Brain imaging of visceral functions in healthy volunteers and IBS patients

From experience, most people know about a link between psychological processes and gastrointestinal sensory and motor functions. Cognitive processes (e.g., attention) as well as affective processes (e.g., fear) play a role in gastrointestinal sensations in healthy controls and patients with irritable bowel syndrome (IBS) alike. However, the exact nature of this relationship has not been completely understood yet. Brain imaging techniques allow for the study of brain-gut interactions in vivo. Accordingly, positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) have been widely used to study neural mechanisms underlying visceral sensations. This article will summarize the results of functional brain imaging studies in healthy controls and selected studies assessing the influence of psychological processes on gastrointestinal functions. Subsequently, this article will deal with those brain areas activated by visceral stimulation in IBS patients. Special attention will be paid to recently published studies concerning psychological factors and novel research questions.     

组织承诺对三级医院护士情绪劳动的影响

目的 探讨护士组织承诺水平对其情绪劳动的影响.方法 对595名在岗护士进行组织承诺与情绪劳动的问卷调查,了解护士组织承诺水平和情绪劳动水平的现状,并探讨二者之间的关系.结果 护士情绪劳动总均分为(3.56±0.68)分;组织承诺总均分为(3.06±0.43)分.护士情绪劳动与组织承诺呈显著正相关.回归分析显示,控制人口学变量后,组织承诺可独立预测情绪劳动的25.9％,其进入回归方程的3个影响因素为感情承诺、规范承诺和理想承诺.结论 提高护士组织承诺水平是促使护士在情绪劳动中有效管理情绪,改善护理服务质量的重要手段.     

“Emotional Chemobrain”: A new concept for chemotherapy adverse drug effect?

“Emotional chemobrain” is a new paradigm that relates the occurrence of alterations in the psychological wellbeing of patients to the adverse drug effects of chemotherapy on the neurobiological level. The concept of “emotional chemobrain” is the analogue concept of the classical concept of “chemobrain” but that concerns emotional disturbances related to chemotherapy. Disgust is a negative emotion that might accompany any stressful life event such as having cancer. Increased disgust may lead to the development of mental disorders such as mood and anxiety disorders. Patients with cancer may develop negative emotions such as self-disgust because of their affected autonomy and life style on the one hand and because of chemotherapy's effect on their brain on the other. Self-disgust might be considered as a factor contributing to psychological distress exacerbation in this category of physically ill individuals. In addition to lifestyle modifications and body changes, self-disgust might be exacerbated by chemotherapy in the same way other negative emotions might be exacerbated by this kind of treatment. It might be speculated that the emotional side effects of chemotherapy concern activation modifications in brain regions relevant to emotional elaboration and regulation such as the insular lobe and the amygdala. “Emotional chemobrain” should be considered whenever neuropsychiatric adverse effects of chemotherapy are manifested in patients with cancer. Future studies might be interested in studying the effect of chemotherapy on brain regions that can affect regulation of emotions such as self-disgust.     

Ensemble perception of emotions in autistic and typical children and adolescents

Ensemble perception, the ability to assess automatically the summary of large amounts of information presented in visual scenes, is available early in typical development. This ability might be compromised in autistic children, who are thought to present limitations in maintaining summary statistics representations for the recent history of sensory input. Here we examined ensemble perception of facial emotional expressions in 35 autistic children, 30 age- and ability-matched typical children and 25 typical adults. Participants received three tasks: a) an ‘ensemble’ emotion discrimination task; b) a baseline (single-face) emotion discrimination task; and c) a facial expression identification task. Children performed worse than adults on all three tasks. Unexpectedly, autistic and typical children were, on average, indistinguishable in their precision and accuracy on all three tasks. Computational modelling suggested that, on average, autistic and typical children used ensemble-encoding strategies to a similar extent; but ensemble perception was related to non-verbal reasoning abilities in autistic but not in typical children. Eye-movement data also showed no group differences in the way children attended to the stimuli. Our combined findings suggest that the abilities of autistic and typical children for ensemble perception of emotions are comparable on average.     

Vocación y profesionalismo: reflexiones de los estudiantes catalizadas por el cine de Spielberg

The medical profession has a marked vocational sense that is closely linked to its ethical dimension. However, there are doubts about the role that undergraduate studies are playing in their development. In order to encourage reflection on this issue, a seminar was held with students and teachers, developed in 3 phases: a) free presentation by students about what they considered to be the medical vocation; b) presentation by professors of the theoretical framework of medical education, followed by the viewing of several scenes of films directed by Steven Spielberg that facilitate reflection on the meaning of the ethical and human components of medicine, and c) open discussion between students and teachers. The main conclusions were analysed: it is worth creating spaces for reflection on the vocational dimension of medicine throughout undergraduate studies. This, in some way, should already be considered in the selection and access procedures to medical school. In the teaching task it is essential that the lecturers are seen as role models, as well as providing individualised tutoring that includes vocational development. Thus, it is necessary to promote training that goes beyond the acquisition of knowledge and skills, paying attention to the management of emotions, the approach to the ethical problems, and the education of attitudes. Early contact with clinical activity, from the beginning of studies is considered a decisive factor to motivate students before the immense theoretical burden they have to face.     

National Institutes of Health Toolbox Emotion Battery: Application of Summary Scores to Adults With Spinal Cord Injury,Traumatic Brain Injury,and Stroke

ObjectiveTo examine the validity of factor analytically based summary scores that were developed using the National Institutes of Health Toolbox Emotion Battery (NIHTB-EB); (ie, psychological well-being, social satisfaction, negative affect) normative sample in individuals with neurologic conditions.DesignCross-sectional, observational cohort.SettingCommunity.ParticipantsA total of 1036 English-speaking adults from the National Institutes of Health Toolbox (NIHTB) normative project and 604 community-dwelling adults with neurologic conditions including spinal cord injury (SCI n=209), traumatic brain injury (TBI n=184), and stroke (cerebrovascular accident [CVA] n=211) (N=1640).InterventionNot applicable.Main Outcome MeasuresThe NIHTB-EB.ResultsA series of univariate analyses comparing summary scores across the 4 groups (SCI, TBI, CVA, normative group) were conducted to identify group differences. Base rates (defined as >1 SD toward the problematic direction) were also identified. The normative group demonstrated better emotional functioning characterized by greater social satisfaction and psychological well-being (normative group > SCI, TBI, CVA; P’s <.0001), and less negative affect (normative group < SCI, P=.016; normative group < TBI, P<.001; normative group < CVA; P=.034) compared with each neurologic group. Using base rates to identify problematic emotions for the 3 summary scores, there were higher rates of problematic emotions on all 3 summary scores for the neurologic groups compared with the normative group.ConclusionsThe NIHTB-EB summary scores demonstrate an increased prevalence of problematic emotions among individuals with 3 neurologic conditions, and might be useful for identifying individuals with similar conditions and potentially in need of psychological support.     

两种不同类型起搏器传感器对情绪刺激频率适应性反应的比较

目的比较闭环式传感器与体动加速度传感器对情绪刺激引起的频率适应性反应。方法共91例患者植入Biotronic Protos起搏器,术后1个月,先后将起搏器程控为闭环式刺激方式(CLS)及体动加速度刺激方式(DDDR或VVIR),在相同情绪活动下,比较两种传感器引起的起搏频率改变。结果 91例患者中,28例起搏比例>75%,并有正常思维能力者纳入研究对象,在情绪试验2、4、6及8 min时间,CLS及体动加速度传感器引起的起搏器频率变化分别是(69.6±4.5)比(63.2±3.2)次/min,(77.6±6.1)比(65.9±5.1)次/min,(75.9±5.6)比(64.6±4.0)次/min及(69.1±5.4)比(66.2±5.0)次/min,各组配对比较差异均有统计学意义(P<0.001)。结论闭环式传感器对情绪刺激引起的起搏频率变化明显大于体动加速度传感器。     

应用3D打印技术的宣传教育对胸椎结核患者术前改善负性情绪的影响

目的 探讨应用3D打印技术的宣传教育对胸椎结核手术患者术前负性情绪改善的效果。方法 选取在浙江省中西医结合医院骨科2016年1月至2017年 12月手术治疗的胸椎结核患者42例,用投硬币法将两个病区随机分为对照组和观察组,两组各21例。对照组实施常规护理;观察组实施常规护理外,还对患者结合3D打印模型进行个体化宣传教育,比较两组患者的术前每日平均起床次数,以及焦虑自评量表(SAS)、自我感受负担量表(SPBS)、抑郁自评量表(SDS)评分结果,评估3D打印技术及相应的宣传教育对胸椎结核患者术前负性情绪的影响。 结果 观察组患者术前每日起床次数为(0.95±0.86)次,低于对照组的(3.66±1.31)次,差异有统计学意义(t=7.90,P<0.05)。观察组术前SAS评分平均为(43.40±6.53)分,明显低于对照组[(58.45±7.78)分];观察组术前SPBS评分平均为(27.09±6.13)分,明显低于对照组[(34.43±5.97)分];观察组术前SDS评分平均为(41.45±5.72)分,明显低于对照组[(53.26±7.53)分],差异均有统计学意义(t值分别为6.79、3.93、5.72,P值均<0.01)。对照组和观察组对术前护理及宣传教育措施的满意度评分分别为(85.56±7.97)分、(94.35±7.56)分,差异有统计学意义(t=3.67,P=0.001)。结论 通过应用3D打印技术对患者进行术前宣传教育能减少患者起床的次数,改善患者的负性情绪,提高患者对护理人员的满意度。