Subjective quality of life of surgically treated glioma patients undergoing polychemotherapy

25 patients with glioma were questioned as to how they apprehended and appreciated their state of health and their psychosocial situation 1 1/2 years (s = 4 months) after the start of their postoperative polychemotherapy. In their opinion, their health was relatively good, that is, they claimed to suffer little pain, few complaints, little feeling of inadequacy, few fears for the future. They regarded the mode of treatment as being somewhat more inconvenient. Such an unexpectedly positive response, in view of the poor prospect, raises the question as to its provenance. A significant cause is seen in the organic psycho-syndrome, and its significance is made the subject of the concluding discussion, with reference to adaptation mechanisms and specifics of the illness.     

Eye blink detection for different driver states in conditionally automated driving and manual driving using EOG and a driver camera

In this article, we examine the performance of different eye blink detection algorithms under various constraints. The goal of the present study was to evaluate the performance of an electrooculogram- and camera-based blink detection process in both manually and conditionally automated driving phases. A further comparison between alert and drowsy drivers was performed in order to evaluate the impact of drowsiness on the performance of blink detection algorithms in both driving modes. Data snippets from 14 monotonous manually driven sessions (mean 2 h 46 min) and 16 monotonous conditionally automated driven sessions (mean 2 h 45 min) were used. In addition to comparing two data-sampling frequencies for the electrooculogram measures (50 vs. 25 Hz) and four different signal-processing algorithms for the camera videos, we compared the blink detection performance of 24 reference groups. The analysis of the videos was based on very detailed definitions of eyelid closure events. The correct detection rates for the alert and manual driving phases (maximum 94%) decreased significantly in the drowsy (minus 2% or more) and conditionally automated (minus 9% or more) phases. Blinking behavior is therefore significantly impacted by drowsiness as well as by automated driving, resulting in less accurate blink detection.     

Acceptability,Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.     

States of grace: Eureka moments and the recognition of the unthought known

In this paper we consider states of grace in analysis. These encompass a range of phenomena which share an experience of something being received or revealed rather than produced by the ego. It feels that they are events that happen rather than events that are made to occur. They are marked by a profound sense of transformation of feeling tone. The quality of relatedness in the analytic dyad is also heightened. Some of these phenomena have been referred to as experiences of the self, synchronicities, moments of meeting, the unthought known and Eureka moments. The latter are experiences of sudden realization where a meaningful thought or image emerges which results in a dramatic shift in direction of the analysis and a transcendence of impasse. Although many authors describe these phenomena, we find that a Jungian approach provides a loom on which these threads can be woven together. Jung's concept of the transcendent function and his understanding of the gift of grace are particularly illuminating here. We also consider the conditions which allow grace to be experienced and how these inform our analytic practice.     

Contextual Integration in Multiparty Audience Design

Communicating with multiple addressees poses a problem for speakers: Each addressee necessarily comes to the conversation with a different perspective—different knowledge, different beliefs, and a distinct physical context. Despite the ubiquity of multiparty conversation in everyday life, little is known about the processes by which speakers design language in multiparty conversation. While prior evidence demonstrates that speakers design utterances to accommodate addressee knowledge in multiparty conversation, it is unknown if and how speakers encode and combine different types of perspective information. Here we test whether speakers encode the perspective of multiple addressees, and then simultaneously consider their knowledge and physical context during referential design in a three‐party conversation. Analyses of referential form—expression length, disfluency, and elaboration rate—in an interactive multiparty conversation demonstrate that speakers do take into consideration both addressee knowledge and physical context when designing utterances, consistent with a knowledge‐scene integration view. These findings point to an audience design process that takes as input multiple types of representations about the perspectives of multiple addressees, and that bases the informational content of the to‐be‐designed utterance on a combination of the perspectives of the intended addressees.     

Audience Design in Multiparty Conversation

How do speakers design what they say in order to communicate effectively with groups of addressees who vary in their background knowledge of the topic at hand? Prior findings indicate that when a speaker addresses a pair of listeners with discrepant knowledge, that speakers Aim Low, designing their utterances for the least knowledgeable of the two addressees. Here, we test the hypothesis that speakers will depart from an Aim Low approach in order to efficiently communicate with larger groups of interacting partners. Further, we ask whether the cognitive demands of tracking multiple conversational partners' perspectives places limitations on successful audience design. We find that speakers can successfully track information about what up to four of their partners do and do not know in conversation. When addressing groups of 3–4 addressees at once, speakers design language based on the combined knowledge of the group. These findings point to an audience design process that simultaneously represents the perspectives of multiple other individuals and combines these representations in order to design utterances that strike a balance between the different needs of the individuals within the group.