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Community Profile
Top 5% contributor
Is there a way to have data driven unit tests using the unit test framework in MATLAB? I have a TestCase class that is set up to...
3 Answers
Asked 3 years ago
It is easier then that. Directly inside MATLAB:
client = org.apache.commons.net.time.TimeTCPClient;
Answered 4 years ago
Similar to expand, I have made a formal request in the past for padarray from the image toolbox to be included in base MATLAB. ...
2852 views
4 years ago
Right now it is not officially released, but there is a class lurking in the lastest install that allows us to programmatically ...
1946 views
6 years ago
Hello, I am trying to figure out how to put buttons in between the ticks on the x axis on a plot. either have the buttons righ...
1410 views
6 years ago
SNIP> Check out the method SUBSREF. You can make your code very flexible with it.
1301 views
5 years ago
Return true if the elements of the input vector increase monotonically (i.e. each element is larger than the previous). Return f...
Solve this!
3 years ago
Flip the outermost columns of matrix A, so that the first column becomes the last and the last column becomes the first. All oth...
Given the input n, return true if n is odd or false if n is even.
4 years ago
Triangle numbers are the sums of successive integers. So 6 is a triangle number because
6 = 1 + 2 + 3
which can be displa...
Given an input vector x, find all elements of x less than 0 or greater than 10 and replace them with NaN.
Input ...
Write a function which returns every other element of the vector passed in. That is, it returns the all odd-numbered elements, s...
Remove the nth column from input matrix A and return the resulting matrix in output B.
So if
and ...
Given an integer n, make an n-by-n matrix made up of alternating ones and zeros as shown below. The a(1,1) should be 1.
Given a and b, return the sum a+b in c.
In MATLAB, you create a vector by enclosing the elements in square brackets like so:
x = [1 2 3 4]
Commas are optional, s...
Find the sum of all the numbers of the input vector x.
Input x = [1 2 3 5]
Output y is 11
Input x ...
Try out this test problem first.
Given the variable x as your input, multiply it by two and put the result in y.
Hello all, Does anyone know a way to report back the progress to the calling application of a matlab simulation compiled with t...
877 views
5 years ago
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Unruly Passengers Disrupting More Flights Than Ever, Trade Group SaysA global airline trade group says the number of incidents of unruly passengers on planes is increasing, and it's calling for more effective deterrents.
Lyft Sued Over 2014 Crash That Killed PassengerLyft is facing a wrongful death and personal injury lawsuit filed in San Francisco by the family of a West Sacramento man killed in the crash of a car with a Lyft driver in 2014.
Death Threats For JetBlue Passenger After Tirade Caught On CameraA passenger on a JetBlue flight out of Long Beach, California on Friday has issued an apology after a very public outburst caught on camera.
Bay Area Uber Passenger Says Driver Responsible For Deadly Hit-And-RunA Bay Area Uber passenger says his driver took him on a wild ride that ended with a deadly hit-and-run.
GEICO's 15 Things To Do In The Bay AreaDave Matthews performs at Shoreline, enjoy a Chocolate Festival in SF, plus take part at a Lobster Clambake at Wente Vineyards... Jayn at firstname.lastname@example.com has more things to do this week in the Bay Area!
Man Arrested For Public Drunkenness, Parole Violation, Warrants At Oakland BART StationBART police arrested a man for public drunkenness, a parole violation and warrants Sunday afternoon on a BART train at the 19th Street station in Oakland, police said.
Passenger Fears Force Delay Of San Francisco Flight, Removal Of TravelerA passenger on a Virgin America flight from San Francisco to Austin, Texas says his flight returned to the gate after another passenger was spotted writing a suicide note.
Widow Says Southwest Airlines Left Husband To Die In Plane Bathroom During Flight From OaklandThe widow of a high-profile financial analyst is filing a wrongful death lawsuit against Southwest Airlines, claiming a flight crew left her husband in an airplane bathroom when he desperately needed help, even treating him like an out-of-control passenger.
Teenage Girl Killed In Santa Rosa CrashA teenage girl was killed in a crash that injured two others on U.S. Highway 101 in Santa Rosa early Saturday morning after a pursuit that started in Windsor, according to the California Highway Patrol and Sonoma County Sheriff's Office.
Trouble Getting An Uber Ride? Drivers Might Think You're A JerkUber customers can rate their drivers, but it turns out that drivers are also rating those customers, and that rating could get some riders blacklisted.
2 Killed In Plane Crash In Sierra Nevada FoothillsTwo people are dead after a small plane crashed not far from an airport in the Sierra Nevada foothills in Northern California.
San Francisco Uber Driver Accused Of Forcibly Pulling Rider From Car, Smashing Her Phone In Dispute Over DirectionsAn Uber driver allegedly forcibly pulled a passenger out of his car before smashing her smartphone as she tried to record the incident in San Francisco.

subset: commoncrawl


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Service Level Agreements (SLA)
Service Level Agreements (SLA) means the service level and response time which must be delivered to an end user. SLA's are negotiated between IT departments and business units. According to Forrester Consulting, 40% of technical quality reports (SLA measurements) do not provide all of the information managers would like to see. With ip-label tools, IT managers can track performance in real time and produce reports on Service Level Agreements complete with all the data they require.
Service Level Agreements (sla) & the end-user
SLA are contracts which define the service provider's obligations with respect to the quality of service provided and the penalties incurred in case of non-compliance. Quality must be measured according to objective criteria agreed on by both parties. Examples: application availability target during office hours; maximum time to restore service in case of an incident.
SLAs drawn up between the provider and the client define the precise terms of the services to be monitored, the conditions of monitoring, the associated indicators and the objectives or thresholds characterizing the expected level of service.
In the context of implementation of our end-user monitoring solutions, scenarios make it possible to model the representative transactions of the service to monitor from a variety of locations. Within our end-user monitoring solutions transactions can be grouped by application and by business process. The statuses of scenarios which our active agents run make it possible to infer the general status of the service. This "real time" supervision, combined with the calculation of indicators and the generation of alarms, facilitates the setup of SLM policies.


text: Lilliano Anagallis /95 750ml 1997 Sku: 9182 Anagallis takes its name from a small orange flower which is very common in Chianti. Tasting notes Colour: deep ruby red. Nose: Ethereal, pervasive, complex with a bottom note of vanilla. Palate: Full, harmonious, slightly tannic. Wine maker notes Anagallis is currently produced with Sangiovese (80%) Colorino (5%) and Merlot (15%) grapes grown in the "le Piagge" ,"la Ripa" and "Vignacatena" vineyards which enjoy southerly and easterly exposure, situated at altitudes between 290 and 330 metres above sea level. After meticulous selection in the vineyard, the grapes undergo soft pressing and upon completion of malic fermentation in stainless steel containers, the wine is transferred to 225-litre oak barriques (made from wood grown in the Allier, Never and Troncai forests and subject to medium toasting), for 10 to 16 months, depending on the vintage and the structure of the wine. Upon completion of ageing in wood the musts are blended in a single container to obtain a wine with consistent quality and characteristics. Ageing is completed with at least six months in the bottle in our cellars . Other text Primarily Sangiovese, blended with Colorino and Merlot. Related SearchesItalyTuscanyChiantiBolgheriBrunello di MontalcinoCarmignano Regional Varietals:CanaioloMerlotRed Italian Blend Regional Wineries:BollaCampobelloCantine Leonardo Da Vinci Country: Italy Region: Tuscany Sub-Region: Chianti Grape Varietal: Sangiovese Type: Still wine Reg. $39.99


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One of the hallmarks of the US criminal justice system is our search and seizure law. The Fourth Amendment to the US Constitution guarantees the right to be free from unlawful or "unreasonable" searches and seizures by the police and other law enforcement personnel. Generally, this means that the police have to have a good reason before they may search you or your property, seize your belongings or even seize or arrest you.
The key term here is "unreasonable." Of course, not all searches and seizures are illegal. The lynchpins to the search and seizure law are probable cause and the expectation of privacy.
Probable Cause
In simple terms, probable cause means that there are facts or circumstances to justify a search or seizure of a place, things or a person. Generally, this means that there's a good reason to believe that a person is or has committed crime or that evidence of a crime can be found in a particular place. Probable cause is the driving factor for any search or arrest.
With probable cause, a police officer may:
- Convince a judge or magistrate to issue a warrant that authorizes him to search a certain and particular place for certain and particular things and seize them, or to arrest a particular person, or
- Conduct a search and seize evidence of a crime, or make an arrest, without a warrant, if there are "exigent" or emergency circumstances that make getting a warrant impractical
For example, during an investigation, police officers gather evidence that a suspect is selling illegal drugs from his home. The officers may ask a judge or magistrate for a search warrant for the home (and an arrest warrant for the suspect), and if the magistrate thinks there's enough evidence, she'll issue the warrant(s). However, if during a stakeout the officers learn that the suspect is about to destroy the drugs in his home, the officers may be justified to enter the home, search it, and seize any drugs and arrest the suspect, all without a warrant.
As a general rule, the police need to get a warrant. It's the mechanism that makes the Fourth Amendment work, that is, it makes sure that a search and seizure is reasonable. If warrantless search and seizure is conducted, the police have to prove that a warrant was needed or that there was no time to get one.
Expectation of Privacy
Generally, unless you have a "reasonable expectation of privacy" in a certain place or thing, it may be searched and/or seized by the police without a search warrant. In other words, the Fourth Amendment doesn't apply to any place or thing in which you don't have a reasonable expectation of privacy. You have a reasonable expectation of privacy if:
- You actually expect privacy in the place or thing. This is called the "subjective" expectation of privacy, and
- Your expectation of privacy is one that that society as a whole would think is legitimate and reasonable. This is called the "objective" expectation of privacy
Some examples of places or things where you may have a reasonable expectation of privacy include:
- Your home, or anywhere you actually live, including a rented apartment or a hotel room
- The trunk of your car
- Luggage or other containers that aren't transparent or see-through, even if you're carrying it in a public place, like an airport or bus station
- Your business office
- A public telephone booth, once you've shut the door
On the other hand, there are many places and things in which there is no reasonable expectation of privacy, such as
- Things that are in "plain view," that is, exposed or out in the open that anyone can see. Illegal drugs or weapons on the front seat of your car are good examples
- Portions of your business office or building that's open to the public, such as a reception area
- Public places, likes restaurants and parks
- Your trash or garbage, once you placed it at the curb for pick-up or collection
Protect Yourself
The laws on search and seizure can be complicated, and the facts and circumstances of each particular case are very important to determining if an unlawful search and seizure has taken place. If you or your property has been searched already, you should contact an attorney to make sure that your rights are protected.
Questions for Your Attorney
- A police officer called me from my home about a break-in. When I got there, they told me that they looked though my home and didn't find the person who broke in, but they found a small amount of marijuana in a drawer in my bedroom. I was then given a ticket for possession of marijuana. Is this legal? Can I fight it?
- Can an officer listen to conversations taking place in my house through an open window?
- My landlord gave the police permission to search my apartment. They found a marijuana plant and I was arrested. Was this a legal search and seizure?


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Cynthia Smith
YOUNGSTOWN – There will be services at 11:00 A.M. Saturday at the Lane Family Funeral Homes, Anstrom Chapel, 8387 Tod Ave. in Boardman for Cynthia Louise Smith, 53, formerly of Wickliffe Circle in Austintown, who died Tuesday afternoon at St. Elizabeth Boardman Health Center.
Cindy was born October 7, 1959 in Youngstown, a daughter of James T. and Florence Coleman Smith.
She was a graduate of Rayen High School and was of the Christian Faith.
Cindy was born with spina bifida and was disabled by its effects, but she loved getting out in her wheelchair. Cindy enjoyed crocheting and watching old movies. She loved being with her family and her dog, "Snowy."
She leaves her sisters, Sarah B. (Vaughn) Bayer of Youngstown and Jeannie Armbruster of Akron; her brothers, James T. and Thomas E. Smith both of Austintown; and her nieces and nephews, Alex, Belinda, Gus, and Jake.
She was preceded in death by her parents.
Friends may call from 10 to 11:00 A.M. prior to the service on Saturday.


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The singer will make her first appearance on her family's reality series in the new season.Read More
This marks the first time the singer will appear on her family's docu-series. Read More
The couple supported Charlie's alma mater at the CFP Championship on Monday. Read More
The singer-songwriter opens up to ET about dating after divorce and all those memoir bombshells.Read More
The singer-songwriter penned a track for the film 'The Crossing Guard' in 1995.Read More
The singer is back in the spotlight with a new memoir and album.Read More
From Kelly Clarkson to Hilary Swank, ETonline takes a look at the stars who were waiting to strike Hollywood gold!Read More
When you think music videos, Jimmy Fallon typically doesn't come to mind… unless you see the latest edition of his...Read More
The folk singer her future ex-husband Ty Murray spent the holiday together with their young son in Colorado.Read More
After nearly six years of marriage, Jewel and her husband Ty Murray have split.Read More
You know it's officially the holiday season when celeb-filled Christmas tree lightings start warming us up for the most festive time of the year! First up is President Obama, who shared a special moment with his daughters Sasha and Malia at the annual lighting of the National Christmas tree on December 6, 2012 in Washington, D.C.Read More
Some of music''s brightest stars joined ET''s Nancy O''Dell last night to officially kick off the holiday season in Los Angeles with a tree-lighting ceremony featuring festive performances by Toni Braxton, Mary J. Blige, Jewel and...Read More


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Family violence
Help is available for those who have experienced family violence. Family violence includes not only physical injury but direct or indirect threats, sexual assault, emotional and psychological torment, economic control, damage to property, social isolation and any behaviour which causes a person to live in fear.
Latest News and Events
More housing support for family violenceMonday 18 April 2016
Women and children escaping family violence will have more access to a range of housing options with new funding of $152 million announced by the Victorian Government.
Family violence online training now availableMonday 11 May 2015
A new e-learning module on the Family Violence Risk Assessment and Risk Management Framework (CRAF).
Applications open for Aboriginal family violence grantsTuesday 28 April 2015
The department invites applications from Victorian Aboriginal organisations, Aboriginal community groups and other community service providers to submit for funding for projects that prevent, reduce and respond to family violence in Victorian Aboriginal communities.
National Plan to Reduce Violence against Women and their ChildrenThursday 24 July 2014
Commonwealth, state and territory governments are working together, with the community to implement the National Plan to Reduce Violence against Women and their Children 2010-2022 (the National Plan).
Get help now - family violence
Contact information for people experiencing family or domestic violence and seeking help.
What is family violence?
Family and domestic violence is any violent, threatening, coercive or controlling behaviour that occurs in current or past family, domestic or intimate relationships.
Adolescent Family Violence Service
Adolescent Family Violence Service aims to reduce family violence and increase the safety family members.
Aboriginal Family Violence
Community led initiatives which focus on violence in Aboriginal families, including project summaries and task force report.
Family violence support for women and children with a disability
The Disability and Family Violence Crisis Response initiative assists Victorian women and children with a disability who are experiencing family violence. It includes support to access family violence crisis accommodation or support to remain safe in their own home.
Homelessness and family violence
People experiencing homelessness not only need a roof over their head, but practical support to help them overcome the issues that can cause homelessness.


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realmagick.com The shrine of knowledge.
Rosey Edeh
A selection of articles related to rosey edeh.
Original articles from our library related to the Rosey Edeh. See Table of Contents for further available material (downloadable resources) on Rosey Edeh.
- Onto Chesed (Gedulah) and Geburah
- The Divine bi-polar energy pours forth from Kether, spilling into Chokmah and Binah, through these two primordial energy becomes form. If you have a diagram of the Tree, you'll see it is composed of three sets of triangles superimposed on three pillars. The...
Magick >> Qabalah
- Renewal, Worship, Cocoa and Home
- from the valley floor i watch as the first green-gold rays a hint of glory to come burst victoriously from behind blue mountains capped with blinding white in the distance dim and barely heard the crow of a rooster lowing of cattle snowbirds begin their daily...
Poetry & Fable >> Poetry
Rosey Edeh is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Rosey Edeh books and related discussion.
Suggested News Resources
- Global News Toronto Announces New Anchor Line-up
- Rosey Edeh will continue to anchor Global News at Noon and will contribute to Global News at 5:30 & 6. With the station's dedication to providing viewers with the most insightful and informative news programming around the clock, Global News at 11 will ...
- Global Toronto Names Antony Robart And Rosey Edeh As Hosts Of The News At Noon
- TORONTO, Aug. 7, 2012 /CNW/ - Global News announced today that Antony Robart and Rosey Edeh have been named as hosts of Global Toronto's new midday News at Noon. A mix of charm and personality coupled with extensive broadcasting experience, ...
- My hair, my choice: Why I wear it natural
- "I would get e-mails from people within the black community saying, 'What's wrong with your hair? You're embarrassing us.'" - Former Much Music VJ Namugenyi Iwanuka.
- Shaw Media Announces Global News as Presenting Partner of Toronto Black Film
- Global News' Rosey Edeh, Anchor of News at Noon, will kick off the festival's opening night at the Isabel Bader Theatre with the film, Thina Sobabili (The Two of Us), directed by Ernest Nkosi.
Great care has been taken to prepare the information on this page. Elements of the content come from factual and lexical knowledge databases, realmagick.com library and third-party sources. We appreciate your suggestions and comments on further improvements of the site.
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Hanna Kroeger's Liver/Gallbladder Fasting Cleanse (aka: Apple Juice Cleanse, Apple Juice Flush or Liver Gallbladder Flush)
Performing fasting cleanses from time to time is important for resting and cleansing various parts of the body; this practice has been common for thousands of years and is even discussed in the Bible! The Liver/Gallbladder Fasting Cleanse aids with dissolving gallstones and cleansing the liver and gallbladder of clay, mucus, parasites and other debris, allowing the liver, gallbladder and colon to flush, then rest from the digestive process.
This cleanse requires consuming no food or drink, other than apple juice and water for the duration of the cleanse (preferably 3 days but at least 2). Also, the person performing the cleanse should be having at least one bowel movement per day consistently before performing the fasting cleanse (if not, please use a fiber supplement that contains NO psyllium, cascara sagrada or senna, such as RenewLife FiberSMART or CleanseMORE for 1-2 weeks daily before performing this cleanse).
Drink 8 oz filtered apple juice * ("100% pure apple juice from U.S. grown apples; natural sediment may occur" – read labels) every hour or so, from the time you get up until you have consumed about 56-60 ounces by the time you go to bed, for three days (2 if you cannot tolerate 3). If you do not consume the full amount, there will not be enough malic acid to dissolve stones, mucus, etc., so if you cannot commit to the full amount every day of the Liver / Gallbladder Fasting Cleanse, please do not follow this fasting cleanse.
Martinelli's Apple Juice is widely available and contains 5 types of apples, including the Granny Smith apple, plus it is clear/filtered with no pulp, which is important for the purposes of this fasting cleanse. If you juice your own*, Granny Smith apples are best (the more tart the apples used, the more malic acid content to breakdown stones) but you must remove all pulp. Remember, the purpose of this fasting cleanse is to allow all organs to rest, not digest pulp or other solids. Drink water as desired.
Just before bedtime of the third day (2nd day if you could not make it three days), add 4 oz fresh olive oil to warm apple juice, stir well and drink (may use 8 oz olive oil if you tend toward constipation but it may create a greater urgency during the night or next morning to have a bowel movement). It is best to lay on your right side with right knee up for about 30 minutes to deliver oil to the gallbladder.
Early the next morning, the body should expel a greenish clay-type looking matter of old bile and debris, commonly referred to as gallstones. This is caused by the malic acid in the apple juice dissolving the deposits in the liver and gallbladder; the olive oil lubricates and flushes the deposits out of the system. You may even see parasites, black mucus and other debris. YAY! That is what you want to see because…who needs that inside?!
Eat a light breakfast and resume a normal lunch and dinner (this is a great opportunity to adopt the Anti-fungal Diet and to spend your fasting days getting rid of all the junk and processed foods in the house, then restocking with only good, God-given foods!).
Diabetics, those undergoing or who just completed chemotherapy or others who are weakened should substitute freshly squeezed lemon or lime juice mixed in water or unsweetened cranberry juice to replace apple juice.
Those without gallbladders also need to complete a liver detoxification fasting cleanse. This may be performed after completing Hanna Kroeger's Liver/Gallbladder Fasting Cleanse OR may be performed a week or so later.
HANNA KROEGER'S LIVER CLEANSE (for those without Gallbladders): For two days, consume nothing but stewed tomatoes and drink tomato juice and water.At the end of the second day, add to the last glass of tomato juice – 4 ounces fresh olive oil and 3 ounces whipping cream. Mix well, consume. Early in the morning, nature will call. Eat a light breakfast and resume a normal lunch and dinner (this is a great opportunity to adopt the ANTI-FUNGAL FOOD
CHOICES List and to spend your fasting days getting rid of all the junk and processed foods in the house, then restocking with only good, God-given foods!).
No one should perform these cleanses without the guidance of their doctor; also Diabetics should keep track of blood sugar monitoring. Do not perform this fasting cleanse without consulting with your physician to determine whether or not this is right for your specific needs.
By the way, did you know that the polyphenols in Granny Smith apples help to dissolve plaque build-up in your veins and arteries? They work more slowly than PSOEs but not everyone can take PSOEs but anyone can eat apples! An apple a day really DOES keep the doctor away!
* If you juice your own apples, please use ONLY a pulverizing or masticating juicer (completely separates all fiber and pulp from the juice). You will need about 36 apples per day; at least half should be Granny Smith Apples per day, but size matters, so keep extras around! Be sure to leave the skin on to derive the vitamins and antioxidants from the skin during the pressing of the apples.
For those who wish to lose weight, following the Hanna Kroeger Liver/Gallbladder Fasting Cleanse with our RAW CLEANSE is a great way to start your weight loss regimen!
Whether or not you are able to use any of the supplements suggested above depends upon your health history, medications taken, surgeries and therapies, etc. FREE SILVER MEMBERS , and those who have NEVER BEEN A MEMBER at all, how about subscribing to a Semi-Annual 6-month ($34.75) or Annual 12-month ($69.50) PLATINUM MEMBERSHIP. We will send an email welcoming you to Platinum Membership and it will include a QUESTIONNAIRE toward the bottom of that email for you to complete and return so that we may suggest a regimen just for you based upon your health history and diet. We will share ideas with you that can help you get back on track and get healthier through diet, exercise and supplements. Whether you take prescription medications or nothing at all, there is something we can suggest for everybody!
All statements are the opinion of staff at www.HealthTalkLive.com and are not intended to diagnose, treat, cure or prevent any disease. All ideas provided are given based upon information provided, including all health experiences, therapies, surgeries, medications taken, etc., in the past, present or foreseeable future. John, Vicki, other healthtalklive.com staff, and anyone directly associated with the website, www.HealthTalkLive.com, are not responsible for negative or harmful side-effects you may experience as a result of ideas shared. No other company, person or entity is associated with HealthTalkLive.com, John, Vicki or any staff member; nor is there any association, obligation or interest between HealthTalkLive.com and sponsors, discount participants or advertisers, implied or otherwise, as having any association or agreement with views and opinions provided on HealthTalkLive.com. Prescription drugs have the potential for harmful side-effects, which may also be influenced by using nutritional supplements; please consult with your Medical Doctor and Pharmacist before using supplements of any kind. Only your Medical Doctor and Pharmacist are acquainted with your health issues and are able to diagnose your specific healthcare requirements. No one at www.HealthTalkLive.com is trained to diagnose and you should never self-diagnose in lieu of proper medical care and advice. Please avail yourself of all diagnostic testing available to you. Statements made may not have been evaluated by the Food and Drug Administration. If you are exhibiting symptoms or have a health concern, we encourage you to contact your physician immediately.


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This was just a simple cake for my niece's 1st birthday. This was for her "friend" party. Not the actual big celebreation.
bright pretty colors! Good Job!
nice colors...great job!
CakeCentral.com is the world's largest cake community for cake decorating professionals and enthusiasts.
(if this is a private computer)
Yes please, register now!


text:
Most Cited Journal of Psychosomatic Research Articles
The most cited articles published since 2011, extracted from Scopus.
Latent structure of the Hospital Anxiety And Depression Scale: A 10-year systematic reviewTheodore D. Cosco | Frank Doyle | Mark Ward | Hannah McGee
Volume 72, Issue 3, March 2012, Pages 180-184
Objective: To systematically review the latent structure of the Hospital Anxiety and Depression Scale (HADS). Methods: A systematic review of the literature was conducted across Medline, ISI Web of Knowledge, CINAHL, PsycInfo and EmBase databases spanning articles published between May 2000 and May 2010. Studies conducting latent variable analysis of the HADS were included. Results: Twenty-five of the 50 reviewed studies revealed a two-factor structure, the most commonly found HADS structure. Additionally, five studies revealed unidimensional, 17 studies revealed three-factor, and two studies revealed four-factor structures. One study provided equal support for two- and three-factor structures. Different latent variable analysis methods revealed correspondingly different structures: exploratory factor analysis studies revealed primarily two-factor structures, confirmatory factor analysis studies revealed primarily three-factor structures, and item response theory studies revealed primarily unidimensional structures. Conclusion: The heterogeneous results of the current review suggest that the latent structure of the HADS is unclear, and dependent on statistical methods invoked. While the HADS has been shown to be an effective measure of emotional distress, its inability to consistently differentiate between the constructs of anxiety and depression means that its use needs to be targeted to more general measurement of distress. © 2011 Elsevier Inc.
Validation of the Edinburgh Depression Scale during pregnancyVeerle Bergink | Libbe Kooistra | Mijke P. Lambregtse-van den Berg | Henny Wijnen | Robertas Bunevicius | Anneloes van Baar | Victor Pop
Volume 70, Issue 4, April 2011, Pages 385-389
Background: Untreated depression during pregnancy may have adverse outcomes for the mother and her child. Screening for depression in the general pregnant population is thus recommended. The Edinburgh Depression Scale (EDS) is widely used for postpartum depression screening. There is no consensus on which EDS cutoff values to use during pregnancy. The aim of the current study was to examine the predictive validity and concurrent validity of the EDS for all three trimesters of pregnancy. Methods: In a large unselected sample of 845 pregnant women, the sensitivity, specificity, and validity of the EDS were evaluated. The Composite International Diagnostic Interview (depression module) was used to examine the predictive validity of the EDS. The anxiety and somatization subscales of the Symptom Checklist 90 (SCL-90) were used to examine its concurrent validity. Only women with a major depressive episode were considered as cases. Results: The prevalence of depression decreased toward end term: 5.6%, 5.4%, and 3.4%. The EDS scores also decreased toward end term, while the SCL-90 subscale anxiety scores increased. The EDS showed high test-retest reliability and high concurrent validity with the SCL-90 anxiety and somatization subscales. The area under the receiver operating characteristic curve was high and varied between 0.93 and 0.97. A cutoff value of 11 in the first trimester and that of 10 in the second and third trimesters gave the most adequate combination of sensitivity, specificity, and positive predictive value. Conclusions: The EDS is a reliable instrument for screening depression during pregnancy. A lower cutoff than commonly applied in the postpartum period is recommended. © 2011 Elsevier Inc.
The Hospital Anxiety and Depression Scale: A meta confirmatory factor analysisSam Norton | Theodore Cosco | Frank Doyle | John Done | Amanda Sacker
Volume 74, Issue 1, January 2013, Pages 74-81
Objective: To systematically evaluate the latent structure of the Hospital Anxiety and Depression Scale (HADS) through reanalysis of previous studies and meta confirmatory factor analysis (CFA). Method: Data from 28 samples were obtained from published studies concerning the latent structure of the HADS. Ten models were considered, including eight previously identified models and two bifactor models. The fit of each model was assessed separately in each sample and by meta CFA. Meta CFA was conducted using all samples and using subgroups consisting of community samples, cardiovascular disease samples and samples from studies administering the English language version of the HADS. Results: A bifactor model including all items loading onto a general distress factor and two orthogonal anxiety and depression group factors provided the best fit for the majority of samples. Meta CFA provided further support for the bifactor model with two group factors. This was the case using all samples, as well as all subgroup analyses. The general distress factor explained 73% of the covariance between items, with the (autonomic) anxiety and (anhedonic) depression factors explaining 11% and 16%, respectively. Conclusion: A bifactor structure provides the most acceptable empirical explanation for the HADS correlation structure. Due to the presence of a strong general factor, the HADS does not provide good separation between symptoms of anxiety and depression. We recommend it is best used as a measure of general distress. © 2012 Elsevier Inc.
Normative values for the hospital anxiety and depression scale (hads) in the general german populationAndreas Hinz | Elmar Brähler
Volume 71, Issue 2, August 2011, Pages 74-78
Objective: The aim of this study was to present normative values for the Hospital Anxiety and Depression Scale (HADS). Methods: A representative sample of the German general population (N=4410) was tested with the HADS. Results: Females are more anxious than males, and older subjects are more depressed than younger subjects. The mean scores for anxiety/depression are 4.4/4.8 (males) and 5.0/4.7 (females). Using the cut-off 8+, the percentages of elevated anxiety and depression in the total sample are 21 % and 23 %, respectively. Regression analyses proved a linear but not a curvilinear age trend of anxiety and depression. Percentile rank norms are given for anxiety, depression, and the HADS total score. Conclusion: The regression coefficients allow the calculation of expected mean scores for each age and gender distribution of any sample of patients. HADS mean scores are better suited to describe the degree of anxiety and depression in patient samples compared to percentages of subjects with elevated values. © 2011 Elsevier Inc.
Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military VeteransAnne Germain | Robin Richardson | Douglas E. Moul | Oommen Mammen | Gretchen Haas | Steven D. Forman | Noelle Rode | Amy Begley | Eric A. Nofzinger
Volume 72, Issue 2, February 2012, Pages 89-96
Objective: Pharmacological and cognitive-behavioral treatments targeting insomnia and nightmares have been shown to be effective in the treatment of military veterans with sleep complaints comorbid with symptoms of stress-related disorders, including Post-Traumatic Stress Disorder (PTSD), but the two approaches have not been directly compared. This randomized controlled trial compared the effects of prazosin vs. a behavioral sleep intervention (BSI), targeting nightmares and insomnia against a placebo pill control condition on sleep and daytime symptoms. Methods: Fifty United States military veterans (mean age 40.9. years, SD = 13.2. years) with chronic sleep disturbances were randomized to prazosin (n= 18), BSI (n= 17), or placebo (n= 15). Each intervention lasted 8. weeks. Participants completed self-report measures of insomnia severity, sleep quality, and sleep disturbances. All kept a sleep diary throughout the intervention period. Polysomnographic studies were conducted pre- and post-intervention. Results: Both active treatment groups showed greater reductions in insomnia severity and daytime PTSD symptom severity. Sleep improvements were found in 61.9% of those who completed the active treatments and 25% of those randomized to placebo. Conclusion: BSI and prazosin were both associated with significant sleep improvements and reductions in daytime PTSD symptoms in this sample of military veterans. Sleep-focused treatments may enhance the benefits of first-line PTSD treatments. © 2011 Elsevier Inc.
The prevalence of anxiety and depression in adults with implantable cardioverter defibrillators: A systematic reviewGina Magyar-Russell | Brett D. Thombs | Jennifer X. Cai | Tarun Baveja | Emily A. Kuhl | Preet Paul Singh | Marcela Montenegro Braga Barroso | Erin Arthurs | Michelle Roseman | Nivee Amin | Joseph E. Marine | Roy C. Ziegelstein
Volume 71, Issue 4, October 2011, Pages 223-231
Objective: The implantable cardioverter defibrillator (ICD) is used to treat life-threatening ventricular arrhythmias and in the prevention of sudden cardiac death. A significant proportion of ICD patients experience psychological symptoms including anxiety. , depression or both, which in turn can impact adjustment to the device. The objective of this systematic review was to assess the prevalence of anxiety and depression or symptoms of anxiety and depression among adults with ICDs. Methods: Search of MEDLINE®, CINAHL®, PsycINFO®, EMBASE® and Cochrane® for English-language articles published through 2009 that used validated diagnostic interviews to diagnose anxiety or depression or self-report questionnaires to assess symptoms of anxiety or depression in adults with an ICD. Results: Forty-five studies that assessed over 5000 patients were included. Between 11% and 28% of patients had a depressive disorder and 11-26% had an anxiety disorder in 3 small studies (Ns=35-90) that used validated diagnostic interviews. Rates of elevated symptoms of anxiety (8-63%) and depression (5-41%) based on self-report questionnaires ranged widely across studies and times of assessment. Evidence was inconsistent on rates pre- versus post-implantation, rates over time, rates for primary versus secondary prevention, and for shocked versus non-shocked patients. Conclusion: Larger studies utilizing structured interviews are needed to determine the prevalence of anxiety and depression among ICD patients and factors that may influence rates of anxiety and depressive disorders. Based on existing data, it may be appropriate to assume a 20% prevalence rate for both depressive and anxiety disorders post-ICD implant, a rate similar to that in other cardiac populations. © 2011 Elsevier Inc.
A longitudinal study of motor subtypes in delirium: Relationship with other phenomenology, etiology, medication exposure and prognosisDavid J. Meagher | Maeve Leonard | Sinead Donnelly | Marion Conroy | Dimitrios Adamis | Paula T. Trzepacz
Volume 71, Issue 6, December 2011, Pages 395-403
Objective: Motor subtypes have promise as a means of identifying clinically relevant delirium subgroups. Little is known about their relationship to etiologies, medication exposure, and outcomes. Methods: Consecutive cases of DSM-IV delirium in palliative care patients were assessed twice-weekly throughout their delirium episodes using the Delirium Motor Subtype Scale (DMSS), Delirium Etiology Checklist (DEC) and Delirium Rating Scale Revised-98 (DRS-R98). Results: 100 patients [mean age 70.2±10.5] were assessed on 303 visits [range 2-9]. Over the entire episode, mean DRS-R98 Severity scores were 16.2±5.7. The mean number of etiologies per case was 3.4±1.2. Motor subtypes were no subtype throughout (6%), hypoactive subtype throughout (28%), mixed subtype throughout (18%), hyperactive subtype throughout (10%) and variable subtype (38%). DRS-R98 Total and Severity scales differed significantly across categories (highest in mixed) but only motor, sleep-wake cycle, perceptual and language disturbance items differed. The Generalized Estimating Equations (GEE) approach was used to explore the relationship between subtype profile and symptoms, medication exposure and etiology. This showed that apart from motor items, only delusions, affective lability, metabolic disturbance and CVA related to any subtype. Cross-sectional assessments indicated greater use of benzodiazepine and antipsychotics in hyperactive patients but GEE analyses did not identify major associations between motor subtype and medication exposure. Patients with sustained hypoactive subtype were significantly more likely to die within one month of study entry. Conclusions: Motor profile in delirium is relatively consistent over episode course and relates more closely to delirium phenomenology than to etiology or medication exposure. Motor subtypes have comparable disturbance of key diagnostic features such as cognitive and thought process abnormalities. Although mixed subtype is the most phenomenologically intense, hypoactives have the poorest prognosis. © 2011 Elsevier Inc..
Autonomic cardiovascular control and responses to experimental pain stimulation in fibromyalgia syndromeGustavo A. Reyes del Paso | Sergio Garrido | Ángeles Pulgar | Stefan Duschek
Volume 70, Issue 2, February 2011, Pages 125-134
Objective: This study involves a comprehensive investigation of autonomic cardiovascular regulation in fibromyalgia syndrome (FMS) at rest and during painful stimulation and its association with pain indices. Methods: In 35 patients and 29 healthy controls, electrocardiography, impedance cardiography, and finger continuous blood pressure measurements were conducted. For the purpose of experimental pain induction, a cold pressor test was applied. Results: FMS patients showed lower pain threshold and tolerance, as well as higher ratings of pain intensity and unpleasantness on visual analogue scales. Resting stroke volume, myocardial contractility, R-R interval, heart rate variability, and sensitivity of the cardiac baroreflex were reduced in the patients, and increases in stroke volume and myocardial contractility during cold pressor stimulation were less pronounced. In the whole sample as well as in the FMS group, baroreflex sensitivity was inversely associated with subjective pain intensity, and a higher number of baroreflex operations per unit of time predicted higher pain tolerance. Conclusions: The data suggest impaired autonomic cardiovascular regulation in FMS in terms of reduced sympathetic and parasympathetic influences, as well as blunted sympathetic reactivity to acute stress. The association between baroreflex function and pain experience reflects the pain inhibition mediated by the baroreceptor system. Given the reduced baroreflex sensitivity in FMS, one may assume deficient ascending pain inhibition arising from the cardiovascular system, which may contribute to the exaggerated pain sensitivity of FMS. © 2011 Elsevier Inc.
Conversion disorder: Current problems and potential solutions for DSM-5Jon Stone | W. Curt LaFrance | Richard Brown | David Spiegel | James L. Levenson | Michael Sharpe
Volume 71, Issue 6, December 2011, Pages 369-376
Conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes neurological symptoms, including weakness, numbness and events resembling epilepsy or syncope, which can be positively identified as not being due to recognised neurological disease. This review combines perspectives from psychiatry, psychology and neurology to identify and discuss key problems with the current diagnostic DSM-IV criteria for conversion disorder and to make the following proposals for DSM-5: (a) abandoning the label "conversion disorder" and replacing it with an alternative term that is both theoretically neutral and potentially more acceptable to patients and practitioners; (b) relegating the requirements for "association of psychological factors" and the "exclusion of feigning" to the accompanying text; (c) adding a criterion requiring clinical findings of internal inconsistency or incongruity with recognised neurological or medical disease and altering the current 'disease exclusion' criteria to one in which the symptom must not be 'better explained' by a disease if present, (d) adding a 'cognitive symptoms' subtype. We also discuss whether conversion symptoms are better classified with other somatic symptom disorders or with dissociative disorders and how we might address the potential heterogeneity of conversion symptoms in classification. © 2011 Elsevier Inc..
Are the available apathy measures reliable and valid? A review of the psychometric evidenceDiana E. Clarke | Jean Y. Ko | Emily A. Kuhl | Robert van Reekum | Rocio Salvador | Robert S. Marin
Volume 70, Issue 1, January 2011, Pages 73-97
Objective: Apathy is highly prevalent among neuropsychiatric populations and is associated with greater morbidity and worse functional outcomes. Despite this, it remains understudied and poorly understood, primarily due to lack of consensus definition and clear diagnostic criteria for apathy. Without a gold standard for defining and measuring apathy, the availability of empirically sound measures is imperative. This paper provides a psychometric review of the most commonly used apathy measures and provides recommendations for use and further research. Methods: Pertinent literature databases were searched to identify all available assessment tools for apathy in adults aged 18 and older. Evidence of the reliability and validity of the scales were examined. Alternate variations of scales (e.g., non-English versions) were also evaluated if the validating articles were written in English. Results: Fifteen apathy scales or subscales were examined. The most psychometrically robust measures for assessing apathy across any disease population appear to be the Apathy Evaluation Scale and the apathy subscale of the Neuropsychiatric Inventory based on the criteria set in this review. For assessment in specific populations, the Dementia Apathy Interview and Rating for patients with Alzheimer's dementia, the Positive and Negative Symptom Scale for schizophrenia populations, and the Frontal System Behavior Scale for patients with frontotemporal deficits are reliable and valid measures. Conclusion: Clinicians and researchers have numerous apathy scales for use in broad and disease-specific neuropsychiatric populations. Our understanding of apathy would be advanced by research that helps build a consensus as to the definition and diagnosis of apathy and further refine the psychometric properties of all apathy assessment tools. © 2011 Elsevier Inc.
The epidemiology of multiple somatic symptomsFrancis H. Creed | Ian Davies | Judy Jackson | Alison Littlewood | Carolyn Chew-Graham | Barbara Tomenson | Gary Macfarlane | Arthur Barsky | Wayne Katon | John McBeth
Volume 72, Issue 4, April 2012, Pages 311-317
Background: The risk factors for a high total somatic symptom count are unclear; and it is not known whether total somatic symptoms count is a predictor of impaired health status. Method: A prospective population-based cohort study in North West England. Randomly sampled residents (1443 participants; 58% response) completed questionnaires to determine number of somatic symptoms (SSI), health status and a wide range of risk factors; 741 completed questionnaires 1. year later. We used logistic regression to identify risk factors for high SSI at follow-up and for persistently high SSI. We used ANCOVAR and multiple regression to assess whether baseline SSI predicted health status at follow-up. Results: Twenty-one percent of participants scored over 25 on the Somatic Symptom Inventory (SSI) at baseline and 14% at both baseline and follow-up. Risk factors for a persistent high SSI were: fewer than 12. years of education, separated, widowed or divorced status, reported psychological abuse during childhood, co-existing medical illnesses, anxiety and depression. In multivariate analysis baseline SSI predicted health status (SF12 physical component score and health-related quality of life (EuroQol)) 12. months later. Persistent high SSI was a clinically meaningful predictor of these outcomes. Conclusions: Our data support a biopsychosocial approach to somatic symptoms rather than the dualistic approach of identifying "medically unexplained" symptoms. The risk factors for total somatic symptom count were those associated with psychiatric disorders including physical illness. A persistent high somatic symptom count provides a readily measured dimension of importance in epidemiology as a predictor of health status. © 2012 Elsevier Inc..
Biomarkers in burnout: A systematic reviewMarie Bernardine Danhof-Pont | Tineke van Veen | Frans G. Zitman
Volume 70, Issue 6, June 2011, Pages 505-524
Background: Burnout is a stress state characterized by symptoms of mental exhaustion and physical fatigue, detachment from work, and feelings of diminished competence. Several biomarkers have been tested for association with burnout, but the results are conflicting. Aim: The objective of this review was to identify potential biomarkers for burnout. Methods: We carried out a systematic review of studies comparing biomarkers in individuals with burnout and healthy controls, or individuals with low scores and those with high scores on burnout questionnaires. Literature searches in MEDLINE and EMBASE were performed. We describe biomarkers on which at least three studies were available. Where appropriate, a meta-analysis was carried out. Results: We identified 31 studies on 38 biomarkers involved in the hypothalamus-pituitary-adrenal axis, autonomic nervous system, immune system, metabolic processes, antioxidant defense, hormones, and sleep. At least 3 studies were available for cortisol in saliva and blood, blood pressure, heart rate, cholesterol, dehydroepiandrosterone sulfate, (numbers or activity of) natural killer cells, C-reactive protein, and prolactin. The comparability of studies was limited, due to differences in the methods used to characterize patients and controls, to assess biomarkers, and to control for confounders. Furthermore, burnout was operationalized in different ways. Meta-analyses showed no differences for cortisol awakening response and cortisol awakening response after administration of dexamethasone, cortisol in blood, and blood pressure. Conclusions: No potential biomarkers for burnout were found, largely due to the incomparability of studies. We emphasize the need for a dimensional and longitudinal approach in future research to account for the heterogeneity of burnout. © 2010 Elsevier Inc.
No further research needed: Abandoning the Hospital and Anxiety Depression Scale (HADS)James C. Coyne | Eric van Sonderen
Volume 72, Issue 3, March 2012, Pages 173-174
The puzzle of depression and acute coronary syndrome: Reviewing the role of acute inflammationLydia Poole | Chris Dickens | Andrew Steptoe
Volume 71, Issue 2, August 2011, Pages 61-68
The relationship between depression and coronary heart disease is well-established, but causal mechanisms are poorly understood. The aim of this review is to stimulate different ways of viewing the relationship between depression and adverse outcomes following acute coronary syndrome (ACS) and coronary artery bypass graft (CABG) surgery patients. We present an argument for depression in ACS and CABG patients being a qualitatively distinct form from that observed in psychiatric populations. This is based on three features: (1) depression developing after cardiac events has been linked in many studies to poorer outcomes than recurrent depression; (2) somatic symptoms of depression following cardiac events are particularly cardiotoxic; (3) depression following an ACS does not respond well to antidepressant treatments. We propose that inflammation is a common causal process responsible in part both for the development of depressive symptoms and for adverse cardiac outcomes, and we draw parallels with inflammation-induced sickness behaviour. Clinical implications of our observations are discussed along with suggestions for further work to advance the field. © 2010 Elsevier Inc.
Comparative efficacy study of haloperidol, olanzapine and risperidone in deliriumSandeep Grover | Vineet Kumar | Subho Chakrabarti
Volume 71, Issue 4, October 2011, Pages 277-281
Objective: The objective of the study was to assess the efficacy and safety of second-generation antipsychotics olanzapine and risperidone vs. haloperidol in patients of delirium admitted to medical and surgical wards. Methods: Prospective follow-up single-blind randomized controlled trials were performed. Consecutive patients with delirium referred to the consultation-liaison psychiatry team were eligible for the study. The study sample comprised 64 patients, with 20 subjects in the haloperidol group, 21 subjects in the risperidone group and 23 subjects in the olanzapine group. A flexible dose regimen (haloperidol -0.25 to 10 mg; risperidone -0.25 to 4 mg; olanzapine -1.25 to 20 mg) was used. Delirium Rating Scale-Revised-98 (DRS-R98) was used as the primary efficacy measure, and mini mental status examination (MMSE) was used as a secondary efficacy measure. Results: There was no significant difference in mean baseline DRS-R98 severity scores and MMSE scores between the three groups. However, there were a significant reduction in DRS-R98 severity scores and a significant improvement in MMSE scores over the period of 6 days, but there was no difference between the three groups. Four patients in the haloperidol group, six subjects in the risperidone group and two subjects in the olanzapine group experienced some side effects. Conclusions: Risperidone and olanzapine are as efficacious as haloperidol in the treatment of delirium. © 2010 Elsevier Inc.
Association of diabetes with anxiety: A systematic review and meta-analysisKimberley J. Smith | Mélanie Béland | Matthew Clyde | Geneviève Gariépy | Véronique Pagé | Ghislaine Badawi | Rémi Rabasa-Lhoret | Norbert Schmitz
Volume 74, Issue 2, February 2013, Pages 89-99
Objectives: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been little research which has specifically examined whether diabetes mellitus is associated with an increased likelihood of co-morbid anxiety. The aim of this systematic review and meta-analysis was to determine whether people with diabetes are more likely to have anxiety disorders or elevated anxiety symptoms than people who do not have diabetes. Methods: A systematic review was performed by three independent reviewers who searched for articles that examined the association between anxiety and diabetes in adults 16 or older. Those studies that met eligibility criteria were put forward for meta-analysis using a random-effects model. Results: A total of twelve studies with data for 12,626 people with diabetes were eligible for inclusion in the systematic review and meta-analysis. Significant and positive associations were found for diabetes with both anxiety disorders, 1.20 (1.10-1.31), and elevated anxiety symptoms, 1.48 (1.02-1.93). The pooled OR for all studies that assessed anxiety was 1.25 (1.10-1.39). Conclusions: Results from this meta-analysis provide support that diabetes is associated with an increased likelihood of having anxiety disorders and elevated anxiety symptoms. © 2012.
The association between mood and anxiety disorders with vascular diseases and risk factors in a nationally representative sampleJess G. Fiedorowicz | Jianping He | Kathleen R. Merikangas
Volume 70, Issue 2, February 2011, Pages 145-154
Objective: To investigate the association between mood and anxiety disorders and vascular diseases after controlling for vascular disease risk factors. Methods: Using a nationally representative sample of adults (N=5692) from the National Comorbidity Survey-Replication (NCS-R), participants with mood disorders were hierarchically classified as having any lifetime history of mania, hypomania, or major depression. Anxiety disorders were also assessed. The reference group consisted of those without mental disorders. Vascular disease was determined by self-reported history of heart disease, heart attack, or stroke on the NCS-R survey. Vascular risk factors included diabetes, high blood pressure, and obesity. Results: In multivariate logistic regression models that controlled for obesity, high blood pressure, smoking and diabetes, vascular disease was associated with bipolar disorder in women [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.63-4.80], and major depressive disorder in men (OR 1.85, 95% CI 1.17-2.92). Controlling for anxiety disorders reduced the associations in both men and women, and in fact, anxiety disorders were more strongly associated with vascular diseases in men, whereas bipolar disorder continued to be an important correlate of vascular disease in women. Conclusion: These findings demonstrate the importance of evaluation of sex differences, mood disorder subtype and co-occurring anxiety disorders in assessing the association between mood disorders and vascular diseases. Future research should investigate potential biologic mechanisms for these associations in order to define potential targets for intervention. © 2011 Elsevier Inc.
Methodological aspects of clinical trials in tinnitus: A proposal for an international standardMichael Landgrebe | Andréia Azevedo | David Baguley | Carol Bauer | Anthony Cacace | Claudia Coelho | John Dornhoffer | Ricardo Figueiredo | Herta Flor | Goeran Hajak | Paul van de Heyning | Wolfgang Hiller | Eman Khedr | Tobias Kleinjung | Michael Koller | Jose Miguel Lainez | Alain Londero | William H. Martin | Mark Mennemeier | Jay Piccirillo | Dirk De Ridder | Rainer Rupprecht | Grant Searchfield | Sven Vanneste | Florian Zeman | Berthold Langguth
Volume 73, Issue 2, August 2012, Pages 112-121
Chronic tinnitus is a common condition with a high burden of disease. While many different treatments are used in clinical practice, the evidence for the efficacy of these treatments is low and the variance of treatment response between individuals is high. This is most likely due to the great heterogeneity of tinnitus with respect to clinical features as well as underlying pathophysiological mechanisms. There is a clear need to find effective treatment options in tinnitus, however, clinical trials differ substantially with respect to methodological quality and design. Consequently, the conclusions that can be derived from these studies are limited and jeopardize comparison between studies. Here, we discuss our view of the most important aspects of trial design in clinical studies in tinnitus and make suggestions for an international methodological standard in tinnitus trials. We hope that the proposed methodological standard will stimulate scientific discussion and will help to improve the quality of trials in tinnitus. © 2012 Elsevier Inc.
Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic reviewKelsey R. O'Dell | Kevin S. Masters | Glen I. Spielmans | Stephen A. Maisto
Volume 71, Issue 4, October 2011, Pages 199-206
Objective: Research generally indicates that psychological variables are stronger predictors of cardiovascular outcomes in healthy populations than in those with preexisting illness. Studies of Type-D personality, however, suggest that it may also be predictive of negative health outcomes in cardiovascular patient populations. To date, no independent, comprehensive meta-analysis centered specifically on Type-D has integrated this literature and provided quantitative estimates of these relationships. The present meta-analysis investigated the associations between Type-D personality and (a) major adverse cardiac events (MACE), (b) health-related quality of life (HRQOL) and (c) biochemical markers of cardiovascular disease among cardiovascular patients. Method: Two independent reviewers abstracted data from 15 separate studies. A random effects meta-analytic model was utilized to calculate omnibus effect sizes for each set of related studies, i.e., for the MACE (N of patients=2903), HRQOL (N of patients=1263) and biochemical marker (N of patients=305) measures. Results: A positive association was found between Type-D personality and MACE, whereas a negative association was observed between Type-D personality and HRQOL. There was a trend toward significance in the association between Type-D personality and cardiovascular disease biomarkers. Conclusion: Type-D personality is a promising construct for understanding psychological relationships with important outcomes among cardiovascular patients. Subsequent investigations undertaken by a more diverse group of unaffiliated scientists are important for further development in this line of research. © 2010 Elsevier Inc.
Persistence of sleep disturbances following cognitive-behavior therapy for posttraumatic stress disorderGeneviève Belleville | Stéphane Guay | André Marchand
Volume 70, Issue 4, April 2011, Pages 318-327
Objectives: The objectives of the present study were (1) to assess the impact of cognitive-behavior therapy (CBT) for posttraumatic stress disorder (PTSD) on associated sleep disturbances and (2) to explore the correlates of persistent sleep difficulties in terms of anxiety and depression symptoms and perceived health. Method: Fifty-five individuals with PTSD were administered a series of assessments designed to evaluate sleep, PTSD symptoms, symptoms of anxiety and depression, and perceived health before and after individual CBT for PTSD and at 6-month follow-up. Results: Significant improvements were observed on sleep quality, sleep onset latency, sleep efficiency, and sleep disturbances. These changes were not fully maintained after 6 months, and 70% of people who reported baseline sleep difficulties (Pittsburgh Sleep Quality Index >5) still reported significant problems with sleep after treatment. Persistent sleep difficulties were associated with more severe posttraumatic, anxious, and depressive symptoms as well as poorer health. Conclusion: Although CBT for PTSD had a favorable impact on sleep, the majority of participants suffered from residual sleep difficulties. Individuals with persistent sleep difficulties posttreatment may experience more residual posttraumatic, depression, and anxiety symptoms and poorer mental and physical health than those who do not report sleep problems posttreatment. Further research in this area will allow clinicians to treat sleep problems in these individuals more effectively. © 2011 Elsevier Inc.
Mindfulness therapy for somatization disorder and functional somatic syndromes - Randomized trial with one-year follow-upLone Overby Fjorback | Mikkel Arendt | Eva Ørnbøl | Harald Walach | Emma Rehfeld | Andreas Schröder | Per Fink
Volume 74, Issue 1, January 2013, Pages 31-40
Objective: To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, defined as bodily distress syndrome (BDS). Methods: We randomized 119 patients to either mindfulness therapy (mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS) or to enhanced treatment as usual (2-hour specialist medical care and brief cognitive behavioral therapy for BDS). The primary outcome measure was change in physical health (SF-36 Physical Component Summary) from baseline to 15-month follow-up. Results: The study is negative as we could not demonstrate a different development over time for the two groups (F(3,2674) = 1.51, P= .21). However, in the mindfulness therapy group, improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up, whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up. The change scores averaged half a standard deviation which amounts to a clinically significant change, 29% changed more than 1 standard deviation. Significant between-group differences were observed at treatment cessation. Conclusion: Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms. Nevertheless, considering the more rapid improvement following mindfulness, mindfulness therapy may be a potentially useful intervention in BDS patients. Clinically important changes that seem to be comparable to a CBT treatment approach were obtained. Further research is needed to replicate or even expand these findings. © 2012 Elsevier Inc.
Are media warnings about the adverse health effects of modern life self-fulfilling? An experimental study on idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF)Michael Witthöft | G. James Rubin
Volume 74, Issue 3, March 2013, Pages 206-212
Objective: Medically unsubstantiated 'intolerances' to foods, chemicals and environmental toxins are common and are frequently discussed in the media. Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) is one such condition and is characterized by symptoms that are attributed to exposure to electromagnetic fields (EMF). In this experiment, we tested whether media reports promote the development of this condition. Methods: Participants (N= 147) were randomly assigned to watch a television report about the adverse health effects of WiFi (n= 76) or a control film (n= 71). After watching their film, participants received a sham exposure to a WiFi signal (15. min). The principal outcome measure was symptom reports following the sham exposure. Secondary outcomes included worries about the health effects of EMF, attributing symptoms to the sham exposure and increases in perceived sensitivity to EMF. Results: 82 (54%) of the 147 participants reported symptoms which they attributed to the sham exposure. The experimental film increased: EMF related worries (β= 0.19; P= .019); post sham exposure symptoms among participants with high pre-existing anxiety (β= 0.22; P= .008); the likelihood of symptoms being attributed to the sham exposure among people with high anxiety (β= .31; P= .001); and the likelihood of people who attributed their symptoms to the sham exposure believing themselves to be sensitive to EMF (β= 0.16; P= .049). Conclusion: Media reports about the adverse effects of supposedly hazardous substances can increase the likelihood of experiencing symptoms following sham exposure and developing an apparent sensitivity to it. Greater engagement between journalists and scientists is required to counter these negative effects. © 2012 Elsevier Inc.
Somatic symptom disorder: An important change in DSMJoel E. Dimsdale | Francis Creed | Javier Escobar | Michael Sharpe | Lawson Wulsin | Arthur Barsky | Sing Lee | Michael R. Irwin | James Levenson
Volume 75, Issue 3, September 2013, Pages 223-228
This paper describes the rationale for the new diagnosis of somatic symptom disorder (SSD) within DSM5. SSD represents a consolidation of a number of previously listed diagnoses. It deemphasizes the centrality of medically unexplained symptoms and defines the disorder on the basis of persistent somatic symptoms associated with disproportionate thoughts, feelings, and behaviors related to these symptoms. Data are presented concerning reliability, validity, and prevalence of SSD, as well as tasks for future research, education, and clinical practice. © 2013 Elsevier Inc.
Reattribution reconsidered: Narrative review and reflections on an educational intervention for medically unexplained symptoms in primary care settingsLinda Gask | Christopher Dowrick | Peter Salmon | Sarah Peters | Richard Morriss
Volume 71, Issue 5, November 2011, Pages 325-334
Objective: Medically unexplained symptoms (MUS) refer to bodily symptoms without a physical health explanation. In the context of MUS, reattribution is a process of attributing physical symptoms to a psychological cause. We review the use of a consultation model which employs reattribution, and which has been extensively utilised in teaching and research in primary care. Methods: Literature search for studies utilising the reattribution model. Narrative review of the results. Results: Data was extracted from 25 publications from 13 studies. The model has been modified over time and comparison between studies is limited by differences in methodology. The skills of the model can be acquired by training, which also improves practitioners' attitudes to MUS. However impact on clinical outcomes has been mixed and this can be explained in part from the findings of nested qualitative studies. Conclusions: The reattribution model is too simplistic in its current form to address the needs of many people presenting with MUS in primary care. Reattribution of physical symptoms to psychological causes is often unnecessary. Further research is required into the effectiveness of stepped and collaborative care models in which education of primary care practitioners forms one part of a complex intervention. The consultation process is best seen as both a conversation and ongoing negotiation between doctor and patient in which there are no certainties about the presence or absence of organic pathology. © 2011 Elsevier Inc.
Diagnostic accuracy of self-rating scales for screening of depression in coronary artery disease patientsAdomas Bunevicius | Margarita Staniute | Julija Brozaitiene | Robertas Bunevicius
Volume 72, Issue 1, January 2012, Pages 22-25
Objective: We evaluated the internal consistency and psychometric properties of the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory-II (BDI-II) for screening of major depressive episodes (MDE) in coronary artery disease (CAD) patients undergoing rehabilitation. Methods: Five-hundred and twenty-two consecutive CAD patients (72% men; mean age 58 ± 9. years) attending a rehabilitation program 2. weeks after inpatient treatment for acute ischemic cardiac events completed the HADS depression subscale (HADS-D), HADS anxiety subscale (HADS-A) and the BDI-II. Interview outcome using the Mini International Neuropsychiatric Interview (MINI) for current MDE according to the DSM-IV-TR criteria was considered as the gold standard. Results: Fifty-six (11%) patients had a current MDE. The HADS-D, HADS-A, HADS-total and BDI-II had high internal consistency. Area under the ROC curve was the highest for the BDI-II followed by the HADS. Optimal cut-off values for screening of MDE were ≥ 5 for the HADS-D, ≥ 8 for the HADS-A and ≥ 14 for the HADS-total and for the BDI-II. At optimal cut-off values the BDI-II had slightly superior psychometric properties when compared to the HADS. However, positive predictive values were low for the HADS and for the BDI-II. Conclusions: In CAD patients undergoing rehabilitation, the HADS and BDI-II had high internal consistency. Screening for MDE at optimal cut-off values the BDI-II was slightly superior when compared to the HADS. Positive predictive values for the BDI-II and for the HADS were low indicating that a large proportion of patients with positive screening results did not meet criteria for MDE. © 2011.


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Specialties & Research
Dr. Michael Pollock, MD is board certified in Orthopaedic Surgery.
- He has special expertise in 3 areas:
- Hip Osteoarthritis
- Knee Osteoarthritis
- Osteoarthritis (Hand and Wrist)
Education & Awards
Dr. Pollock graduated from University of Pittsburgh .
Dr. Pollock has 5 hospital affiliations:
- Meyersdale Community Hospital
- Conemaugh Valley Memorial Hospital
- English
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- Additional Information
- Dr. Michael Stephen Pollock MD is a male Orthopaedic Surgeon, has 34 years of experience and practices in Orthopaedic Surgery.
- Where does Dr. Michael S. Pollock practice?
- Dr. Michael Pollock has 1 office location.
Dr. Michael Pollock practices Orthopaedic Surgery near Indiana, PA.
See Indiana Orthopedic Surgeons.


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Sixt Rental Unterrath Deals
Relax during your next trip to Unterrath and avoid the hassle of dealing with expensive cab rides and stuffy buses. Instead, book your Sixt car rentals in Unterrath today, right here on Expedia.com and experience the comfort and convenience of traveling with your own set of rental wheels. This way, you can explore all the major sites and attractions of Unterrath at your leisure instead of trying to navigate public transportation routes.
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Cleaning an industrial facility can be a real challenge. It is time-consuming to clean every surface and you might not have the best equipment to clean your facility. KP Group offers a comprehensive cleaning solution for any kind of business, facility or building.
KP Group is a company dedicated to providing industrial cleaning services to a wide range of clients. They are professional, reliable, efficient and always do an amazing job. Their industrial vacuum cleaning Auckland service could be what you need if you are dealing with dust or other particles that are difficult to clean. A lot of businesses simply do not have enough time to clean their facilities, or do not have time to properly train employees to thoroughly clean the facilities.
Keeping your facility clean is very important for safety reasons. A poor work environment could also lead to some occupational health problems, especially if workers have to breathe air that is saturated with dust or other particles.
Cleaning your facility by yourself is difficult because industrial-grade equipment and training are needed. The professionals who work for KP Group will use cherry pickers to clean areas that are too high to reach and will also use extensions to clean behind machines and other areas that are not easy to access.
The industrial vacuum cleaning Auckland service offered by KP Group is a very thorough cleaning process that will remove any trace of dust, dirt and other particles present in your facility. This is an excellent option if you have to meet certain cleanliness requirements in your industry or are concerned about the health of workers due to dust being present in the air they breathe.
The benefits of using an industrial vacuum cleaning Auckland service include making your work environment safer and preventing health problems such as eye irritation or respiratory difficulties. A clean environment is better for your products since thorough cleaning reduces the risks of contamination and eliminates the need to re-wrap products.
KP Group is an excellent choice for all your industrial and commercial cleaning needs since this company offers a wide range of services. You can always count on them to do a great job and their operators receive extensive training when it comes to cleaning industrial and commercial facilities.
The industrial vacuum cleaning service offered is performed with the best industrial-grade equipment, including filtration vacuums that get every dust particle.
You should also consider using industrial cleaning services on a regular basis to maintain a clean and healthy work environment. This could reduce the risks of accidents, contamination and health problems among workers on the long-term.
You can learn more about the industrial vacuum cleaning Auckland service offered by KP Group by visiting this URL: http://www.kpgroupltd.co.nz/vacuuming.html
Keeping your facilities clean is very important, both for the health of workers and for the quality of the products being manufactured. Failing to choose a great industrial cleaning service could result a poorly-cleaned facility, which is why you should consider KP Group and their team of experienced professionals for your cleaning needs.


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Tickets to some of the most exclusive functions at the Margaret River Gourmet Escape have already sold out.
After the doors were officially opened last week, sources said the limited run of $500 tickets to the icon dinner with Heston Blumenthal sold out almost immediately.
Brand Events Gourmet Escape director Naomi Wilson said the response was "phenomenal".
"Ticket sales have been strong, which has seen some events such as (the) Matt Moran Beach Barbecue and (the) Heston icon dinner already selling out," she told the Times.
"We are thrilled with the feedback which is testament to the uniqueness of the event concept and the calibre of talent represented."
The company has pitched 10,000 visitors to go through the Gourmet Village at Leeuwin Estate at which all the celebrities would attend, Ms Wilson said.
More events would be announced in coming weeks.


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Hotel Vincci Málaga
Pácifico, 44, 29004 Malaga, Spain |Show on the map
from €37
Modern hotel with incomparable style of Vincci hotels, newly built in
front the beach of la Misericordia.
Choose your room
Share it
Destinia Score
Score based on 23 reviews
Score based on 23 reviews
Tripadvisor Score Score based on 818 reviews
Average price per night for this hotel for the following weeks
|10/24/16 - 10/30/16
|10/31/16 - 11/6/16
|11/7/16 - 11/13/16
|11/14/16 - 11/20/16
Services and terms: Hotel Vincci Málaga
Standard Room Services
- Air Conditioning
- Safe
- Heating
- Minibar
- Hairdryer
- Telephone
- Television
Accommodation facilities
- Lift
- Bar/Café
- Business Centre
- Internet Centre
- Laundry
- People with reduced mobility access
- Non-smoker Rooms
- Parking
- Restaurant
- 24 hr Room Service
Leisure facilities
- Massage
- Solarium
Useful information: Hotel Vincci Málaga
Other names for Hotel Vincci Málaga
Location: Hotel Vincci Málaga
Vincci Málaga is a new four-star from Vincci chain. Situated on the
promenade of Malaga, Malaga Vincci is in an exceptional area, 50 meters
from the beach, 1 km from the Martin Carpena Sports Hall, 2 miles from
downtown, 3 miles from the Palace Conference and Exhibition Centre and 5
km from Malaga airport.
The hotel has easy access from Malaga capital, reaching the port you can
take the boardwalk that leads directly to the hotel. It can be useful
sites like map24 http://www.es.map24.com in which you can calculate
Nearby points of interest
Reviews: Hotel Vincci Málaga
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From February 28 to March 19, 2016, we welcome you to the 16th annual Vancouver International Dance Festival.
The Vancouver International Dance Festival has featured artists from China, Spain, the United States of America, France, Germany, Japan, Poland, Switzerland, Thailand, Taiwan, Lithuania, Mexico, and Canada performing techniques and styles as diverse as butoh, aboriginal, hip hop, flamenco, ballet, as well as cutting edge contemporary dance.
Each year at the Festival we invite you to experience three weeks of performances, workshops and other activities at venues including the Roundhouse, the Vancouver Playhouse, and the Woodward's Atrium in Vancouver's DTES.
Please join us this year to enjoy the dynamic energy and outstanding artistry of the VIDF's unique artists and creations.


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Kirby Corner Restaurants
Soup & Sandwich Co.: Subs
Specialty sub shop. They have many different subs with a twist in addition to the usual tried and true. The subs are very good and quite filling. There is a small seating area, but it's better as a take out. They also have soups.
Favorite Dish: The pilgrim: roast beef with lettuce, stuffing and cranberry. The tartness of the cranberry is great with the stuffing and bread.Add to your Trip Planner
Evergreen Eddy's Wilderness Grill: Evergreen Eddy's
This is a decent steakhouse in Taft Corners. It's probably the nicest here in Taft Corners and the closest one to the shops. Not one of my favorites, but most visitors to the area seem to love it. The dish names typically have a Vermont-ish quality to it. Also there's a nice moose statue in front of the restaurant .
Favorite Dish: The long trail terriaki steak.Add to your Trip Planner
Kirby Corner Hotels0 Hotels in Kirby Corner
Kirby Corner Shopping
Maple Tree Place: More Big Box Stores
This area was designed to be a new downtown for Williston. However, thus far it's just become an extension of Taft Corners Shopping Center which is across the street. Here the big box stores include: Best Buy, Dicks Sporting Goods, Linens and More, and StaplesAdd to your Trip Planner
Taft Corners Shopping: Big Box Stores
Well, if you're in Taft Corners, it's likely to go shopping at one of the big box stores here. This is the most popular place to shop in Vermont, according to retail sales. Here's a list of the stores in the center running along Marshall Ave: Bed Bath & Beyond, Circuit City, Home Depot, PetsMart,Toys R Us, and Walmart
Also see Maple Tree PlaceAdd to your Trip Planner
Don't Forget Insurance
If your current health insurance doesn't cover you while your abroad, you should consider getting international travel insurance just in case something should go wrong.
Instant Answers: Kirby Corner
Get an instant answer from local experts and frequent travelers


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A teenage girl is in the hospital, critically injured after someone shot her in the stomach late Thursday night.
Omaha police said it happened near 24th and Evans streets around 10 p.m.
Paramedics took the 15-year-old victim to the Nebraska Medical Center for treatment of critical injuries.
Police identified the victim as Veaughan Johnson. The investigation is ongoing.
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As in all furniture, even the most durable furniture starts to degenerate over time. Due to old age, the appearance is affected. The wicker furniture will look old, dirty and unusable. If you find yourself in a similar position, do not throw away your All these features make wicker furniture the best and most popular choice when furnishing the patio. This article gives you other reasons which tell you why you should not shy from swearing by wicker furniture for your patio. People are always on the Enjoy the outdoors in comfort and style with this 4-piece outdoor wicker patio set. Includes Rocker, Lounge Chair, Ottoman, and Glass-top Round Table. Weather-resistant sea-green plush cushions included. Excellent condition. $475 or best offer. Call 617 The inside track on Washington politics. Be the first to know about new stories from PowerPost. Sign up to follow, and we'll e-mail you free updates as they're published. You'll receive free e-mail news updates each time a new story is published. As one of its daily deals, Aosom via Sears offers the Outsunny 4-Piece Outdoor Rattan Wicker Sectional Set, model no. 841-086, for $399.99 with free shipping. That's $300 off list and lowest total price we've seen. It features a double sofa, two chairs Porches filled with wicker furniture, beautiful plants and slow moving fans come to mind. Lemonade sipped on the porch swing, while visiting with the neighbors. I love the romance of leaded glass windows, the intricate gingerbread trim and period features .
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