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Rhythm in language and music: parallels and differences.

Rhythm is widely acknowledged to be an important feature of both speech and music, yet there is little empirical work comparing rhythmic organization in the two domains. One approach to the empirical comparison of rhythm in language and music is to break rhythm down into subcomponents and compare each component across domains. This approach reveals empirical evidence that rhythmic grouping is an area of overlap between language and music, but no empirical support for the long-held notion that language has periodic structure comparable to that of music. Focusing on the statistical patterning of event duration, new evidence suggests that the linguistic rhythm of a culture leaves an imprint on its musical rhythm. The latter finding suggests that one effective strategy for comparing rhythm in language and music is to determine if differences in linguistic rhythm between cultures are reflected in differences in musical rhythm.

Auditory Perception↗

Caring and justice: a study of two approaches to health care ethics.

This article presents an empirical study of approaches to ethical decision-making among nurses and doctors. It takes as its starting point the distinction between the perspectives of care and of justice in ethical thinking, and the view that nurses' thinking will be aligned with the former and doctors' with the latter. It goes on to argue that the differences in these approaches are best understood in terms of the distinction between partialist and impartialist modes of moral thinking. The study seeks to determine the distribution of these modes of thinking between nurses and doctors, and finds that these are no significant differences between them. A 'two-level' philosophical view of the nature of moral thinking is appealed to in order to explain the study findings.

Adult↗

Spontaneous eye blinking in human infants: a review.

Spontaneous eye blinking has been studied in clinical and neuropharmacological research in adult humans and nonhuman primates as a putative index of central dopamine system activity. One purpose of this review is to provide a general overview of the research on spontaneous eye blinking with an emphasis on the relationship between spontaneous eye blinking and central dopamine systems. We suggest that the body of research from human (adults, children, and infants) and nonhuman primates supports the continued empirical investigation of spontaneous eye blinking in human infants. A second purpose is to present approaches for empirical work to further investigate the development, correlates, and mechanisms of spontaneous eye blinking in human infants. The results of further investigation may reveal new insights into relationships between the central nervous system activity and behavior in early human development.

Blinking↗

Determining the competency of Alzheimer patients to consent to treatment and research.

Loss of competency is an inevitable consequence of Alzheimer disease (AD) and other progressive dementias. Of particular importance to clinicians and researchers studying dementia is determining whether a patient has the capacity to provide informed consent to treatment and medical research. No widely accepted standardized instruments exist for competency assessment, nor has competency assessment training been available to physicians. As a result, physician competency assessment has been a subjective and even idiosyncratic process. Recent studies have suggested that physicians have difficulty assessing capacity to consent in older adults and frequently disagree in their competency judgments. Accordingly, one important goal for advancing ethical and legal research in AD will involve the development of standardized approaches to determining patient capacity to give consent. This article reports the findings of recent empirical studies of competency determination in AD, focusing on work in the areas of physician competency assessment, development of standardized assessment instruments, and neuropsychological modeling of competency loss. Future directions for research in these three areas are identified.

Aged↗

Posterior probability maps and SPMs.

This technical note describes the construction of posterior probability maps that enable conditional or Bayesian inferences about regionally specific effects in neuroimaging. Posterior probability maps are images of the probability or confidence that an activation exceeds some specified threshold, given the data. Posterior probability maps (PPMs) represent a complementary alternative to statistical parametric maps (SPMs) that are used to make classical inferences. However, a key problem in Bayesian inference is the specification of appropriate priors. This problem can be finessed using empirical Bayes in which prior variances are estimated from the data, under some simple assumptions about their form. Empirical Bayes requires a hierarchical observation model, in which higher levels can be regarded as providing prior constraints on lower levels. In neuroimaging, observations of the same effect over voxels provide a natural, two-level hierarchy that enables an empirical Bayesian approach. In this note we present a brief motivation and the operational details of a simple empirical Bayesian method for computing posterior probability maps. We then compare Bayesian and classical inference through the equivalent PPMs and SPMs testing for the same effect in the same data.

Algorithms↗

Development of the Motivational Interviewing Supervision and Training Scale.

The movement to use empirically supported treatments has increased the need for researchers and supervisors to evaluate therapists' adherence to and the quality with which they implement those interventions. Few empirically supported approaches exist for providing these types of evaluations. This is also true for motivational interviewing, an empirically supported intervention important in the addictions field. This study describes the development and psychometric evaluation of the Motivational Interviewing Supervision and Training Scale (MISTS), a measure intended for use in training and supervising therapists implementing motivational interviewing. Satisfactory interrater reliability was found (generalizability coefficient p(2) = .79), and evidence was found supporting the convergent and discriminant validity of the MISTS. Recommendations for refinement of the measure and future research are discussed.

Clinical Competence↗

Prevention of childhood depression: recent findings and future prospects.

Traditionally, research on childhood mood disorders has focused on clinical trials and longitudinal course and outcome studies, rather than on prevention. Recently, however, advances in the design, methodology, and evaluation of prevention approaches and progress in understanding what factors predispose children to depression have made possible the development of theoretically driven, empirically justified approaches to the prevention of depression in youngsters who are at high risk, either because of elevated symptom levels or parental mood disorder. In this review, we outline recent empirical findings on risk factors for depression in nonreferred samples of youngsters and also in children of depressed parents. Additionally, we review three trials of preventive interventions for childhood depression that yield promising initial findings. We emphasize the need to understand both risks for depression and factors that protect youngsters at risk from succumbing to depression in guiding the development of prevention programs. We also argue that consideration of prevention of depression requires addressing broader social adversity influences that lead to poor mental health outcomes in children, even beyond the effects of parental mood disorder. We conclude with an emphasis on the importance of a developmental-transactional perspective that highlights opportunities for intervention at different points across the lifespan.

Adaptation, Psychological↗

Structured additive regression for categorical space-time data: a mixed model approach.

Motivated by a space-time study on forest health with damage state of trees as the response, we propose a general class of structured additive regression models for categorical responses, allowing for a flexible semiparametric predictor. Nonlinear effects of continuous covariates, time trends, and interactions between continuous covariates are modeled by penalized splines. Spatial effects can be estimated based on Markov random fields, Gaussian random fields, or two-dimensional penalized splines. We present our approach from a Bayesian perspective, with inference based on a categorical linear mixed model representation. The resulting empirical Bayes method is closely related to penalized likelihood estimation in a frequentist setting. Variance components, corresponding to inverse smoothing parameters, are estimated using (approximate) restricted maximum likelihood. In simulation studies we investigate the performance of different choices for the spatial effect, compare the empirical Bayes approach to competing methodology, and study the bias of mixed model estimates. As an application we analyze data from the forest health survey.

Bayes Theorem↗

Community-acquired pneumonia in patients with HIV.

Patients with HIV frequently present at some time in their illness with community-acquired pneumonia (CAP). Early in the prognosis of HIV when CD4 counts are somewhat decreased, HIV patients with CAP are infected with the same pulmonary pathogen as normal hosts plus Legionella, Salmonella or Chlamydia pneumoniae. Later in HIV, when the CD4 counts are markedly reduced, Pneumocystis carinii (PCP), CMV and acid-fast organisms (TB or MAI) are important pulmonary pathogens. This article presents a clinical approach to empiric antibiotics based on chest x-ray appearance and CD4 count. This permits a rational therapeutic approach to avoid excessive coverage commonly employed by clinicians because of the multiplicity of potential pulmonary pathogens in HIV patients with CAP.

Journal Article↗

The role of antimicrobial policies in neutropenic patients.

Antimicrobial policies in neutropenic patients are under continual review. The development of more potent broad spectrum antibiotics has allowed new approaches to empiric antibiotic therapy, including the use of a single agent rather than an antibiotic combination. The standard clinical approach in cancer patients with persistent, severe neutropenia, is hospitalization until the infective complication has resolved, but an accurate clinical stratification of patients based on different medical risks could suggest different approaches to infective complications. The desire of cancer patients to spend as much time as possible at home during the palliative or terminal phase of their illness and the high costs of hospitalization are the main motives behind the early discharge of patients from hospital and the development of strategies that move traditionally inpatient problems or therapies, to the outpatient setting.

Anti-Bacterial Agents↗

National practices regarding payment to research subjects for participating in pediatric research.

OBJECTIVE: Payment to subjects for participation in research is reportedly common, but no published data documents the nature of this practice. Institutional review boards (IRBs) are responsible for ensuring both the safety and voluntary participation of research subjects, yet guidance from federal and expert pediatric sources regarding appropriate payment approaches is conflicting. Ethical issues of payment for participation of adult versus pediatric research subjects may differ. This empirical study sought to examine current payment practices for participation in pediatric research as reported by IRBs. DESIGN: An 18-question survey regarding payment practices for participation in pediatric research was sent to IRB chairs at member institutions of the National Association of Children's Hospitals and Related Institutions, and to a systematic random sample of IRB chairs listed with the Office for Protection From Research Risks. Descriptive, nonparametric, and qualitative analyses were used to describe institution types, payment practices, and correlations among responses. RESULTS: Data from 128 institutions that conduct pediatric research revealed that payment for participation in pediatric research was allowed by 66% of responding institutions, and practices varied widely among institutions. Most responding IRBs that allowed payment required disclosure of payment before enrollment (during the consent process), following federal guidelines more closely than American Academy of Pediatrics guidelines. An IRB's perception of potential benefits or harms of a study correlated with the amount of payment approved. CONCLUSIONS: IRBs must balance the need to recruit pediatric research subjects against the risk of undue influence during the recruitment process. Federal guidelines and expert pediatric opinion differ in recommendations regarding payment; responding IRBs appeared to follow federal guidelines more closely than guidelines proposed by the American Academy of Pediatrics.

Child↗

Problems in Extinction Model Selection and Parameter Estimation.

It is a vexing problem to achieve a consensus about the proper scientific way to assess population viability for habitat conservation plans. Rather than a hypothesis-testing approach, here it is proposed to select population models, estimate extinction parameters, and assess prediction uncertainty using a pragmatic, empirical Bayesian approach. The simplest usable models include the effects of population growth, r; carrying capacity, K; Allee threshold, N(A); and environmental stochasticity, v(r). Analytic predictions of expected extinction times are available for such models. Models that are more complex can be elaborated from this basis. Selection from a hierarchy of nesting population models can often be done through the evaluation of parameters. The estimation of the most important extinction parameters can be undertaken in a variety of ways. Time series can be analyzed to estimate r(d), v(r), rho, and K. Habitat models and individualistic population models may help estimate N(A) and K and demographic stochasticity. Fine-scale biogeography and climatological data may be useful in the estimation of a variety of parameters. Because it takes many years to estimate extinction parameters accurately for a given population of interest, the most efficient estimation procedures are desirable. I propose the use of prior information from an (as yet nonexistent) population biology database. The accumulation of local information through monitoring will improve our estimates allowing adaptive management. Uncertainty in the estimates will always remain, but it may be quantified by the posterior distributions. A crude example is discussed using treefrog population data. Although the motivations, beliefs, and biases of competing stakeholders will differ, a habitat conservation plan could accommodate this variation in the prior distributions. Field experience from monitoring will increasingly clear up any discrepancies between the opposing beliefs and the real ecosystem. As the world is an uncertain place and because there is no universal scientific method, there will always be controversy and surprises. The best we can do is (1) agree about our prior information, (2) agree about the strategy of model selection and parameter estimation, and (3) agree about our strategy for adaptive management. Perhaps the greatest impediment to such prior agreements for HCPs is the likely paranoia inspired by the use of unfamiliar statistical methodology. We need to train students of ecology in a more flexible and deeper understanding of statistics and philosophy of science.

Journal Article↗

Guidelines for the microbiological quality of treated wastewater used in agriculture: recommendations for revising WHO guidelines.

Three different approaches for establishing guidelines for the microbiological quality of treated wastewater that is reused for agriculture are reviewed. These approaches have different objectives as their outcomes: the absence of faecal indicator organisms in the wastewater, the absence of a measurable excess of cases of enteric disease in the exposed population and a model-generated estimated risk below a defined acceptable risk. If the second approach (using empirical epidemiological studies supplemented by microbiological studies of the transmission of pathogens) is used in conjunction with the third approach (using a model-based quantitative risk assessment for selected pathogens) a powerful tool is produced that aids the development of regulations. This combined approach is more cost-effective than the first approach and adequately protects public health. The guideline limit for faecal coliform bacteria in unrestricted irrigation (< or = 1000 faecal coliform bacteria/ 100 ml) is valid, but for restricted irrigation < or = 10(5) faecal coliform bacteria/100 ml is recommended when adult farmworkers are exposed to spray irrigation. A limit of < or = 10(3) faecal coliform bacteria/100 ml is recommended if flood irrigation is used or children are exposed. The guideline limit for nematode eggs for both types of irrigation is adequate except when conditions favour the survival of nematode eggs and where children are exposed; in these cases it should be reduced from < or = 1 egg/l to < or = 0.1 egg/l.

Adult↗

Use of the polymerase chain reaction in the diagnosis of herpes simplex encephalitis: a decision analysis model.

PURPOSE: To evaluate the utility of an assay based on a polymerase chain reaction (PCR) of cerebrospinal fluid in the management of patients with suspected herpes simplex encephalitis. METHODS: A decision model was constructed and used to compare a PCR-based approach with empiric therapy. Inputs required by the model included the sensitivity (96%) and specificity (99%) of PCR (derived from review of the literature), the prevalence of herpes simplex encephalitis (5%, based on the actual prevalence at Barnes Hospital among patients treated empirically with acyclovir), the outcomes for patients with and without herpes simplex encephalitis (derived from clinical studies of the Collaborative Antiviral Study Group and the actual experience at Barnes Hospital), and the average duration of empiric acyclovir therapy for patients with possible herpes simplex encephalitis (5.3 days based on actual experience at Barnes Hospital). RESULTS: Using these input values, the decision model predicted better outcomes with empiric therapy. However, low rates of inappropriate discontinuation of empiric therapy in patients with herpes simplex encephalitis or improved diagnosis and outcome resulting from a negative PCR assay result in patients without herpes simplex encephalitis led to better outcomes with the PCR-based approach. The PCR-based approach was associated with 9.2 fewer doses of acyclovir per patient. CONCLUSION: Based on the decision model using conservative assumptions, a PCR-based approach can yield better outcomes and reduced acyclovir use compared with empiric therapy.

Acyclovir↗

Dual-diagnosis empirical and developmental-humanistic approaches.

The association between alcohol and/or drug dependence and major psychiatric conditions such as schizophrenia has received increased attention from the professional community. Terms such as "dual diagnosis" used to designate these clinical occurrences have become common, reflecting the interest mentioned. This chapter reviews the prevalence of the association between substance abuse and psychiatric disorder, the nature of the interactions observed, and some of the implications for patient care and health policy. Following this empirical perspective, we present a developmental-humanistic approach that has been used in the psychotherapeutic management of these problems. Our review of information on dual diagnosis suggests that the association between the two processes--substance abuse and psychiatric disorder--is not fortuitous or just the result of environmental conditions. There are complex physiopathological links at the neurobiological level that deserve research attention.

Alcoholism↗

Hierarchical Bayes models for cDNA microarray gene expression.

cDNA microarrays are used in many contexts to compare mRNA levels between samples of cells. Microarray experiments typically give us expression measurements on 1000-20 000 genes, but with few replicates for each gene. Traditional methods using means and standard deviations to detect differential expression are not satisfactory in this context. A handful of alternative statistics have been developed, including several empirical Bayes methods. In the present paper we present two full hierarchical Bayes models for detecting gene expression, of which one (D) describes our microarray data very well. We also compare the full Bayes and empirical Bayes approaches with respect to model assumptions, false discovery rates and computer running time. The proposed models are compared to existing empirical Bayes models in a simulation study and for a set of data (Yuen et al., 2002), where 27 genes have been categorized by quantitative real-time PCR. It turns out that the existing empirical Bayes methods have at least as good performance as the full Bayes ones.

Animals↗