A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

On the participation of mTOR in recognition memory

Evidence indicates that activation of the neuronal protein synthesis machinery is required in areas of the brain relevant to memory for consolidation and persistence of the mnemonic trace. Here, we report that inhibition of hippocampal mTOR, a protein kinase involved in the initiation of mRNA translation, immediately or 180min but not 540min after training impairs consolidation of long-term object recognition memory without affecting short-term memory retention or exploratory behavior. When infused into dorsal CA1 after long-term memory reactivation in the presence of familiar objects the mTOR inhibitor rapamycin (RAP) did not affect retention. However, when given immediately after exposing animals to a novel and a familiar object, RAP impaired memory for both of them. The amnesic effect of the post-retrieval administration of RAP was long-lasting, did not happen after exposure to two novel objects or following exploration of the training arena in the absence of other stimuli, suggesting that it was contingent with reactivation of the consolidated trace in the presence of a behaviorally relevant and novel cue. Our results indicate that mTOR activity is required in the dorsal hippocampus for consolidation of object recognition memory and suggest that inhibition of this kinase after memory retrieval in the presence of a particular set of cues hinders persistence of the original recognition memory trace.     

mTOR signaling in the hippocampus is necessary for memory formation

It is widely accepted that the formation of long-term memory (LTM) requires mRNA translation, but little is known about the cellular mechanisms in the brain that regulate this process. Mammalian target of rapamycin (mTOR) is a key regulator of translational efficacy and capacity. Here, we show that LTM formation of one-trial inhibitory avoidance (IA) in rats, a hippocampus-dependent fear-motivated learning task, requires mTOR activation. IA training is specifically associated with a rapid increase in the phosphorylation state of mTOR and its substrate ribosomal S6 kinase (p70S6K). Bilateral intra-CA1 infusion of rapamycin, a selective mTOR inhibitor, 15 min before, but not immediately after training completely hinders IA LTM without affecting short-term memory (STM) retention. Therefore, our findings indicate that the regulation of hippocampal mRNA translation is a major control step in memory consolidation.     

Post-training down-regulation of memory consolidation by a GABA-A mechanism in the amygdala modulated by endogenous benzodiazepines

In rats, amygdala benzodiazepine-like immunoreactivity decreases by 29% immediately after the animals step down from the platform of an inhibitory avoidance apparatus and decreases by a further 45% immediately after they receive a training footshock. The decrease is attributable to a release of diazepam or diazepam-like molecules. The immediate post-training intraamygdala injection of the central benzodiazepine antagonist flumazenil (10 nmole/amygdala) causes memory facilitation, and that of the GABA-A agonist muscimol (0.005 to 0.5 nmole) causes retrograde amnesia. Pretraining ip flumazenil administration (2.0 and 5.0 mg/kg) attenuates the effect of post-training muscimol by a factor of at least 100. The higher dose of pretraining flumazenil also causes memory facilitation. The data suggest that post-training consolidation is down-regulated by a GABA-A mechanism in the amygdala modulated by endogenous benzodiazepines released during training and at the time of consolidation.     

Matching, maximizing, and the behavioral unit: concurrent reinforcement of response sequences.

Pigeons pecked two keys in a probability matching situation in which four two-peck sequences were intermittently reinforced: left-left, left-right, right-left and right-right. In Phase 1, relative reinforcement rate was varied with respect to the first response of a sequence: reinforcers were differentially assigned for left-left and left-right sequences as opposed to right-left and right-right sequences. The second response of reinforced sequences occurred equally on the left and right keys across conditions. In Phase II, relative reinforcement rate was varied for sequences that involve an alternation as opposed to those that did not. The relative outputs of the different sequences matched the relative reinforcement rates for the different sequences in both phases. Relative response rates for key pecks did not always match relative reinforcement rates. The intertrial interval separating responses was varied in both phases; increases in the intertrial interval affected the relative frequency of different sequences. The results demonstrate that response sequences acted as functional units influencing choice and thus support a structural account of choice. At the same time, the matching of relative sequence proportion and relative reinforcement rate supports a matching account.     

School climate and ethnic‐racial identity in school: A longitudinal examination of reciprocal associations

The messages youth receive in schools about how they matter as individuals and as members of ethnic‐racial groups are influential in constructing their developing ethnic‐racial identities (ERI). However, the developing ERI students hold also have a role in shaping their experiences at school. The current study examined the longitudinal and reciprocal association between ERI (exploration and resolution) and school climate (support for cultural pluralism and teacher supportiveness) among 491 Black, Latino, and White middle school youth (M_age = 12.03, SD = 1.05, range: 11–17) in the Midwest. Cross‐lagged analyses revealed that greater perceptions of support for cultural pluralism within the school predicted greater exploration and resolution at later time points for all students. Moreover, greater exploration and resolution among White students was predictive of greater perceptions of support for cultural pluralism at the school. Higher quality teacher–student relationships predicted greater engagement in ERI exploration for all youth. The findings highlight the importance of school climate in helping shape ERI among youth attending a culturally diverse school and the role of such youth in shaping the climate at their school.     

The Relationship Between the Fear-Avoidance Model of Pain and Personality Traits in Fibromyalgia Patients

This study examined the relationship between several cognitive-affective factors of the fear-avoidance model of pain, the big five model of personality, and functional impairment in fibromyalgia (FM). Seventy-four FM patients completed the NEO Five-Factor Inventory, the Pain Catastrophizing Scale, the Pain Anxiety Symptoms Scale-20, the Pain Vigilance and Awareness Questionnaire, and the Impairment and Functioning Inventory. Results indicated that the cognitive-affective factors of pain are differentially associated with personality traits. Neuroticism and conscientiousness were significant predictors of pain catastrophizing, and neuroticism, openness, and agreeableness were significant predictors of pain anxiety. Personality traits did not contribute significantly to vigilance to pain. The effect of neuroticism upon pain anxiety was mediated by pain catastrophizing, and neuroticism showed a trend to moderate the relationship between impairment and pain anxiety. Results support the fear-avoidance model of pain. Implications of the findings for the understanding and management of FM are discussed.     

Exposure to novelty enhances retrieval of very remote memory in rats

Rats were trained in a one-trial step-down inhibitory avoidance task at the age of 3 months and tested for retention 1 day later, or 3, 6, 9, 12, 15, and 19 months later, i.e., when the animals were 3, 6, 9, 12, 15, 18, or 22 months of age. Retrieval performance declined with time and was undetectable in the last two age groups. Exposure to an unrelated novel environment (a square box lined with black plastic) 1 h before retention testing enhanced retrieval at all ages, regardless of the decline in the level of test session performance. The effect cannot be explained by an anxiogenic effect of the novelty box, or by an influence of novelty on locomotion or exploration, or by a nonspecific influence of exposure to novelty on step-down latency in the inhibitory avoidance apparatus.