Development and validation of the HIV Medication Readiness Scale

Excellent medication adherence (>95%) is required for optimal HIV treatment success. This study aimed to develop and validate a brief scale to assess psychological readiness for successfully starting and adhering to HIV medications. HIV-positive men and women (N = 142) from an HIV outpatient clinic completed the proposed HIV Medication Readiness Scale (HMRS) prior to starting HIV medications. The 10-item HMRS demonstrated high internal consistency (alpha = .90), test-retest reliability (r = .83), and sensitivity to change following a standardized 4-session psychoeducational intervention designed to increase readiness for successful adherence. Predictive validity was supported by higher readiness scores on the day starting HIV medications, predicting higher treatment adherence at 1-month follow-up. The HMRS is a brief, easy-to-use, clinically relevant tool that can assist in identifying people living with HIV at high risk of nonadherence, who might benefit from tailored readiness counseling prior to initiating HIV medications.     

How fish do geometry in large and in small spaces

It has been shown that children and non-human animals seem to integrate geometric and featural information to different extents in order to reorient themselves in environments of different spatial scales. We trained fish (redtail splitfins, Xenotoca eiseni) to reorient to find a corner in a rectangular tank with a distinctive featural cue (a blue wall). Then we tested fish after displacement of the feature on another adjacent wall. In the large enclosure, fish chose the two corners with the feature, and also tended to choose among them the one that maintained the correct arrangement of the featural cue with respect to geometric sense (i.e. left-right position). In contrast, in the small enclosure, fish chose both the two corners with the features and the corner, without any feature, that maintained the correct metric arrangement of the walls with respect to geometric sense. Possible reasons for species differences in the use of geometric and non-geometric information are discussed.     

A systematic review and meta‐analysis of tertiary interventions in clinical burnout

Clinical burnout is one of the leading causes of work absenteeism in high‐ and middle‐income countries. There is hence a great need for the identification of effective intervention strategies to increase return‐to‐work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non‐randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random‐effects meta‐analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait‐list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15–9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59–2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.     

Neural pathways mediating vaginal function: the vagus nerves and spinal cord oxytocin

The initial observations, made in our laboratory with Knut Larsson, of the ability of vaginocervical stimulation (VCS) to block withdrawal responses to foot pinch in rats has led to findings of multiple behavioral, autonomic, and neuroendocrine effects of this potent stimulus in rats and also in women. It has led to an understanding of: (1) the neuroanatomical and neurochemical basis of a novel and potent pain-blocking mechanism; (2) likely neuroanatomical pathways mediating both the Ferguson reflex and a specific autonomic response - the pupil-dilating effect of VCS; (3) a role for oxytocin as a putative central nervous system neurotransmitter that stimulates autonomic sympathetic preganglionic neurons within the spinal cord; and (4) a novel pathway that can convey sensory activity from the cervix, adequate to induce orgasm, via the vagus nerves. This latter pathway bypasses the spinal cord and projects directly to the medulla oblongata, and thus can convey genital afferent activity despite complete spinal cord injury at any level.     

Contents of Volume 58

Volume Contents

Contents of Volume 58     

Psychometric properties of the eating disorders inventory-2 among women seeking treatment for binge eating disorder

Psychometric properties of the Eating Disorders Inventory-2 (EDI-2) when used for women with Binge Eating Disorder (BED) are assessed. The EDI-2 was administered to 144 outpatients seeking treatment for BED and 152 outpatients seeking treatment for Bulimia Nervosa (BN). Most EDI-2 scales had acceptable internal consistence for both the BED and BN samples. EDI-2 scales demonstrated adequate stability within a subsample of those with BED who were retested. Confirmatory factor analyses revealed a hypothesized second-order two-factor structure for the original EDI scales for the BED group but not for those with BN. When the provisional EDI-2 scales were included, a two-factor structure was not supported for any group. Some scales differentiated the BED from the BN sample, and the second-order factors correlated with measures of similar constructs. The original EDI scales can be used reliably for those with BED.     

A presentation of Attentional Semantics

The paper presents the two main assumptions of Attentional Semantics—(A) and (B), and its main aim (C). (A) Conscious experience is determined by attention: there cannot be consciousness without attention. Consciousness is explained as the product of attentional activity. Attentional activity can be performed thanks to a special kind of energy: nervous energy. This energy is supplied by the organ of attention. When we perform attentional activity, we use our nervous energy. This activity directly affects the organ of attention, causing a variation in the state of the nervous energy. This variation constitutes the phenomenal aspect of consciousness. (B) Words are tools to pilot attention. The meanings of words isolate, de-contextualize, “freeze” and classify in an articulated system the ever-changing and multiform stream of our conscious experiences. Each meaning is composed of the sequence of invariable elements that, independently of any individual occurrence of a given conscious experience, are responsible for the production of any instance of that conscious experience. The elements composing the meanings of words are attentional operations: each word conveys the condensed instructions on the attentional operations one has to perform if one wants to consciously experience what is expressed through and by it. (C) Attentional Semantics aims at finding the attentional instruction conveyed by the meanings of words. To achieve this goal, it tries: (1) to identify the sequence of the elementary conscious experiences that invariably accompany, and are prompted by, the use of the word being analyzed; (2) to describe these conscious experiences in terms of the attentional operations that are responsible for their production; and (3) to identify the unconscious and non-conscious operations that, directly or indirectly, serve either as the support that makes it possible for the attentional operations to take place, be completed, and occur in a certain way, or as the necessary complement that makes it possible to execute and implement the activities determined and triggered by the conscious experiences. The origins of Attentional Semantics are also presented, and the methodological problems researchers encounter when analyzing meanings in attentional terms are discussed. Finally, a brief comparison with the other kinds of semantics is made.