When does size not matter? Effects of stimulus size on affective modulation

Motivationally relevant stimuli have been shown to receive prioritized processing compared to neutral stimuli at distinct processing stages. This effect has been related to the evolutionary importance of rapidly detecting dangers and potential rewards and has been shown to be modulated by the distance between an organism and a faced stimulus. Similarly, recent studies showed degrees of emotional modulation of autonomic responses and subjective arousal ratings depending on stimulus size. In the present study, affective modulation of pictures presented in different sizes was investigated by measuring event-related potentials during a two-choice categorization task. Results showed significant emotional modulation across all sizes at both earlier and later stages of processing. Moreover, affective modulation of earlier processes was reduced in smaller compared to larger sizes, whereas no changes in affective modulation were observed at later stages.     

Patient-practitioner agreement: does it matter?

BACKGROUND: Good communication is a crucial clinical skill. Previous research demonstrated better clinical outcomes when practitioners and patients agree about the nature of patients' core presenting complaints. We investigated the nature of this agreement and its impact on outcome among depressed primary care patients. METHOD: We compared presenting problem formulations completed by patients, GPs and therapists in a primary care randomized controlled trial of cognitive-behavioural therapy and non-directive counselling for depression. Participants compiled formulations from a list of 13 potential problems of self-completed questionnaires. Subjects scored at least 14 on the Beck Depression Inventory (BDI) at baseline. Outcome measure for this study included BDI at 4 and 12 months, failure to attend for therapy when referred, dropout from therapy and patient satisfaction. RESULTS: Among 464 trial patients, 395 received therapy. Patient baseline problem formulations included significantly more items than GPs, who identified significantly more items than therapists. Agreement levels varied according to a range of patient and professional variables. While patients in complete agreement with their therapists about their main problem after assessment had lower average BDI scores at 12 months (9.7 v. 12.8, P=0.03); we found no other significant associations between the extent of agreement and clinical outcome. There were significant (but relatively weak) associations between agreement and aspects of patient satisfaction. CONCLUSION: Our results suggest that detailed mutual understanding of the presenting complaints may be less important than agreement that the core problem is psychological, and that referral for psychological therapy is appropriate.     

Migraines and meditation: does spirituality matter?

Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86–92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647–656, 2000). Previous research suggests that spiritual meditation may ameliorate some of the negative traits associated with migraine headaches (Wachholtz and Pargament Journal of behavioral Medicine, 30: 311–318, 2005). This study examined two primary questions: (1) Is spiritual meditation more effective in enhancing pain tolerance and reducing migraine headache related symptoms than secular meditation and relaxation? and, (2) Does spiritual meditation create better mental, physical, and spiritual health outcomes than secular meditation and relaxation techniques? Eighty-three meditation naïve, frequent migraineurs were taught Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Muscle Relaxation which participants practiced for 20 min a day for one month. Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.     

The response of the host microcirculation to bacterial sepsis: does the pathogen matter?

Sepsis results from the interaction between a host and an invading pathogen. The microcirculatory dysfunction is now considered central in the development of the often deadly multiple organ dysfunction syndrome in septic shock patients. The microcirculatory flow shutdown and flow shunting leading to oxygen demand and supply mismatch at the cellular level and the local activation of inflammatory pathways resulting from the leukocyte–endothelium interactions are both features of the sepsis-induced microcirculatory dysfunction. Although the host response through the inflammatory and immunologic response appears to be critical, there are also evidences that Gram-positive and Gram-negative bacteria can exert different effects at the microcirculatory level. In this review we discuss available data on the potential bacterial-specific microcirculatory alterations observed during sepsis.     

Autoantibodies in the grocery shop: does quantity matter?

Testing for autoantibodies is an integrated part in the diagnostic process of many autoimmune diseases. As a consequence, the detection of autoantibodies is increasingly recognized in classification criteria and diagnostic guidelines. In this review, the question is addressed whether quantification of autoantibodies is clinically useful, not only in the diagnostic stage, but also during follow-up of patients with autoimmune diseases. It can be concluded that for a multitude of autoantibodies, there is sufficient evidence that the higher the amount of autoantibodies, the more likely that the patient has the respective autoimmune disease. Quantification is also of added value for monitoring therapeutic efficacy, although this depends on the type of therapy that is installed. The relation between rises in autoantibody levels and the occurrence of subsequent disease relapses, however, is far from absolute. Obviously, if quantification of autoantibodies is performed in the laboratory, results should also be reported quantitatively together with an appropriate interpretation for the clinician.     

Human DNA contamination of mortuaries: does it matter?

With the continuing development of extremely sensitive, automated systems for the detection of human DNA from a number of cellular sources, the problem of sample contamination from scenes of crime, cadavers, and the mortuary environment has become a potentially serious issue, with implications for all involved in forensic investigations. A recent survey of 20 mortuaries identified quantifiable human DNA on mortuary work surfaces and instruments which, when amplified, produced in some cases three or more profiles from single site samples. Possible sources of DNA contamination in the mortuary are discussed, along with implications related to its presence and its avoidance during the sampling process. These observations may not be confined to forensic practice.     

Diffusion of treatment research: does open access matter?

Advocates of the Open Access movement claim that removing access barriers will substantially increase the diffusion of academic research. If successful, this movement could play a role in efforts to increase utilization of psychotherapy research by mental health practitioners. In a pair of studies, mental health professionals were given either no citation, a normal citation, a linked citation, or a free access citation and were asked to find and read the cited article. After 1 week, participants read a vignette on the same topic as the article and gave recommendations for an intervention. In both studies, those given the free access citation were more likely to read the article, yet only in one study did free access increase the likelihood of making intervention recommendations consistent with the article.     

Unexplained infertility: does it really exist? Does it matter?

Unexplained infertility (UI) refers to a diagnosis made in couples in whom standard investigations including semen analysis, tests of ovulation and tubal patency are normal. It has been suggested that the term UI is unsustainable, as conditions such as endometriosis, tubal infertility, premature ovarian ageing and immunological infertility tend to be misdiagnosed as UI. In this debate, we present the view that, although scientifically unsatisfying, the diagnosis of UI is sustainable from a clinical and practical perspective. Given our present treatment options, further investigations leading to a more 'accurate' diagnosis is unlikely to change our management in these cases. Scientific curiosity must take second place to a more pragmatic approach, which takes into account the clinical and financial costs of making a more 'accurate' diagnosis.     

Semantic errors in deep dyslexia: does orthographic depth matter?

Semantic errors of oral reading by aphasic patients are said to be comparatively rare in languages with a shallow orthography. The present report concerns three bilingual brain-damaged patients who prior to their stroke were fluent in both English, an orthographically deep language, and Welsh, an orthographically shallow language. On a picture-naming task, each patient made a similar proportion of semantic errors in the two languages. Similarly, in oral reading of the corresponding words, no patient produced proportionally more semantic paralexias in English than in Welsh. The findings are discussed in relation to the summation hypothesis as invoked by Miceli, Capasso, and Caramazza (1994) to explain apparent differences in frequency of semantic errors of reading in languages differing in orthographic depth.     

Extended telephone counseling for smoking cessation: does content matter?

Telephone counseling is a popular modality for smoking cessation treatment; however, little attention has been paid to evaluating the efficacy of different contents of calls. This study compared 2 types of proactive telephone calls following a group program. Participants were randomized to receive either: (a) basic content, consisting primarily of support; or (b) enhanced content, tailored to the stage of cessation (still smoking, abstinent, or relapsed) and targeting factors hypothesized to be related to success (motivation, self-efficacy, and negative mood). There was a significant interaction between treatment condition and gender. For men, the enhanced condition produced better abstinence rates through 15 months and lower relapse rates. For women, the basic condition was better. History of depression did not interact with condition.     

Predicting affective responses to exercise using resting EEG frontal asymmetry: Does intensity matter?

Affective responses to exercise may be important for improving adherence to regular programs of exercise. The present study sought to determine whether resting frontal EEG asymmetry, an individual difference measure of affective style, is predictive of affective responses to exercise performed at distinct intensities standardized relative to a metabolic landmark (i.e., the ventilatory threshold, VT). Resting EEG was collected from 30 participants and used to predict affective responses following treadmill running at three exercise intensities: below-VT, at-VT, and above-VT. Affect was assessed [via Activation-Deactivation Adjective Check List, yielding measures of Energetic Arousal (EA) and Tense Arousal (TA)] before, immediately following exercise, after 5 min cool down, and 10 and 20 min post-cool down. Resting mid-frontal asymmetry (F4-F3) significantly predicted EA immediately following below-VT exercise; resting lateral frontal asymmetry (F8-F7) predicted EA at 20 min post-cool down. Resting mid-frontal asymmetry predicted in EA immediately following and following cool down in above-VT exercise. As a whole, frontal asymmetry was predictive of affective responses following exercise, namely greater relative left frontal activity predicting lower EA. This was opposite to the predictions of the valenced motivation model, but may provide some support for the motivation direction model. This is based on the fact that low EA could be indicative of approach motivation, especially at higher exercise intensities.     

The hygiene hypothesis: does it function worldwide?

PURPOSE OF REVIEW: This article intends to be a systematic review of papers published during 2003-2004 quoted in a Medline search for 'hygiene hypothesis'. The worldwide perspective of the article does not refer just to a geographical concept, but tries also to address the question of whether the consensus on the hypothesis is global or whether it applies to all types of allergic or immunologic disease, to any age sample or infectious agent. Furthermore, the article outlines those clinical and experimental studies which, in the authors' opinion, may represent significant contributions to a better understanding of the hygiene hypothesis and may guide further investigations on the subject. RECENT FINDINGS: The association between a reduced exposure to infectious agents (as a part of a changed lifestyle) and a higher prevalence of atopy seems now to be confirmed by consistent evidence. Mechanisms underlying this association, however, are not yet completely clear (immune deviation or immune regulation). SUMMARY: Further experimental and clinical studies are needed, with special reference to the time, duration and intensity of exposure to any specific infectious agent which is related to well-defined allergy outcomes. The background information for using microbial products in allergy prevention and treatment is still limited.