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We examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology.
Prior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (<40 v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic).
Our cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men.
Our study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort.
Boredom has traditionally been viewed as detrimental to learning. We present an alternative perspective. The vast majority of past research on academic boredom has examined judgments about the boringness of a situation and the propensity to feel bored, rather than actual state boredom. While retrospective judgments about the boringness of a task may be a cause of later disengagement, we argue that in-the-moment state boredom is a consequence of disengagement. This claim flows from our definition of boredom as the uncomfortable feeling associated with the unfulfilled desire to be mentally engaged.We propose that in-the-moment feelings of boredom can be an aid to learning. First, boredom is an immediate process indicator of a failure in learning, which can signal the need to correct disengaged, ineffectual learning. Second, boredom is an uncomfortable feeling, so it motivates an engagement of mental resources as a means of eliminating boredom. We believe our theoretical analysis points towards fruitful future empirical inquiry, clarifies the interpretation of existing findings, and highlights areas where theory development and conceptual precision are needed.
The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality.
The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries.
Sub-Saharan Africa with high diarrhoea mortality.
Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)).
Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF.
Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.
The diagnosis of smear-positive pulmonary tuberculosis in a medical officer working in a metropolitan Australian neonatal intensive care unit led to a contact investigation involving 125 neonates, 165 relatives, and 122 healthcare workers with varying degrees of exposure. There was no evidence of nosocomial tuberculosis transmission from the index case.
Produce growers in Kentucky, North Carolina, and Tennessee were surveyed in 2002 to gather information about their decision making in the areas of planting, postharvest handling, marketing, and expected changes. North Carolina has proportionately more respondents with large operations, and Kentucky and Tennessee were more similar and concentrated in smaller farms. Tennessee and Kentucky respondents were less likely to have engaged in activities that were associated with the commercial distribution system. Greater reliance on the commercial distribution system on the part of North Carolina growers is consistent with more produce export activity.
For over a decade, managed care has profoundly altered how healthcare
is delivered in the United States. There have been concerns that the
patient-physician relationship may be undermined by various aspects of
managed care, such as restrictions on physician choice, productivity
requirements that limit the time physicians may spend with patients,
and the use of compensation formulas that reward physicians for
healthcare dollars not spent. We have previously published data on the
effects of managed care on the physician-patient relationship from the
physician's perspective. In 1999, we collected data on
the impact of managed care arrangements on the physician-patient
relationship from the patient's perspective. This article
discusses our collective findings.
Lack of early childhood education has been implicated as a risk factor for dementia in late life. It is unclear whether dementia risk is also associated with less education in the adult years. The purpose of the present study was to determine whether amount of postsecondary education (i.e., education beyond the high school or 12th-grade level) is associated with dementia after age 60. Cognitive function (assessed by a neuropsychological test battery) and the prevalence of dementia (assessed by clinical criteria) were determined in 86 Jesuit priests (age 60 to 98) who had from 0 to 23 years of postsecondary education. Logistic regression was used to estimate the odds of dementia as a function of postsecondary education. The risk of dementia was increased in those with less postsecondary education (odds ratio = 3.4; 95% confidence interval, 1.2 to 10.0) after adjustment for age, IQ, and depression. These findings support an association between amount of postsecondary education and risk of dementia in late life.
Preliminary forecasts using the Box-Jenkins methodology for supermarket scan data for ground beef and roast item movement are described. The functional form and the accuracy of the forecasts vary by product. Results suggest that further analyses incorporating price and advertising may increase the accuracy of the forecasts.
Consumer behavior with respect to purchase regularity, satisfaction, origin, and willingness to pay for selected local versus non-Tennessee grown fresh produce is examined. Except for origin, consumer behavior with respect to the above is affected by income, household size and age distribution, race, age of respondent, college education, and occupation. The pattern of significant variables changed by commodity. Tomatoes, followed by peaches, had the greatest local market potential. Local promotion of other products may be more difficult. Results suggested consumers have no strong preferences for or against locally grown fresh produce. The prices of locally grown commodities in Knoxville should be less than or equal to those of comparable quality non-Tennessee commodities.
A characteristics model, which assumes goods generate a common set of attributes but no unique attribute, is described. The model yielded two equations which were estimated. One was a set of hedonic price equations in which the price paid for each food purchased was a function of imputed attribute prices. This set of equations was estimated at the household level. Nutrient demand equations were estimated across households. Imputed prices, income, and household characteristics including location, size, education, age distribution, and race affected nutrient demand levels.
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