Medication treatment perceptions, concerns and expectations among depressed individuals with Type I Bipolar Disorder

BACKGROUND: Subjective experience of illness affects outcomes among populations with bipolar disorder (BD). This cross-sectional study combined qualitative and quantitative approaches to evaluate perceived treatment effects, concerns and expectations among 90 individuals with BD. METHODS: Adults with type I BD, mean age 36.6 years, 51% women, completed a semi-structured interview that was audio taped, transcribed, coded and analyzed along emergent themes. Quantitative scales measured depressive symptoms (Hamilton Depression Scale/HAMD), psychopathology (Clinical Global Impression/CGI), and insight and treatment attitudes (Insight and Treatment Attitudes Questionnaire/ITAQ). RESULTS: Individuals had moderate depression and psychopathology with good insight into need for treatment. Drug treatment was perceived as beneficial, by “stabilizing” or “balancing” mood (42%, N=38), decreasing anxiety/depressive symptoms (19%, N=17) and improving sleep (10%, N=9). While 39%, (N=35) of individuals denied medication concerns, nearly 29%, (N=26) feared possible long-term effects, particularly diabetes or liver/kidney damage. Media stories and advertisements contributed to medication fears. Hopes and expectations for treatment ranged from those that were symptom or functional status-based, such as desiring mood stabilization and elimination of specific symptoms (23%, N=21), to more global hopes such as “being normal” (20%, N=18) or “cured” (18%, N=16). LIMITATIONS: Limitations include relatively small sample, lack of a comparator, inclusion of only depressed individuals and those willing to discuss their illness experience. CONCLUSIONS: While individuals with BD appreciate the effects of medications, concerns regarding adverse effects and discrepancy between actual and hoped-for outcomes can be substantial. Subjective experience with medications using qualitative and quantitative methods should be explored in order to optimize treatment collaboration and outcomes

Second generation of AVTIS FMCW millimeter wave radars for mapping volcanic terrain

The second generation AVTIS ground-based millimeter wave instruments designed for monitoring topography of volcanic lava domes are solid state 94 GHz FMCW rastered, real beam radars operating at ranges of up to ~7 km with a range resolution of ~2.5 m. Operating ten times faster than the prototype with reduced power consumption suitable for battery powered portable use as well as installation at a telemetered site under solar power, we examine their performance as tools for monitoring topography over time and report on the operational statistics both as a radar sensor and as a means of generating digital elevation maps

The Citizen and neighborhood renewal : a collection of working papers on planning with people in the inner city

Report: ii, 328 p., maps, digital fileThis report is designed primarily to be of assistance to those involved in the act of renewing or developing our cities, whether elected politician, civic administrator, professional advisor, community organizer or ordinary citizen. It will hopefully provide suggestions that can be immediately applied and used in developing new polid.es, planning projects or carrying out programs. It is intended as a guide, a manual, a catalogue on how to better plan and design city neighbourhoods

Outcomes and Duration of Tidal Evolution in a Star-Planet-Moon System

We formulated tidal decay lifetimes for hypothetical moons orbiting extrasolar planets with both lunar and stellar tides. Previous work neglected the effect of lunar tides on planet rotation, and are therefore applicable only to systems in which the moon's mass is much less than that of the planet. This work, in contrast, can be applied to the relatively large moons that might be detected around newly-discovered Neptune-mass and super-Earth planets. We conclude that moons are more stable when the planet/moon systems are further from the parent star, the planets are heavier, or the parent stars are lighter. Inclusion of lunar tides allows for significantly longer lifetimes for a massive moon relative to prior formulations. We expect that the semi-major axis of the planet hosting the first detected exomoon around a G-type star is 0.4-0.6 AU and is 0.2-0.4 AU for an M-type star.Comment: Accepted for publication in ApJ, 19 pages, 19 figure

Bioreactance is a reliable method for estimating cardiac output at rest and during exercise

Background: Bioreactance is a novel noninvasive method for cardiac output measurement that involves analysis of blood flow-dependent changes in phase shifts of electrical currents applied across the thorax. The present study evaluated the test-retest reliability of bioreactance for assessing haemodynamic variables at rest and during exercise. Methods: 22 healthy subjects (26 (4) yrs) performed an incremental cycle ergometer exercise protocol relative to their individual power output at maximal O2 consumption (Wmax) on two separate occasions (trials 1 and 2). Participants cycled for five 3 min stages at 20, 40, 60, 80 and 90% Wmax. Haemodynamic and cardiorespiratory variables were assessed at rest and continuously during the exercise protocol. Results: Cardiac output was not significantly different between trials at rest (P=0.948), or between trials at any stage of the exercise protocol (all P>0.30). There was a strong relationship between cardiac output estimates between the trials (ICC=0.95, P0.15), and strong relationships between trials were found (ICC=0.83, P<0.001). Conclusions: The bioreactance method demonstrates good test-retest reliability for estimating cardiac output at rest and during different stages of graded exercise testing including maximal exertion

Current definitions of “transdiagnostic” in treatment development: A search for consensus

Research in psychopathology has identified psychological processes that are relevant across a range of Diagnostic and Statistical Manual (DSM) mental disorders, and these efforts have begun to produce treatment principles and protocols that can be applied transdiagnostically. However, review of recent work suggests that there has been great variability in conceptions of the term “transdiagnostic” in the treatment development literature. We believe that there is value in arriving at a common understanding of the term “transdiagnostic.” The purpose of the current manuscript is to outline three principal ways in which the term “transdiagnostic” is currently used, to delineate treatment approaches that fall into these three categories, and to consider potential advantages and disadvantages of each approachFirst author draf

The effect of age on the relationship between cardiac and vascular function

Age-related changes in cardiac and vascular function are associated with increased risk of cardiovascular mortality and morbidity. The aim of the present study was to define the effect of age on the relationship between cardiac and vascular function. Haemodynamic and gas exchange measurements were performed at rest and peak exercise in healthy individuals. Augmentation index was measured at rest. Cardiac power output, a measure of overall cardiac function, was calculated as the product of cardiac output and mean arterial blood pressure. Augmentation index was significantly higher in older than younger participants (27.7 ± 10.1 vs. 2.5 ± 10.1%, P < 0.01). Older people demonstrated significantly higher stroke volume and mean arterial blood pressure (P < 0.05), but lower heart rate (145 ± 13 vs. 172 ± 10 beats/min, P < 0.01) and peak oxygen consumption (22.5 ± 5.2 vs. 41.2 ± 8.4 ml/kg/min, P < 0.01). There was a significant negative relationship between augmentation index and peak exercise cardiac power output (r = −0.73, P = 0.02) and cardiac output (r = −0.69, P = 0.03) in older participants. Older people maintain maximal cardiac function due to increased stroke volume. Vascular function is a strong predictor of overall cardiac function in older but in not younger people