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Vulvar and extragenital clinical sensory perception*
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Miranda A. Farage, Kenneth W. Miller, Denniz A. Zolnoun, William J. Ledger
Two general methods are employed to determine these thresholds: (i) the method of limits; and (ii) the method of levels. With the method of limits, the stimulus is progressively increased and the subject declares when it first becomes perceptible. With the method of levels, a stimulus of a defined intensity is applied, then increased or decreased by specific increments depending on whether or not the subject perceives it. (Protocols may differ in terms of the number of consistent responses required to progress upward or downward in stimulus intensity.)
Analysis of covariance (ANCOVA)
Published in Pat Dugard, John Todman, Harry Staines, Approaching Multivariate Analysis, 2010
Pat Dugard, John Todman, Harry Staines
Consider another example. Suppose someone has come up with a new method of teaching children to read and you want to test it against the current method employed in a school. Let us assume that you can randomly assign the children who are due to be taught to read to new and current method groups (levels of the IV) and that a standardized test of reading skills is available as the DV. If the children’s scores on an intelligence test were available, it would be a good idea to use them as a covariate, because individual differences in intelligence are likely to have an effect on the attainment of reading skills. If there happened to be a preponderance of brighter children in the new group, we might be led to conclude, possibly erroneously, that the new method was indeed superior. If, on the other hand, there happened to be a preponderance of brighter children in the current group, any real superiority of the new method might be masked by the effect of intelligence on the DV. The risk of making a Type I error (finding a significant effect when the null hypothesis is true) or a Type II error (failing to find a significant effect when the null hypothesis is false) can be reduced by using a random NV as a covariate, provided that there really is a correlation between the covariate and the DV.
Clinical diagnosis and management of small fiber neuropathy: an update on best practice
Published in Expert Review of Neurotherapeutics, 2020
Grazia Devigili, Daniele Cazzato, Giuseppe Lauria
QST is based on measurements of responses to graded sensory stimuli (e.g. mechanical, thermal) and it could be considered as an extension of the routine bedside clinical examination of the somatosensory system [80]. It is a noninvasive psychophysical examination based on two main detection methods: the method of limits where the stimulus starts on a neutral level and increases until it is stopped, and the method of levels that include a force choice algorithm after a pre-defined stimulus (i.e. thermal, mechanical stimuli). This latter, being not a time-dependent reaction, has the advantage to reduce the bias related to cognitive and behavioral variables. Indeed, it is a method of choice to test children, resulting more reliable than the method of limits that, on the contrary, require the patient to push a button as soon as a change in temperature is perceived. The method of levels showed better diagnostic efficacy than that of limits for diagnosing SFN [81], especially if performed bilaterally [1].
Opioid use potentiates the virulence of hospital-acquired infection, increases systemic bacterial dissemination and exacerbates gut dysbiosis in a murine model of Citrobacter rodentium infection
Published in Gut Microbes, 2020
Fuyuan Wang, Jingjing Meng, Li Zhang, Sabita Roy
Mice received morphine through the pellet implantation method, as previously described.54 Using this method, plasma levels of morphine were maintained in the 0.6–2.0 μg/ml range (range observed in opioid abusers and patients on opioids for moderate to severe pain). Furthermore, this model is commonly used in studies of opiate dependence and addiction.54 Briefly, placebo or 25 mg morphine pellets (National Institutes of Health [NIH]/National Institute on Drug Abuse [NIDA], Bethesda, MD) were inserted in a small pocket on the dorsal side of animals that was created by a small skin incision; incisions were closed using surgical wound clips (Stoelting, 9 mm stainless steel, Wooddale, IL). Mice were subcutaneously treated with placebo or 25 mg morphine pellet for 24 h prior to infection. Mice were infected with 1x109 (CFU value) C. rodentium in 200 μl medium via oral gavage.53 Mice were sacrificed for study at day 5 post-infection with C. rodentium.
Feasibility and Patient Experiences of Method of Levels Therapy in an Acute Mental Health Inpatient Setting
Published in Issues in Mental Health Nursing, 2020
Hannah Jenkins, Jordan Reid, Claire Williams, Sara Tai, Vyv Huddy
The foregoing discussion indicates a need for a psychotherapeutic approach that can focus on a variety of problems, potentially concurrently, that is not of fixed duration, and has no pre-determined session content or phases of application (i.e. assessment, formulation to intervention). Method of Levels (MOL) therapy has potential to address these requirements within an inpatient setting (MOL; Carey, 2008). MOL is an application of Perceptual Control Theory (PCT; Powers, 1973), which states that psychological distress results from an individual having reduced control over experiences important to them. The task of a therapist delivering MOL is to 1) help the patient talk about what is distressing them by asking questions to sustain the client’s attention on the problem. The second step is 2) to notice and explore background thoughts about the problem being discussed. Background thoughts are usually detectable when the client experiences ‘disruptions’—for example, moments when the client emphasises certain words, pauses, laughs, looks away, or otherwise indicates they are thinking about something else. In MOL, the therapist’s task is to ensure the patient generates the focus of conversation, rather than the therapist being directive. Evaluations of MOL in primary care (Carey & Mullen, 2008, Carey, Carey, Mullan, Spratt, & Spratt, 2009) and secondary care services (Carey, Tai, & Stiles, 2013) report positive outcomes with effect sizes at least as positive as other interventions such as CBT. Qualitative evaluation of patients’ experiences of MOL across different service contexts indicated that the approach is acceptable (Carey et al., 2009; Griffiths et al., 2019).