G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences

A new method of assessing ability to perform activities of daily living: design, methods and baseline data

PURPOSE

To describe study protocol and baseline characteristics of initial subjects.

METHODS

Prospective study of 194 glaucoma patients. After informed consent, patients were evaluated using a third-generation, performance-based measure, Assessment of Disability Related to Vision (ADREV), nine tasks to simulate daily living activities; including: reading in reduced illumination, recognizing facial expression, detecting motion, recognizing street signs, locating objects, ambulating, placing pegs into different sized holes, telephoning, and matching socks. All patients completed clinical tests including visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS]), monocular and binocular visual fields, contrast sensitivity, stereopsis, and National Eye Institute's Visual Functioning Questionnaire (NEI VFQ-25). Main outcome measures are scores on subtests, total scores of ADREV and NEI VFQ-25.

RESULTS

Mean age was 67.1 years; 51% were female, 55% were of European extraction. Seventy-two percent had open-angle glaucoma. Visual acuity (logMAR) ranged from -0.18 to 2.20, visual field mean defect ranged from -32.68 to 2.62, Binocular field score ranged from 5 to 100 and contrast sensitivity score ranged from 0 to 1.8. While ADREV score ranges from 0 (total disability) to 63 (no disability), total ADREV score ranged from 3.0 to 61.7. Total NEI VFQ-25 score ranged from 17.8 (low score indicates incapable) to 100 (high score indicates not hindered).

CONCLUSIONS

Methodology of this study should provide information about disability caused by visual loss, specifically glaucoma, how difficulties in performing activities relate to standard clinical tests, and how they correlate to quality of life from patient's point of view. Subsequent papers will delineate findings and discuss their application.

Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study

OBJECTIVE

Fibromyalgia is a chronic pain disorder that is characterized by diffuse musculoskeletal pain and sensitivity to mechanical stimulation. In this pilot clinical trial, we tested the effectiveness of low-dose naltrexone in treating the symptoms of fibromyalgia.

DESIGN

Participants completed a single-blind, crossover trial with the following time line: baseline (2 weeks), placebo (2 weeks), drug (8 weeks), and washout (2 weeks).

PATIENTS

Ten women meeting criteria for fibromyalgia and not taking an opioid medication.

INTERVENTIONS

Naltrexone, in addition to antagonizing opioid receptors on neurons, also inhibits microglia activity in the central nervous system. At low doses (4.5 mg), naltrexone may inhibit the activity of microglia and reverse central and peripheral inflammation.

OUTCOME MEASURES

Participants completed reports of symptom severity everyday, using a handheld computer. In addition, participants visited the lab every 2 weeks for tests of mechanical, heat, and cold pain sensitivity.

RESULTS

Low-dose naltrexone reduced fibromyalgia symptoms in the entire cohort, with a greater than 30% reduction of symptoms over placebo. In addition, laboratory visits showed that mechanical and heat pain thresholds were improved by the drug. Side effects (including insomnia and vivid dreams) were rare, and described as minor and transient. Baseline erythrocyte sedimentation rate predicted over 80% of the variance in drug response. Individuals with higher sedimentation rates (indicating general inflammatory processes) had the greatest reduction of symptoms in response to low-dose naltrexone.

CONCLUSIONS

We conclude that low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia.

Daily affect relations in fibromyalgia patients reveal positive affective disturbance

OBJECTIVES

To examine daily positive affective disturbance in the context of negative affect (NA) and pain among patients with fibromyalgia (FM) to determine a) if FM patients experience a deficit in daily positive affect (PA) relative to osteoarthritis (OA) patients; b) if FM patients differ from OA patients in the day-to-day relations of PA and NA; and c) if patients diagnosed with both OA and FM differ from patients with either OA-only or FM-only with respect to major outcomes.

METHODS

A total of 260 women with physician-diagnosed OA (n = 106), FM (n = 53), or OA/FM (n = 101) completed a 30-day electronic diary. Participants were assessed once daily on levels of PA, NA, and pain.

RESULTS

Multilevel models indicated that FM patients had less overall PA than OA patients and exhibited a stronger inverse PA-NA relation. Analyses further suggest that the OA/FM group may have been the most impaired of the three included in our study. This group was responsible for a lagged effect of PA on both affects, whereby high PA days resulted in low next-day PA and high next-day NA.

CONCLUSION

FM patients exhibit a PA disturbance compared with OA patients. This disturbance is reflected by an overall deficit in PA and an inability to sustain PA in the face of pain and NA. Patients with both OA and FM may represent a subgroup of FM that is at particular risk for dysregulation of PA.

A specific deficit in visuospatial simultaneous working memory in Down syndrome

BACKGROUND

Recent studies have demonstrated that individuals with Down syndrome (DS) present both central and verbal working memory deficits compared with controls matched for mental age, whereas evidence on visuospatial working memory (VSWM) has remained ambiguous. The present paper uses a battery of VSWM tasks to test the hypothesis that individuals with DS can also encounter specific difficulties in VSWM.

METHOD

Four tasks were administered to 34 children and adolescents with DS and 34 controls matched for verbal mental age. In two of these tasks, participants had to remember a series of locations sequentially presented on a matrix (spatial-sequential WM); in another two, they had to remember locations simultaneously presented (spatial-simultaneous WM).

RESULTS AND CONCLUSIONS

Results showed that individuals with DS are poorer than controls in the spatial-simultaneous tasks, but not in the spatial-sequential tasks. These findings were not due to a difference in speed of visuospatial processing. In fact, when performances of the two groups in VSWM were compared using speed measures as covariates, differences between groups remained. It is suggested that the simultaneous VSWM deficit of individuals with DS could be due to the request for processing more than one item at a time.

Hyperalgesia in the setting of anxiety: sex differences and effects of the oestrous cycle in Wistar rats

Sex differences to noxious thermal cutaneous stimulation were compared in Wistar rats. Male and female rats showed similar baseline tail flick latencies. However, sex differences emerged when nociceptive testing was carried out in the setting of mild non-noxious anxiogenic stress (4Hz vibration for 5min). On cessation of vibration stress 16/35 (46%) of male rats showed hyperalgesia (decrease in tail flick latency lasting >20min) whist the reminder showed a brief (<2min) hypoalgesia. In 15 animals re-tested the next day, stress-induced hyperalgesia was reproducible (n=7) but the hypoalgesia initially present in 8 rats was less stable, being reduced (n=2) or replaced by weak hyperalgesia (n=3) in some cases. The response of females was oestrous cycle dependent. On cessation of the vibration stress, females in late dioestrus displayed rapid onset hyperalgesia lasting 10min (n=12) whilst others showed either brief (<2min) hypoalgesia (proestrus, n=13 and early dioestrus, n=9) or brief (<2min) delayed hyperalgesia (oestrus, n=16). On re-testing the next day, when most rats were in a different stage of their cycle, the responsiveness of individual female rats changed according to cycle stage. Thus in females, stage of the oestrous cycle rather than trait differences between individuals appears to be the important determinant of responsiveness to stress. Hyperalgesia in females in late dioestrus correlated with increased anxiety behaviour in a novel environment: rats in late dioestrus showed longer latencies to re-enter the inner zone of an open field compared to rats in other cycle stages. Rats undergoing withdrawal from a progesterone dosing regimen (5mgkg(-1) IP twice daily for 6 days) to mimic the fall in progesterone that occurs naturally during late dioestrus, exhibited a stress-induced hyperalgesia similar to animals in late dioestrus. Falling levels of progesterone during late dioestrus may therefore be a pre-disposing factor for the development of stress-induced hyperalgesia in females.

Headache sufferers' drawings reflect distress, disability and illness perceptions

OBJECTIVE

Drawings have recently been used with patients with heart problems to assess their perceptions of their illness. This study aimed to investigate whether drawings could be a useful way to assess headache patients' perceptions of their headaches and their reactions.

METHODS

In a cross-sectional study, 65 university students who experienced persistent headaches were asked to draw a picture of how their headaches usually affected them. Drawings were assessed in three ways: they were categorized based on content; their size was measured; and image analysis software assessed their darkness. Associations between drawings, illness perceptions, mood, and health outcomes were assessed.

RESULTS

Twenty-seven people drew an external force to the head and these people had greater ratings of average pain and were more likely to attribute their headache to stress. Darker drawings were associated with greater emotional distress and lower vitality. Larger drawing size was associated with perceptions of worse consequences, worse symptoms, worse emotional representations, lower vitality, higher pain, and more days of restricted activity, lower happiness, and higher sadness.

CONCLUSION

Drawings offer an additional way to assess peoples' experience of their headaches and reflect illness perceptions and distress. People draw how they see themselves experiencing their headache and often include expressions and reactions. The inclusion of force to the head, darker drawings, and larger drawings are associated with worse perceptions of the headache and higher pain. Drawings may be a useful way for clinicians to understand patients' experience of pain.

Association analysis of serotonin receptor 7 gene (HTR7) and risperidone response in Chinese schizophrenia patients

Several lines of evidence suggest that the human 5-HT(7) receptor may be involved in the pharmacodynamics of risperidone and may influence clinical response of the drug. A pharmocogenetics study of this receptor may therefore be useful in developing individualized therapy. But few studies about it have been done. In this study, we genotyped ten single nucleotide polymorphisms (SNPs) distributed throughout the HTR7 gene and analyzed six of them for association with the reduction of Brief Psychiatric Rating Scale (BPRS) scores in drug-naive Chinese schizophrenia patients, following an eight-week period of risperidone monotherapy. The confounding effects of nongenetic factors were estimated and the baseline symptom score as well as the duration of illness were included as covariates for adjustment. No significant correlation of HTR7 with antipsychotic efficacy was detected in either genotype or haplotype analysis. These results demonstrate that variations in the HTR7 gene may not be good genetic markers for predicting the therapeutic efficacy of risperidone.

Comparable performance of patients with obsessive-compulsive disorder (OCD) and healthy controls for verbal and nonverbal memory accuracy and confidence: time to forget the forgetfulness hypothesis of OCD?

The memory deficit or forgetfulness hypothesis of obsessive-compulsive disorder (OCD) has received considerable attention and empirical effort over the past decades. The present study aimed to provide a fair test of its various formulations: (1) memory dysfunction in OCD is ubiquitous, that is, manifests irrespective of modality and material; (2) memory dysfunction is found for nonverbal but not verbal material, (3) memory dysfunction is secondary to executive impairment; and (4) memory dysfunction affects meta-memory rather than memory accuracy. Participants comprised 43 OCD patients and 46 healthy controls who were tested on the Picture Word Memory Test (PWMT), which provides several unconfounded parameters for nonverbal and verbal memory accuracy and confidence measures across different time-points. In addition, the Trail-Making Test B was administered to test assumption number 3. Replicating earlier work of our group, samples displayed similar performance on all indices. None of the different formulations of the memory deficit hypothesis were supported. In view of waning evidence for a global memory deficit in OCD, neuropsychological research on OCD should more thoroughly investigate moderators and triggers of occasional instances of impaired performance, particularly cognitive biases such as perfectionism and an inflated sense of responsibility.

Beneficial changes in energy expenditure and lipid profile after eccentric exercise in overweight and lean women

The aim was to compare lean and overweight females in regard to the effects of eccentric exercise on muscle damage indices, resting energy expenditure (REE) and respiratory quotient (RQ) as well as blood lipid and lipoprotein profile. Lean and overweight females (deviated by their body mass index) performed an eccentric exercise session. Muscle damage, energy cost and lipid profile were assessed pre-exercise and up to 72 h post-exercise. After eccentric exercise (i) muscle damage indices were affected more in the overweight subjects compared with the lean subjects; (ii) the elevation of absolute and relative REE was larger and more prolonged in the overweight group compared with the lean group; (iii) after 24 h, RQ had significantly declined, with the overweight subjects exhibiting a larger reduction compared with the lean group; and (iv) the blood lipid profile was favorably modified, with the overweight group exhibiting more favorable responses compared with the lean group. The differences between the lean and the overweight subjects may be partly due to the fact that overweight individuals experienced greater muscle damage than lean individuals. Eccentric exercise may be a promising lifestyle factor to combat obesity and dyslipidemias.

Test of a brief theory of planned behaviour-based intervention to promote adolescent safe sex intentions

The present study tested a brief (303 word) intervention designed to change attitude, subjective norm, and perceived behavioural control regarding a safe sex behaviour in a sample of 16- to 18-year-olds. Participants (N=288) were randomized to receive either an experimental intervention or a control (knowledge only) intervention and completed measures of their reactions to the stimuli as well as pre- and post-test measures of theory of planned behaviour variables. The experimental intervention significantly increased message processing (mean between-group difference=0.73, 95% CI=0.40, 1.06; Cohen's d=.52), message acceptance (mean between-group difference=0.82, 95% CI=0.57, 1.07; Cohen's d=.77), subjective norm (adjusted Mean between-group difference=0.54, 95% CI = 0.26, 0.81; Cohen's d=.37; mean within-group difference for intervention condition=0.59, 95% CI = 0.36, 0.81; Cohen's d=.38) and intention (adjusted Mean between-group difference=0.27, 95% CI = 0.02, 0.53; Cohen's d=.20; mean within-group difference for intervention condition=0.54, 95% CI = 0.33, 0.75; Cohen's d=.31), but not attitude or perceived behavioural control. The effects of the experimental intervention on intention were mediated solely through subjective norm. The present findings: (a) compare favourably in terms of the effect sizes reported in previous research in this area (mean Cohen's d for within-group difference for intervention conditions=.009 and .09, for norms and intention, respectively, see Albarracín et al. (2003)), (b) imply that subjective norms are causally related to intentions, and (c) suggest that interventions designed to change subjective norms (as opposed to communication of risks and fear appeals) might ultimately be effective in changing behaviour.

Haematological parameters are normal in dominant white Franches-Montagnes horses carrying a KIT mutation

The KIT receptor protein-tyrosine kinase plays an important role during embryonic development. Activation of KIT is crucial for the development of various cell lineages such as melanoblasts, stem cells of the haematopoietic system, spermatogonia and intestinal cells of Cajal. In mice, many mutations in the Kit gene cause pigmentation disorders accompanied by pleiotropic effects on blood cells and male fertility. Previous work has demonstrated that dominant white Franches-Montagnes horses carry one copy of the KIT gene with the p.Y717X mutation. The targeted breeding of white horses would be ethically questionable if white horses were known to suffer from anaemia or leukopenia. The present study demonstrates that no statistically significant differences in peripheral blood parameters are detectable between dominant white and solid-coloured Franches-Montagnes horses. The data indicate that KIT mutations may have different effects in mice, pigs, and horses. The KIT p.Y717X mutation does not have a major negative effect on the haematopoietic system of dominant white horses.

Designing clinical trials and experiments efficiently with the program package CADEMO

This paper suggests the use of the program package CADEMO when designing clinical trials. Using this package a number of frequently incorrect or inefficient applications of statistical methods can be avoided. For instance, by determining the sample size for statistical tests in advance, the type-II-risk is guaranteed to be taken into account and, foremost, only relevant effects are likely to become significant. Although this is also true for some other program packages, CADEMO in addition exclusively analyzes data by sequential testing, specifically by sequential triangular tests according to Schneider [Schneider, B. 1992. An interactive computer program for design and monitoring of sequential clinical trials. In Proceedings of the XVIth international biometric conference (pp. 237-250). Hamilton, New Zealand.]; which on average lead to a lower sample size. Moreover CADEMO serves to determine the sample size for a confidence estimation of an unknown parameter and for the so-called selection procedures, which should be applied instead of using multiple comparisons of means, if the true objective of a study is to select only the best of all possibilities. Finally, CADEMO serves to factually randomize subjects into any more-way designed experiment. For each of the indicated applications an example is given and the respective handling of CADEMO is illustrated.

Availability of free fruits and vegetables at canteen lunch improves lunch and daily nutritional profiles: a randomised controlled trial

Canteens are known to be promising settings for activities to promote intake of fruits and vegetables, but it remains unclear to what extent distributing free fruits and vegetables can influence dietary patterns of customers. The present study evaluated the effect of providing fruits and vegetables for free in a university canteen on the daily diet of university canteen customers. Canteen customers (n 209) were randomly allocated to a fruit and vegetable group (FVG) and a control group (CG). FVG participants were given two portions of fruits and one portion of vegetables for free at lunchtime. Food and beverage intake was measured using a dietary record for 3 d and dietary quality was appraised using a comprehensive scoring system. The FVG participants ate 80 g more fruits (P < 0.01) and 108 g more vegetables (P < 0.001) on a daily basis compared with the CG participants. No differences were found for energy density, total energy, Na and energy from fat between the groups per day. A higher intake of fruits and vegetables was observed at lunch and of vegetables during the dinner and evening snacks. The FVG participants were more likely to comply with dietary recommendations for fruits and vegetables and had a better dietary profile on the study days and for the lunch consumed on those days. The results of the present study demonstrate how modifications of a canteen lunch can be instrumental to enhance the nutritional quality of lunch as well as the overall quality of the diet of the customers.

Sustained efficacy of virtual reality distraction

The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of 8 weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent 1 baseline cold pressor trial and 1 VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a nonpharmacological analgesic are discussed.

PERSPECTIVE

This article addresses the concern that the efficacy of virtual reality-assisted distraction from pain could potentially decrease with repeated exposure. The current finding that efficacy did not diminish over several repeated exposures provides support for the use of virtual reality as an adjuvant treatment of pain.

Einfluss von Länge und Perfektion einer „Hot-Hand”-Sequenz auf Zuspielentscheidungen im Volleyball

Zusammenfassung. In der Forschung zum Hot-Hand-Glauben ist die Frage, inwieweit der Glaube Zuspielentscheidungen beeinflusst, bislang weitgehend ungeklärt. In der vorliegenden Arbeit wurde überprüft, ob zwei zentrale Aspekte einer Angriffssequenz, die für den Glauben relevant sind, das Zuspielverhalten tatsächlich beeinflussen: die Länge von Treffersequenzen und deren Perfektion. Versuchsteilnehmern wurden Videosequenzen erfolgreicher und nicht erfolgreicher Volleyballangriffsschläge gezeigt, die nach jedem Angriff Zuspielentscheidungen zu zwei Spielern treffen sollten. Die Ergebnisse zeigen, dass die Struktur und Länge der Hot-Hand-Sequenzen differentiell die Zuspielentscheidungen der Versuchsteilnehmer mit unterschiedlichem Expertisegrad beeinflussen.

Intrauterine testosterone exposure and risk for disordered eating

Previous research has suggested that prenatal testosterone exposure masculinises disordered eating by comparing opposite- and same-gender twins. The objective of the current study is to replicate this finding using a sample of 439 identical and 213 fraternal females, 461 identical and 344 fraternal males, and 361 males and 371 females from opposite-gender twin pairs. Disordered eating was compared across twin types using the Eating Disorder Inventory-2. Inconsistent with previous findings, a main effect of co-twin gender was not found. Our results raise questions about the validity of prior evidence of the impact of prenatal testosterone exposure on patterns of disordered eating.

Examining unsupervised time with peers and the role of association with delinquent peers on adolescent smoking

INTRODUCTION

This study explored the association between unsupervised time with peers and adolescent smoking behavior both directly and indirectly through interaction with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers.

METHODS

A cross-sectional survey was used for the study and included 248 male and female middle school students.

RESULTS

Results of structural equation modeling revealed that unsupervised time with peers is associated indirectly with adolescent smoking behavior through the mediation of association with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers.

DISCUSSION

Interventions designed to motivate adolescents without adult supervision to associate more with friends who engage in prosocial activities may eventually reduce adolescent smoking. Further implications for structured supervised time for students outside of school time are discussed.

Validation of an Australian sign language instrument of outcome measurement for adults in mental health settings

OBJECTIVE

There are currently no adult mental health outcome measures that have been translated into Australian sign language (Auslan). Without a valid and reliable Auslan outcome measure, empirical research into the efficacy of mental health interventions for sign language users is unattainable. To address this research problem the Outcome Rating Scale (ORS), a measure of general functioning, was translated into Auslan and recorded on to digital video disk for use in clinical settings. The purpose of the present study was therefore to examine the reliability, validity and acceptability of an Auslan version of the ORS (ORS-Auslan).

METHOD

The ORS-Auslan was administered to 44 deaf people who use Auslan as their first language and who identify as members of a deaf community (termed 'Deaf' people) on their first presentation to a mental health or counselling facility and to 55 Deaf people in the general community. The community sample also completed an Auslan version of the Depression Anxiety Stress Scale-21 (DASS-21).

RESULTS

t-Tests indicated significant differences between the mean scores for the clinical and community sample. Internal consistency was acceptable given the low number of items in the ORS-Auslan. Construct validity was established by significant correlations between total scores on the DASS-21-Auslan and ORS-Auslan. Acceptability of ORS-Auslan was evident in the completion rate of 93% compared with 63% for DASS-21-Auslan.

CONCLUSIONS

This is the only Auslan outcome measure available that can be used across a wide variety of mental health and clinical settings. The ORS-Auslan provides mental health clinicians with a reliable and valid, brief measure of general functioning that can significantly distinguish between clinical and non-clinical presentations for members of the Deaf community.

A randomized trial of a cognitive-behavioral therapy and hypnosis intervention on positive and negative affect during breast cancer radiotherapy

Breast cancer radiotherapy can be an emotionally difficult experience. Despite this, few studies have examined the effectiveness of psychological interventions to reduce negative affect, and none to date have explicitly examined interventions to improve positive affect among breast cancer radiotherapy patients. The present study examined the effectiveness of a multimodal psychotherapeutic approach, combining cognitive-behavioral therapy and hypnosis (CBTH), to reduce negative affect and increase positive affect in 40 women undergoing breast cancer radiotherapy. Participants were randomly assigned to receive either CBTH or standard care. Participants completed weekly self-report measures of positive and negative affect. Repeated and univariate analyses of variance revealed that the CBTH approach reduced levels of negative affect [F(1, 38)=13.49; p=.0007, omega(2)=.56], and increased levels of positive affect [F(1, 38)=9.67; p=.0035, omega(2)=.48], during the course of radiotherapy. Additionally, relative to the control group, the CBTH group demonstrated significantly more intense positive affect [F(1, 38)=7.09; p=.0113, d=.71] and significantly less intense negative affect [F(1, 38)=10.30; p=.0027, d=.90] during radiotherapy. The CBTH group also had a significantly higher frequency of days where positive affect was greater than negative affect (85% of days assessed for the CBTH group versus 43% of the Control group) [F(1, 38)=18.16; p=.0001, d=1.16]. Therefore, the CBTH intervention has the potential to improve the affective experience of women undergoing breast cancer radiotherapy.

Enhanced Source Memory for Names of Cheaters

The present experiment shows that source memory for names associated with a history of cheating is better than source memory for names associated with irrelevant or trustworthy behavior, whereas old-new discrimination is not affected by whether a name was associated with cheating. This data pattern closely replicates findings obtained in previous experiments using facial stimuli, thus demonstrating that enhanced source memory for cheaters is not due to a cheater-detection module closely tied to the face processing system, but is rather due to a more general bias towards remembering the source of information associated with cheating.

Digital templating in hip replacement with and without radiological markers

Digital templating in hip replacement is commonly performed with radiological markers to determine the magnification. The latter can also be determined by measuring the distance from the x-ray focal spot to the object and the distance from the x-ray focal spot to the radiological cassette or image receptor. We used post-operative radiographs of total hip replacements and hemiarthroplasties from 22 patients to calculate the magnification using both methods. The accuracy of each method was ascertained by measuring the size of the head of the implant projected on to the radiographs and comparing the result with the known size recorded in the medical records.

The accuracy was found to be similar with a mean absolute measurement error of 2.6% (sd 1.4; 0.0% to 5.2%) for the radiological marker and 2.8% (sd 2.2; 0.4% to 10.1%) for the distance method (p = 0.75). The mean radiation dose for templating radiographs (pelvis and lateral of the hip) was similar when taken using a radiological marker (328 mSv sd 142) (n = 51) or using the distance measurement method (324 mSv sd 39) (n = 39) (p = 0.90).

We conclude that the distance measuring method is as accurate as the radiological marker method, but may avoid some of the disadvantages such as misplacement of the marker or placement outside the radiological field. It may also be more acceptable to the patient and radiographer.

Grandmother caregiving, family stress and strain, and depressive symptoms

This study used the resiliency model of family stress, adjustment, and adaptation as the framework to examine the main and moderating effects of social support and resourcefulness in the relationship between family life stresses and strain and depressive symptoms in grandmothers raising grandchildren, grandmothers in multigenerational homes, and noncaregivers to grandchildren. A sample of 486 Ohio grandmothers, recruited using random and supplemental convenience methods, completed mailed surveys. Analysis of variance was used to examine differences in family life stresses and strain, resourcefulness, support, and depressive symptoms across the three groups of grandmothers. Hierarchical multiple regression analyses were used to examine whether family stresses and strains affected the grandmother's depressive symptoms and whether social support and resourcefulness moderated the relationship between family stresses and strain and grandmothers' mental health. Grandmothers raising grandchildren reported more depressive symptoms, but in multiple regression analyses of the full sample that controlled for demo-graphics, primary caregiving status was not related to depressive symptoms. More strain and less subjective support and resourcefulness were associated with higher depressive symptoms for all grandmothers, with 33% to 54% explained variances of such symptoms for each caregiving group and the full sample. Subjective support moderated the effects of strain and instrumental support moderated the effects of family life stresses on depressive symptoms. Social support and resourcefulness may help protect grandmothers from the effects of family stresses and strain, and interventions to enhance these factors may assist grandmother caregivers to achieve better mental health.

Think, blink or sleep on it? The impact of modes of thought on complex decision making

This paper examines controversial claims about the merit of “unconscious thought” for making complex decisions. In four experiments, participants were presented with complex decisions and were asked to choose the best option immediately, after a period of conscious deliberation, or after a period of distraction (said to encourage “unconscious thought processes”). In all experiments the majority of participants chose the option predicted by their own subjective attribute weighting scores, regardless of the mode of thought employed. There was little evidence for the superiority of choices made “unconsciously”, but some evidence that conscious deliberation can lead to better choices. The final experiment suggested that the task is best conceptualized as one involving “online judgement” rather than one in which decisions are made after periods of deliberation or distraction. The results suggest that we should be cautious in accepting the advice to “stop thinking” about complex decisions.

Sleep patterns and psychological distress in women living in an inner city

Psychological distress, including symptoms of anxiety, depression, and psychological trauma, is common in women living in inner cities and can be associated with disturbed sleep. The purposes of the study of 115 women were to examine: (a) objective and subjective sleep patterns; (b) extent of psychological distress; and (c) the relationship between objective and subjective sleep patterns and psychological distress. Wrist actigraphs were worn. High levels of life stress, sleep pattern disturbance, and psychological distress were common. Self-reported sleep patterns, but not objective sleep pattern variables, explained 12.5% to 44% of the variance in psychological distress, suggesting the importance of screening for sleep and psychological distress. These findings suggest that interventions focusing on sleep or psychological distress may reduce symptoms.

Adherence to Medical Regimens

Adherence studies have taken center stage due to the life-threatening risks associated with nonadherence to highly active antiretroviral therapy (HAART) regimens for people with HIV/AIDS. This study examines adherence through self-report of individuals on HAART regimens in a manner to account for demand characteristic bias, while still attempting to get an accurate portrayal of individuals' adherence to their medication. Results indicate that individuals who are more certain about their course of treatment, are more trusting of their medical provider, have family resources, and are more optimistic about life adhere better. The model predicts who will be adherent with 92% accuracy while accounting for 55% of the variance in adherence. Practice implications for increasing adherence and accurately assessing adherence are discussed.

Strengthening the case for stimulus-specificity in artificial grammar learning: no evidence for abstract representations with extended exposure

Different theories have been proposed regarding the nature of the mental representations formed as a result of implicit learning of sequential regularities. Some theories postulate abstract surface-independent representations, while other theories postulate stimulus-specific representations. This article reports three experiments investigating the development of abstract representations in artificial grammar learning (AGL), using a methodological approach developed by Conway and Christiansen (2006). In all the experiments, the number of blocks during the exposure phase was manipulated (6 blocks vs. 18 blocks of exposure to sequences). Experiments 1 and 2 investigated both visual and auditory learning where sequences were presented element-by-element. Experiment 3 investigated visual learning using a sequence-by-sequence presentation technique more commonly used in visual AGL studies. Extending previous research (Conway & Christiansen, 2006) and in support of stimulus-specific accounts, the results of the experiments showed that extended observational learning results in increased stimulus-specific knowledge rather than abstraction towards surface-independent representations.

[Effectiveness of parent training for children with ADHD in routine clinical practice]

Studies on the effectiveness of parent trainings, especially for children treated with stimulants, yielded conflicting results. This study investigated the effectiveness of parent training (PT) as a part of routine clinical care. Compared to a waitlist control (n=16) PT-mothers (n=16) reported significantly fewer ADHD-symptoms, better acceptance of their children and a trend to better relationship satisfaction. No differences were found between children treated with or without stimulants. Contrary to the high level of consumer satisfaction fathers didn't report any improvements on all outcome domains.

Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial

Background

Several uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism.

Methods

62 children with autism recruited from 6 centers, ages 2–7 years (mean 4.92 ± 1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen ("treatment group", n = 33) or slightly pressurized room air at 1.03 atm and 21% oxygen ("control group", n = 29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC).

Results

After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved" compared to 2/26 (8%) of controls (p = 0.0471); 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p = 0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0336), receptive language (p = 0.0168), and eye contact (p = 0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p < 0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p = 0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p = 0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated.

Conclusion

Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air.

Trial Registration

clinicaltrials.gov NCT00335790

Anti-melanin antibodies are increased in sera in Parkinson's disease

An increasing body of research suggests that a number of immune mechanisms play a role in degenerative pathways in Parkinson's disease (PD). In the current work we investigated a posited humoral immune response in this disorder. Sera from PD patients exhibited a significantly enhanced absorbance response on a novel ELISA for anti-melanin antibodies, compared to sera from age-matched control subjects. The enhanced ELISA absorbance response was specific for catecholamine-based melanins and was unrelated to antiparkinsonian dopaminergic medication. Further, the absorbance response was significantly and negatively correlated with disease duration. These data suggest that a specific humoral anti-melanin antibody response is present in PD and is more active in early disease. While the contribution of this novel immune response to the initiation and progression of this disorder is unclear, this finding supports the hypothesis that specific immune responses occurring in PD may respond to therapeutic interventions in this disorder.

Assessing age-related macular degeneration with the ADREV performance-based measure

PURPOSE

To validate a new third-generation performance-based measure titled the "assessment of disability related to vision" (ADREV) in a study population of individuals with age-related macular degeneration.

METHODS

Patients with either exudative or nonexudative age-related macular degeneration, but without ocular comorbidity, completed the ADREV, the 25-item National Eye Institute's visual functioning questionnaire, and a range of clinical assessments. Correlations were calculated between the data provided by the ADREV, visual functioning questionnaire, and clinical ophthalmic measures. Regression and bootstrap analysis were preformed to determine the relative relationship between specific clinical measures and ADREV performance, while controlling for a range of potentially confounding factors.

RESULTS

One hundred twelve patients completed the study and correlative analysis showed that ADREV total and subscale scores were more related to nearly all measures of clinical ophthalmic status in comparison with the data provided by the visual functioning questionnaire. Significant correlative relationships between ADREV and visual functioning questionnaire scores showed moderate to high correlation. Central visual acuity and contrast sensitivity shared the strongest association with performance of activities.

CONCLUSIONS

The ADREV is a valid instrument for the assessment of visual disability in patients with age-related macular degeneration. Furthermore, the data provided by this performance measure had stronger relationships with clinical indicators of visual impairment in comparison with self-report.

Grandmother caregiving, family stress and strain, and depressive symptoms

This study used the resiliency model of family stress, adjustment, and adaptation as the framework to examine the main and moderating effects of social support and resourcefulness in the relationship between family life stresses and strain and depressive symptoms in grandmothers raising grandchildren, grandmothers in multigenerational homes, and noncaregivers to grandchildren. A sample of 486 Ohio grandmothers, recruited using random and supplemental convenience methods, completed mailed surveys. Analysis of variance was used to examine differences in family life stresses and strain, resourcefulness, support, and depressive symptoms across the three groups of grandmothers. Hierarchical multiple regression analyses were used to examine whether family stresses and strains affected the grandmother's depressive symptoms and whether social support and resourcefulness moderated the relationship between family stresses and strain and grandmothers' mental health. Grandmothers raising grandchildren reported more depressive symptoms, but in multiple regression analyses of the full sample that controlled for demo-graphics, primary caregiving status was not related to depressive symptoms. More strain and less subjective support and resourcefulness were associated with higher depressive symptoms for all grandmothers, with 33% to 54% explained variances of such symptoms for each caregiving group and the full sample. Subjective support moderated the effects of strain and instrumental support moderated the effects of family life stresses on depressive symptoms. Social support and resourcefulness may help protect grandmothers from the effects of family stresses and strain, and interventions to enhance these factors may assist grandmother caregivers to achieve better mental health.

A functional and regulatory network associated with PIP expression in human breast cancer

BACKGROUND

The PIP (prolactin-inducible protein) gene has been shown to be expressed in breast cancers, with contradictory results concerning its implication. As both the physiological role and the molecular pathways in which PIP is involved are poorly understood, we conducted combined gene expression profiling and network analysis studies on selected breast cancer cell lines presenting distinct PIP expression levels and hormonal receptor status, to explore the functional and regulatory network of PIP co-modulated genes.

PRINCIPAL FINDINGS

Microarray analysis allowed identification of genes co-modulated with PIP independently of modulations resulting from hormonal treatment or cell line heterogeneity. Relevant clusters of genes that can discriminate between [PIP+] and [PIP-] cells were identified. Functional and regulatory network analyses based on a knowledge database revealed a master network of PIP co-modulated genes, including many interconnecting oncogenes and tumor suppressor genes, half of which were detected as differentially expressed through high-precision measurements. The network identified appears associated with an inhibition of proliferation coupled with an increase of apoptosis and an enhancement of cell adhesion in breast cancer cell lines, and contains many genes with a STAT5 regulatory motif in their promoters.

CONCLUSIONS

Our global exploratory approach identified biological pathways modulated along with PIP expression, providing further support for its good prognostic value of disease-free survival in breast cancer. Moreover, our data pointed to the importance of a regulatory subnetwork associated with PIP expression in which STAT5 appears as a potential transcriptional regulator.

Comparable efficacy of contingency management for cocaine dependence among African American, Hispanic, and White methadone maintenance clients

Cocaine use is a significant problem among methadone maintenance clients. Contingency management (CM) is a reinforcement-based approach with demonstrated efficacy for reducing cocaine use. This study examines whether the efficacy of CM treatment for cocaine-dependent individuals receiving methadone maintenance for opioid dependence differs by ethnicity. Participants were 191 African American, Hispanic, and White cocaine-dependent methadone maintenance clients, randomly assigned to standard methadone treatment or standard methadone treatment plus CM for 12 weeks. Hispanic participants were younger, less educated, and reported fewer years of cocaine use than did African American and White participants and reported fewer years of heroin use than did African American participants. African American participants were less likely to report a history of psychiatric symptoms or treatment in comparison with Hispanic and White participants. While CM was associated with longer duration of continuous cocaine abstinence and a greater proportion of submitted urine samples negative for cocaine, ethnicity was not related to treatment outcomes, and there was no significant interaction between treatment and ethnicity. CM appears to be an efficacious treatment for cocaine dependence among methadone maintenance clients, regardless of ethnicity. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

DEVELOPMENTAL SEX DIFFERENCES IN THE RELATION OF NEUROANATOMICAL CONNECTIVITY TO INTELLIGENCE

Recent neuroimaging research has shown sex-related differences in the relationship between brain structure and cognitive function. Anatomical studies have shown a greater reliance for cognitive function on white matter structure in adult females, and a greater reliance on gray matter structure in adult males. Functional neuroimaging studies have also shown a greater correlation between brain connectivity and cognitive function in females. However, this relationship is not present in young childhood (5 years old) but appears during the developmental period. Here sex differences in structure-function relationships and their developmental trajectory are investigated using diffusion tensor imaging (DTI) on a large cohort of over 100 normal children ages 5-18. Significant sex-X-IQ interactions on fractional anisotropy (FA), a marker for white matter organization, were seen in the left frontal lobe, in fronto-parietal areas bilaterally, and in the arcuate fasciculus bilaterally, with girls showing positive correlations of FA with IQ, and boys showing a negative correlation. Significant sex-X-IQ-X-age interactions on FA were also seen in the left frontal lobe and in fronto-parietal areas bilaterally, showing a developmental effect. These results strongly corroborate previous findings regarding sex differences in structure-function relationships regarding intelligence. Results also indicate that a naïve interpretation of "more is better" with respect to FA may not be accurate, especially in adult males.

The catechol-O-methyltransferase Val(108/158)Met polymorphism affects antidepressant response to paroxetine in a naturalistic setting

RATIONALE

The noradrenergic and dopaminergic systems are targets for antidepressants and are stimulated by serotonergic antidepressant drugs. The COMT enzyme inactivates catecholamines, and the COMT Val(108/158)Met polymorphism (rs4680) influences the enzyme activity. Clinical studies on the effect of rs4680 on antidepressant response gave contrasting results.

OBJECTIVES

We studied the effect of rs4680 on response to paroxetine antidepressant monotherapy at doses administered upon clinical need.

MATERIALS AND METHODS

Fifty-five consecutively referred outpatients affected by a major depressive episode without psychotic features in course of major depressive disorder were administered paroxetine at a mean daily dose of 31.64 mg for 1 month. Changes in severity of depression were assessed with weekly Hamilton depression ratings and analyzed with repeated measures analysis of variance in the context of general linear model, taking into account potential confounding variables (age, sex, number of previous illness episodes, duration of current episode and paroxetine daily dose).

RESULTS

rs4680 significantly interacted with time in affecting antidepressant response to paroxetine, with outcome being inversely proportional to the enzyme activity: better effects in Met/Met homozygotes, worse effects in Val/Val homozygotes and intermediate effects in heterozygotes. The effect became significant at the third week of treatment. Paroxetine daily dose was proportional to baseline severity, but did not influence outcome.

CONCLUSIONS

This is the first study that reports a positive effect of rs4680 on response to selective serotonin reuptake inhibitors monotherapy in a Caucasian sample. Our findings support the hypothesis that factors affecting catecholaminergic neurotransmission might contribute to shape the individual response to antidepressants.

The effect of cam FAI on hip and pelvic motion during maximum squat

Femoroacetabular impingement (FAI) causes abnormal contact at the anterosuperior aspect of the acetabulum in activities requiring a large hip range of motion (ROM). We addressed the following questions in this study: (1) Does FAI affect the motions of the hip and pelvis during a maximal depth squat? (2) Does FAI decrease maximal normalized squat depth? We measured the effect of cam FAI on the 3-D motion of the hip and pelvis during a maximal depth squat as compared with a healthy control group. Fifteen participants diagnosed with cam FAI and 11 matched control participants performed unloaded squats while 3-D motion analysis was collected. Patients with FAI had no differences in hip motion during squatting but had decreased sagittal pelvic range of motion compared to the control group (14.7 +/- 8.4 degrees versus 24.2 +/- 6.8 degrees , respectively). The FAI group also could not squat as low as the control group (41.5 +/- 12.5% versus 32.3 +/- 6.8% of leg length, respectively), indicating the maximal depth squat may be useful as a diagnostic exercise. Limited sagittal pelvic ROM in FAI patients may contribute to their decreased squatting depth, and could represent a factor amongst others in the pathomechanics of FAI.