Outcome Trajectories for Adolescents in Residential Treatment: A Statewide Evaluation

Although residential treatment represents one of the largest and most expensive components of the mental health service system for children and adolescents, little is known about the anticipated outcomes of this service. Still less is known about the trajectory through which change occurs within these settings. We examined the clinical status of 285 adolescents over a 2-year period after placement in residential treatment by the Department of Mental Health in a western state. Using a growth modeling technique, the rate of change was determined over a set of symptoms measured by the Acuity of Psychiatric Illness—Child and Adolescent Version (CAPI). Results suggest that while adolescents tended to improve overall during the course of their stays, there was considerable variation in which symptoms improved and which did not. Two symptoms actually became reliably worse with treatment. In addition, significant variation in outcomes was demonstrated across sites, with adolescents in one site getting reliably worse during the course of residential treatment. Our findings demonstrate the utility of outcomes management and have significant implications for how residential services for children and adolescents should be managed.     

The Evaluation of Arkansas Act 1220 of 2003 to Reduce Childhood Obesity: Conceptualization, Design, and Special Challenges

This article describes the evaluation of the Arkansas Act 1220 of 2003, a comprehensive legislative proposal to address the growing epidemic of childhood obesity through changes in the school environment. In addition, the article discusses specific components of the evaluation that may be applicable to other childhood obesity policy evaluation efforts. The conceptual framework for the evaluation, research questions, and evaluation design are described, along with data collection methods and analysis strategies. A mixed methods approach, including both quantitative (surveys, telephone interviews) and qualitative (key informant interviews, records reviews) approaches, was utilized to collect data from a range of informant groups including parents, adolescents, school principals, school district superintendents, and other stakeholders. Challenges encountered with the evaluation are discussed, as are strategies to overcome those challenges. Now in its 9th year, this evaluation has documented substantial changes to school policies and environments but fewer changes to student and family behaviors. The evaluation may inform the methods of other evaluations of childhood obesity prevention policies, as well as inform policymakers about how quickly they might expect implementation of such policies in their own states and localities and anticipate both positive and adverse outcomes.     

Empirically and clinically useful decision making in psychotherapy: differential predictions with treatment response models

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research networks. This article presents a strategy to disaggregate patients into homogeneous subgroups to generate optimal expected treatment response profiles, which can be used to predict and track the progress of patients in different treatment modalities. The study was based on data from 618 diagnostically diverse patients treated with either a cognitive-behavioral treatment protocol (n = 262) or an integrative cognitive-behavioral and interpersonal treatment protocol (n = 356). The validity of expected treatment response models to predict treatment in those 2 protocols for individual patients was evaluated. The ways such a procedure might be used in outpatient centers to learn more about patients, predict treatment response, and improve clinical practice are discussed.     

Bicartesian Coherence

Coherence is demonstrated for categories with binary products and sums, but without the terminal and the initial object, and without distribution. This coherence amounts to the existence of a faithful functor from a free category with binary products and sums to the category of relations on finite ordinals. This result is obtained with the help of proof-theoretic normalizing techniques. When the terminal object is present, coherence may still be proved if of binary sums we keep just their bifunctorial properties. It is found that with the simplest understanding of coherence this is the best one can hope for in bicartesian categories. The coherence for categories with binary products and sums provides an easy decision procedure for equality of arrows. It is also used to demonstrate that the categories in question are maximal, in the sense that in any such category that is not a preorder all the equations between arrows involving only binary products and sums are the same. This shows that the usual notion of equivalence of proofs in nondistributive conjunctive-disjunctive logic is optimally defined: further assumptions would make this notion collapse into triviality.     

Complex Interaction of Religiousness with other Factors in Relation to Substance Use and Misuse Among Female Athletes

Strength of religious faith (SRF) is rarely studied as a protective factor against substance use and misuse in sports. Herein, we studied the potential buffering effect of the complex socio-educational, sports, and religiousness factors in the protection against substance use and misuse, including cigarettes, analgesics, appetite suppressants, potential doping behavior, and binge drinking. The sample of subjects included 40 high-class female athletes (22–26 years of age). Using a strictly anonymous questionnaire, we investigated different social, educational, and sports factors (including SRF measured by the Santa Clara Strength of Religious Faith Questionnaire) in relation to substance use and misuse. Following the calculation of simple correlations, multiple regression analysis revealed that in combination with low sports experience, SRF has a significant buffering effect against binge alcohol drinking and consumption of appetite suppressants. The data are discussed in comparison with previous findings and theoretical background. Future studies should study the topic while observing samples of recreational and competitive athletes of both genders.     

The Enhancement of Visuospatial Processing Efficiency Through Buddhist Deity Meditation

ABSTRACT— This study examined the effects of meditation on mental imagery, evaluating Buddhist monks' reports concerning their extraordinary imagery skills. Practitioners of Buddhist meditation were divided into two groups according to their preferred meditation style: Deity Yoga (focused attention on an internal visual image) or Open Presence (evenly distributed attention, not directed to any particular object). Both groups of meditators completed computerized mental-imagery tasks before and after meditation. Their performance was compared with that of control groups, who either rested or performed other visuospatial tasks between testing sessions. The results indicate that all the groups performed at the same baseline level, but after meditation, Deity Yoga practitioners demonstrated a dramatic increase in performance on imagery tasks compared with the other groups. The results suggest that Deity meditation specifically trains one's capacity to access heightened visuospatial processing resources, rather than generally improving visuospatial imagery abilities.     

Coherence in Substructural Categories

It is proved that MacLane's coherence results for monoidal and symmetric monoidal categories can be extended to some other categories with multiplication; namely, to relevant, affine and cartesian categories. All results are formulated in terms of natural transformations equipped with graphs (g-natural transformations) and corresponding morphism theorems are given as consequences. Using these results, some basic relations between the free categories of these classes are obtained.     

Does playing blindfold chess reduce the quality of game: comments on chabris and hearst (2003)

Blindfold chess is a special type of chess game where both the board and pieces are not visible to its players. This paper aims to determine whether the quality of the game played blindfolded is lower than when played under normal conditions. The best chess program was used to analyze games played by the world's top Grandmasters under both conditions. We have analyzed the Monaco 1993–1998 data set introduced by Chabris and Hearst (2003) . The results showed that although a larger number of mistakes occurred while playing blindfolded, no significant statistical difference between the rapid and blindfold games has been found. Nevertheless, by applying the same methodology to the Monaco 2002–2007 data set a substantial difference between the blindfold and the rapid chess game was noticed. In this paper, we have addressed the possible improvement of the chess game quality and the advances in chess programs that may be responsible for detecting more blunders.     

Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study

Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca’s area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.