‘The lesser of two evils…’ – views of persons with rheumatoid arthritis on medication adherence: a qualitative study

Objective: This study aimed to explore medication adherence among adherent and non-adherent persons suffering from rheumatoid arthritis (RA). A special focus was put on the reasons accounting for successful medication adherence and on potential barriers or facilitating factors.

Design: A qualitative study with semi-structured interviews was conducted. Eighteen participants were recruited through stratified purposive sampling according to their medication adherence level. Interviews were analysed by interpretative phenomenological analysis.

Results: Medication adherence behaviour was described on a continuum ranging from non-adherent to adherent. Participants’ current adherence level was represented as a result of inner negotiations between a variety of influential factors and the successful application of a range of strategies. The influential factors were: experiences with medication, outcome expectations, knowledge of therapeutic options, the traits ‘openness’ and ‘conscientiousness’, belief in medical progress, characteristics of the medication, level of trust in one’s physician, and perceived autonomy. Facilitating strategies were: establishing routines, using social support and the deliberate suppression of information about potential adverse events.

Conclusion: The experience of and the reasons for medication (non-)adherence from the perspective of people with RA were explored comprehensively. Participants’ ongoing negotiations between adherence and non-adherence emerged as a key finding with implications for health service providers.     

When Marcel Mauss’s <Emphasis Type="Italic">Essai sur le Don</Emphasis> becomes <Emphasis Type="Italic">The Gift</Emphasis>: variations on the theme of solidarity

Since the early 1970s, Marcel Mauss’s Essai sur le Don (1923), translated into English as The Gift in 1954, has been a standard reference in the social science and bioethical literature on the use of human body parts and substances for medical and research purposes. At that time, three social scientists—political scientist Richard Titmuss in the United Kingdom and sociologist Renée C. Fox working with historian Judith Swazey in the United States—had the idea of using this concept to highlight the fundamental structure of the biomedical practices they were studying, respectively, blood donation, and hemodialysis and organ transplantation. The fact that these first applications of Mauss’s essay should emerge in English- rather than in French-speaking countries raises the question of what the translation of the essay, and notably of the word don as gift, may have to do with this fact. Reading Mauss in translation undoubtedly inspired a seminal approach to interpreting medical and research practices based on bodily giving. This article posits that something may have also been lost: a much broader concept of giving with unquestionable links to the Durkheimian concept of solidarity, which Mauss conceptualizes not only as an obligation but also as a liberty to give.     

Attention to configural information in change detection for faces

In recent research the change-detection paradigm has been used along with cueing manipulations to show that more attention is allocated to the upper than lower facial region, and that this attentional allocation is disrupted by inversion. We report two experiments the object of which was to investigate how the type of information changed might be a factor in these findings by explicitly comparing the role of attention in detecting change to information thought to be 'special' to faces (second-order relations) with information that is more useful for basic-level object discrimination (first-order relations). Results suggest that attention is automatically directed to second-order relations in upright faces, but not first-order relations, and that this pattern of attentional allocation is similar across features.     

Are Children Attracted to Play Elements with an Open Function?

Abstract

The present study aimed to determine the degree to which play elements have an “open function”, and whether children are attracted to them. The architect van Eyck hypothesized that play elements with an open function attract playing children because such elements do not suggest a certain type of behavior and are, thus, likely to stimulate the children’s creativity. Children of three different age groups (5-6, 7-8, and 11-12?years of age) played freely in a Parkour playground that consists of play elements that were supposed to vary in the degree of having an open function. Based on the judgments of parents on what action children will mainly perform on each of the elements, we concluded that the play elements indeed differed in the degree of having an open function. The play behavior, however, revealed that the children were less attracted to elements with an open function. The implications of these findings are discussed.     

The relationship between maladaptive personality functioning and problematic technology use in adolescence: A cluster analysis approach

In the last two decades, scientific research has explored the problematic use of internet, videogames and mobile phones. However, there is still little consistent knowledge regarding the co-occurrence of problematic technology use and the role of maladaptive personality characteristics in adolescence. The present study aimed to investigate adolescents' styles of technology use with a cluster analysis approach focusing on personality functioning. The sample comprised 408 Italian adolescents (46.3% males) aged 11 to 18 years (M _age = 13.80; SD = 2.08). Data were collected using the Internet Addiction Test, the Videogame Dependency Scale, the Test of Mobile-Phone Dependence Brief Form and the Personality Inventory for DSM5 Brief Form. Results provided a four-cluster solution based on the co-occurrence of problematic technology use. The four clusters were labeled as follows: cluster 1: “Above average internet and mobile-phone use”; cluster 2: “Below average technology use”; cluster 3: “Above average videogame use”; and cluster 4: “Problematic technology use.” Analyses on demographic variables (e.g., gender and age) demonstrated significant differences between the four groups. Adolescents with high levels of problematic technology use reported greater overall personality dysfunction than the other three groups. This finding supported our hypothesis on maladaptive personality functioning in adolescents at risk for addiction. Finally, the Antagonism domain played a specific role in differentiating the severity of adolescents' involvement in technology use. Further studies are needed to confirm our findings and to plan preventive interventions as well as therapeutic treatments.     

Change in action: how infants learn to walk down slopes

A critical aspect of perception–action coupling is the ability to modify ongoing actions in accordance with variations in the environment. Infants’ ability to modify their gait patterns to walk down shallow and steep slopes was examined at three nested time scales. Across sessions, a microgenetic training design showed rapid improvements after the first session in infants receiving concentrated practice walking down slopes and in infants in a control group who were tested only at the beginning and end of the study. Within sessions, analyses across easy and challenging slope angles showed that infants used a ‘braking strategy’ to curb increases in walking speed across increasingly steeper slopes. Within trials, comparisons of infants’ gait modifications before and after stepping over the brink of the slopes showed that the braking strategy was planned prospectively. Findings illustrate how observing change in action provides important insights into the process of skill acquisition.     

Estimating long-range dependence in time series: An evaluation of estimators implemented in R

Recent studies have shown that many physiological and behavioral processes can be characterized by long-range correlations. The Hurst exponent H of fractal analysis and the fractional-differencing parameter d of the ARFIMA methodology are useful for capturing serial correlations. In this study, we report on different estimators of H and d implemented in R, a popular and freely available software package. By means of Monte Carlo simulations, we analyzed the performance of (1) the Geweke—Porter-Hudak estimator, (2) the approximate maximum likelihood algorithm, (3) the smoothed periodogram approach, (4) the Whittle estimator, (5) rescaled range analysis, (6) a modified periodogram, (7) Higuchi’s method, and (8) detrended fluctuation analysis. The findings—confined to ARFIMA (0, d, 0) models and fractional Gaussian noise—identify the best estimators for persistent and antipersistent series. Two examples combining these results with the step-by-step procedure proposed by Delignières et al. (2006) demonstrate how this evaluation can be used as a guideline in a typical research situation.     

Rapid cerebral hemodynamic modulation during set shifting: Evidence of time-locked associations with cognitive control in females

Set shifting provokes specific alterations of cerebral hemodynamics in basal cerebral arteries. However, no gender differences have been reported. In the following functional transcranial Doppler study, we introduced cerebral hemodynamic modulation to the aspects of set shifting during Wisconsin Card Sorting Test (WCST). Twenty-one subjects underwent the WCST during insonation of the middle cerebral arteries. We examined gender effects on task performance and cerebral hemodynamic modulation. Further, we investigated the linkage between performance and cerebral hemodynamic modulation. In females, maximum positive modulation was restricted to the behaviorally relevant time point of set shifting, and there were time-locked associations between mental slowing during set shifting and rapid cerebral hemodynamic modulation exclusively in females. This study provides evidence of gender-related cerebral hemodynamic modulation during set shifting, and we detected time-locked brain–behavior relationship during cognitive control in females.     

Roughness perception during the rubber hand illusion

Watching a rubber hand being stroked by a paintbrush while feeling identical stroking of one’s own occluded hand can create a compelling illusion that the seen hand becomes part of one’s own body. It has been suggested that this so-called rubber hand illusion (RHI) does not simply reflect a bottom–up multisensory integration process but that the illusion is also modulated by top–down, cognitive factors. Here we investigated for the first time whether the conceptual interpretation of the sensory quality of the visuotactile stimulation in terms of roughness can influence the occurrence of the illusion and vice versa, whether the presence of the RHI can modulate the perceived sensory quality of a given tactile stimulus (i.e., in terms of roughness). We used a classical RHI paradigm in which participants watched a rubber hand being stroked by either a piece of soft or rough fabric while they received synchronous or asynchronous tactile stimulation that was either congruent or incongruent with respect to the sensory quality of the material touching the rubber hand. (In)congruencies between the visual and tactile stimulation did neither affect the RHI on an implicit level nor on an explicit level, and the experience of the RHI in turn did not cause any modulations of the felt sensory quality of touch on participant’s own hand. These findings first suggest that the RHI seems to be resistant to top–down knowledge in terms of a conceptual interpretation of tactile sensations. Second, they argue against the hypothesis that participants own hand tends to disappear during the illusion and that the rubber hand actively replaces it.     

On agency and body-ownership: phenomenological and neurocognitive reflections

The recent distinction between sense of agency and sense of body-ownership has attracted considerable empirical and theoretical interest. The respective contributions of central motor signals and peripheral afferent signals to these two varieties of body experience remain unknown. In the present review, we consider the methodological problems encountered in the empirical study of agency and body-ownership, and we then present a series of experiments that study the interplay between motor and sensory information. In particular, we focus on how multisensory signals interact with body representations to generate the sense of body-ownership, and how the sense of agency modulates the sense of body-ownership. Finally, we consider the respective roles of efferent and afferent signals for the experience of one's own body and actions, in relation to self-recognition and the recognition of other people's actions. We suggest that the coherent experience of the body depends on the integration of efferent information with afferent information in action contexts. Overall, whereas afferent signals provide the distinctive content of one's own body experience, efferent signals seem to structure the experience of one's own body in an integrative and coherent way.