Modelling elderly patients’ perception of the community pharmacist image when providing professional services*

Professional pharmaceutical services may impact on patient’s health behaviour as well as influence on patients’ perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients’ beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients’ perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients’ HBs to patient’s perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that ‘Perceived benefits’ were significantly associated with ‘Perceived Pharmacist Image’ in the whole sample. Differences were found in the IG with also ‘Self-efficacy’ significantly influencing ‘Perceived pharmacist image’. A model of patients’ HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients’ HBs that in turn influence public perception of the pharmacist.     

The effects of aging on the working memory processes of multimodal information

Normal aging is associated with deficits in working memory processes. However, the majority of research has focused on storage or inhibitory processes using unimodal paradigms, without addressing their relationships using different sensory modalities. Hence, we pursued two objectives. First, was to examine the effects of aging on storage and inhibitory processes. Second, was to evaluate aging effects on multisensory integration of visual and auditory stimuli. To this end, young and older participants performed a multimodal task for visual and auditory pairs of stimuli with increasing memory load at encoding and interference during retention. Our results showed an age-related increased vulnerability to interrupting and distracting interference reflecting inhibitory deficits related to the off-line reactivation and on-line suppression of relevant and irrelevant information, respectively. Storage capacity was impaired with increasing task demands in both age groups. Additionally, older adults showed a deficit in multisensory integration, with poorer performance for new visual compared to new auditory information.     

Study of behavioural and neural bases of visuo‐spatial working memory with an fMRI paradigm based on an n‐back task

The goal of this study was to propose a new functional magnetic resonance imaging (fMRI) paradigm using a language‐free adaptation of a 2‐back working memory task to avoid cultural and educational bias. We additionally provide an index of the validity of the proposed paradigm and test whether the experimental task discriminates the behavioural performances of healthy participants from those of individuals with working memory deficits. Ten healthy participants and nine patients presenting working memory (WM) deficits due to acquired brain injury (ABI) performed the developed task. To inspect whether the paradigm activates brain areas typically involved in visual working memory (VWM), brain activation of the healthy participants was assessed with fMRIs. To examine the task's capacity to discriminate behavioural data, performances of the healthy participants in the task were compared with those of ABI patients. Data were analysed with GLM‐based random effects procedures and t‐tests. We found an increase of the BOLD signal in the specialized areas of VWM. Concerning behavioural performances, healthy participants showed the predicted pattern of more hits, less omissions and a tendency for fewer false alarms, more self‐corrected responses, and faster reaction times, when compared with subjects presenting WM impairments. The results suggest that this task activates brain areas involved in VWM and discriminates behavioural performances of clinical and non‐clinical groups. It can thus be used as a research methodology for behavioural and neuroimaging studies of VWM in block‐design paradigms.     

Word recognition in Alzheimer's disease: Effects of semantic degeneration

Impairments of word recognition in Alzheimer's disease (AD) have been less widely investigated than impairments affecting word retrieval and production. In particular, we know little about what makes individual words easier or harder for patients with AD to recognize. We used a lexical selection task in which participants were shown sets of four items, each set consisting of one word and three non‐words. The task was simply to point to the word on each trial. Forty patients with mild‐to‐moderate AD were significantly impaired on this task relative to matched controls who made very few errors. The number of patients with AD able to recognize each word correctly was predicted by the frequency, age of acquisition, and imageability of the words, but not by their length or number of orthographic neighbours. Patient Mini‐Mental State Examination and phonological fluency scores also predicted the number of words recognized. We propose that progressive degradation of central semantic representations in AD differentially affects the ability to recognize low‐imageability, low‐frequency, late‐acquired words, with the same factors affecting word recognition as affecting word retrieval.     

Distance stability analysis in multidimensional scaling using the jackknife method

Stability or sensitivity analysis is an important topic in data analysis that has received little attention in the application of multidimensional scaling (MDS), for which the only available approaches are given in terms of a coordinate‐based analytical jackknife methodology. Although in MDS the prime interest is in assessing the stability of the points in the configuration, this methodology may be influenced by imprecisions resulting from the inherently necessary Procrustes method. This paper proposes an analytical distance‐based jackknife procedure to study stability and cross‐validation in MDS in terms of the jackknife distances, which is not influenced by the Procrustes method. For each object, the corresponding jackknife estimated points are considered as naturally clustered points, and stability and cross‐validation are analysed in terms of the MDS distances arising from the jackknife procedure, on the basis of a weighted cluster‐MDS algorithm. A jackknife‐relevant configuration is also proposed for cross‐validation in terms of coordinates, in a cluster‐MDS framework.     

Alternatives to the fixed-set model: A review of appraisal models of emotion

Over several decades, appraisal theory has emerged as a prominent theoretical framework explaining the elicitation and differentiation of emotions, and has stimulated a great deal of theorising and empirical research. Despite the large amount of research in this area, there are many aspects of appraisal theory and research that remain unclear or problematic. In this review, we identify a common assumption of many appraisal theories—the fixed appraisal set—and argue that this assumption, combined with a lack of explicit theorising about the predicted relationship between appraisals and emotions, leads to a lack of clarity in both appraisal models and the empirical testing of those models. We recommend that appraisal theorists move in a direction already taken by a small number of theorists, and adopt the starting assumption of a variable appraisal set. We further suggest that theories of concepts and categorisation may inform theorising about appraisal–emotion relationships.     

Contrasting cue-density effects in causal and prediction judgments

Many theories of contingency learning assume (either explicitly or implicitly) that predicting whether an outcome will occur should be easier than making a causal judgment. Previous research suggests that outcome predictions would depart from normative standards less often than causal judgments, which is consistent with the idea that the latter are based on more numerous and complex processes. However, only indirect evidence exists for this view. The experiment presented here specifically addresses this issue by allowing for a fair comparison of causal judgments and outcome predictions, both collected at the same stage with identical rating scales. Cue density, a parameter known to affect judgments, is manipulated in a contingency learning paradigm. The results show that, if anything, the cue-density bias is stronger in outcome predictions than in causal judgments. These results contradict key assumptions of many influential theories of contingency learning.     

Basolateral amygdala inactivation impairs learned (but not innate) fear response in rats

Numerous studies have suggested that the amygdala is involved in the formation of aversive memories, but the possibility that this structure is merely related to any kind of fear sensation or response could not be ruled out in previous studies. The present study investigated the effects of bilateral inactivation of the amygdaloid complex in rats tested in the plus-maze discriminative avoidance task. This task concomitantly evaluates aversive memory (by discrimination of the two enclosed arms) and innate fear (by open-arm exploration). Wistar rats (3-5 months-old) were implanted with bilateral guide cannulae into basolateral amygdala. After surgery, all subjects were given 1 week to recover before behavioral experiments. Afterwards, in experiment 1, 15 min prior to training, 0.5 μl of saline or muscimol (1 mg/ml) was infused in each side via microinjection needles. In experiment 2 the animals received injections immediately after the training session and in experiment 3 rats were injected prior to testing session (24 h after training). The main results showed that (1) pre-training muscimol prevented memory retention (evaluated by aversive arm exploration in the test session), but did not alter innate fear (evaluated by percent time in open arms); (2) post-training muscimol impaired consolidation, inducing increased percent in aversive arm exploration in the test session and (3) pre-testing muscimol did not affect retrieval (evaluated by aversive enclosed arm exploration in the test session). The results suggest that amygdala inactivation specifically modulated the learning of the aversive task, excluding a possible secondary effect of amygdala inactivation on general fear responses. Additionally, our data corroborate the hypothesis that basolateral amygdala is not the specific site of storage of aversive memories, since retention of the previously learned task was not affected by pre-testing inactivation.     

Pre-training anandamide infusion within the basolateral amygdala impairs plus-maze discriminative avoidance task in rats

Endocannabinoids (eCBs) modulate a variety of brain functions via activation of the widely expressed CB1 receptor. One site of high density of this receptor is the basolateral amygdala (BLA), a structure involved in the formation of aversive memories. The activation and blockade of CB1 receptors by systemic or hippocampal drug administrations have been shown to modify memory processing. However, little is known about the role of the BLA endocannabinoid system in aversive memories. Additionally, BLA endocannabinoid transmission seems to be related to emotional states, but the relevance of these effects to memory formation is still unknown. In this study we investigated the effects of the eCB anandamide (AEA) and the CB1 antagonist/inverse agonist AM251 infused into the BLA on the acquisition of an aversive memory task, concomitantly evaluating basal anxiety levels in rats. Male rats received pre-training micro-injection of AEA, AM251 or vehicle bilaterally into the BLA, and were studied with the plus-maze discriminative avoidance task (a paradigm that allows concomitant and independent evaluation of anxiety-like behavior and the memory of an aversive task). Our results showed that AEA into the BLA before training prevented memory retrieval 24 h later, as evaluated by exploration of the aversive arm of the maze, while AM251 into the BLA did not interfere with animals' performance. In addition, AEA had no effect on anxiety-like behavior (as evaluated by open arm exploration and risk assessment), while AM251 induced an anxiogenic effect. Our data indicate an important role of BLA CB1 receptors in aversive memory formation, and suggest that this involvement is not necessarily related to a possible modulation of anxiety states.     

Relative quantity judgments in South American sea lions (<Emphasis Type="Italic">Otaria flavescens</Emphasis>)

There is accumulating evidence that a variety of species possess quantitative abilities although their cognitive substrate is still unclear. This study is the first to investigate whether sea lions (Otaria flavescens), in the absence of training, are able to assess and select the larger of two sets of quantities. In Experiment 1, the two sets of quantities were presented simultaneously as whole sets, that is, the subjects could compare them directly. In Experiment 2, the two sets of quantities were presented item-by-item, and the totality of items was never visually available at the time of choice. For each type of presentation, we analysed the effect of the ratio between quantities, the difference between quantities and the total number of items presented. The results showed that (1) sea lions can make relative quantity judgments successfully and (2) there is a predominant influence of the ratio between quantities on the subjects’ performance. The latter supports the idea that an analogue representational mechanism is responsible for sea lions’ relative quantities judgments. These findings are consistent with previous reports of relative quantities judgments in other species such as monkeys and apes and suggest that sea lions might share a similar mechanism to compare and represent quantities.