The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study

This study assessed the validity of the Patient–Doctor Relationship Questionnaire-9 (PDRQ-9) in a primary care sample (N = 180). Convergent validity was assessed through a correlation between the patient-rated PDRQ-9 and the physician-rated Difficult Doctor Patient Relationship Questionnaire-10 (DDPRQ-10). Discriminant validity was assessed through correlations between the PDRQ-9 and patient age, patient- and physician-reported health and psychological distress. To determine if the PDRQ-9 could discriminate between groups, patient PDRQ-9 ratings were compared between patients who were treated by faculty physicians versus those who were treated by residents. An exploratory factor analysis confirmed that the PDRQ-9 was made up of a single factor. The PDRQ-9 scale was internally consistent (α = .96) and significantly and negatively correlated with the DDPRQ-10 (r = ?.22, p = .003) and was not significantly correlated with patient age, health, or psychological distress. PDRQ-9 ratings were statistically greater in patients who were treated by faculty physicians than those who were treated by residents (p = .01). This study provides additional support for the reliability and validity of the PDRQ-9 as a measure of the doctor–patient relationship in a primary care sample.     

Correction to: A psychophysiological investigation of mourning: There are two sides to the story

Motivation and Emotion - Mourning constitutes an important human emotion, which might cause—among other things—major depressive symptoms when lasting for too long. To date, no study...     

Immobility reaction at birth in newborn infant

Objective

To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns.

Method

We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR.

Results

IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2 h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p = .037), and a close to significant one between infants’ lividness at Time 0 and IR (p = .053). The first breath of the 31 newborns occurred before and was not associated with the first cry (p < .001).

Discussion

The main features of IR at birth are similar to those of the universal most severe response to severe stress or danger. The relationship with PS suggests that children who had IR at birth might be at risk for similar disorders as those associated with PS. Sudden neonatal collapse of one of the IR newborns needs further research to determine if they are at risk for sudden infant death syndrome.

Conclusion

This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined.     

Proximodistal exploration in motor learning as an emergent property of optimization

To harness the complexity of their high‐dimensional bodies during sensorimotor development, infants are guided by patterns of freezing and freeing of degrees of freedom. For instance, when learning to reach, infants free the degrees of freedom in their arm proximodistally, that is, from joints that are closer to the body to those that are more distant. Here, we formulate and study computationally the hypothesis that such patterns can emerge spontaneously as the result of a family of stochastic optimization processes, without an innate encoding of a maturational schedule. In particular, we present simulated experiments with an arm where a computational learner progressively acquires reaching skills through adaptive exploration, and we show that a proximodistal organization appears spontaneously, which we denote PDFF (Proximo Distal Freezing and Freeing of degrees of freedom). We also compare this emergent organization between different arm morphologies—from human‐like to quite unnatural ones—to study the effect of different kinematic structures on the emergence of PDFF.     

Molecular Tumor Boards: Ethical Issues in the New Era of Data Medicine

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine” (DM) (big data, data mining). The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision of care. Molecular tumor boards (MTB) are one response to these changes and are now providing better access to next-generation sequencing (NGS) and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent (IC) documents at all academic medical centers and to introduce dynamic and electronic informed consent (e-IC).     

Spatial numerical associations in preschoolers

ABSTRACT

Three-to-five-year-old French children were asked to add or remove objects to or from linear displays. The hypothesis of a universal tendency to represent increasing number magnitudes from left to right led to predict a majority of manipulations at the right end of the rows, whatever children's hand laterality. Conversely, if numbers are not inherently associated with space, children were expected to favour laterality-consistent manipulations. The results showed a strong tendency to operate on the right end of the rows in right-handers, but no preference in left-handers. These findings suggest that the task elicited a left-to-right oriented representation of magnitudes that counteracted laterality-related responses in left-handed children. The young age of children and the lack of a developmental trend towards right preference weaken the hypothesis of a cultural origin of this oriented representation. The possibility that our results are due to weaker brain lateralisation in left-handers compared to right-handers is addressed in Discussion section.     

Frequency of finger looking during finger counting is related to children's working memory capacities

Finger counting can be useful in solving arithmetic problems, noticeably because it reduces the working memory demand of mental calculations. However, proprioceptive information might not be sufficient to keep track of the number of fingers raised during problem solving, and visual input may play an important role in this process. The present study was designed to address this question and shows that 8-year-old children look at their fingers in 60% of the trials during finger counting when solving additive problems. Moreover, our results reveal that the frequency of finger looking is negatively correlated with working memory capacities and is higher for more difficult problems. These findings suggest that finger looking is recruited in managing the cognitive demand of the arithmetic task, probably by providing additional external cues to monitor the number of steps that have to be incremented during finger counting.     

Temporal grouping effects in musical short-term memory

Recent theoretical accounts of verbal and visuo-spatial short-term memory (STM) have proposed the existence of domain-general mechanisms for the maintenance of serial order information. These accounts are based on the observation of similar behavioural effects across several modalities, such as temporal grouping effects. Across two experiments, the present study aimed at extending these findings, by exploring a STM modality that has received little interest so far, STM for musical information. Given its inherent rhythmic, temporal and serial organisation, the musical domain is of interest for investigating serial order STM processes such as temporal grouping. In Experiment 1, the data did not allow to determine the presence or the absence of temporal grouping effects. In Experiment 2, we observed that temporal grouping of tone sequences during encoding improves short-term recognition for serially presented probe tones. Furthermore, the serial position curves included micro-primacy and micro-recency effects, which are the hallmark characteristic of temporal grouping. Our results suggest that the encoding of serial order information in musical STM may be supported by temporal positional coding mechanisms similar to those reported in the verbal domain.     

Do distractors interfere with memory for study pairs in associative recognition?

In an associative recognition task, distractors generally consist of a rearrangement of the items composing the study pairs. This makes it possible that processing the distractors generates retroactive interference on memory for the study pairs. In Experiment 1, we explored this possibility in ayes/no recognition test concerning previously learned arbitrary associations between visual symbols and auditory syllables. Rearranged pairs had a deleterious impact on the accuracy and the speed of responses to related correct pairs. This effect did not vary as a function of the number of training blocks, and furthermore, in Experiment 2, the same effect was observed for overlearned small multiplication facts. These results suggest that exposure to potentially confounding information generates interference even if this information is known to be incorrect. Some implications are outlined, especially with regard to the widespread use of multiple-choice tests in knowledge evaluation.