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Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.
A logistic model developed by Birnbaum was tested in two ways. First, plots of proportions of subjects in different score categories were examined for consistency with the assumption of a logistic trace line, and especially for departures from the logistic which seemed due to guessing in multiple choice items. The results showed that guessing seemed to have little effect. Second, an attempt was made to predict the obtained score distributions of samples of subjects on six tests from item parameters estimated on independent samples. The fits were good in all cases, despite considerable differences between the tests, and some extremely odd distributions.
The difference in factor structure resulting from the factorization of correlations, covariances, and cross products is discussed. Factoring cross products has the advantage of retaining information on both means and variances; this method of factoring learning data is recommended. The conditions under which factoring covariances and cross products lead to the same essential structure are investigated.
It is shown that to combine readings from “points of view” configurations as assumed in Tucker and Messick's model is not to combine configurations in any simple way. Both empirical and logical consequences of the disparity are discussed.
Coombs and Kao have conjectured that, given the distances between a set of points representing persons and another representing objects, factor analytic methods can be used to recover the locations of the persons and objects. In the present paper it is proved that the conjecture applies, with some qualifications, to squared distances rather than distances themselves. Possible applications to scaling and to inventory responses are discussed.
The question “How much does a set of variables tell us?” is formulated in terms of information measures, and a set of formulas is established which allows appropriate information measures to be derived from correlations. Particular attention is given to the question in the context of factor analysis and to formulas involving the latent roots of correlation matrices.
The bright radio source, GLEAM J091734$-$001243 (hereafter GLEAM J0917$-$0012), was previously selected as a candidate ultra-high redshift ($z \gt 5$) radio galaxy due to its compact radio size and faint magnitude ($K(\mathrm{AB})=22.7$). Its redshift was not conclusively determined from follow-up millimetre and near-infrared spectroscopy. Here we present new HST WFC3 G141 grism observations which reveal several emission lines including [NeIII]$\lambda$3867, [NeV]$\lambda$3426 and an extended ($\approx 4.8\,$kpc), [OII]$\lambda$3727 line which confirm a redshift of $3.004\pm0.001$. The extended component of the [OII]$\lambda$3727 line is co-spatial with one of two components seen at 2.276 GHz in high resolution ($60\times 20\,$mas) Long Baseline Array data, reminiscent of the alignments seen in local compact radio galaxies. The BEAGLE stellar mass ($\approx 2\times 10^{11}\,\textit{M}_\odot$) and radio luminosity ($L_{\mathrm{500MHz}}\approx 10^{28}\,$W Hz$^{-1}$) put GLEAM J0917$-$0012 within the distribution of the brightest high-redshift radio galaxies at similar redshifts. However, it is more compact than all of them. Modelling of the radio jet demonstrates that this is a young, $\approx 50\,$kyr old, but powerful, $\approx 10^{39}\,$W, compact steep spectrum radio source. The weak constraint on the active galactic nucleus bolometric luminosity from the [NeV]$\lambda$3426 line combined with the modelled jet power tentatively implies a large black hole mass, $\ge 10^9\,\textit{M}_\odot$, and a low, advection-dominated accretion rate, i.e. an Eddington ratio $\le 0.03$. The [NeV]$\lambda$3426/[NeIII]$\lambda$3867 vs [OII]$\lambda$3727/[NeIII]$\lambda$3867 line ratios are most easily explained by radiative shock models with precursor photoionisation. Hence, we infer that the line emission is directly caused by the shocks from the jet and that this radio source is one of the youngest and most powerful known at cosmic noon. We speculate that the star-formation in GLEAM J0917$-$0012 could be on its way to becoming quenched by the jet.
Leader–member exchange (LMX), a well-researched leadership theory that focuses on the dyadic relationships between leaders and subordinates, is associated with positive subordinates’ outcomes. However, the contexts outside the LMX dyadic relationship might influence those favorable outcomes. In this study, we investigate the cross-level moderating effect of leader’s feelings of violation, as a contextual boundary, on LMX outcomes. Based on social exchange theory, crossover model, and the psychological contract literature, we discuss how the relationship between a subordinate’s perceived LMX and favorable subordinate attitudes and behaviors, such as performance, task-focused citizenship behaviors, and organizational commitment, is reduced when the leader experiences feelings of violation toward the organization. Using a three-wave time-lagged multilevel design with a sample of 226 subordinates and 39 leaders, we find that leader’s feelings of violation mitigate the positive association of perceived LMX on citizenship behavior and commitment but have no effect on performance. Research and practical implications are discussed.
We present the second data release for the GaLactic and Extragalactic All-sky Murchison Widefield Array eXtended (GLEAM-X) survey. This data release is an area of 12 892-deg$^2$ around the South Galactic Pole region covering 20 h40 m$\leq$RA$\leq$6 h40 m, -90$^\circ$$\leq$Dec$\leq$+30$^\circ$. Observations were taken in 2020 using the Phase-II configuration of the Murchison Widefield Array (MWA) and covering a frequency range of 72–231 MHz with twenty frequency bands. We produce a wideband source finding mosaic over 170–231 MHz with a median root-mean-squared noise of $1.5^{+1.5}_{-0.5}$ mJy beam$^{-1}$. We present a catalogue of 624 866 components, including 562 302 components which are spectrally fit. This catalogue is 98% complete at 50 mJy, and a reliability of 98.7% at a 5 $\sigma$ level, consistent with expectations for this survey. The catalogue is made available via Vizier, and the PASA datastore and accompanying mosaics for this data release are made available via AAO Data Central and SkyView.
Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers’ burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer.
Methods
This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates.
Results
Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers’ spirituality on the relationship between depression and caregiver burden over time (b = −1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support.
Significance of results
Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients’ health.
Class III obesity is associated with increased risk for cognitive impairment. Though hypothesized to be partially attributable to sedentary time (ST), past research examining the association between ST and cognitive function has produced mixed findings. One possible explanation is that studies do not typically account for the highly correlated and almost inverse relationship between ST and light intensity physical activity (LPA), such that ST displaces time engaging in LPA. Therefore, we aimed to evaluate whether: (1) higher ST-to-LPA time ratio associates with poorer performance across multiple cognitive domains in patients with Class III obesity seeking bariatric surgery; and (2) the associations differ by sex.
Participants and Methods:
Participants (N = 121, 21-65 years of age, BMI > 40 kg/m2) scheduled for either Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy (SG) completed the NIH Toolbox, a computerized neuropsychological assessment battery and wore a waist-mounted ActiGraph monitor during waking hours for 7 days to measure minutes/day spent in ST, LPA, and moderate-to-vigorous physical activity (MVPA). A ratio of time spent in ST-to-LPA was calculated by dividing the percentage of daily wear time spent in sedentary behavior (SB) by the percentage of daily wear time spent in LPA.
Results:
On average, participants (mean age = 43.22 years old and BMI = 45.83 kg/m2) wore the accelerometer for 909±176 minutes/day and spent 642±174 minutes/day in ST, 254±79 minutes/day in LPA, and 14±13 minutes/day in MVPA. Mean daily ST-to-LPA time ratio was 2.81 ± 1.3 (0.73-7.11). Overall, bivariate Pearson correlations found no significant relationships between LPA and cognitive performance on any of the NIH Toolbox subtests (r values = -.002 to -.158, all p values >.05). Additionally, bivariate Pearson correlations also found no significant relationships between daily ST-to-LPA time ratio and cognitive performance on any of the subtests (r values = .003 to .108, all p values >.05). However, higher ST-to-LPA was associated with lower scores on the Dimensional Change Card Sort Test in women (r = -.26, p = .01).
Conclusions:
Results showed that participants’ mean daily time spent in ST was 2.5 times higher than that spent in LPA and a higher ratio of ST-to-LPA was associated with poorer set-shifting in women with Class III obesity. Future studies should look to clarify underlying mechanisms, particularly studies examining possible sex differences in the cognitive benefits of PA. Similarly, intervention studies are also needed to determine if increasing LPA levels for individuals with Class III obesity would lead to improved cognitive performance by means of reducing ST.
The current study aimed to examine real-time associations between non-cognitive symptoms and cognitive dysfunction (latter measured both objectively and subjectively in real-time) using ecological momentary assessment (EMA).
Participants and Methods:
Forty-five persons with MS completed EMA four times per day for three weeks. For each EMA, participants completed mobile versions of the Trail-Making Test part B (mTMT-B) and a finger tapping task, as well as surveys about symptom severity. Trait (usual levels of a symptom) and state (when symptom level was higher or lower than the individual's usual levels) aspects of each symptom's severity were calculated. Multilevel models were conducted to account for within-person clustering, with performance on the mTMT-B and self-reported rating of cognitive dysfunction as primary outcomes.
Results:
A total of 3,174 EMA sessions were collected; compliance rate was 84%. There was significant intra-day variability in mTMT-B performance, anxiety, fatigue, and pain. More severe state depressive symptoms predicted lower performance on the mTMT-B in real-time. Self-reported difficulties with sleeping the night before predicted mTMT-B performance the following day. In contrast, state (but not trait) fatigue, depression, anxiety, and pain all predicted self-reported cognitive dysfunction in real time. Further, state self-reported cognitive dysfunction (but not mTMT-B performance) was associated with a higher perceived sense of accomplishment.
Conclusions:
Self-reported cognitive dysfunction was more susceptible to influences of other MS symptoms (especially when the symptom is more severe than the individual's usual levels) and better predicted perceived sense of accomplishment than objectively measured executive functioning in real-time. Objective executive functioning performance was sensitive to effects of depressive symptoms and sleep difficulties. The current study demonstrated the feasibility of assessing real-time associations among MS symptoms using smartphone-administered EMA.
Arachnoid cysts are fluid-filled sacs thought to be a developmental abnormality which form as a result of splitting or duplication of the arachnoid membrane. In most cases, arachnoid cysts are congenital and asymptomatic throughout an individual’s life. Rarely, arachnoid cysts develop because of head injury, intraventricular hemorrhage of prematurity, presence of a tumor, infection or surgery on the brain. Intracranial cysts are typically incidental brain imaging findings and most commonly located in the middle fossa, the suprasellar region, and the posterior fossa. In cases where the cyst enlarges significantly individuals may experience symptoms of increased intracranial pressure, mass effects, seizures, nausea and vomiting, focal neurological deficits, or hydrocephalus. This presentation compares the differing symptom presentation of two individuals with medically confirmed arachnoid cysts -- one in the middle cranial fossa region (Patient A) and the other in the posterior cranial fossa region (Patient B).
Participants and Methods:
The 2 patients were referred to a private practice neuropsychological clinic for neuropsychological assessment. Patient A was a 39-year-old, right-handed, married Syrian male with 12 years if education, unemployed at the time of testing. Changes in cognition, behavior and personality were reported for Patient A approximately two years after a known cerebrovascular accident. Patient B was a 48-year-old, left-handed married Caucasian male with 16 years of education, on disability due to his medical condition. Patient B reported severe memory impairment, speech and language deficits, variable attention, executive dysfunction, impaired gait with falls, emotional dysregulation, and sleep difficulties. He was diagnosed with bipolar disorder and alcohol use disorder in remission for 9 years.
Results:
Neuropsychological testing results for Patient A were not valid, due to initiation difficulties, paranoia about the testing and consequent limited engagement in the process. Predominant symptoms were consistent with negative symptoms of schizophrenia, (i.e., avolition, abulia, and diminished emotional expression); no positive symptoms were observed or reported. His speech was limited -he lacked spontaneous speech and only responded to direct questions. His informant completed a measure assessing pre/post changes in frontal systems and there were significant increases in apathy and executive dysfunction reported. Neuropsychological results collected from Patient B revealed mild to severe impairment of aspects of executive functioning, memory, processing speed, visual attention, expressive language, and manual dexterity bilaterally and manual motor strength - more consistent with subcortical neurological disease. Self-report and informant data revealed significant difficulties with functional abilities, pre/post changes in frontal systems (apathy, disinhibition, and executive dysfunction), sleep efficiency and daytime fatigue, and psychological distress (anxiety and depressive symptoms).
Conclusions:
The presenting case analysis illustrates the importance of neuropsychology in identifying and tracking the nature of symptoms associated with neuroimaging confirmed arachnoid cysts. This case analysis is unique as it highlights the complexities of differing symptom phenotypes of the same condition due to location of the cyst. Surgical intervention usually through draining the cyst directly or implantation of a shunt is typically recommended for symptomatic patients and that course of treatment was suggested to both patients. Treatment recommendations geared to target psychosocial and functional difficulties should also be considered.
Thyroid surgery carries risks that significantly impact patients. This paper describes the landscape of thyroid surgery related litigation claims in the National Health Service from April 2015 to April 2020, to establish learning points in order to improve patient care and minimise litigation risk.
Methods
Data were requested from National Health Service Resolution and Hospital Episode Statistics. Claims were classified into operative and non-operative causes. Subspecialty information, incident details and claim costings were analysed.
Results
Sixty claims were identified. Thirty-eight claims (63.3 per cent) were closed, with an average total claim cost of £68 816 and average damages paid of £36 349. Claims related to diagnostic issues were most common (n = 19); of claims associated with operative causes (n = 30), those relating to nerve injury were most common (n = 8), with issues of nerve monitoring and consent being cited.
Conclusion
Utilisation of well-established protocols will likely reduce litigation in thyroid surgery, as we move towards a landscape in which the patient journey is thoroughly scrutinised for targeted improvements.