Identifying the psychosexual implications of radical radiation treatment in prostate cancer

The purpose of this study was to determine whether there was any evidence of psychosexual morbidity among men who experienced radical radiation treatment for prostate cancer. With relatively little known or available retrospective data on the psychosexual implications of radical radiation treatment in men with prostate cancer, this study posited eight research questions which provided the basis for the research. Fifty men from Southern Ontario, between the ages of 52 to 78 years, were included in the study. They had been previously randomized to a clinical trial comparing radical radiation therapy by external beam radiation, or radical radiation using a combination of a temporary iridium implant plus external beam radiation, for localized or locally advanced prostate cancer. Assessment of sexual functioning, drive, attitudes, body image, and sexual satisfaction was drawn from a multidimensional approach, since psychosexuality was viewed as having an impact on biological, psychological, and sociological domains of functioning. Medical chart reviews, semi-structured interviews, demographical profiles of each participant, and the Derogatis Sexual Functioning Inventory (DSFI) were the methods used to collect data over a four-month period. Both quantitative and qualitative research methods were incorporated in the design and evaluation of the study. Frequencies, contingency analysis, Pearson's coefficient of correlation, t-tests, and ANOVA comprised the quantitative analysis. Data obtained from audio-taped interviews were analyzed qualitatively, and used for offering further insight and for facilitating the quantitative aspect of the analysis. Overall, there was sufficient evidence to suggest psychosexual morbidity among men who were treated with radiation therapy for prostate cancer. As well,there were a number of significant findings available to answer all of the posited research questions. The most significant findings were noted in post-treatment erectile ability and sexual activity. A post-treatment change in erectile ability was reported by eighty percent of men. Sixty percent of men noted a decrease in their ability to achieve an erection by reporting some morning stiffness only, penile rigidity insufficient for penetration, decreased control of erection, and loss of spontaneous erection. Other contributing factors associated with change in erectile status were: pain or altering sensation of orgasm, blood in ejaculate, pain and decreased amount of ejaculate, and penile numbness or pain. Eighty-two percent of men experienced a post-treatment change in sexual function, primarily due to the impact of decreasing erectile status. Only seven men reported that they experienced a decrease in desire mentally, whereas the vast majority did not experience any change in desire. Changes in foreplay, stress with optimal sexual positioning, and reduced spontaneity of sex, were other factors reported with the changes in sexual activity. The findings in this study broaden our understanding of what middle- to later-aged men feel and experience as they venture onward following treatment. This was the first study that evaluated available prospective data on pre-treatment erectile status and sexual activity. As well, this study was the first (with participant compliance rates of 100 percent) to have included an interview format to capture the views of such a large number of men. This study concluded with recommendations and implications for future research and practice as we move in the direction of understanding what is necessary for preserving psychosexual well being and enhancing quality of life in men treated with radiation therapy for prostate cancer.

Developmental and individual differences in novelty and error detection in 10-year-old children and young adults /

Event-related potentials were recorded from 10-year-old children and young adults in order to examine the developmental dififerences in two frontal lobe functions: detection of novel stimuli during an auditory novelty oddball task, and error detection during a visual flanker task. All participants showed a parietally-maximal P3 in response to auditory stimuli. In children, novel stimuli generated higher P3 amplitudes at the frontal site compared with target stimuli, whereas target stimuli generated higher P3 amplitudes at the parietal site compared with novel stimuli. Adults, however, had higher P3 amplitude to novel tones compared with target tones at each site. Children also had greater P3 amplitude at more parietal sites than adults during the novelty oddball and flanker tasks. Furthermore, children and adults did not show a significant reduction in P3 amplitude from the first to second novel stimulus presentation. No age differences were found with respect to P3 latency to novel and target stimuli. These findings suggest that the detection of novel and target stimuli is mature in 10-year-olds. Error trials typically elicit a negative ERP deflection (the ERN) with a frontal-central scalp distribution that may reflect response monitoring. There is also evidence of a positive ERP peak (the Pe) with a posterior scalp distribution which may reflect subjective recognition of a response. Both children and adults showed an ERN and Pe maximal at frontal-central sites. Children committed more errors, had smaller ERN across sites, and had a larger Pe at the parietal site than adults. This suggests that response monitoring is still immature in 10-year-olds whereas recognition of and emotional responses to errors may be similar in children and adults.

Managing Risk in a Culture of Rights: Providing Support and Treatment in Community-Based Settings for Persons with Intellectual Disabilities who Sexually Offend

People with intellectual disability who sexually offend commonly live in community-based settings since the closing of all institutions across the province of Ontario. Nine (n=9) front line staff who provide support to these individuals in three different settings (treatment setting, transitional setting, residential setting) were interviewed. Participants responded to 47 questions to explore how sex offenders with intellectual disability can be supported in the community to prevent re-offenses. Questions encompassed variables that included staff attitudes, various factors impacting support, structural components of the setting, quality of life and the good life, staff training, staff perspectives on treatment, and understanding of risk management. Three overlapping models that have been supported in the literature were used collectively for the basis of this research: The Good Lives Model (Ward & Gannon, 2006; Ward et al., 2007), the quality of life model (Felce & Perry, 1995), and variables associated with risk management. Results of this research showed how this population is being supported in the community with an emphasis on the following elements: positive and objective staff attitude, teamwork, clear rules and protocols, ongoing supervision, consistency, highly trained staff, and environments that promote quality of life. New concepts arose which suggested that all settings display an unequal balance of upholding human rights and managing risks when supporting this high-risk population. This highlights the need for comprehensive assessments in order to match the offender to the proper setting and supports, using an integration of a Risk, Need, Responsivity model and the Good Lives model for offender rehabilitation and to reduce the likelihood of re-offenses.

The doing and undoing of global literature : myth, microcosm and atopia in triestine writing

La présente étude conduit les traditions fragmentées de la culture littéraire de Trieste vers les préoccupations contemporaines de la littérature mondiale à l’époque actuelle où la mondialisation est largement perçue comme le paradigme historique prédominant de la modernité. Ce que j’appelle la « littérature globalisée » renvoie à la refonte de la Weltliteratur – envisagée par Goethe et traduite comme « world literature » ou la « littérature universelle » – par des discours sur la culture mondiale et le post-nationalisme. Cependant, lorsque les études littéraires posent les questions de la « littérature globalisée », elles sont confrontées à un problème : le passage de l’idée universelle inhérente au paradigme de Goethe entre le Scylla d’un internationalisme relativiste et occidental, et le Charybde d’un mondialisme atopique et déshumanisé. Les spécialistes de la littérature mondiale qui tendent vers la première position acquièrent un fondement institutionnel en travaillant avec l’hypothèse implicite selon laquelle les nations sont fondées sur les langues nationales, ce qui souscrit à la relation entre la littérature mondiale et les littératures nationales. L’universalité de cette hypothèse implicite est réfutée par l’écriture triestine. Dans cette étude, je soutiens que l’écriture triestine du début du XXe siècle agit comme un précurseur de la réflexion sur la culture littéraire globalisée du XXIe siècle. Elle dispose de sa propre économie de sens, de sorte qu’elle n’entre pas dans les nationalismes littéraires, mais elle ne tombe pas non plus dans le mondialisme atopique. Elle n’est pas catégoriquement opposée à la littérature nationale; mais elle ne permet pas aux traditions nationales de prendre racine. Les écrivains de Triestine exprimaient le désir d’un sentiment d’unité et d’appartenance, ainsi que celui d’une conscience critique qui dissout ce désir. Ils résistaient à l’idéalisation de ces particularismes et n’ont jamais réussi à réaliser la coalescence de ses écrits dans une tradition littéraire unifiée. Par conséquent, Trieste a souvent été considérée comme un non-lieu et sa littérature comme une anti-littérature. En contournant les impératifs territoriaux de la tradition nationale italienne – comme il est illustré par le cas de Italo Svevo – l’écriture triestine a été ultérieurement incluse dans les paramètres littéraires et culturels de la Mitteleuropa, où son expression a été imaginée comme un microcosme de la pluralité supranationale de l’ancien Empire des Habsbourg. Toutefois, le macrocosme projeté de Trieste n’est pas une image unifiée, comme le serait un globe; mais il est plutôt une nébuleuse planétaire – selon l’image de Svevo – où aucune idéalisation universalisante ne peut se réaliser. Cette étude interroge l’image de la ville comme un microcosme et comme un non-lieu, comme cela se rapporte au macrocosme des atopies de la mondialisation, afin de démontrer que l’écriture de Trieste est la littérature globalisée avant la lettre. La dialectique non résolue entre faire et défaire la langue littéraire et l’identité à travers l’écriture anime la culture littéraire de Trieste, et son dynamisme contribue aux débats sur la mondialisation et les questions de la culture en découlant. Cette étude de l’écriture triestine offre des perspectives critiques sur l’état des littératures canoniques dans un monde où les frontières disparaissent et les non-lieux se multiplient. L’image de la nébuleuse planétaire devient possiblement celle d’un archétype pour le monde globalisé d’aujourd’hui.

Correcting Measurement Error Bias in Interaction Models with Small Samples

Several methods have been suggested to estimate non-linear models with interaction terms in the presence of measurement error. Structural equation models eliminate measurement error bias, but require large samples. Ordinary least squares regression on summated scales, regression on factor scores and partial least squares are appropriate for small samples but do not correct measurement error bias. Two stage least squares regression does correct measurement error bias but the results strongly depend on the instrumental variable choice. This article discusses the old disattenuated regression method as an alternative for correcting measurement error in small samples. The method is extended to the case of interaction terms and is illustrated on a model that examines the interaction effect of innovation and style of use of budgets on business performance. Alternative reliability estimates that can be used to disattenuate the estimates are discussed. A comparison is made with the alternative methods. Methods that do not correct for measurement error bias perform very similarly and considerably worse than disattenuated regression

Clinical experience of clobazam as add-on treatment in a cohort of adults with epilepsy

Objective: Epilepsy is a common neurologic disorder affecting 1% of the world population with one-third of these patients failing to have seizure control for more than one year. Clobazam is a long-acting benzodiazepine used worldwide for the treatment of epilepsy. This antiepileptic drug has demonstrated great clinical benefits with mild side effects. The objective of this study was to better understand the efficacy of clobazam treatment on adult patients with refractory epilepsy. Design: A retrospective review of 44 adult patients with diagnosis of epilepsy that were seen at our Epilepsy Clinic between January 2014 and May 2015. Setting: An outpatient epilepsy clinic at the Hospital Universitario Fundación Santa Fe de Bogota, Colombia. Participants: 44 adult patients with diagnosis of epilepsy. Measurements: Seizure frequency, adverse effects and the use of concomitant AEDs were reviewed in each of the patient´s clinical charts. Results: The responder rate of patients with clobazam was 52% at 3 months, 50% at 6 months and 55% at 12 month. Seizure freedom rates at 3, 6 and 12 months were 18%, 25% and 25% respectively. Clobazam related adverse events occurred only in four patients (9%) at the end of the twelve months with somnolence being the most common. Conclusion: These findings suggest that clobazam treatment in adult patients with focal or generalized epilepsy is effective and safe. Its use should be considered early when first-line agents fail to provide seizure control.

Combination treatment in the rehabilitation of visuo-spatial neglect

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Can wavelets improve the representation of forecast error covariances in variational data assimilation?

Two wavelet-based control variable transform schemes are described and are used to model some important features of forecast error statistics for use in variational data assimilation. The first is a conventional wavelet scheme and the other is an approximation of it. Their ability to capture the position and scale-dependent aspects of covariance structures is tested in a two-dimensional latitude-height context. This is done by comparing the covariance structures implied by the wavelet schemes with those found from the explicit forecast error covariance matrix, and with a non-wavelet- based covariance scheme used currently in an operational assimilation scheme. Qualitatively, the wavelet-based schemes show potential at modeling forecast error statistics well without giving preference to either position or scale-dependent aspects. The degree of spectral representation can be controlled by changing the number of spectral bands in the schemes, and the least number of bands that achieves adequate results is found for the model domain used. Evidence is found of a trade-off between the localization of features in positional and spectral spaces when the number of bands is changed. By examining implied covariance diagnostics, the wavelet-based schemes are found, on the whole, to give results that are closer to diagnostics found from the explicit matrix than from the nonwavelet scheme. Even though the nature of the covariances has the right qualities in spectral space, variances are found to be too low at some wavenumbers and vertical correlation length scales are found to be too long at most scales. The wavelet schemes are found to be good at resolving variations in position and scale-dependent horizontal length scales, although the length scales reproduced are usually too short. The second of the wavelet-based schemes is often found to be better than the first in some important respects, but, unlike the first, it has no exact inverse transform.

Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers

Acute doses of Ginkgo biloba have been shown to improve attention and memory in young, healthy participants, but there has been a lack of investigation into possible effects on executive function. In addition, only one study has investigated the effects of chronic treatment in young volunteers. This study was conducted to compare the effects of ginkgo after acute and chronic treatment on tests of attention, memory and executive function in healthy university students. Using a placebo-controlled double-blind design, in experiment 1, 52 students were randomly allocated to receive a single dose of ginkgo (120 mg, n=26) or placebo (n=26), and were tested 4h later. In experiment 2, 40 students were randomly allocated to receive ginkgo (120 mg/day; n=20) or placebo (n=20) for a 6-week period and were tested at baseline and after 6 weeks of treatment. In both experiments, participants underwent tests of sustained attention, episodic and working memory, mental flexibility and planning, and completed mood rating scales. The acute dose of ginkgo significantly improved performance on the sustained-attention task and pattern-recognition memory task; however, there were no effects on working memory, planning, mental flexibility or mood. After 6 weeks of treatment, there were no significant effects of ginkgo on mood or any of the cognitive tests. In line with the literature, after acute administration ginkgo improved performance in tests of attention and memory. However, there were no effects after 6 weeks, suggesting that tolerance develops to the effects in young, healthy participants.