Schizotypy and hemispheric asymmetry: results from two Chapman scales, the O-LIFE questionnaire, and two laterality measures

Schizotypy is a multidimensional personality construct representing the extension of psychosis-like traits into the general population. Schizotypy has been associated with attenuated expressions of many of the same neuropsychological abnormalities as schizophrenia, including atypical pattern of functional hemispheric asymmetry. Unfortunately, the previous literature on links between schizotypy and hemispheric asymmetry is inconsistent with some research indicating that elevated schizotypy is associated with relative right over left hemisphere shifts, left over right hemisphere shifts, bilateral impairments, or with no hemispheric differences at all. This inconsistency may result from different methodologies, scales, and / or sex proportions between studies. In a within-participant design, we tested for the four possible links between laterality and schizotypy by comparing the relationship between two common self-report measures of multidimensional schizotypy (the O-LIFE questionnaire, and two Chapman scales, magical ideation and physical anhedonia) and performance in two computerized lateralised hemifield paradigms (lexical decision, chimeric face processing) in 80 men and 79 women. Results for the two scales and two tasks did not unequivocally support any of the four possible links. We discuss the possibilities that a link between schizotypy and laterality 1) exists, but is subtle, probably fluctuating, unable to be assessed by traditional methodologies used here; 2) does not exist, or 3) is indirect, mediated by other factors (e.g. stress-responsiveness, handedness, drug use) whose influences need further exploration.

Accuracy of prehospital triage of trauma patients by emergency physicians: a retrospective study in western Switzerland.

OBJECTIVE: Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage.METHODS: Retrospective study of trauma patients triaged by physicians. Prehospital triage was analyzed using criteria defining major trauma victims (MTVs, Injury Severity Score >15, admission to ICU, need for immediate surgery and death within 48 h). Adequate triage was defined as MTVs oriented to the trauma centre or non-MTV (NMTV) oriented to regional hospitals.RESULTS: One thousand six hundred and eighti-five patients (blunt trauma 96%) were included (558 MTV and 1127 NMTV). Triage was adequate in 1455 patients (86.4%). Overtriage occurred in 171 cases (10.1%) and undertriage in 59 cases (3.5%). Sensitivity and specificity was 90 and 85%, respectively, whereas positive predictive value and negative predictive value were 75 and 94%, respectively. Using logistic regression analysis, significant (P<0.05) predictors of undertriage were head or thorax injuries (odds ratio >2.5). Predictors of overtriage were paediatric age group, pedestrian or 2 wheel-vehicle road traffic accidents (odds ratio >2.0).CONCLUSION: Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study.

Minimal clinically meaningful differences for the EORTC QLQ-C30 and EORTC QLQ-BN20 scales in brain cancer patients.

BACKGROUND: We aimed to determine the smallest changes in health-related quality of life (HRQoL) scores in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 and the Brain Cancer Module (QLQ-BN20), which could be considered as clinically meaningful in brain cancer patients. Materials and methods: World Health Organisation performance status (PS) and mini-mental state examination (MMSE) were used as clinical anchors appropriate to related subscales to determine the minimal clinically important differences (MCIDs) in HRQoL change scores (range 0-100) in the QLQ-C30 and QLQ-BN20. A threshold of 0.2 standard deviation (SD) (small effect) was used to exclude anchor-based MCID estimates considered too small to inform interpretation. RESULTS: Based on PS, our findings support the following integer estimates of the MCID for improvement and deterioration, respectively: physical (6, 9), role (14, 12), and cognitive functioning (8, 8); global health status (7, 4*), fatigue (12, 9), and motor dysfunction (4*, 5). Anchoring with MMSE, cognitive functioning MCID estimates for improvement and deterioration were (11, 2*) and for communication deficit were (9, 7). Estimates with asterisks were <0.2 SD and were excluded from our MCID range of 5-14. CONCLUSION: These estimates can help clinicians evaluate changes in HRQoL over time, assess the value of a health care intervention and can be useful in determining sample sizes in designing future clinical trials.

The family alliance assessment scales : steps toward validity and reliability of an observational assessment tool for early family interactions

We present the first steps in the validation of an observational tool for father-mother-infant interactions: the FAAS (Family Alliance Assessment Scales). Family-level variables are acknowledged as unique contributors to the understanding of the socio-affective development of the child, yet producing reliable assessments of family-level interactions poses a methodological challenge. There is, therefore, a clear need for a validated and clinically relevant tool. This validation study has been carried out on three samples: one non-referred sample, of families taking part in a study on the transition to parenthood (normative sample; n = 30), one referred for medically assisted procreation (infertility sample; n = 30) and one referred for a psychiatric condition in one parent (clinical sample; n = 15). Results show that the FAAS scales have (1) good inter-rater reliability and (2) good validity, as assessed through known-group validity by comparing the three samples and through concurrent validity by checking family interactions against parents' self-reported marital satisfaction.

Phosphorus burial in the ocean over glacial-interglacial time scales

The role of nutrients, such as phosphorus (P), and their impact on primary productivity and the fluctuations in atmospheric CO2 over glacial-interglacial periods are intensely debated. Suggestions as to the importance of P evolved from an earlier proposal that P actively participated in changing productivity rates and therefore climate change, to most recent ones that changes in the glacial ocean inventory of phosphorus were important but not influential if compared to other macronutrients, such as nitrate. Using new data coming from a selection of ODP sites, we analyzed the distribution of oceanic P sedimentary phases and calculate reactive P burial fluxes, and we show how P burial fluxes changed over the last glacial-interglacial period at these sites. Concentrations of reactive P are generally lower during glacial times, while mass accumulation rates (MAR) of reactive P show higher variability. If we extrapolate for the analyzed sites, we may assume that in general glacial burial fluxes of reactive P are lower than those during interglacial periods by about 8%, because the lack of burial of reactive P on the glacial shelf reduced in size, was apparently not compensated by burial in other regions of the ocean. Using the calculated changes in P burial, we evaluate their possible impact on the phosphate inventory in the world oceans. Using a simple mathematical approach, we find that these changes alone could have increased the phosphate inventory of glacial ocean waters by 17-40% compared to interglacial stages. Variations in the distribution of sedimentary P phases at the investigated sites seem to indicate that at the onset of interglacial stages, shallower sites experienced an increase in reactive P concentrations, which seems to point to P-richer waters at glacial terminations. All these findings would support the Shelf-Nutrient Hypothesis, which assumes that during glacial low stands nutrients are transferred from shallow sites to deep sea with possible feedback on the carbon cycle.

Maize yield and rainfall on different spatial and temporal scales in Southern Brazil

This study aimed to establish relationships between maize yield and rainfall on different temporal and spatial scales, in order to provide a basis for crop monitoring and modelling. A 16-year series of maize yield and daily rainfall from 11 municipalities and micro-regions of Rio Grande do Sul State was used. Correlation and regression analyses were used to determine associations between crop yield and rainfall for the entire crop cycle, from tasseling to 30 days after, and from 5 days before tasseling to 40 days after. Close relationships between maize yield and rainfall were found, particularly during the reproductive period (45-day period comprising the flowering and grain filling). Relationships were closer on a regional scale than at smaller scales. Implications of the crop-rainfall relationships for crop modelling are discussed.

A comparison of pain scales in Thai children.

Three commonly used pain scales, the visual analogue scale, the Wong-Baker Faces Pain Scale, and the Faces Pain Scale Revised were administered to 122 Thai children, of whom half were HIV infected, in order to assess their validity. These scales presented moderate to good correlation and moderate agreement, sufficient for valid use in Thai children.

Mapping the human connectome at multiple scales with diffusion spectrum MRI.

The global structural connectivity of the brain, the human connectome, is now accessible at millimeter scale with the use of MRI. In this paper, we describe an approach to map the connectome by constructing normalized whole-brain structural connection matrices derived from diffusion MRI tractography at 5 different scales. Using a template-based approach to match cortical landmarks of different subjects, we propose a robust method that allows (a) the selection of identical cortical regions of interest of desired size and location in different subjects with identification of the associated fiber tracts (b) straightforward construction and interpretation of anatomically organized whole-brain connection matrices and (c) statistical inter-subject comparison of brain connectivity at various scales. The fully automated post-processing steps necessary to build such matrices are detailed in this paper. Extensive validation tests are performed to assess the reproducibility of the method in a group of 5 healthy subjects and its reliability is as well considerably discussed in a group of 20 healthy subjects.

Scales and causes of heterogeneity in bars in a large multi-channel river: Rio Parana, Argentina

To date, published studies of alluvial bar architecture in large rivers have been restricted mostly to case studies of individual bars and single locations. Relatively little is known about how the depositional processes and sedimentary architecture of kilometre-scale bars vary within a multi-kilometre reach or over several hundreds of kilometres downstream. This study presents Ground Penetrating Radar and core data from 11, kilometre-scale bars from the Rio Parana, Argentina. The investigated bars are located between 30km upstream and 540km downstream of the Rio Parana - Rio Paraguay confluence, where a significant volume of fine-grained suspended sediment is introduced into the network. Bar-scale cross-stratified sets, with lengths and widths up to 600m and thicknesses up to 12m, enable the distinction of large river deposits from stacked deposits of smaller rivers, but are only present in half the surface area of the bars. Up to 90% of bar-scale sets are found on top of finer-grained ripple-laminated bar-trough deposits. Bar-scale sets make up as much as 58% of the volume of the deposits in small, incipient mid-channel bars, but this proportion decreases significantly with increasing age and size of the bars. Contrary to what might be expected, a significant proportion of the sedimentary structures found in the Rio Parana is similar in scale to those found in much smaller rivers. In other words, large river deposits are not always characterized by big structures that allow a simple interpretation of river scale. However, the large scale of the depositional units in big rivers causes small-scale structures, such as ripple sets, to be grouped into thicker cosets, which indicate river scale even when no obvious large-scale sets are present. The results also show that the composition of bars differs between the studied reaches upstream and downstream of the confluence with the Rio Paraguay. Relative to other controls on downstream fining, the tributary input of fine-grained suspended material from the Rio Paraguay causes a marked change in the composition of the bar deposits. Compared to the upstream reaches, the sedimentary architecture of the downstream reaches in the top ca 5m of mid-channel bars shows: (i) an increase in the abundance and thickness (up to metre-scale) of laterally extensive (hundreds of metres) fine-grained layers; (ii) an increase in the percentage of deposits comprised of ripple sets (to >40% in the upper bar deposits); and (iii) an increase in bar-trough deposits and a corresponding decrease in bar-scale cross-strata (<10%). The thalweg deposits of the Rio Parana are composed of dune sets, even directly downstream from the Rio Paraguay where the upper channel deposits are dominantly fine-grained. Thus, the change in sedimentary facies due to a tributary point-source of fine-grained sediment is primarily expressed in the composition of the upper bar deposits.

Clinical Utility of the 2 New Scales of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA): A Naturalistic, Prospective Study in a Psychiatric Unit for Adolescents.

OBJECTIVES: The goal of this study was to assess the clinical usefulness of the emotional symptoms (Emo) and externalizing problems (Ext) scales compared with the Total score on the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). METHODS: The HoNOSCA was rated at admission and discharge for 260 adolescent inpatients. The primary outcomes assessed were (a) the sensitivity of the 3 HoNOSCA scores to clinical improvement; and (b) the between diagnoses discriminative value of these scores. RESULTS: Analyses of variances [2 (time: admission vs. discharge) ×5 (diagnostic groups)] revealed a main effect of time for the 3 scores, a main effect of the diagnostic group for the Total and Ext scores, and an interaction effect between time and diagnosis for the Emo score. A moderate correlation was observed between the change in Ext and Emo scores between admission and discharge. DISCUSSION: These 2 new scales of the HoNOSCA demonstrated good clinical utility and the ability to assess different aspects of clinical improvements. A significant discriminative value of both scores was observed. SIGNIFICANT OUTCOMES: The clinical utility of the 2 new scales on the HoNOSCA was established. These 2 new scales provided a sensitive measure of clinical outcome for assessing improvement between admission and discharge on a psychiatric inpatient unit for adolescents, regardless of diagnostic group, and captured additional information about clinical improvements. Adolescents with psychosis and conduct disorders presented with higher externalizing symptoms than those with other disorders, as rated on the HoNOSCA, at admission and discharge. The Emo score differentiated between clinical improvement in patients with psychosis versus eating disorders. LIMITATIONS: The sample in this study represented a homogeneous population of adolescent inpatients, so that further research is needed before these findings can be generalized to outpatients. In addition, the small number of patients in some diagnostic groups did not allow for their inclusion in some of the statistical analyses.

Lidar measurement of surface melt for a temperate Alpine glacier at the seasonal and hourly scales

This study shows how a new generation of terrestrial laser scanners can be used to investigate glacier surface ablation and other elements of glacial hydrodynamics at exceptionally high spatial and temporal resolution. The study area is an Alpine valley glacier, Haut Glacier d'Arolla, Switzerland. Here we use an ultra-long-range lidar RIEGL VZ-6000 scanner, having a laser specifically designed for measurement of snow- and ice-cover surfaces. We focus on two timescales: seasonal and daily. Our results show that a near-infrared scanning laser system can provide high-precision elevation change and ablation data from long ranges, and over relatively large sections of the glacier surface. We use it to quantify spatial variations in the patterns of surface melt at the seasonal scale, as controlled by both aspect and differential debris cover. At the daily scale, we quantify the effects of ogive-related differences in ice surface debris content on spatial patterns of ablation. Daily scale measurements point to possible hydraulic jacking of the glacier associated with short-term water pressure rises. This latter demonstration shows that this type of lidar may be used to address subglacial hydrologic questions, in addition to motion and ablation measurements.

Triage hoitajien kokemana yhteispäivystyksessä

Opinnäytetyömme käsittelee hoitajien kokemuksia triagen käytöstä Peijaksen sairaalan yhteispäivystyksessä. Työmme perustuu pääkaupunkiseudulla käynnissä olevaan päivystyshankkeeseen, jonka tavoitteena on päivystystoiminnan kehittäminen niin, että yhteispäivystyskäyntimäärät vähenevät puoleen nykyisestä ja päivystyspotilaiden hoito on sujuvaa, sekä laadukasta, Hankkeen tavoitteena on luoda päivystykseen uusi toimintamalli, joka turvaa kiireellisen hoidon entistä paremmin sitä tarvitseville. Yksi päivystyksen kehittämisen työväline on päivystyspotilaiden hoidon tarpeen kiireellisyyden arviointi eli triage, jota vuorossa oleva kokenut hoitaja toteuttaa paikallisen ohjeistuksen ja kokemuksensa avulla. Tutkimuksen tarkoituksena on kartoittaa triage-hoitajien myönteisiä ja kielteisiä kokemuksia hoidon tarpeen kiireellisyyden arvioinnista. Lisäksi selvitämme triage-hoitajan tärkeimmät ominaisuudet ja järjestelmän kehittämisideat. Aiheesta on tehty maailmalla useita tutkimuksia hoitajien näkökulmasta. Asian tutkimisen tärkeyttä korostaa se, ettei vastaava tutkimusta ole Suomessa aiemmin tehty. Aineisto kerättiin kriittisten tapahtumien tekniikalla ja tulokset muodotettiin induktiivisella sisällön analyysillä. Tutkimusta varten haastateltiin 12 Peijaksen yhteispäivystyksessä työskentelevää triage -hoitajaa. Myönteisten kokemusten perusteella haastatellut hoitajat pitivät triage -järjestelmää lähtökohtaisesti toimivana työvälineenä. Hoitajat kokivat myönteisenä myös potilasohjauksen tehostumisen ja työyhteisön tuen triagen teossa. Merkittävimmiksi kielteisiksi kokemuksiksi nousivat kuitenkin näkemyserot, järjestelmään sitoutumattomuus, vastuun kasvu ja koulutuksen puute. Haastattelujen mukaan triage -hoitajan tärkeimmät ominaisuudet ovat työkokemus, vakuuttavuus, vuorovaikutustaidot ja laaja-alainen osaaminen. Kehitystarpeista tärkeimmäksi nousi koulutuksen lisääminen. Tutkimusta voidaan käyttää tukena triage -koulutuksessa ja kehitystyössä paikallisesti, sekä sovellettuna muihin toimipisteisiin. Triagea tukevan koulutuksen määrää tulisi merkittävästi lisätä ja sen sisältöä tulisi muokata enemmän triage-hoitajan näkökulmaan soveltuvaksi. Mielestämme koulutuksen lisääminen on avainasemassa järjestelmän toimivuutta tehostaessa. Henkilökunnan yhteinen koulutus vähentäisi näkemyseroja työyhteisössä, helpottaisi vastuunottamista triagesta ja edistäisi järjestelmään sitoutumista.