EMOTIONS AND EATING IN EVERYDAY LIFE: APPLICATION OF THE EXPERIENCE-SAMPLING METHOD

Previous research emphasized relationships between negative emotions and eating. This study explored associations of both positive and negative emotions with eating by experience-sampling in the natural environment. Eight healthy volunteers (6 female, 2 male) were beeped at random intervals, 10 times daily on 7 consecutive days. Upon each signal, participants rated their emotional state and indicated whether they had eaten during the previous 15 minutes. In total, 485 situations were sampled. Emotional states reported in these situations were classified by cluster analysis. In 145 situations subjects reported having eaten. Thirty-seven percent of eating bouts occurred in situations classified as emotionally positive; 30% occurred in situations classified as emotionally negative. Participants rated that eating influenced their emotional state to a higher degree in emotionally positive situations than in emotionally negative ones. Positive emotions may play a stronger role in the relationship between emotions and eating than has been generally acknowledged.     

How successful is teaching on terminal care?

Teaching on terminal care in the Dundee University Medical School is being evaluated over the next 4 years (1985-89). The paper describes the present course and the intended procedures of evaluation. A pilot evaluation was conducted on a class of fourth-year students during the academic year 1984-85. Students' recall of factual information presented 2 years and also 2 terms prior to the pilot evaluation was acceptable although questions relating to pain relief were not well answered. When asked to rate ten areas of medical management from most to least satisfying and worrying, the majority of students saw both the care of the terminally ill and speaking with those about to face bereavement as relatively high on worry and low on satisfaction. The overall results of the pilot study challenged teachers to consider the cost-effectiveness of their chosen methods of teaching on terminal care.     

Automatic External Defibrillation of Patients After Myocardial Infarction by Family Members: Practical Aspects and Psychological Impact of Training

Automatic external defibrillation (AED) offers the potential for minimally trained individuals to convert life-threatening ventricular arrhythmias prior to arrival of emergency rescue personnel but optimum usage of AED remains undefined. To test the practical aspects of home AED in high risk patients after myocardial infarction, we identified 40 consecutive high risk post-MI patients, who satisfied inclusion and exclusion criteria. Fifteen (38%) patients were eliminated at their physician's request and nine others refused to participate. Twenty-six family members of the remaining 16 patients were trained in AED with follow-up testing at 3 months. Level of skill, especially in CPR performance, declined to unsatisfactory levels in 35% of trainees, including all over age 55. Trainees felt more confident due to availability of AED and 90% felt no strain in intrapersonal relationships. Psychological testing revealed a decrease in patient and trainee depression scores and no change in anxiety or obsessiveness during the study. These observations suggest the following: (1) better awareness of benefits of AED by physicians and lay persons is necessary, (2) retraining at <3 month intervals will be required for many spouse trainees and (3) there are no common adverse psychologic sequelae to training in AED.     

Differentiation of Arrhythmias in the Dog by Measurement of Activation Sequence Using an Atrial and Two Ventricular Electrodes

Timing of atrioventricular activation and ventricular dispersion identifies and discriminates between beats of different origin. In eight dogs, three bipolar epicardial electrodes recorded left atrial and left and right ventricular depolarizations simultaneously during arrhythmias induced by programmed electrical stimulation and coronary artery occlusion and release. The interval between the left atrial and left ventricular intrinsic deflections (V₁-V₂) and between the left ventricular and right ventricular intrinsic deflections (V₁-V₂) of each heat was measured. Recordings were of normal sinus rhythm (NSR) (mean of five beats in 8/8 dogs), atrial flutter (AFL) (five beats of one episode), atrial fibrillation (AF) (144 beats in 29 episodes in 7/8), monomorphic ventricular tachycardia (MVT) (24 beats with six morphologies in 2/8), polymorphic ventricular tachycardia (PVT) (63 beats in 15 episodes in 5/8) and premature ventricular contractions (PVC) (29 beats with 29 morphologies in 5/8). Supraventricular rhythms can be differentiated from ventricular rhythms by V₁-V₂ timing. The mean difference in V₁-V₂ during AFL and AF vs NSR was 1 ms (range of 0–3 ms). The change from sinus during MVT ranged from 38 to 43 ms (m 31 ms) and during PVC 10 to 75 ms (m 38 ms). Thirty-five of 35 of these ectopic ventricular morphologies exhibited 10 ms or more timing difference compared to corresponding beats of NSR. PVT was consistently distinguished from supraventricular rhythms and MVT by the variability of V₁-V₂,A-V₁ intervals can be used to distinguish supraventricular arrhythmias from sinus rhythm; a 32 ms difference existed for AFL. AF could be detected by the variability in AV₁. One atrial and two ventricular leads can provide a means of differentiating normal sinus rhythm from supraventricular and ventricular arrhythmias that may be applicable to implantable antitachycardia devices.     

Pacemaker Implantation in Children: A 21-Year Experience

Forty-one children, 20 hoys and 21 girls, aged 11 days to 19 years (mean 9.9 years) at initial pacemaker implant, were followed 1 to 248 months (mean 90 months). Ten (mean age 8.2 years) were implanted between 1966 and 1972 (Group I), 14 (mean age 9.9 years) between 1973 and 1980 (Group 11) and 17 (mean age 10.9 years) from 1981 through April 1988 (Group 111). Arrhythmias were congenital complete heart block in 19, postoperative heart block in 15, acquired heart block in 3, sick sinus syndrome in 3, and bradycardia-induced ventricular fibrillation in 1. Twenty-eight of 41 children had a transvenous implant: 40% of Group I, 71% of Group 11 and 82% of Group III. Thirteen were cephalic, four subclavian and 11 jugular. Generator site was pectoral in 19, abdominal in 12, intrathoracic in one, and retromammary in nine of 12 girls aged 10 years or more at implant. In Groups 1,11 and 111, 5, 14 and 6 had VOO or WI units; 5, 0 and 8 dual chamber (VAT, VDD and DDD) pacemakers; 0, 0 and 1 AAI; and 0, 0 and 2 rate-modulated (WIR) units at initial implant. The average interval between pacer-related hospitalizations in Groups I, II and III was 20, 42, and 39 months. Complications included infection in six, hemothorax in one, and impending pacemaker erosion in one. Six patients died, one of pacer infection, four from primary cardiac disease, and one suddenly without apparent reason. Follow-up continues in 31: 14 are employed full-time, three are homemakers, eight are full-time students, and six are active pre-schoolers. Four women have had normal children. We conclude: (1) children with implanted pacemakers can have a normal lifestyle, with prognosis based on underlying cardiac disease; (2) elective epicardial electrodes are now rarely needed; (3) implantation via the cephalic vein is feasible and complication-free; (4) retromammary implant is technically easy and cosmetic; (5) dual chamber and rate-modulated pacemakers can be utilized effectively.(PACE, Vol. 11 November Part II 1988)     

Conditioning with facial expressions of emotion: Effects of CS sex and age

Two experiments examined the effects of facial expressions of emotion as conditioned stimuli (CSs) on human electrodermal conditioning and on a continuous measure of expectancy of the shock unconditioned stimulus. In Experiment 1, the CS+ was a picture of a person displaying an angry face and CS? was a neutral face. For half of the subjects, the expressions were depicted by males, for the other half by females. Male subjects showed larger skin conductance responses to pictures of males than did females. The responding of female subjects was the same regardless of the sex of the person in the picture. In Experiment 2, the CS+ and CS? were pictures of an angry or a happy face. For half of the subjects, the expressions were depicted by adult males, for the other half by preadolescent males, Subjects displayed greater differentiation when an adult male depicting anger was employed as the CS+ than when a preadolescent male depicting anger was the CS+. There were no differences when an adult or a child displayed happiness.     

Enhanced calcitonin secretion in the rat after parathyroidectomy and during chronic calcium deprivation

The thyroidal content of calcitonin (CT) and the serum calcitonin responses to acute hypercalcaemia were studied in female rats during chronic hypocalcaemia induced by parathyroidectomy (PTX), a low calcium (Ca) diet, or both. The thyroidal CT content of the PTX animals 50 days after surgery was twice that of intact rats. An acute intraperitoneal (i.p.) calcium load on day 50 after PTX resulted in an increase in serum CT twice as large as that observed in control animals. Reversal of the chronic hypocalcaemia with 1,25(OH)2D3 resulted in a reduction in thyroidal CT as well as a depression of the calcium-induced CT response. In each case the values were similar to those observed in normocalcaemic controls. A low calcium diet increased the thyroidal CT content in intact rats and induced a further increase in PTX rats. The CT response to an acute Ca load was exaggerated by a low calcium diet in intact as well as in PTX rats. These results suggest that in the rat chronic hypocalcaemia enhances CT storage and secretion.     

Development of a sandwich ELISA to detect IgG and IgG sub-class antibodies specific for a major antigen (Ag 7) of Aspergillus fumigatus

A sandwich ELISA has been developed, using an affinity purified monospecific antiserum as a capture antibody, to detect specific IgG and IgG sub-classes to a major antigen (Ag 7) of Aspergillus fumigatus in the sera of patients with allergic bronchopulmonary aspergillosis (ABPA). Significantly elevated levels of specific IgG to Ag 7 were detected in 97% of ABPA sera tested, as compared to control sera and to sera from A. fumigatus skin-prick test positive individuals. IgG sub-class antibody levels to Ag 7 were also determined in a similar sandwich ELISA, but using specific monoclonal antisera instead of the polyclonal anti-IgG. Both Ag 7 specific IgG1 and IgG4 levels were found to be significantly raised in the ABPA sera compared to controls. It is proposed that this antigen-specific ELISA may provide a more specific diagnostic test for IgG antibody detection in sera of ABPA patients.