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BACKGROUND: The COVID-19 pandemic is characterized by both health and economic risks. A 'safety loop' model postulates risk-related decisions are not based on objective and measurable risks but on the subjective perception of those risks. We here illustrate a quantification of the difference between objective and subjective risks. METHOD: The objective risks (or chances) can be obtained from traditional 2 × 2 tables by calculating the positive (+LR) and negative (-LR) likelihood ratios. The subjective perception of objective risks is calculated from the same 2 × 2 tables by exchanging the X- and Y-axes. The traditional 2 × 2 table starts with the hypothesis, uses a test and a gold standard to confirm or exclude the investigated condition. The 2 × 2 table with inverted axes starts with the communication of a test result and presumes that the communication of bad news (whether right or false) will induce 'Perceived Anxiety' while good news will induce 'Perceived Safety'. Two different functions (confirmation and exclusion) of both perceptions (Perceived Anxiety and Safety) can be quantified with those calculations. RESULTS: The analysis of six published tests and of one incompletely reported test on COVID-19 polymerase chain reactions (completed by four assumptions on high and low sensitivities and specificities) demonstrated that none of these tests induces 'Perceived Safety'. Eight of the ten tests confirmed the induction of 'Perceived Anxiety' with + LRs (range 3.1-5900). In two of these eight tests, a -LR (0.25 and 0.004) excluded the induction of 'Perceived Safety'. CONCLUSIONS: Communication of test results caused perceived anxiety but not perceived safety in 80% of the investigated tests. Medical tests - whether true or false - generate strong psychological messages. In the case of COVID-19 tests may induce more perceived anxiety than safety. Risk communication has to balance objective and subjective risks.

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INTRODUCTION: The present study investigated the effect of interventions aiming to improve attitudes toward the use of respiratory protective equipment (RPE), knowledge of RPE and the use of RPE in the Norwegian smelter industry. METHOD: The surveys received 567 respondents to baseline and 240 respondents 2 weeks after the intervention. Participants were invited to either a fit-testing of respirators [Group 1] or a fit-testing combined with a lecture on exposure [Group 2], health effects and RPE. The control group [Group 3] received no training. Questionnaires containing measures of subjective knowledge, attitudes and behavior regarding RPE use were assessed. RESULTS: Testing indicated an improvement in knowledge of RPE and a reduction in perceived inconveniences regarding the use of RPE for both intervention groups. Group 1 showed an improvement in attitudes and organizational support, while intervention Group 2 showed an improvement in subjective norms related to RPE use. Intention to use or rate of respirator use was not shown to change significantly for any group using paired testing. Regression analysis indicated that participation in either intervention influenced intention to use respirators. The effect was significant for Group 1 and was marginally significant for intervention Group 2. CONCLUSION: The results indicate that interventions can increase workers' knowledge and attitudes, and reduce perceived inconvenience regarding the use of respiratory protective equipment. However, even though some variables seemed to positively change, reported respirator use did not improve for either groups participating in the study. It may be that physical barriers with regards to using RPE, such as fogging of protective goggles, sweating, breathing and communication issues outweigh individual attitudes, intentions and social pressure to use respirators. PRACTICAL APPLICATIONS: The tailored course and practical training in RPE use in the current intervention can be applied in the smelting industry to provide up to date information on dust exposure, health effects and protective equipment. Some adjustments may be warranted for the content to fit specific risks and exposures of other industries. However, the general pedagogical framework of the educational material regarding health effects and RPE should be useful for most heavy industries.

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Scatter plots are the most commonly employed technique for the visualization of bivariate data. Despite their versatility and expressiveness in showing data aspects, such as clusters, correlations, and outliers, scatter plots face a main problem. For large and dense data, the representation suffers from clutter due to overplotting. This is often partially solved with the use of density plots. Yet, data overlap may occur in certain regions of a scatter or density plot, while other regions may be partially, or even completely empty. Adequate pixel-based techniques can be employed for effectively filling the plotting space, giving an additional notion of the numerosity of data motifs or clusters. We propose the Pixel-Relaxed Scatter Plots, a new and simple variant, to improve the display of dense scatter plots, using pixel-based, space-filling mappings. Our Pixel-Relaxed Scatter Plots make better use of the plotting canvas, while avoiding data overplotting, and optimizing space coverage and insight in the presence and size of data motifs. We have employed different methods to map scatter plot points to pixels and to visually present this mapping. We demonstrate our approach on several synthetic and realistic datasets, and we discuss the suitability of our technique for different tasks. Our conducted user evaluation shows that our Pixel-Relaxed Scatter Plots can be a useful enhancement to traditional scatter plots.

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There is sparse research on quality of life (QoL) as an outcome measure in patients with substance use disorders (SUD), with or without attention deficit hyperactivity disorder (ADHD). We aimed to investigate whether SUD patients with and without ADHD (SUD + ADHD vs. SUD - ADHD) differed in QoL at baseline and at a 12-month follow-up after SUD treatment. The groups were additionally compared with data from a national population sample (NPS). From a sample of 16 SUD + ADHD and 87 SUD - ADHD patients originally recruited between 2010 and 2012, eight SUD + ADHD (50.0%) and 28 SUD - ADHD (32.2%) patients were reached at follow-up. QoL was measured with the short version of the World Health Organization QoL instrument (WHOQOL-BREF). Cross-sectional data on QoL from NPS was utilized. Compared to NPS, SUD patients reported significantly lower QoL at baseline and follow-up. Furthermore, QoL was similar at baseline in SUD + ADHD and SUD - ADHD patients. At a 12-month follow-up after SUD treatment, SUD + ADHD patients 'QoL had improved, however, not significantly differing from SUD - ADHD patients or the NPS. SUD - ADHD patients' QoL remained significantly lower. At follow-up, SUD + ADHD patients' QoL improved nominally compared to SUD - ADHD patients, but not the NPS. The clinical and functional relevance of these findings should be investigated further.

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The association between depressive symptoms and elevated cortisol levels, and depression and cognitive functioning, has been less robust in outpatients with symptoms in the mild to moderate range. Furthermore, the association between elevated cortisol levels and cognitive functioning is unclear. In the present study, currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50) were assessed on a range of neuropsychological measures. Salivary cortisol was measured in the morning and evening. Participants with current depression were non-hospitalized and had symptoms predominately in the mild to moderate range. Elevated salivary evening cortisol, but not morning cortisol, was significantly related to depressive symptoms. The difference in cortisol levels between the previously depressed group and the never depressed controls was not significant. The groups had significantly different cognitive profiles, with the currently depressed performing poorer on tasks related to working memory compared to the never depressed controls. Both the currently and previously depressed performed worse on attentional tasks. The findings indicate that outpatients with mild to moderate depression have elevated cortisol levels and limited mild cognitive impairments. Furthermore, mild impairments in attention may persist after remission, indicating that this could be a trait-marker in depression. The present study did not find support for a significant relationship between cortisol and cognitive functioning.

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Previous research has revealed a higher prevalence of respiratory symptoms in Norwegian smelter workers compared to average population controls. Nevertheless, respiratory protective equipment (RPE) is not always used, even in situations with high exposure risk. A questionnaire was distributed to workers in the Norwegian smelting industry to investigate the relationship between psychological factors and self-reported use of RPEs. Response rate was 567/1,253. A scale measuring attitudes toward behavior (ATT), subjective norms (SN), perceived behavioral control (PBC), and behavioral intention (BI) was constructed based on the Theory of Planned Behavior (TPB). Reliability and Confirmatory Factor Analyses partially supported the theoretical structure of the TPB-based scale, the Work Experience Measurement Scale (WEMS) and the Short Scale for Safety Climate (SC). A model explaining the relationship between observed variables, latent constructs from TPB, WEMS and SC was developed by SEM-analysis. Significant influence on BI from ATT (ß = 0.31 p < 0.01), SN (ß = 0.36 p < 0.01), and SC (ß = 0.19, p < 0.01) emerged. Among the observed variables included, relationship status (ß = -0.12 p < 0.05), education level (ß = 0.09, p < 0.05), previously completed respirator fit-testing (ß = -0.09, p < 0.05) and average hours spent in exposed areas (ß = -0.09) p < 0.05) had significant influence on behavioral intention. The model explained 48% of the variance in BI. BI and PBC significantly predicted PB, with ß = 0.65 and ß = -0.06, respectively. Results of this investigation can help facilitate further work and development of health & safety routines within industrial settings.

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OBJECTIVES: We compared sex-stratified developmental and temperamental profiles at 18 months in children screening negative for autism spectrum disorder (ASD) on the Modified Checklist for Autism in Toddlers (M-CHAT) but later receiving diagnoses of ASD (false-negative group) versus those without later ASD diagnoses (true-negative group). METHODS: We included 68 197 screen-negative cases from the Norwegian Mother and Child Cohort Study (49.1% girls). Children were screened by using the 6 critical items of the M-CHAT at 18 months. Groups were compared on domains of the Ages and Stages Questionnaire and the Emotionality Activity Sociability Temperament Survey. RESULTS: Despite passing M-CHAT screening at 18 months, children in the false-negative group exhibited delays in social, communication, and motor skills compared with the true-negative group. Differences were more pronounced in girls. However, with regard to shyness, boys in the false-negative group were rated as more shy than their true-negative counterparts, but girls in the false-negative group were rated as less shy than their counterparts in the true-negative group. CONCLUSIONS: This is the first study to reveal that children who pass M-CHAT screening at 18 months and are later diagnosed with ASD exhibit delays in core social and communication areas as well as fine motor skills at 18 months. Differences appeared to be more pronounced in girls. With these findings, we underscore the need to enhance the understanding of early markers of ASD in boys and girls, as well as factors affecting parental report on early delays and abnormalities, to improve the sensitivity of screening instruments.

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The autism mental status exam is an eight-item observational assessment that structures the way we observe and document signs and symptoms of ASD. Investigations of test performance indicate strong sensitivity and specificity using gold-standard assessment as reference standard. This study aims to explore potential sex differences in AMSE test performance and observations of 123 children referred for autism assessment. Results indicates more language deficits in females with ASD than in males with ASD and less sensory symptoms in females compared to males with ASD. The AMSE performance is similar in identifying ASD and non-ASD in females compared to males. Less disruptive behaviors in females, might cause a need for a bigger hit to other areas of development to raise concern.

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BACKGROUND: Previous research shows that depression is associated with an increase in stressful life events and perceived stress as well as dysfunctional ways of coping with stress. However, knowledge about coping in previously depressed individuals is scant. METHODS: This study compared perceived stress, coping, and thought suppression in a sample of 30 currently depressed, 63 previously depressed, and 42 never depressed individuals. RESULTS: Analysis of variance revealed that previously depressed individuals showed less wishful thinking and thought suppression than the currently depressed individuals, but scored significantly higher on these strategies than the never depressed individuals. However, the group differences became nonsignificant when controlling for perceived stress and intrusions. CONCLUSIONS: This study shows that both current depression and previous depression is related to avoidant coping (wishful thinking and thought suppression). However, these associations might be explained by the higher level of perceived stress among individuals with current or previous depression.

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Stochastically solving the rendering integral (particularly visibility) is the de-facto standard for physically-based light transport but it is computationally expensive, especially when displaying heterogeneous volumetric data. In this work, we present efficient techniques to speed-up the rendering process via a novel visibility-estimation method in concert with an unbiased importance sampling (involving environmental lighting and visibility inside the volume), filtering, and update techniques for both static and animated scenes. Our major contributions include a progressive estimate of partial occlusions based on a fast sweeping-plane algorithm. These occlusions are stored in an octahedral representation, which can be conveniently transformed into a quadtree-based hierarchy suited for a joint importance sampling. Further, we propose sweep-space filtering, which suppresses the occurrence of fireflies and investigate different update schemes for animated scenes. Our technique is unbiased, requires little precomputation, is highly parallelizable, and is applicable to a various volume data sets, dynamic transfer functions, animated volumes and changing environmental lighting.

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AIM: The main purpose of this study was to evaluate the effectiveness of the parental part of the Norwegian Unge & Rus (Youth and Alcohol) programme. The intervention was aimed at changing parents' rules and attitudes towards adolescent alcohol use, and their ability to talk with their adolescents about alcohol, as well as improving parents' relationships with and knowledge about their adolescents. These topics were addressed during parent meetings at school. METHOD: The effectiveness of the parent programme was tested using a longitudinal quasi-experimental control group design. Parents completed four online questionnaires N = 1166 at T1 in 2011 and N = 591 at T4 in 2013. Mixed models with observations nested in individuals were used to test the difference in rates of change between the groups. RESULTS: Parents in both groups reported strict rules and attitudes towards alcohol use. There were no significant differences in the changes between the two parent groups in terms of rules and attitudes at the three follow-up time points. The parents in the intervention did not change significantly compared to the parents in the comparison group on other alcohol-related questions. CONCLUSIONS: Parents are important facilitators for the transmission of alcohol-related attitudes and rules. However, our study did not show significant differences between changes experienced by the intervention group and those of the comparison group for the main outcome variables, such as rules, attitudes and talking about alcohol with their adolescents.

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The primary aim of the study was to test (1) how metacognition relates to the concept of mindful attention awareness, and (2) whether metacognitions or mindful attention awareness best predicted symptoms of depression. Data was collected from three samples: currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50). There was a moderate correlation between mindful attention awareness and three of five metacognitive subscales. Both mindful attention awareness and metacognition were significantly correlated with depression severity scores after controlling for anxiety. The depressed group had significantly more dysfunctional metacognitions and less mindful attention awareness than the never depressed group. Negative beliefs about worry and mindful attention awareness were also significantly different in the previously depressed group compared with the never depressed. This suggests that metacognitions and mindful attention awareness can be vulnerability factors for depression. The results also indicated that anxiety symptoms and negative beliefs about worry were the most important factors in predicting depression. In conclusion, the study shows that metacognitions and mindful attention awareness are two related but separate constructs and that metacognitions emerged as the best predictor of depression. These results provide support for the metacognitive model of emotional disorders. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Metacognitions and mindful attention awareness are related but separate constructs Both mindful attention awareness and metacognition are associated with depression Anxiety and negative beliefs about worry (metacognitions) are most important in predicting depression Addressing metacognitions in therapy should be considered in treatment of depression.

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Sex differences in typical development can provide context for understanding ASD. Baron-Cohen (Trends Cogn Sci 6(6):248-254, 2002) suggested ASD could be considered an extreme expression of normal male, compared to female, phenotypic profiles. In this paper, sex-specific M-CHAT scores from N = 53,728 18-month-old toddlers, including n = 185 (32 females) with ASD, were examined. Results suggest a nuanced view of the "extreme male brain theory of autism". At an item level, almost every male versus female disadvantage in the broader population was consistent with M-CHAT vulnerabilities in ASD. However, controlling for total M-CHAT failures, this male disadvantage was more equivocal and many classically ASD-associated features were found more common in non-ASD. Within ASD, females showed relative strengths in joint attention, but impairments in imitation.

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BACKGROUND: To examine demographic and clinical characteristics as potential predictors of change for children and youth with emotional disorders treated at two child and adolescent mental health outpatient services (CAMHS) in Norway. METHODS: The study was of naturalistic observational type with "treatment as usual" (TAU). The sample consisted of 84 children and youth with emotional disorders. The Health of the Nation Outcome Scale (HONOSCA), and the Children's Global Assessment Scale (CGAS) were administered at intake (T0), during the assessment (T1) and approximately six months after assessment (T2). Change was analysed by means of the linear mixed models procedure. RESULTS: For the HONOSCA total score, youths with a diagnosis of depression had statistically higher symptom severity levels at baseline and significantly lower change rates as compared to youths with an anxiety disorder. CONCLUSIONS: The current study adds to the limited knowledge of predictors of rate of change for children and adolescents with emotional disorders treated within CAMHS. Our results point to a special need to improve clinical care for depressed children and adolescents. Important limitations comprising the external validity of the study concern missing data, a small study sample, and lack of information regarding the content and extent of the service provided.

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Parallel Coordinate Plots (PCPs) is one of the most powerful techniques for the visualization of multivariate data. However, for large datasets, the representation suffers from clutter due to overplotting. In this case, discerning the underlying data information and selecting specific interesting patterns can become difficult. We propose a new and simple technique to improve the display of PCPs by emphasizing the underlying data structure. Our Orientation-enhanced Parallel Coordinate Plots (OPCPs) improve pattern and outlier discernibility by visually enhancing parts of each PCP polyline with respect to its slope. This enhancement also allows us to introduce a novel and efficient selection method, the Orientation-enhanced Brushing (O-Brushing). Our solution is particularly useful when multiple patterns are present or when the view on certain patterns is obstructed by noise. We present the results of our approach with several synthetic and real-world datasets. Finally, we conducted a user evaluation, which verifies the advantages of the OPCPs in terms of discernibility of information in complex data. It also confirms that O-Brushing eases the selection of data patterns in PCPs and reduces the amount of necessary user interactions compared to state-of-the-art brushing techniques.

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Parents of children with Autism spectrum disorders often report elevated levels of stress, depression and anxiety compared to parents of children with other developmental disorders. The present study investigated experiences of mothers of children with autistic disorder, both boys and girls. The results show that mothers report problems related to communication, behavior and interests of their child, which impact their quality of life. There were also differences between boys and girls.

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We propose the computation of a perceptual motion blur in videos. Our technique takes the predicted eye motion into account when watching the video. Compared to traditional motion blur recorded by a video camera our approach results in a perceptual blur that is closer to reality. This postprocess can also be used to simulate different shutter effects or for other artistic purposes. It handles real and artificial video input, is easy to compute and has a low additional cost for rendered content. We illustrate its advantages in a user study using eye tracking.

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BACKGROUND: Several studies have demonstrated the effect of guided Internet-based cognitive behavioral therapy (ICBT) for depression. However, ICBT is not suitable for all depressed patients and there is a considerable level of nonresponse. Research on predictors and moderators of outcome in ICBT is inconclusive. OBJECTIVE: This paper explored predictors of response to an intervention combining the Web-based program MoodGYM and face-to-face therapist guidance in a sample of primary care patients with mild to moderate depressive symptoms. METHODS: Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition or to a delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, face-to-face guidance from a psychologist, and reminder emails. In this paper, data from the treatment phase of the 2 groups was merged to increase the sample size (n=82). Outcome was improvement in depressive symptoms during treatment as assessed with the Beck Depression Inventory-II (BDI-II). Predictors included demographic variables, severity variables (eg, number of depressive episodes and pretreatment depression and anxiety severity), cognitive variables (eg, dysfunctional thinking), module completion, and treatment expectancy and motivation. Using Bayesian analysis, predictors of response were explored with a latent-class approach and by analyzing whether predictors affected the slope of response. RESULTS: A 2-class model distinguished well between responders (74%, 61/82) and nonresponders (26%, 21/82). Our results indicate that having had more depressive episodes, being married or cohabiting, and scoring higher on a measure of life satisfaction had high odds for positively affecting the probability of response. Higher levels of dysfunctional thinking had high odds for a negative effect on the probability of responding. Prediction of the slope of response yielded largely similar results. Bayes factors indicated substantial evidence that being married or cohabiting predicted a more positive treatment response. The effects of life satisfaction and number of depressive episodes were more uncertain. There was substantial evidence that several variables were unrelated to treatment response, including gender, age, and pretreatment symptoms of depression and anxiety. CONCLUSIONS: Treatment response to ICBT with face-to-face guidance may be comparable across varying levels of depressive severity and irrespective of the presence and severity of comorbid anxiety. Being married or cohabiting, reporting higher life satisfaction, and having had more depressive episodes may predict a more favorable response, whereas higher levels of dysfunctional thinking may be a predictor of poorer response. More studies exploring predictors and moderators of Internet-based treatments are needed to inform for whom this treatment is most effective. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry number: ACTRN12610000257066; https://www.anzctr.org.au/trial_view.aspx?id=335255 (Archived by WebCite at http://www.webcitation.org/6GR48iZH4).

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In this paper, we present and investigate an approach to fast multilabel color image segmentation using convex optimization techniques. The presented model is in some ways related to the well-known Mumford-Shah model, but deviates in certain important aspects. The optimization problem has been designed with two goals in mind. The objective function should represent fundamental concepts of image segmentation, such as incorporation of weighted curve length and variation of intensity in the segmented regions, while allowing transformation into a convex concave saddle point problem that is computationally inexpensive to solve. This paper introduces such a model, the nontrivial transformation of this model into a convex-concave saddle point problem, and the numerical treatment of the problem. We evaluate our approach by applying our algorithm to various images and show that our results are competitive in terms of quality at unprecedentedly low computation times. Our algorithm allows high-quality segmentation of megapixel images in a few seconds and achieves interactive performance for low resolution images.

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BACKGROUND: The effectiveness of the universal school-based alcohol prevention program "Unge & Rus" [Youth & Alcohol] was tested by an independent research group. The program aims to prevent alcohol use and to change adolescents' alcohol-related attitudes. The main outcome measure was frequency of monthly alcohol use, favorable alcohol attitudes, perceived behavioral control (PBC), positive alcohol expectancy and alcohol-related knowledge. METHODS: Junior high school students (N = 2,020) with a mean age of 13.5 years participated in this longitudinal pre, post and one-year follow-up study with a quasi-experimental design, involving an intervention group and a comparison group recruited from 41 junior high schools in Norway. Multilevel analysis was used to account for the repeated observations (level 1) nested within students (level 2) who in turn were clustered within school classes (level 3). RESULTS: Results showed an increased level of alcohol-related knowledge in the intervention group (p < .005) as compared to the comparison group at one-year follow-up. However, no significant difference in change was found between the intervention group and the comparison group in frequency of monthly alcohol use, alcohol-related attitudes, PBC or alcohol expectancy at one-year follow-up. CONCLUSIONS: This study offers adequate data on the effectiveness of a school-based alcohol prevention program widely implemented in Norway. Under its current method of implementation, use of the program cannot be supported over the use of standard alcohol curriculum within schools.

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