: Recovery potential after successful early epilepsy surgery.

Purpose: Epilepsy surgery in young children with focal lesions offers a unique opportunity to study the impact of severe seizures on cognitive development during a period of maximal brain plasticity, if immediate control can be obtained. We studied 11 children with early refractory epilepsy (median onset, 7.5 months) due to focal lesion who were rendered seizure-free after surgery performed before the age of 6 years. Methods: The children were followed prospectively for a median of 5 years with serial neuropsychological assessments correlated with electroencephalography (EEG) and surgery-related variables. Results: Short-term follow-up revealed rapid cognitive gains corresponding to cessation of intense and propagated epileptic activity [two with early catastrophic epilepsy; two with regression and continuous spike-waves during sleep (CSWS) or frontal seizures]; unchanged or slowed velocity of progress in six children (five with complex partial seizures and frontal or temporal cortical malformations). Longer-term follow-up showed stabilization of cognitive levels in the impaired range in most children and slow progress up to borderline level in two with initial gains. Discussion: Cessation of epileptic activity after early surgery can be followed by substantial cognitive gains, but not in all children. In the short term, lack of catch-up may be explained by loss of retained function in the removed epileptogenic area; in the longer term, by decreased intellectual potential of genetic origin, irreversible epileptic damage to neural networks supporting cognitive functions, or reorganization plasticity after early focal lesions. Cognitive recovery has to be considered as a "bonus," which can be predicted in some specific circumstances.