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Advances in digital technology have put music libraries at people’s fingertips, giving them immediate access to more music than ever before. Here we overcome limitations of prior research by leveraging ecologically valid streaming data: 17.6 million songs and over 662,000 hr of music listened to by 5,808 Spotify users spanning a 3-month period. Building on interactionist theories, we investigated the link between personality traits and music listening behavior, described by an extensive set of 211 mood, genre, demographic, and behavioral metrics. Findings from machine learning showed that the Big Five personality traits are predicted by musical preferences and habitual listening behaviors with moderate to high accuracy. Importantly, our work contrasts a recent self-report-based meta-analysis, which suggested that personality traits play only a small role in musical preferences; rather, we show with big data and advanced machine learning methods that personality is indeed important and warrants continued rigorous investigation.

Background: Uncontrolled blood pressure (BP) in intracerebral hemorrhage (ICH) survivors is common and associated with adverse clinical outcomes. We investigated whether characteristics of the ICH itself were associated with uncontrolled BP at follow-up. Methods: Subjects were consecutive patients aged ⩾18 years with primary ICH enrolled in the prospective longitudinal ICH study at Massachusetts General Hospital between 1994 and 2015. We assessed the prevalence of uncontrolled BP (mean BP ⩾140/90 mmHg) 6 months after index event. We used multivariable logistic regression models to assess the effect of hematoma location, volume, and event year on uncontrolled BP. Results: Among 1492 survivors, ICH was lobar in 624 (42%), deep in 749 (50%), cerebellar in 119 (8%). Lobar ICH location was associated with increased risk for uncontrolled BP after 6 months (OR 1.35; 95% CI [1.08–1.69]). On average, lobar ICH survivors were treated with fewer antihypertensive drugs compared to the rest of the cohort: 2.1 ± 1.1 vs 2.5 ± 1.2 ( p Conclusions: ICH survivors with lobar hemorrhage were more likely to have uncontrolled BP after 6 months follow-up. This appears to be a result of being prescribed fewer antihypertensive medications. Future treatment strategies should focus on aggressive BP control after ICH independent of hemorrhage location.

Sensory stimulation evokes a local, vasodilation-mediated blood flow increase to the activated brain region, which is referred to as functional hyperemia. Spontaneous vasomotion is a change in arteriolar diameter that occurs without sensory stimulation, at low frequency (∼0.1 Hz). These vessel diameter changes are a driving force for perivascular soluble waste clearance, the failure of which has been implicated in neurodegenerative disease. Stimulus-evoked vascular reactivity is known to propagate along penetrating arterioles to pial arterioles, but it is unclear whether spontaneous vasomotion propagates similarly. We therefore imaged both stimulus-evoked and spontaneous changes in pial arteriole diameter in awake, head-fixed mice with 2-photon microscopy. By cross-correlating different regions of interest (ROIs) along the length of imaged arterioles, we assessed vasomotion propagation. We found that both during rest and during visual stimulation, one-third of the arterioles showed significant propagation (i.e., a wave), with a median (interquartile range) wave speed of 405 (323) µm/s at rest and 345 (177) µm/s during stimulation. In a second group of mice, with GCaMP expression in their vascular smooth muscle cells, we also found spontaneous propagation of calcium signaling along pial arterioles. In summary, we demonstrate that spontaneous vasomotion propagates along pial arterioles like stimulus-evoked vascular reactivity.

The pathophysiology of microhemorrhages in the context of cerebral amyloid angiopathy (CAA) remains poorly understood. Here we used in vivo two-photon microscopy in aged APP/PS1 mice with mild-to-moderate CAA to assess the formation of microhemorrhages and their spatial relationship with vascular Aβ depositions in the surrounding microvascular network. Mice with chronic cranial windows were intravenously injected with fluorescent dextran to visualize the vessels and a fluorescently labeled anti-fibrin antibody to visualize microhemorrhages. Focal vessel irradiations resulted in extravascular fibrin-positive clots at individual rupture sites that remained visible for weeks. Spontaneous extravascular fibrin-positive clots were more often observed in 19-month-old transgenic APP/PS1 mice compared to their wild-type littermate controls ( p = 0.039), after heparin administration. In the transgenic mice, these spontaneous leakage sites frequently occurred at arteriolar segments without CAA at bifurcations or vessel bends. These findings suggest that the presence of vascular Aβ per se does not directly predispose vessels to leak, but that complex flow dynamics within CAA-affected vascular networks likely play a role. Our in vivo approach for the detection of individual spontaneous leakage sites may be used in longitudinal studies aimed to assess structural and functional alterations at the single-vessel level leading up to microhemorrhage formation.

Funder: Zuckerman STEM Leadership Program, There is evidence that music-based interventions can be effective in treating clinical and non-clinical populations. With the emergence of audio-visual technologies, there are new opportunities for developing web-based applications that have therapeutic effects in mental health and medical settings. Here we conducted a pilot study ( N = 100) to test if an immersive web-based spatial audio application can decrease stress and negative mood states. Results showed that the application was effective for both clinical ( n = 40) and non-clinical ( n = 60) groups, and that the effect was most profound for individuals diagnosed with depression and anxiety disorders. Though the present study needs to be replicated with physiological methods, the findings provide initial evidence that web-based spatial audio applications can be effective for short-term stress reduction and have the potential to be a supplement to clinical music interventions, but not a replacement or substitute for such interventions.

Funder: Jacobs and Nuffield Foundations, Previous research on the links between music and posttraumatic resilience have typically relied on small sample sizes and case studies from clinical settings. To address this important gap, we conducted an online study to measure childhood trauma and adult musical engagement in everyday life in non-clinical contexts. The present study ( N = 634) investigated these links by administering online questionnaires about musical engagement, personality, and demographics to adult survivors of childhood trauma. Hierarchical regression analyses showed that social music listening predicted increased well-being in males while affective music listening predicted decreased well-being in males. Gender moderated the interaction between affective engagement and well-being: affective engagement was linked to increased well-being in females and a decrease in males. Furthermore, neuroticism moderated the interaction between narrative listening and well-being: narrative listening was linked to increased well-being for participants with low neuroticism and a decrease for those with high neuroticism. These findings may reflect general gender differences in coping styles: emotional reflection for females and emotional distraction for males, and suggest gender differences in attentional biases, rumination, and capacities for disassociation. Taken together, the results show that there are individual differences in musical engagement and posttraumatic resilience based on gender and personality. These findings are useful for the development of music-based coping strategies that mental health professionals can tailor for individual clients.

Background: Management options for Peyronie’s disease (PD) are determined by the phase of the condition. Experts counsel against surgical intervention during the active phase of PD. Patients with chronic phase of PD are offered either collagenase injections or surgical intervention. Accurately characterising a patient’s phase of PD is crucial in determining the appropriate treatment option. Objective: To investigate neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as possible predictors for the determination of acute or chronic phase of PD. Methods: This study retrospectively queried all patients who presented for initial diagnosis of PD from 2016 to 2020 and had complete blood count (CBC) laboratory values before initial therapy. PD phase was defined per the American Urological Association guidelines. The active phase of PD was defined as a changing penile curvature and/or growing palpable plaque. The chronic phase of PD was defined as a stabilised penile curvature. All statistical analyses were two-tailed, using a significance level of 0.05. Results: One hundred nine patients met inclusion: 27 (25%) active phase and 82 (75%) chronic phase patients. Demographic and erectile characteristics were not statistically different between the two groups. NLR and PLR values between active and chronic phase patients were comparable ( p > 0.05). A linear regression evaluated correlations between the duration of PD and either NLR or PLR. Neither NLR nor PLR was correlated with PD duration on Spearman, Pearson, or Kandall tests. In addition, NLR and PLR were not noted to be predictors of PD phase on multiple logistic regression. Finally, a receiver operator characteristic curve was generated. NLR and PLR yielded an area under curve of 58% and 57.8%, respectively. Conclusions: Two recent studies suggested NLR and PLR could be used to predict the phases of PD. However, after evaluating a cohort of 109 men from our institution, our data do not support the use of peripheral blood PLR or NLR to determine the phase of PD.

Background: Patient reported outcome measures (PROM) allow for a comprehensive assessment of physical and emotional factors not accounted for by functional performance testing after anterior cruciate ligament reconstruction (ACLR). The ACL-RSI gauges an athlete’s psychological readiness to return to sport and recent evidence suggest this measure may help identify individuals at risk of secondary injury. Our current knowledge of how physical function and psychological preparedness change during recovery after ACLR in youth athletes it limited. Understanding the change and interplay between these factors will help optimize rehabilitation and improve patient care. Purpose: The purpose of this study was to evaluate changes in psychological readiness (ACL-RSI), knee related function (Pedi-IKDC) and generalized activity (Pedi-FABS) throughout the course of rehabilitation in a group of pre-adolescents after ACLR. Methods: A prospective observational cohort study of pre-adolescent athletes who underwent ACLR within a single institution. All subjects had surgery between 12/2017-12/2020 and followed institutional specific protocol emphasizing clinical rehabilitation for a duration of 7-9 months. Subjects completed a series of PROM (ACL-RSI, Pedi-IKDC and Pedi-FABS) quarterly for the initial 12 months following ACLR. Friedman’s test for repeated measures and Wilcoxon Matched Pairs Signed Ranks Test with a Bonferonni correction (p Results: A total of 28 subjects were included in this analysis (21 male; mean age 12.43 ± 1.40 yrs). Pedi-FABS and Pedi-IKDC both demonstrated significant changes from 3 months (Pedi-FABS 2.63 ± 3.95, Pedi-IKDC 70.84 ± 11.36) to 6 months (Pedi-FABS 9.9 ± 8.55, Pedi-IKDC 87.05 ± 8.03) and from 6 to 9 months (Pedi-FABS 16.57 ± 6.88, Pedi-IKDC 94.40 ± 5.24) (p Conclusion: In preadolescent athletes, steady improvements in generalized activity and knee function occur during the first 9 months following ACLR. Psychological readiness to return to sport trended upwards, but didn’t reach statistical significance until later in recovery. Beyond 9 months, physical function and psychological preparedness remain largely unchanged. These data support a prolonged recovery period is required to maximize self-reported function and psychological readiness after ACLR in preadolescent athletes. [Figure: see text][Figure: see text][Figure: see text]

In 2011, the National Prevention, Health Promotion, and Public Health Council named mental and emotional well-being as 1 of 7 priority areas for the National Prevention Strategy. In this article, we discuss emotional well-being as a scientific concept and its relevance to public health. We review evidence that supports the association between emotional well-being and health. We propose a national emotional well-being initiative and describe its 6 components: systematic measurement of emotional well-being, identification of the drivers of emotional well-being, formation of partnerships with diverse stakeholders, implementation and dissemination of evidence-based interventions to promote emotional well-being and its drivers, development of public health messaging, and identification of and strategies to address disparities in emotional well-being and its drivers. Finally, we discuss ways in which a national emotional well-being initiative would complement current public health efforts and the potential challenges to such an initiative.

Open plan offices are both popular and controversial. We studied the response of a group moving from shared, but closed offices to an open plan office. The main data source reported here is a workplace satisfaction survey given pre-move, post-move, and to a lab baseline comparison group at the same organization, with some additional data from observations and interviews. Workers moving to the open plan office appreciated the flexible support for collaboration and the space’s appearance. There was lower satisfaction related to space for private concentrated work, temperature control, and ability to have private conversations. There were also some statistical interactions suggesting more positive responses by males and less positive responses by introverts; analysis was limited by small sample size. Observations and interviews gave further insight into open plan “neighborhoods” and the design of ad hoc spaces.

Cerebral amyloid angiopathy (CAA) is a common cause of cognitive impairment in older individuals. This study aimed to investigate predictors of dementia in CAA patients without intracerebral hemorrhage (ICH). A total of 158 non-demented patients from the Stroke Service or the Memory Clinic who met the modified Boston Criteria for probable CAA were included. At baseline, neuroimaging markers, including lobar microbleeds (cerebral microbleeds (CMBs)), white matter hyperintensities (WMH), cortical superficial siderosis (cSS), magnetic resonance imaging (MRI)-visible centrum semiovale perivascular spaces (CSO-PVS), lacunes, and medial temporal atrophy (MTA) were assessed. The overall burden of small vessel disease (SVD) for CAA was calculated by a cumulative score based on CMB number, WMH severity, cSS presence and extent and CSO-PVS severity. The estimated cumulative dementia incidence at 1 year was 14% (95% confidence interval (CI): 5%–23%), and 5 years 73% (95% CI: 55%, 84%). Age (hazard ratio (HR) 1.05 per year, 95% CI: 1.01–1.08, p = 0.007), presence of MCI status (HR 3.40, 95% CI: 1.97–6.92, p

Cyber defense requires decision making under uncertainty, yet this critical area has not been a focus of research in judgment and decision-making. Future defense systems, which will rely on software-defined networks and may employ “moving target” defenses, will increasingly automate lower level detection and analysis, but will still require humans in the loop for higher level judgment. We studied the decision making process and outcomes of 17 experienced network defense professionals who worked through a set of realistic network defense scenarios. We manipulated gain versus loss framing in a cyber defense scenario, and found significant effects in one of two focal problems. Defenders that began with a network already in quarantine (gain framing) used a quarantine system more, as measured by cost, than those that did not (loss framing). We also found some difference in perceived workload and efficacy. Alternate explanations of these findings and implications for network defense are discussed.

Background and purpose Blood pressure reduction is a promising intervention for acute intracerebral hemorrhage, but clinical trials of this treatment often exclude those with anticoagulant-associated intracerebral hemorrhage, leaving it unclear whether this population might benefit. We examined whether persistently elevated blood pressure values (blood pressure burden) over the first 24 h are associated with hematoma expansion and mortality in anticoagulant-associated intracerebral hemorrhage. Methods We retrospectively identified consecutive patients with primary anticoagulant-associated intracerebral hemorrhage (warfarin anticoagulation) who presented within 6 h after symptom onset and a matched set of non-anticoagulant-associated intracerebral hemorrhage patients. Associations between 24 h blood pressure burden, hematoma expansion, and mortality were evaluated using univariable and multivariable logistic regression. Results Sixty-nine anticoagulant-associated intracerebral hemorrhage and 69 matched non-anticoagulant-associated intracerebral hemorrhage patients were included. Hematoma expansion occurred in 25 anticoagulant-associated intracerebral hemorrhage patients (36%) and 15 control patients (22 %; p = 0.091). Twenty-four-hour blood pressure burden was in fact lower in anticoagulant-associated intracerebral hemorrhage than in non-anticoagulant-associated intracerebral hemorrhage patients (p = 0.033). No association was found in anticoagulant-associated intracerebral hemorrhage and non-anticoagulant-associated intracerebral hemorrhage between BP burden, hematoma expansion, and 30-day mortality. Conclusion We found no evidence that higher 24 h blood pressure burden is associated with hematoma expansion or mortality in anticoagulant-associated intracerebral hemorrhage.

Research suggests that musical preferences are linked to personality, but this research has been hindered by genre-based theories and methods. We address this limitation using a novel method based on the actual attributes that people perceive from music. In Study 1, using 102 musical pieces representing 26 genres and subgenres, we show that 38 perceived attributes in music can be organized into three basic dimensions: arousal, valence, and depth. In Study 2 ( N = 9,454), we show that people’s preferences for these musical attributes reflected their self-ratings of personality traits. Importantly, personality was found to predict musical preferences above and beyond demographic variables. These findings advance previous theory and research and have direct applications for the music industry, recommendation algorithms, and health-care professionals.

Perivascular spaces are an emerging marker of small vessel disease. Perivascular spaces in the centrum semiovale have been associated with cerebral amyloid angiopathy. However, a direct topographical relationship between dilated perivascular spaces and cerebral amyloid angiopathy severity has not been established. We examined this association using post-mortem magnetic resonance imaging in five cases with evidence of cerebral amyloid angiopathy pathology. Juxtacortical perivascular spaces dilation was evaluated on T2 images and related to cerebral amyloid angiopathy severity in overlying cortical areas on 34 tissue sections stained for Amyloid β. Degree of perivascular spaces dilation was significantly associated with cerebral amyloid angiopathy severity (odds ratio = 3.3, 95% confidence interval 1.3–7.9, p = 0.011). Thus, dilated juxtacortical perivascular spaces are a promising neuroimaging marker of cerebral amyloid angiopathy severity.

The importance of triangulating multiple sources of data in the design of tools, technology, and clinical workspaces has not been explicitly addressed in the applied human factors literature. In this paper, we describe an applied human factors case study in which Cognitive Task Analysis was used to triangulate the needs, goals, and design requirements from various stakeholder groups for the design of a Newborn Intensive Care Unit. To facilitate development of common ground on the design goals, in our interviews, we asked questions about (a) stated design goals to elicit the perspectives of meaning across the user groups and (b) schematic renderings of the proposed space. They served as a way to establish a representative definition of each design goal accounting for the perspectives of all user groups. We found that each role brought a perspective and a level of detail based on his/her role goals and lived experience to the design goals. The goals and tradeoffs illuminated by our approach can only be identified when multiple perspectives are collected. Source triangulation should be pursued as part of standard human factors methods to achieve design and evaluation objectives in the context of complex sociotechnical systems.

Cerebral amyloid angiopathy (CAA) is a common form of cerebral small vessel disease and an important risk factor for intracerebral hemorrhage and cognitive impairment. While the majority of research has focused on the hemorrhagic manifestation of CAA, its ischemic manifestations appear to have substantial clinical relevance as well. Findings from imaging and pathologic studies indicate that ischemic lesions are common in CAA, including white-matter hyperintensities, microinfarcts, and microstructural tissue abnormalities as detected with diffusion tensor imaging. Furthermore, imaging markers of ischemic disease show a robust association with cognition, independent of age, hemorrhagic lesions, and traditional vascular risk factors. Widespread ischemic tissue injury may affect cognition by disrupting white-matter connectivity, thereby hampering communication between brain regions. Challenges are to identify imaging markers that are able to capture widespread microvascular lesion burden in vivo and to further unravel the etiology of ischemic tissue injury by linking structural magnetic resonance imaging (MRI) abnormalities to their underlying pathophysiology and histopathology. A better understanding of the underlying mechanisms of ischemic brain injury in CAA will be a key step toward new interventions to improve long-term cognitive outcomes for patients with CAA.

The incidence of stroke and dementia are diverging across the world, rising for those in low-and middle-income countries and falling in those in high-income countries. This suggests that whatever factors cause these trends are potentially modifiable. At the population level, neurological disorders as a group account for the largest proportion of disability-adjusted life years globally (10%). Among neurological disorders, stroke (42%) and dementia (10%) dominate. Stroke and dementia confer risks for each other and share some of the same, largely modifiable, risk and protective factors. In principle, 90% of strokes and 35% of dementias have been estimated to be preventable. Because a stroke doubles the chance of developing dementia and stroke is more common than dementia, more than a third of dementias could be prevented by preventing stroke. Developments at the pathological, pathophysiological, and clinical level also point to new directions. Growing understanding of brain pathophysiology has unveiled the reciprocal interaction of cerebrovascular disease and neurodegeneration identifying new therapeutic targets to include protection of the endothelium, the blood-brain barrier, and other components of the neurovascular unit. In addition, targeting amyloid angiopathy aspects of inflammation and genetic manipulation hold new testable promise. In the meantime, accumulating evidence suggests that whole populations experiencing improved education, and lower vascular risk factor profiles (e.g., reduced prevalence of smoking) and vascular disease, including stroke, have better cognitive function and lower dementia rates. At the individual levels, trials have demonstrated that anticoagulation of atrial fibrillation can reduce the risk of dementia by 48% and that systolic blood pressure lower than 140 mmHg may be better for the brain. Based on these considerations, the World Stroke Organization has issued a proclamation, endorsed by all the major international organizations focused on global brain and cardiovascular health, calling for the joint prevention of stroke and dementia. This article summarizes the evidence for translation into action. © 2019 the Alzheimer’s Association and the World Stroke Organisation. Published by Elsevier Inc. All rights reserved.

A key strategy for improving healthcare outcomes is the development of a sufficient number of health care professionals at both the front line and in leadership positions who partner with human factors experts to promulgate the lessons of patient safety and quality improvement (PS/QI). The complexity of healthcare systems necessitates effective collaboration to achieve gains in PS/QI. A “Patient Safety and Quality Leadership” (PASQUAL) Scholars program was developed at the University of Michigan to provide clinicians with a theoretical and practical underpinning of human factors, QI, and PS knowledge. The scholars program's curriculum has been developed and refined to create clinical leaders who can work together with human factors professionals to have a significant impact on healthcare outcomes. The PASQUAL Scholars curriculum provides a concrete, time-tested blueprint for a successful program to improve safety and quality, and provide a human infrastructure of partners in human factors efforts.

Recent decades have witnessed shifts in the division of labor among actors in the public, nonprofit, and private sectors, leading in part to new forms of governance. Indeed, some recent scholarship argues that nongovernmental organizations may go beyond their provisional and advocacy functions to play a much more central role in actually governing by contributing directly to public decision-making and action as part of the governing process. This article examines the governance roles of neighborhood organizations acting to shape community action in Chicago and their relationships with local government. It finds that while engaging in governance processes in both direct and indirect ways, neighborhood organizations often function at the interstices of public and private action created by absences or gaps in state policy or by local action. Developing these liminal spaces may be important to increase the influence of neighborhood organizations and their capacity to contribute directly to governing.

We report a study of monitor alarm response conducted in the newly designed Transitional Care Center (TCC) at Cincinnati Children’s Hospital Medical Center. A key component of the new TCC design has been the development and implementation of a Monitor Technician (MT) position. We examined the MT role from a human factors perspective, with particular focus on the MT’s coordination and communication with nurses (RNs) and respiratory therapists (RTs). We conducted observations and Cognitive Task Analysis interviews of MTs, RNs, and RTs. In this paper, we describe the value of the MT’s role and define the challenges associated with the MT’s responsibilities. MTs serve an important support function, but they face challenges in locating RNs/RTs to respond to alarms and at times, may be the only “eyes on” the patients, making training and preparation a critical aspect of the MT’s function. In response to findings, CCHMC has taken a number of steps to improve alarm and alert responses and provide further support to the MT’s role. The current study serves as a demonstration of the principles and methods that human factors can offer to healthcare organizations to support patient safety and quality of care.

The authors developed advance consent in Japanese for epidural anesthesia for pregnant Japanese-speaking women. Their explanatory, sequential mixed methods design involved a survey (QUAN) and telephone interviews with Japanese women (QUAL). An e-mail survey of health professionals (quan/ qual) was conducted concurrently to the QUAL arm. Japanese women and health professionals found advance consent as helpful, though minor problems were identified. Advance consent helped lower communication barriers, and the women wanted more information about pain control. This mixed methods study of Japanese women suggests that bilingual advance consent offers an innovative tool to help overcome the language barrier for non-English-proficient women who predictably needed interventions (e.g., epidurals) under unpredictable circumstances.

This study examined whether there were variables that moderated the relationship between denial and recidivism among adult male sexual offenders. The first study (N=489) found that the relationship with sexual recidivism was moderated by risk (as measured by the Rapid Risk Assessment for Sexual Offense Recidivism) but not by psychopathy (as measured by the Psychopathy Checklist-Revised). Contrary to expectations, denial was associated with increased sexual recidivism among the low-risk offenders and with decreased recidivism among the high-risk offenders. Post hoc analyses suggested that the risk item most responsible for the interaction was "relationship to victims". For incest offenders, denial was associated with increased sexual recidivism, but denial was not associated with increased recidivism for offenders with unrelated victims. These interactions were substantially replicated in two independent samples (N=490 and N=73). The results suggest that denial merits further consideration for researchers as well as those involved in applied risk assessment of sexual offenders.

This study examined perceptions regarding intimate partner abuse (IPV) in a largely Latino community in NewJersey through focus groups with Latino communitymembers and key informant interviews with providers of services to this population. Questions examined definitions of partner abuse; perceptions of factors contributing to, or protecting against, IPV; and barriers to reporting IPV both for the victim and the community at large. Atlas.ti, a qualitative data package, was used to analyze transcripts for themes drawn from the literature and preliminary review of transcripts. Findings point to both similarities and some potentially important differences between the perspectives of community members and service providers in such areas as definitions of partner abuse, factors associated with abuse, and barriers to reporting. Although both community members and service providers can individually offer important insights with regard to IPV, a more complete picture emerges when the views of both groups are considered.

The “Pillars of Creation” is arguably the most famous image produced by the Hubble space telescope, and it has led a quite unexpected life. On one hand, by tracing the trajectory of the image from its genesis through the traditional media channels between science and the public, this paper is a straightforward case study in the black-boxing of a scientific image. However, by continuing the story and following the “Pillars” into the hands of a group of enthusiasts whose interpretations of it differ from those of the scientific community, we find that the power of black-boxed scientific rhetoric can be co-opted by those who would use it for their own purposes.

Exhibitionists have traditionally been regarded as nuisance offenders. However, empirical studies show that some offenders can be highly recidivistic and can escalate to incidents of Hands-on sexual assault. The objective of this study was to investigate predictors of recidivism in exhibitionists and clarify the differences between Hands-on and Hands-off sexual recidivists. Two hundred and twenty-one exhibitionists were assessed at a university teaching hospital between 1983 and 1996. Archival data came from medical files and police files. The Psychopathy Checklist - Revised (PCL-R) was assessed retrospectively. Results indicated that over a meanfollow-up period of 6.84 years, 11.7, 16.8, and 32.7% of exhibitionists were charged with or convicted of sexual, violent, or criminal offenses, respectively. Sexual reoffending recidivists were less educated, and had more prior sexual and criminal offenses. Violent, recidivists were also less educated, had lower Derogatis Sexual Functioning Inventory (DSFI) scores, higher PCL-R Totals, and more prior sexual, violent, and criminal offenses. Criminal recidivists were younger, less educated, had lower DSFI scores, higher PCL-R scores, higher Pedophile Indices, and more prior sexual, violent, and criminal offenses. Hands-on sexual recidivists demonstrated higher PCL-R ratings, higher Pedophile and Rape indices, and more prior sexual, violent, and criminal offenses than did Hands-off counterparts.

One hundred ninety-two convicted extrafamilial child molesters were followed for an average of 7.8 years after their conviction. The percentage of men who had committed a sexual, a violent, or any criminal offense by the 12th year was 15.1, 20.3, and 41.6, respectively. The sexual recidivists, compared with the nonrecidivists, demonstrated more problems with alcohol and showed greater sexual arousal to assaultive stimuli involving children than to mutually consenting stimuli with children. The violent recidivists, compared with the nonrecidivists, were more likely to have a history of violence in the families in which they were raised and were rated significantly more psychopathic on the Psychopathy Checklist—Revised (PCL-R). They also showed more sexual arousal to stimuli depicting mutually consenting sexual interactions with children than to adult stimuli. In terms of any criminal recidivism, recidivists were younger, had completed fewer years of school, and were raised in psychologically more harmful family environments compared with nonrecidivists. They also reported that, before 16 years of age, they were more likely to have been physically abused and were more likely to have been removed from their homes compared to those that did not recidivate. In addition, recidivists demonstrated more general hostility on the Buss-Durkee Hostility Inventory and were rated significantly more psychopathic on the PCL-R. The phallometric assessments revealed, that the criminal recidivists, compared to the nonrecidivists, showed more sexual arousal to stimuli depicting coercive sexual activity with children than consenting sexual activities with children. In addition, they showed more sexual arousal to scenes depicting adult rape then adult mutually consenting sex. Finally, the rcidivists also had more charges or convictions for violence and any criminal acts. The small number of significant differences between recidivists and nonrecidivists in the sexual and violent categories precluded an attempt to determine which combination of factors meaningfully predicted reoffending. However, for criminal recidivism, a stepwise discriminant function analysis to assess the combination of factors that most successfully distinguished between groups in terms of criminal recidivism was significant, with subjects' age, total number of criminal convictions, and pedophile assault index being retained for optimal prediction. The procedure correctly classified 70.6% of the original group, 82.8% of the nonrecidivists, and 52.6% of the recidivists. PCL-R Total Score alone was equally successful in a similar discriminant function.

Approximately 6.5 years after their conviction, the percentage of incest offenders who had committed a sexual, violent, or criminal offense of any kind was 6.4, 12.4, and 26.7, respectively. The sexual recidivists scored higher on the Michigan Alcohol Screening Test (MAST), and the Psychopathy Checklist-Revised (PCL-R). The violent recidivists had higher MAST and PCL-R scores as well as more violence in their police records. Regarding any criminal recidivism, recidivists were older and reported higher rates of being physically abused, and being removed from their homes prior to 16 years of age. They demonstrated more hostility on the Buss-Durkee Hostility Inventory, and higher MAST and PCL-R scores. They also had more previous charges or convictions for sexual, violent, and criminal acts. A combination of total criminal offenses, PCL-R, age, and the number of previous sexual offenses correctly classified 97.6% of the nonrecidivists and 35.4% of the recidivists for any reoffense.

Seventeen extrafamilial homicidal child molesters (HCM) were compared to 35 convicted extrafamilial child molesters (CM) who had not murdered, or attempted to murder, their victims. The two groups did not differ on age, IQ, education, history of marriage, or family history, although marriage rates of both groups were well below the national average. Similarly, both groups had high rates of features representing family instability. HCM more frequently victimized strangers. The results on the self-report psychological inventories, the Derogatis Sexual Functioning Inventory (DSFI) and the Buss-Durkee Hostility Inventory (BDHI), did not distinguish between the groups, although the DSFI revealed sexual inadequacy in both groups. The BDHI did not describe the groups as pathological. The Psychopathy Checklist—Revised Total Score, Factor 1, and Factor 2 described both groups as demonstrating high levels of psychopathy, with the HCM scoring significantly higher. Factor 1 and Factor 2 scores placed the HCM group in the 93rd and 82nd percentiles, respectively, compared to published norms for forensic patients. A greater proportion of HCM suffered from antisocial personality disorders and paraphilias, especially sexual sadism. Over 53% of the HCM, and none of the CM, were comorbid for pedophilia and sexual sadism. Significantly more HCM received three or more DSM III-R diagnoses. The phallometric assessments generally supported DSM diagnoses. The HCM demonstrated significantly higher levels of deviant arousal to pedophilic and adult assault stimuli. Police files revealed that, prior to the index offense, a significantly greater proportion of HCM had been charged with, or convicted of, violent nonsexual, and sexual offenses. The HCM had been charged with, or convicted of, more than 2.5 times as many criminal charges than the CM. A discriminant function analysis revealed that two variables, Factor 1 of the PCL-R and the number of violent entries in the police records, correctly predicted 78.6% of the HCM and 97.1% of the CM. Implications for understanding homicidal child molesters and for future research are discussed.

Objective: To examine the recidivism rates of the various types of adult sex offenders including incest offenders, extrafamilial child molesters, exhibitionists, and rapists. Method: An examination of the literature over the past 4 decades and the data from our own study group. Results: Methodological shortfalls and differences across the studies make statistical appraisal of the results difficult. Nevertheless, there is a consensus that incest offenders are less likely to reoffend compared with extrafamilial child molesters. Rapists and exhibitionists are thought to be at a higher risk for recidivism. Conclusion: A combined actuarial predictive approach in conjunction with empirically guided clinical assessment is probably the best method to predict recidivism of sex offenders.

Most approaches to improving education in the United States fail; some succeed in certain schools only to fail elsewhere. Why? The main thesis of this study is that various programs to school reform fail because they neglect to consider the role of legitimacy as an intervening factor as a school moves from a strict bureaucratic to a community governance regime. This article develops and estimates a causal model describing the relationship between bureaucracy, legitimacy, and community as predictors of teachers' job satisfaction-an important school outcome that is highly related to student achievement. Data for the study are from a national survey of National Education Association teacher members.

The quota controversy is a highly emotional one. Many whites fear that quotas mean the end of the merit system. Minorities previously denied access to mainstream institutions feel that they should be put in the position they would have reached, but for discrimination, as quickly as possible. Men fear that jobs previously reserved for them will be overrun by women, and so on. As I shall illustrate shortly, however, when the issues are viewed in terms of concrete situations, rather than in the abstract, the areas of disagreement narrow, and it usually becomes unnecessary to resolve the broad general issues concerning quotas, goals, or other preferential treatment.

Neutrophils are known to undergo a burst of metabolic activity in response to particulate and soluble stimuli. Most of these stimuli depend upon calcium in the extracellular medium to exert their maximal effects. We have shown that 24 mM sodium fluoride (NaF) stimulates the metabolic burst in canine neutrophils as measured by chemiluminescence and CO2 formation from the carbon-1 position of glucose. Because these phenomena are calcium dependent, we determined the uptake of calcium by neutrophils activated with NaF. Neutrophils suspended in buffer were incubated with 45CaCl2 and exposed to NaF. This caused an increase in cell-associated calcium from 1.89 ± 0.43 × 10−10 mol/107 cells to 1.06 ± 0.15 × 10−8mol/107 cells in 2 min. In comparison, the calcium ionophore A23187 (10−6M) caused only a modest increase in cell calcium, from 1.89 ± 0.43 × 10−10 mol/107 cells to 4.89 ± 0.85 × 10−10 mol/107 cells. When treated with EGTA (3 mM), NaF-stimulated neutrophils rapidly lost 90% of their cell-associated ...

Teachers rated 1337 school children to determine norms for a hyperactivity rating scale; teacher ratings of 45 hyperactive children, referred by physicians, were also obtained. Although hyperative and norm means were clearly separated, a nontrivial portion of hyperactive children had teacher ratings within the normal range. Norm data were factor-analyzed, and a hyperactivity factor was identified. Behaviors with the highest loadings on the hyperactivity factor yielded the largest differences between hyperactive and norm groups. Within the norm group, black children had the highest hyperactive ratings and oriental children had the lowest. Hyperactivity ratings were slightly higher for boys than for girls.

Perceptual-motor effects of imipramine and methylphenidate were evaluated in a double-blind study of 47 hyperactive children. No effects were found for imipramine, although methylphenidate improved performance on several tests. Improvement due to methylphenidate was not related to baseline scores. A discriminant function was computed to compare baseline perceptual-motor scores of the hyperactive and 41 normal children. Only half of the hyperactive children were clearly discriminated from normal children by the discriminant function. The digit-span test, which was not sensitive to methylphenidate, effectively discriminated hyperactive from normal children.

SummaryPerosis has been produced in chicks reared on a synthetic manganese-deficient diet. Tracer experiments with labeled manganese show that the major part of the manganese, whether administered orally or by injection, is excreted by both the deficient and control chicks. The liver is the most active participant in the body in the metabolism of manganese. The uptake of labeled manganese by bone was not measurable when the dose was administered orally.

Considerable experimental evidence has in recent years been brought forth which indicates that the union of proteins with acids and bases takes place by chemical combination.1 It has been suggested by Robertson2 that the −COHNgroups in the protein molecule are responsible for the acid and base-combining capacity but this hypothesis has been recently questioned by ourselves.3 Kossel and Cameron4 pointed out many years ago that the acid-combining capacity of salmin is equal to the combining capacity of the guanidine groups in the arginine, and Bracewell5 has carried this idea further by showing in a number of proteins a close agreement between the acid-combining capacity and the sum of the free amino nitrogen and the amino group of arginine which does not react with HNO2. The recent work of Hitchcock6 in which he determined the acid-combining capacity of gelatin and of deaminized gelatin affords an opportunity for checking this hypothesis and our calculations which are given in Table I show an excellent agr...

Summary1. In acute intoxication experiments with the liver poisons, phosphorus, hydrazine and carbon tetrachloride it was found that phosphorus intoxication almost eliminates the serum calcium rise normally produced by injection of parathyroid extract, hydrazine causes a less marked rise and carbon tetrachloride has no appreciable retarding effect. 2. Since the bone-marrow poison, benzol, causes no alteration in the blood calcium curve following injection of parathyroid extract, the action of phosphorus and hydrazine appears not to be through an injurious action on the bone cells.

In Exp. I, 22 poor readers and 22 normal readers of elementary-school age were matched on age, IQ, and sex and tested with a visual reaction-time task requiring same-different judgments. On initial trials poor readers were slower than normal readers. In addition, the performance of poor readers deteriorated faster than that of normal readers as testing progressed. In Exp. II, 20 hyperactive boys taking methylphenidate medication, 19 hyperactive boys whose medication was temporarily discontinued, and 19 normal boys were tested. Reaction time on early trials was not significantly different for boys in the on-medication and off-medication groups; however, both hyperactive groups were slower than the normal group. As testing progressed, reaction times of normal boys and boys taking medication remained fairly stable, while the performance of hyperactive boys not taking medication declined. The significance of these results to reading and spelling is discussed.

Cameron and Moorhouse1 have proposed using the cerebrospinal fluid calcium as a measure of the diffusible calcium of the blood plasma, arguing that the choroid plexus as a living, colloid impermeable membrane gives us a more perfect distribution of the diffusible constituents of the blood than can be obtained in any in vitro manner. This implies both that the cerebrospinal fluid is formed by a process of diffusion rather than of active secretion and also that the fluid is continuously in diffusion equilibrium with the constituents of the plasma. Whether the cerebrospinal fluid is formed by an active process of secretion or is simply a dialysate of the blood plasma is still a mooted question.Histological data and evidence from the mechanics of circulation, favoring the dialysis theory have recently been reviewed by Fremont-Smith.2 It has been pointed out by Updegraff, Greenberg and Clark3 and by Fremont-Smith,2 that the published data of various authors for the amounts of uric acid, urea, glucose, magnesiu...

SummaryBetween 4 and 5% of an injected dose of labeled strontium or calcium is eliminated with the bile out of a total excretion of about 25% in bile fistula animals in a period of about 3 days.

Summary1. The cytoplasm of liver has been fractionated by centrifugation in sucrose solution into microsomes, an upper pink mitochondrial layer and a lower normal, yellow mitochondrial layer. These fractions have been studied with respect to amino acid incorporation, cholesterol formation and the ratio of nucleic to protein radioactivity. The mitochondria-P differed sufficiently in these properties from the normal microsomes and mitochondria to be considered a distinct type of cytoplasmic particle. 2. The curve of the ratios of the lower, normal mitochondria to that of the top layer was found to parallel the weight curve of the rat upon aging. The total amount of mitochondria per unit weight of liver remained fairly constant, with the lower fraction increasing and the upper decreasing with age.

SummaryAt very low dietary levels, chlorpromazine has a favorable effect on growth and metabolism of Vit. B6-deficient rats. These animals gained more weight, had more nearly normal organ weights, and excreted less creatine and phosphates than did the pyridoxine-deficient controls.