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The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears.
An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis.
A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ a = 1.98–5.03; PWQ a = 4.10–10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change.
The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.
Anyone over the age of 60 would be foolhardy not to be fearful of dementia in general and Alzheimer's disease (AD) in particular, because it is very common. About one-third of people in the developed world have a family member or friend who has succumbed to one form or another of dementia, and these numbers are expected to soar thanks to longer lifespans. What makes dementia so horrifying is that it comes with the annihilation of memory and personal identity, to the extent that you eventually are unable to recognize even your loved ones. You end up as an empty shell of your former self.
When thinking about AD it is important to appreciate that AD and dementia are not one and the same thing. AD, which accounts for about 60 percent of dementia cases, causes problems with memory, language, and reasoning. It is characterized by the accumulation of deposits made up of a protein amyloid-β between, and tangles of another protein known as tau both between and within, brain cells. In describing AD it is important to distinguish “characterized by” from “caused by” because, as we will see, there is still some doubt here.
Addressing archaeology's most compelling substantive challenges requires synthetic research that exploits the large and rapidly expanding corpus of systematically collected archaeological data. That, in turn, requires a means of combining datasets that employ different systematics in their recording while at the same time preserving the semantics of the data. To that end, we have developed a general procedure that we call query-driven, on-the-fly data integration that is deployed within the Digital Archaeological Record digital repository. The integration procedure employs ontologies that are mapped to the original datasets. Integration of the ontology-based dataset representations is done at the time the query is executed, based on the specific content of the query. In this way, the original data are preserved, and data are aggregated only to the extent necessary to obtain semantic comparability. Our presentation draws examples from the largest application to date: an effort by a research community of Southwest US faunal analysts. Using 24 ontologies developed to cover a broad range of observed faunal variables, we integrate faunal data from 33 sites across the late prehistoric northern Southwest, including about 300,000 individually recorded faunal specimens.
While striving to succeed in the face of adversity may provide individuals with outward benefits, it may come at a cost to individuals’ physical health. The current study examines whether striving predicts greater physiological or psychosocial costs among those who experienced child maltreatment, a stressor that disrupts the caregiving environment and threatens relationship security. Using data from the National Longitudinal Study of Adolescent to Adult Health, we tested whether greater striving after childhood maltreatment would come at a cost, increasing underlying cardiovascular disease (CVD) risk and depressive symptoms despite showing outward success via income and college degree attainment. The study included 13,341 Black, Hispanic, and White adolescents who self-reported striving and their experiences of childhood neglect, physical abuse, and sexual abuse. As young adults, participants reported depressive symptoms, income, and college degree attainment and completed a health assessment from which a 30-year Framingham-based CVD risk score was calculated. Higher striving was associated with lower CVD risk and depressive symptoms, and higher income and college degree attainment, regardless of maltreatment history. These findings highlight the potential for striving as a target for interventions and support the need to examine multiple biological and behavioral outcomes to understand the multifaceted nature of resilience.
The question of how modernity has influenced medievalism and how medievalism has influenced modernity is the theme of this volume. The opening essays examine the 2001 film Just Visiting's comments on modern anxieties via medievalism; conflations of modernity with both medievalism and the Middle Ages in rewriting sources; the emergence of modernity amid the post-World War I movement The MostNoble Order of Crusaders; António Sardinha's promotion of medievalism as an antidote to modernity; and Mercedes Rubio's medievalism in her feminist commentary on modernity. The eight subsequent articles build on this foundation while discussing remnants of medieval London amid its modern descendant; Michel Houellebecq's critique of medievalism through his 2011 novel La Carte et le territoire; historical authenticity in Michael Morrow's approach to performing medieval music; contemporary concerns in Ford Madox Brown and David Gentleman's murals; medieval Chester in Catherine A.M. Clarkeand Nayan Kulkarni's Hryre (2012); medieval influences on the formation of and debate about modern moral panics; medievalist considerations in modern repurposings of medieval anchorholds; andmedieval sources for Paddy Molloy's Here Be Dragons (2013). The articles thus test the essays' methods and conclusions, even as the essays offer fresh perspectives on the articles.
Karl Fugelso is Professor of Art History at Towson University in Baltimore, Maryland.
Contributors: Edward Breen, Katherine A. Brown, Catherine A.M. Clarke, Louise D'Arcens, Joshua Davies, John Lance Griffith, Mike Horswell, Pedro Martins, Paddy Molloy, Lisa Nalbone, Sarah Salih, Michelle M. Sauer, James L. Smith
Improving the care provided for people dying in acute healthcare facilities has been identified as a priority for Australian healthcare. Previous observations support the idea that quality care improves outcomes for the dying person as well as for their relatives. To improve care it is essential that there be a clear understanding of which issues require attention. The aim of our project was to improve the understanding of the experiences of family members whose relatives had died on an acute medical ward.
A mixed-methods approach was adopted for our study. With the approval of the human ethics committee, relatives were approached within three months of the death of their family member and invited to participate in an interview based on a quality-of-dying-and-death (QoDD) tool.
Of the 50 families approached, 10 agreed to be interviewed. When they were asked to reflect on the experiences of the dying person, the issues that they articulated most strongly related to the need to have time before death to address issues and spend time with important others. With regards to the needs of the dying person's relatives, people articulated strongly that they needed information, support, and evidence of good symptom control. The provision of support post-death was also poignantly highlighted.
Significance of Results:
This study supports observations made in other clinical areas that have identified that timely communication, good symptom control, and ongoing support for both the dying person and their family has important ramifications. Articulating such details is an important part of understanding which aspects of care require attention.