Concurrent and Predictive Associations Between Infants’ and Toddlers’ Fearful Temperament,Coparenting, and Parental Anxiety Disorders

This study investigated the bidirectional relations between two dimensions of coparenting (the way parental figures cooperate in parenting), undermining and support, and child fearful temperament longitudinally from infancy to toddlerhood, while inspecting the moderating role of parents’ anxiety disorders. Questionnaire data on coparenting and child fearful temperament were obtained from 135 mothers, fathers, and their firstborns at 4 months, 12 months, and 30 months. Parental anxiety disorder severity was assessed with a semistructured interview before the birth of the child. Multilevel analysis revealed that, across measurement moments, undermining coparenting, but not supportive coparenting, was concurrently related to higher child fearful temperament. Parental anxiety disorder severity was related to more undermining coparenting but not to supportive coparenting. No moderation effects for parental anxiety disorder or for parent gender were found in the relations between coparenting and child fearful temperament. We conclude that more parental anxiety is related to a lower quality of the coparenting relationship, which in turn is associated to more child fearful temperament. More specifically, it appears that undermining coparenting, and not supportive coparenting, is related to child fearful temperament and parental anxiety disorder severity. Our results suggest that undermining coparenting, by both father and mother, is one of the mechanisms that may contribute to the intergenerational transmission of anxiety from parent to child. The coparenting relationship may be a useful target in the prevention and treatment of child anxiety.     

Immunology, Autoimmunity, and Autoantibodies in Parkinson’s Disease

Recent revelations of immune alterations in Parkinson??s disease have led to the convergence that an autoimmune mechanism may play a role in the etiopathogenesis of this neurodegenerative disease. In the current study, 77 Parkinson??s disease patients and 77 matched healthy controls were analyzed for the presence of seven autoantibodies previously found to be associated with central nervous system manifestations namely: antineuronal-cells, anti-brain lysate, anti-dsDNA, anti-phosphatidylserine, anti-cardiolipin, anti-serotonin, and anti-melanocytes antibodies. Patients underwent systematic assessments of demographics, clinical, and biochemical manifestations. Three autoantibodies were found to be more prevalent among Parkinson??s disease patients (antineuronal cells10.3% vs. 1.3%, p?=?0.017; anti-brain lysate 9.1% vs. 1.3%, p?=?0.032; anti-dsDNA 10.3% vs. 2.6%, p?=?0.049). Clinical manifestations of Parkinson??s disease, particularly dyskinesia and depression, were found to be associated with the presence of these autoantibodies.     

Shared perturbations in the metallome and metabolome of Alzheimer’s,Parkinson’s,Huntington’s,and dementia with Lewy bodies: A systematic review

Despite differences in presentation, age-related dementing diseases such as Alzheimer’s (AD), Parkinson’s (PD), and Huntington’s diseases (HD), and dementia with Lewy bodies (DLB) may share pathogenic processes. This review aims to systematically assemble and compare findings in various biochemical pathways across these four dementias.PubMed and Google Scholar were screened for articles reporting on brain and biofluid measurements of metals and/or metabolites in AD, PD, HD, or DLB. Articles were assessed using specific a priori-defined inclusion and exclusion criteria. Of 284 papers identified, 198 met criteria for inclusion.Although varying coverage levels of metals and metabolites across diseases and tissues made comparison of many analytes impossible, several common findings were identified: elevated glucose in both brain tissue and biofluids of AD, PD, and HD cases; increased iron and decreased copper in AD, PD and HD brain tissue; and decreased uric acid in biofluids of AD and PD cases. Other analytes were found to differ between diseases or were otherwise not covered across all conditions.These findings indicate that disturbances in glucose and purine pathways may be common to AD, PD, and HD. However, standardisation of methodologies and better coverage in some areas – notably of DLB – are necessary to validate and extend these findings.     

Behcet’s disease: epidemiology,clinical manifestations,and diagnosis

Introduction: Behcet’s Disease (BD) is classified among vasculitides. The aim of this review was to put together different known reports in order to help the reader to better understand the disease, to avoid the frequent misdiagnosis, and to decide the best treatment.

Areas covered: a) Epidemiology: BD is rare, and is seen along the Silk Road, from 20 to 420/100,000 in Turkey and 80/100,000 in Iran, to 0.64/100,000 in the UK. b) Clinical manifestations: oral aphthosis is seen in more than 95% of patients, genital aphthosis (60–90%), skin (pseudofolliculitis/erythema nodosum, 40–90%), eyes (uveitis/retinal vasculitis, 45–90%), gastrointestinal (diarrhea/hemorrhage/perforation/pain, 4–38%), vascular (venous/arterial thrombosis, aneurysm, 2.2–50%), neurological (all kinds, especially meningo-encephalitis, 2.3–38.5%), and articular (arthralgia/arthritis/ankylosing spondylitis, 11.6–93%). c) Pathergy test is positive in some patients: 8.6% (in India) to 70.7% (in China). This data was extracted from the five nationwide surveys and the largest case series from BD conference reports and a Pubmed search.

Expert commentary: Diagnosis is clinical but classification/diagnosis criteria may help. The best criteria for BD is the International Criteria for Behcet’s Disease (ICBD). BD is a multisystem disease progressing by attacks and remissions. Each attack may resemble the preceding or it may be different in duration, severity, and the systems involved.     

Spirituality,Religiosity, and Health: a Comparison of Physicians’ Attitudes in Brazil,India, and Indonesia

Background

One of the biggest challenges in the spirituality, religiosity, and health field is to understand how patients and physicians from different cultures deal with spiritual and religious issues in clinical practice.

Purpose

The present study aims to compare physicians’ perspectives on the influence of spirituality and religion (S/R) on health between Brazil, India, and Indonesia.

Method

This is a cross-sectional, cross-cultural, multi-center study carried out from 2010 to 2012, examining physicians’ attitudes from two continents. Participants completed a self-rated questionnaire that collected information on sociodemographic characteristics, S/R involvement, and perspectives concerning religion, spirituality, and health. Differences between physicians’ responses in each country were examined using chi-squared, ANOVA, and MANCOVA.

Results

A total of 611 physicians (194 from Brazil, 295 from India, and 122 from Indonesia) completed the survey. Indonesian physicians were more religious and more likely to address S/R when caring for patients. Brazilian physicians were more likely to believe that S/R influenced patients’ health. Brazilian and Indonesians were as likely as to believe that it is appropriate to talk and discuss S/R with patients, and more likely than Indians. No differences were found concerning attitudes toward spiritual issues.

Conclusion

Physicians from these different three countries had very different attitudes on spirituality, religiosity, and health. Ethnicity and culture can have an important influence on how spirituality is approached in medical practice. S/R curricula that train physicians how to address spirituality in clinical practice must take these differences into account.

     

Bimanual Fitts’ tasks: Kelso,Southard, and Goodman, 1979 revisited

The experiment was designed to replicate and extend to an integrated feedback condition the pattern of movement time results found by Kelso et al. (J Exp Psychol Hum Percept Perform 5:229–238, 1979a, Science 204:1029–1031, 1979b) where the simultaneous movement of one hand to a low ID target and the other to a higher ID target indicated “a tight coordinate coupling between the hands” (p. 229). In the present experiment, a control group was provided feedback that depicted the independent movement of the two limbs under low and higher indexes of difficulty (ID). A Lissajous group was provided integrated feedback in the form of a Lissajous plot. The results indicated a pattern of results for the control and Lissajous groups similar to that found by Kelso et al. for one and two-limb movements to the same difficulty targets. The control group also replicated the finding for two-limb movements to mixed ID tasks. However, the Lissajous group simultaneously produced disparate movement in the mixed target conditions. The results are consistent with recent findings indicating that when provided salient integrated feedback participants can effectively produce disparate movements of the two limbs.     

Contingencies Between Infants’ Gaze,Vocal, and Manual Actions and Mothers’ Object-Naming: Longitudinal Changes From 4 to 9 Months

ABSTRACT

Infants’ early motor actions help organize social interactions, forming the context of caregiver speech. We investigated changes across the first year in social contingencies between infant gaze and object exploration, and mothers’ speech. We recorded mother–infant object play at 4, 6, and 9 months, identifying infants’ and mothers’ gaze and hand actions, and mothers’ object naming and general utterances. Mothers named objects more when infants vocalized, looked at objects or the mother’s face, or handled multiple objects. As infants aged, their increasing object exploration created opportunities for caregiver contingencies and changed how gaze and hands accompany object naming over time.     

UV photography, masculinity, and college men’s sun protection cognitions

This study examined the impact of an ultraviolet (UV) photography intervention and masculinity on college men's sun protection cognitions, including: perceived vulnerability to skin damage, attitudes toward sun protection, willingness to engage in sun protection behaviors, and intentions to receive a skin cancer exam. After completing a baseline survey, participants (N = 152) viewed a black-and-white photo of their face. Half also viewed a photo showing their UV damage. Participants then completed a second survey assessing sun protection cognitions. Regressions revealed that masculinity predicted lower sun protection cognitions, and men in the UV photograph condition reported higher sun protection cognitions. Masculinity by condition interactions showed that the positive effect of UV photography was stronger among masculine men. Negative associations between masculinity and sun protection cognitions were significant only among men who did not receive the intervention. Findings suggest that UV photography is a promising sun protection intervention among masculine men.     

The Impact of Militarism,Patriarchy, and Culture on Israeli Women’s Reproductive Health and Well-Being

Purpose

In this paper, we situate and frame Israeli women’s reproductive health within the social, historical, political, cultural, and geographical context of Israeli women’s lives.

Methods

We used a theoretical review in this paper.

Results

Militarism, patriarchy, and cultural values heavily shape and influence Jewish and Arab women’s access to and experience of reproductive health when it comes to the imperative to have children, pregnancy, birth, access to contraception and abortion, and other reproductive healthcare services. We discuss five main factors pertaining to Israeli women’s reproductive health including (1) fertility and emphasis on reproduction; (2) infertility; (3) pregnancy, birth, and miscarriage; (4) reproductive rights including contraception and abortion; and (5) maternity leave and accessible childcare.

Conclusions

Israel is a pro-natalist country, in which both Jewish and Arab women share many of the consequences of the social imperative to have children. Though Arab women, as part of their double minority status, are exposed to more mental health risks pre- and postpartum, the personal and public reproductive health decisions and reproductive healthcare services are largely shaped by similar social forces. These include the patriarchal and religious culture that dictates a value system that highly cherishes motherhood, and within the military political context of the on-going Israeli-Palestinian conflict and past social and political traumas. We address four major gaps that need to be addressed in order to improve Israeli women’s reproductive health and well-being that include the neoliberal gap, the information gap, the reproductive health services gap, and the leadership and policy gap.

     

Living with huntington’s disease: illness perceptions,coping mechanisms,and spouses’ quality of life

Chronic illness not only affects the life of those suffering from Huntington’s disease but also threatens the quality of life (QOL) of their spouses. In this study, we focus on Huntington’s disease (HD). The impact of HDonthe QOL of spouses has been hardly studied from a behavioral medicine or health psychology perspective. We hypothesize that spouses’ illness perceptions and coping mechanisms will contribute significantly to the prediction of their QOL. Illness perceptions, coping mechanisms, and the QOL of 90 spouses ofpatients with HD were assessed by meansof the Illness Perception Questionnaire, the COPE, and the Medical Outcome Study 36-item Short Form Health Survey, respectively. After controlling for demographic and illness-related variables, coping mechanisms explained a significant amount of variance of spouses’ role functioning. Given our results, more empirical and longitudinal research is justified on coping mechanisms and illness perceptions of spouses living with Huntington’s disease.     

Altruism,happiness, and health: it’s good to be good

Altruistic (other-regarding) emotions and behaviors are associated with greater well-being, health, and longevity. This article presents a summary and assessment of existing research data on altruism and its relation to mental and physical health. It suggests several complimentary interpretive frameworks, including evolutionary biology, physiological models, and positive psychology. Potential public health implications of this research are discussed, as well as directions for future studies. The article concludes, with some caveats, that a strong correlation exists between the well-being, happiness, health, and longevity of people who are emotionally and behaviorally compassionate, so long as they are not overwhelmed by helping tasks. The author wishes to acknowledge the support of the John Templeton Foundation; the Institute for Research on Unlimited Love—Altruism, Compassion, Service; and the Ford Foundation.     

Hashimoto’s thyroiditis: TGAb,TPOAb, TRAb and recovery from hypothyroidism

Hashimoto described four patients with goiter. The histology of the goiter was characterized by diffuse lymphocytic infiltration, fibrosis and epithelial cell destruction. Thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) have been used to diagnose Hashimoto’s thyroiditis. Patients with positive TGAb and/or TPOAb have been assumed to have Hashimoto’s thyroiditis. Approximately 10% of those with positive TGAb and/or TPOAb have hypothyroidism. There are two types of autoimmune thyroiditis: goitrous Hashimoto’s thyroiditis and atrophic thyroiditis. The latter patients have blocking antibody (thyroid-stimulating hormone [TSH]-stimulation blocking antibody [TSBAb]). TSBAb is a TSH-receptor antibody (TRAb). TSBAb causes thyroid atrophy and hypothyroidism. TGAb and/or TPOAb do not necessarily cause hypothyroidism. Hypothyroid patients with Hashimoto’s thyroiditis usually receive life-long l-thyroxine therapy. However, spontaneous recovery from hypothyroidism has been reported. Patients who had Hashimoto’s hypothyroidism and then Graves’ hyperthyroidism (and vice versa), have also been reported. Hashimoto’s hypothyroidism and Graves’ hyperthyroidism could be the opposite spectrums of one disease.     

Parents’ Paradoxicality and Adolescents’ Self-Engendering Fantasy

In this paper, I discuss psychotherapy sessions that I undertook with a female adolescent patient. As a psychoanalyst specialized in couple and family psychoanalysis, I was primed to focus on her representation of her parents’ and family's dysfunctional dynamics. She felt locked in perverse narcissistic relationships and vampirized by her internal ‘objects’, her attachments causing her to experience libidinal haemorrhage. Her links to her internal ‘objects’ seemed like chains that impeded her individuation. In my analysis, I build on Racamier's concepts of pregenital ‘incestual’ functioning, primal mourning, paradoxicality, and self-engendering fantasy. However, while Racamier noted that the self-engendering fantasy is part of an ‘incestual’ picture, which serves the death drive, I interpret this fantasy as a constructive effort to achieve psychic reorganization; it helped my patient disengage from her internalized incestual family dynamics and the violence of an incestuous primal scene. Through this fantasy, she seemed to end the narcissistic depletion that threatened to overwhelm the boundaries of her weak ego. The self-engendering fantasy serves the life drive, albeit paradoxically, using this logic. With this thesis in mind, I accompanied my patient in her process of separation and individuation and interpreted transference and countertransference dynamics.     

Independent and relative effects of stress,depressive symptoms,and affect on college students’ daily health behaviors

Stress and depressive symptoms are associated with maladaptive health behavior practices such as unhealthy eating, sedentary behavior, insufficient sleep, and substance use. The relative and interactive effects of stress and depressive symptoms on health behavior practices are less well understood. The present study examined these processes in a daily diary study of 127 college students. Results from hierarchical generalized linear models indicated that depressive symptoms, and chronic and daily stress, but not acute stressful life events, were significantly associated with a composite score of daily maladaptive health behavior engagement (depressive symptoms b = .01, SE=?.00, p?<?.01; chronic stress, b?=?.03, SE=?.01, p?<?.01; daily stress, b?=?.01, SE=?.01, p?=?.02); unexpectedly, the effect of stress on health behaviors was not moderated by depressive symptoms. Additionally, results demonstrated that the effect of depressive symptoms on health behaviors was mediated by fluctuations in daily negative affect. These results bear implications for intervention during a crucial period in the development of mental and physical health.     

eHealth,Participatory Medicine,and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

Background

The rapid explosion in online digital health resources is seen as transformational, accelerating the shift from traditionally passive patients to patients as partners and altering the patient–health care professional (HCP) relationship. Patients with chronic conditions are increasingly engaged, enabled, and empowered to be partners in their care and encouraged to take responsibility for managing their conditions with HCP support.

Objective

In this paper, we focus on patients’ and HCPs’ use of health-related Internet information and how it influences the patient-HCP relationship. In particular, we examine the challenges emerging in medical encounters as roles and relationships shift and apply a conceptual framework of relational ethics to examine explicit and nuanced ethical dimensions emerging in patient-HCP interactions as both parties make increased use of health-related Internet information.

Methods

We purposively sampled patients and HCPs in British Columbia, Canada, to participate in focus groups. To be eligible, patients self-reported a diagnosis of arthritis and at least one other chronic health condition; HCPs reported a caseload with >25% of patients with arthritis and multimorbidity. We used a semistructured, but flexible, discussion guide. All discussions were audiotaped and transcribed verbatim. Elements of grounded theory guided our constant comparison thematic analytic approach. Analysis was iterative. A relational ethics conceptual lens was applied to the data.

Results

We recruited 32 participants (18 patients, 14 HCPs). They attended seven focus groups: four with patients and three with rehabilitation professionals and physicians. Predominant themes to emerge were how use of health-related Internet information fostered (1) changing roles, (2) patient-HCP partnerships, and (3) tensions and burdens for patients and HCPs.

Conclusions

Relational aspects such as mutual trust, uncertainty, and vulnerability are illuminated in patient-HCP interactions around health-related Internet information and the negotiated space of clinical encounters. New roles and associated responsibilities have key ethical dimensions that make clear the changes are fundamental and important to understand in ethical care. When faced with tensions and burdens around incorporating health-related Internet information as a resource in clinical encounters, participants described a particular ambivalence illustrating the fundamental changes being negotiated by both patients and HCPs.