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Studies of agreement commonly occur in psychiatric research. For example, researchers are often interested in the agreement among radiologists in their review of brain scans of elderly patients with dementia or in the agreement among multiple informant reports of psychopathology in children. In this paper, we consider the agreement between two raters when rating a dichotomous outcome (e.g., presence or absence of psychopathology). In particular, we consider logistic regression models that allow agreement to depend on both rater- and subject-level covariates. Logistic regression has been proposed as a simple method for identifying covariates that are predictive of agreement (Coughlin et al., 1992). However, this approach is problematic since it does not take account of agreement due to chance alone. As a result, a spurious association between the probability (or odds) of agreement and a covariate could arise due entirely to chance agreement. That is, if the prevalence of the dichotomous outcome varies among subgroups of the population, then covariates that identify the subgroups may appear to be predictive of agreement. In this paper we propose a modification to the standard logistic regression model in order to take proper account of chance agreement. An attractive feature of the proposed method is that it can be easily implemented using existing statistical software for logistic regression. The proposed method is motivated by data from the Connecticut Child Study (Zahner et al., 1992) on the agreement among parent and teacher reports of psychopathology in children. In this study, parents and teachers provide dichotomous assessments of a child's psychopathology and it is of interest to examine whether agreement among the parent and teacher reports is related to the age and gender of the child and to the time elapsed between parent and teacher assessments of the child.
Psychological therapies can be effective in reducing symptoms of depression and anxiety in people living with dementia (PLWD). However, factors associated with better therapy outcomes in PLWD are currently unknown.
Aims
To investigate whether dementia-specific and non-dementia-specific factors are associated with therapy outcomes in PLWD.
Method
National linked healthcare records were used to identify 1522 PLWD who attended psychological therapy services across England. Associations between various factors and therapy outcomes were explored.
Results
People with frontotemporal dementia were more likely to experience reliable deterioration in depression/anxiety symptoms compared with people with vascular dementia (odds ratio 2.98, 95% CI 1.08–8.22; P = 0.03) or Alzheimer's disease (odds ratio 2.95, 95% CI 1.15–7.55; P = 0.03). Greater depression severity (reliable recovery: odds ratio 0.95, 95% CI 0.92–0.98, P < 0.001; reliable deterioration: odds ratio 1.73, 95% CI 1.04–2.90, P = 0.04), lower work and social functioning (recovery: odds ratio 0.98, 95% CI 0.96–0.99, P = 0.002), psychotropic medication use (recovery: odds ratio 0.67, 95% CI 0.51–0.90, P = 0.01), being of working age (recovery: odds ratio 2.03, 95% CI 1.10–3.73, P = 0.02) and fewer therapy sessions (recovery: odds ratio 1.12, 95% CI 1.09–1.16, P < 0.001) were associated with worse therapy outcomes in PLWD.
Conclusions
Dementia type was generally not associated with outcomes, whereas clinical factors were consistent with those identified for the general population. Additional support and adaptations may be required to improve therapy outcomes in PLWD, particularly in those who are younger and have more severe depression.
Advance consent could allow individuals at high risk of stroke to provide consent before they might become eligible for enrollment in acute stroke trials. This survey explores the acceptability of this novel technique to Canadian Research Ethics Board (REB) chairs that review acute stroke trials. Responses from 15 REB chairs showed that majority of respondents expressed comfort approving studies that adopt advance consent. There was no clear preference for advance consent over deferral of consent, although respondents expressed significant concern with broad rather than trial-specific advance consent. These findings shed light on the acceptability of advance consent to Canadian ethics regulators.
Examines the role of Christianity in British statecraft, politics, media, the armed forces and in the education and socialization of the young during the Second World War.
Recombinant angiotensin II is an emerging drug therapy for refractory hypotension. Its use is relevant to patients with disruption of the renin–angiotensin–aldosterone system denoted by elevated direct renin levels. We present a child that responded to recombinant angiotensin II in the setting of right ventricular hypertension and multi-organism septic shock.
Three-dimensional (3D) food printing is a rapidly emerging technology offering unprecedented potential for customised food design and personalised nutrition. Here, we evaluate the technological advances in extrusion-based 3D food printing and its possibilities to promote healthy and sustainable eating. We consider the challenges in implementing the technology in real-world applications. We propose viable applications for 3D food printing in health care, health promotion and food waste upcycling. Finally, we outline future work on 3D food printing in food safety, acceptability and economics, ethics and regulations.
Advance consent presents a potential solution to the challenge of obtaining informed consent for participation in acute stroke trials. Clinicians in stroke prevention clinics are uniquely positioned to identify and seek consent from potential stroke trial participants. To assess the acceptability of advance consent to Canadian stroke clinic physicians, we performed an online survey. We obtained 58 respondents (response rate 35%): the vast majority (82%) expressed comfort with obtaining advance consent and 92% felt that doing so would not be a significant disruption to clinic workflow. These results support further study of advance consent for acute stroke trials.
Often to the detriment of human decision making, people are prone to an impact bias when making affective forecasts, overestimating the emotional consequences of future events. The cognitive processes underlying the impact bias, and methods for correcting it, have been debated and warrant further exploration. In the present investigation, we examined both individual differences and contextual variables associated with cognitive processing in affective forecasting for an election. Results showed that the perceived importance of the event and working memory capacity were both associated with an increased impact bias for some participants, whereas retrieval interference had no relationship with bias. Additionally, an experimental manipulation effectively reduced biased forecasts, particularly among participants who were most distracted thinking about peripheral life events. These findings have theoretical implications for understanding the impact bias, highlight the importance of individual differences in affective forecasting, and have ramifications for future decision making research. The possible functional role of the impact bias is discussed within the context of evolutionary psychology.
This article offers a new approach to early modern global history, dubbed (dis)entangled history as a way to combine the conventional focus on the history of connections with a necessary appreciation of the elements of disconnection and disintegration. To exemplify this approach, it offers a case study related to the history of cannibalism as both a disputed anthropophagic practice and a cultural reference point across the early modern world. Through a rich multilingual and multimedia source base, we trace how the idea of Indigenous Tapuya endo-cannibalism in Brazil travelled across the Atlantic through Europe and Africa to East Asia. The idea of Tapuya cannibalism crossed some linguistic borders, stopped at others and interacted unevenly with long-standing Ottoman, Polish, West African, Islamic and Chinese ideas about ‘cannibal countries’, of which it was just one more example. This trajectory challenges the historiographical consensus that early modern ideas about cannibalism were centred on the Atlantic world. By tracing how one particular discourse did and did not travel around the globe, this article offers not just a theoretical statement, but a ‘fleshed out’ and concrete approach to writing about intermittent connectedness during the period 1500–1800.
Scientists imagine for epistemic reasons, and these imaginings can be better or worse. But what does it mean for an imagining to be epistemically better or worse? There are at least three metaepistemological frameworks that offer different answers to this question: epistemological consequentialism, deontic epistemology, and virtue epistemology. This paper presents empirical evidence that scientists adopt each of these different epistemic frameworks with respect to imagination, but argues that the way they do this is best explained if scientists are fundamentally epistemic consequentialists about imagination.