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In an empirical study on the classification of the psychoses, 302 patients were rated using the Longitudinal Psychopathology Schedule. The data were condensed by factor analysis, which yielded 10 factors - mania and schizomania, depression and suicidal activity, and 6 factors concerned with psychotic symptoms (verbal hallucinosis/passivity, delusion formation, defect symptoms, social decline, cycloid symptomatology and a factor loading depressive auditory hallucinations and visual hallucinations). Provisional diagnostic groups were obtained using DSM III. Discriminant function analyses showed that the only clearly distinct diagnostic group was bipolar disorder, and this was true for various definitions. Canonical variate analyses were performed using 3- and 4-criterion groups. These showed that a group corresponding approximately to cycloid psychosis also met criteria for being a distinct group. The most detailed examination pf the data, using 4-criterion groups and serial reclassification, suggested that the psychoses might fall into 5 groups - bipolar disorder, cycloid psychosis, depression, defect states and schizoaffective depression.
We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.
Background: Children with myocarditis have multiple risk factors for thrombotic events, yet the role of antithrombotic therapy is unclear in this population. We hypothesised that thrombotic events in critically ill children with myocarditis are common and that children with myocarditis are at higher risk for thrombotic events than children with non-inflammatory dilated cardiomyopathy. Methods: This is a retrospective chart review of all children presenting to a single centre cardiac intensive care unit with myocarditis from 1995 to 2008. A comparison group of children with dilated cardiomyopathy was also examined. Antithrombotic regimens were recorded. The primary outcome of thrombotic events included intracardiac clots and any thromboembolic events. Results: Out of 45 cases with myocarditis, 40% were biopsy-proven, 24% viral polymerase chain reaction-supported, and 36% diagnosed based on high clinical suspicion. There were two (4.4%) thrombotic events in the myocarditis group and three (6.7%) in the dilated cardiomyopathy group (p = 1.0). Neither the use of any antiplatelet or anticoagulation therapy, use of intravenous immune globulin, presence of any arrhythmia, nor need for mechanical circulatory support were predictive of thrombotic events in the myocarditis, dilated cardiomyopathy, or combined groups. Conclusions: Thrombotic events in critically ill children with myocarditis and dilated cardiomyopathy occurred in 6% of the combined cohort. There was no difference in thrombotic events between inflammatory and non-inflammatory cardiomyopathy groups, suggesting that the decision to use antithrombotic prophylaxis should be based on factors other than the underlying aetiology of a child's acute decompensated heart failure.
Although widely used, the term repellency needs to be employed with care when applied to ticks and other periodic or permanent ectoparasites. Repellency has classically been used to describe the effects of a substance that causes a flying arthropod to make oriented movements away from its source. However, for crawling arthropods such as ticks, the term commonly subsumes a range of effects that include arthropod irritation and consequent avoiding or leaving the host, failing to attach, to bite, or to feed. The objective of the present article is to highlight the need for clarity, to propose consensus descriptions and methods for the evaluation of various effects on ticks caused by chemical substances.
Although the role of testosterone in the aetiology of social dominance is often suggested, surprisingly few studies have addressed the relationship between sex steroid hormones and dominance as a personality trait. In this paper, the relationship between testosterone and dominance is studied in a sample of adolescent boys and girls, taking into account the moderating role of gender ideology and same-sex peer group orientation. A direct association between free testosterone (FT) and dominance was found in girls but not in boys. In boys, masculine ideology moderated the relationship between FT and dominance, while in girls the relationship between FT and dominance was moderated by same-sex peer group affiliation.
Survivors of severe traumatic brain injury (TBI) often demonstrate impairments in the cognitive control functions of detecting response conflict and signaling for recruitment of cognitive resources to appropriately adjust performance. These cognitive control functions can be measured using conflict adaptation effects, wherein manifestations of conflict detection and processing are reduced following high- relative to low-conflict trials. Event-related potentials (ERPs) were collected while 18 survivors of severe traumatic brain injury (TBI) and 21 demographically matched control participants performed a modified Stroop task. The incongruent-minus-congruent trial Stroop effect for trials preceded by incongruent (high conflict) and congruent (low conflict) trials were compared for behavioral (response time [RT] and error rate) and ERP reflections of cognitive control. Behavioral data showed a reduction in the Stroop effect for both control and TBI participant RTs when preceded by incongruent trials. The magnitude of these effects did not differentiate control and TBI participants. ERP data revealed a centro-parietal conflict slow potential (conflict SP) that differentiated incongruent from congruent trials. Planned comparisons showed a decreased amplitude conflict SP when ERPs were preceded by incongruent trials in control, but not TBI participants. Results indicate subtle TBI-related impairments in conflict resolution mechanisms in the context of intact RT-related conflict adaptation. (JINS, 2009, 15, 927–937.)
The draft paper sets out the authors' views of what good practice for the actuarial aspects of internal models will look like in 2012, the year Solvency II is expected to be implemented. Actuaries working on internal models can expect to have to follow such practices if their internal models are to be approved for use in calculating regulatory capital. The paper is therefore relevant for actuaries who plan to work on internal model implementation for Solvency II.
Moreover, the risk quantification techniques discussed in the paper can also be used in the Own Risk Solvency Assessment (ORSA) process also required by Solvency II. The paper is therefore relevant to actuaries working in companies that are not planning to apply to use an internal model.
The paper covers both life and non-life insurance and reinsurance, and reviews current practice as well as setting out possible future practice. This leads to identification of areas for research by the Profession to prepare for 2012 and an indication of the directions this work might take.
The paper is effectively a work in progress, and readers should ask themselves what they should do in response to the ideas discussed.
The high XO production in Bpa+ mouse stocks appears to be due, not to Bpa itself, but to a closely linked factor for high XO production (Fxo) which may be a gene or a chromosomal aberration. The change of Bpa Fxo to Bpa non-Fxo occurs with a frequency of about 6%; the reciprocal change from Bpa Fxo to Fxo non-Bpa has not been found. There is some evidence that Fxo might involve a structural alteration such as an inversion or a deletion. The X-chromosome loss is due to non-disjunction which occurs in about one-third of the oocytes, probably mainly at meiosis I. Frequencies of other chromosomal abnormalities found in the stocks are given.