Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study

Given that many patients referred to cardiac rehabilitation (CR) are obese, diet therapy, exercise training, nutritional and psychological counselling for both obesity and psychological distress should be included as important components in all CR programmes. In this practice-level, observational study we evaluated the short-term within-group effects of a four-week multi-factorial inpatient CR programme specifically addressed to weight loss, fitness improvement and psychological health increase on 176 obese in-patients with coronary heart disease (CHD). Outcome measures were exercise capacity measured with estimated metabolic equivalents (METs), body mass index (BMI) and psychological well-being (PGWBI). Results show statistically significant improvements in all the PGWBI sub-scales and total score, except in general health (p = 0.393). No moderation effects were found for BMI class, age, diabetes and ejection fraction (EF). METs significantly increased by 30.3% (p < 0.001) and BMI decreased by 1.37 points (p < 0.001). Significant correlations were found between BMI and weight reductions with PGWBI anxiety and total score improvements. This multi-disciplinary CR programme including diet therapy, exercise training and psychological counselling provides indication for short-term within-group effectiveness on functional exercise capacity, BMI and PGWBI in a sample of obese in-patients with CHD. However, controlled studies are needed to corroborate the results we found.     

Motor excitability is reduced prior to voluntary movements in children and adolescents with Tourette syndrome

Tourette syndrome (TS) is a neuro‐developmental disorder characterized by the occurrence of motor and vocal tics: involuntary, repetitive, stereotyped behaviours that occur with a limited duration, often typically many times in a single day. Previous studies suggest that children and adolescents with TS may undergo compensatory, neuroplastic changes in brain structure and function that help them gain control over their tics. In the current study we used single‐pulse and dual‐site paired‐pulse transcranial magnetic stimulation (TMS), in conjunction with a manual choice reaction time task that induces high levels of inter‐manual conflict, to investigate this conjecture in a group of children and adolescents with TS, but without co‐morbid Attention Deficit Hyperactivity Disorder (ADHD). We found that performance on the behavioural response‐conflict task did not differ between the adolescents with TS and a group of age‐matched typically developing individuals. By contrast, our study demonstrated that cortical excitability, as measured by TMS‐induced motor‐evoked potentials (MEPs), was significantly reduced in the TS group in the period immediately preceding a finger movement. This effect is interpreted as consistent with previous suggestions that the cortical hyper‐excitability that may give rise to tics in TS is actively suppressed by cognitive control mechanisms. Finally, we found no reliable evidence for altered patterns of functional inter‐hemispheric connectivity in TS. These results provide evidence for compensatory brain reorganization that may underlie the increased self‐regulation mechanisms that have been hypothesized to bring about the control of tics during adolescence.     

Third Men: The Logic of the Sophisms at Arist. SE 22, 178b36–170a10

This article aims at elucidating the logic of Arist. SE 22, 178b36–179a10 and, in particular, of the sophism labelled "Third Man" discussed in it. I suggest that neither the sophistic Walking Man argument, proposed by ancient commentators, nor the Aristotelian Third Man of the , suggested by modern interpreters, can be identified with the fallacious argument Aristotle presents and solves in the passage. I propose an alternative reconstruction of the Third Man sophism and argue that an explanation of the lines regarding the identity of Coriscus and Coriscus the musician (178b39–179a3) is indispensable for its correct understanding, since they hint at another sophism in some important aspects analogous. Finally, I show that two contradictions concerning spotted by scholars in the passage are only apparent and can be dissolved once the assumption that the anti-Platonic Third Man argument is at stake here is discarded, and once the passage is read in the light of its agonistic context.     

Recognition memory in mentally retarded persons

The continuous recognition memory of retarded and normal subjects was assessed. The stimuli were magazine pictures, arranged so that lags of up to 250 pictures occured. The overall performance of the retarded subjects was poorer, in terms of hit rate or d′. However, the differences were present at 0 lag and the slopes of the forgetting curves were similar in both groups. It was concluded that differences between these subjects were due to a perception related process and not to memory.     

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

Electrophysiological and behavioral measures of the influence of literal and figurative contextual constraints on proverb comprehension

Proverbs tend to have meanings that are true both literally and figuratively (i.e., Lightning really doesn't strike the same place twice). Consequently, discourse contexts that invite a literal reading of a proverb should provide more conceptual overlap with the proverb, resulting in more rapid processing, than will contexts biased towards a non-literal reading. Despite this, previous research has failed to find the predicted processing advantage in reading times for familiar proverbs when presented in a literally biasing context. We investigate this issue further by employing both ERP methodology and a self-paced reading task and, second, by creating an item set that controls for problems with items employed in earlier studies. Our results indicate that although people do not take longer to read proverbs in the literally and proverbially biasing contexts, people have less difficulty integrating the statements in literal than figurative contexts, as shown by the ERP data. These differences emerge at the third word of the proverbs.     

Autobiographical recall training in elderly adults with subjective memory complaint: a pilot study

Subjective memory complaint is a self-reported memory impairment which affects elderly people. This problem does not interfere with daily living activities but could decrease quality of life. This study's purpose was to verify whether a specific, newly developed, autobiographical recall training could modify self-perception of memory of subjects with subjective memory complaint. Seven elderly subjects (4 women and 3 men; mean age 65.5 yr., SD=11) with such complaint, evidenced through a specific questionnaire, attended the training course and were prospectively assessed on standard neuropsychological tests, depressive symptomatology, and self-perception of memory. Self-perception of memory, as assessed by scores on a formalized questionnaire, improved significantly after the training, while depressive symptoms did not change. Neuropsychological performances were normal before and after the training, but a statistically significant improvement was observed only on the phonological fluency test. Thus the present pilot study suggested that the training may be effective in improving self-perception of memory and metamnestic capacity in elderly people with subjective memory complaints but not in changing subjects' depressive symptoms. This requires replication of this work with a much larger sample so statistical power is adequate.     

What happens to our representation of identity as familiar faces age? Evidence from priming and identity aftereffects

Matching identity in images of unfamiliar faces is error prone, but we can easily recognize highly variable images of familiar faces – even images taken decades apart. Recent theoretical development based on computational modelling can account for how we recognize extremely variable instances of the same identity. We provide complementary behavioural data by examining older adults’ representation of older celebrities who were also famous when young. In Experiment 1, participants completed a long-lag repetition priming task in which primes and test stimuli were the same age or different ages. In Experiment 2, participants completed an identity after effects task in which the adapting stimulus was an older or young photograph of one celebrity and the test stimulus was a morph between the adapting identity and a different celebrity; the adapting stimulus was the same age as the test stimulus on some trials (e.g., both old) or a different age (e.g., adapter young, test stimulus old). The magnitude of priming and identity after effects were not influenced by whether the prime and adapting stimulus were the same age or different age as the test face. Collectively, our findings suggest that humans have one common mental representation for a familiar face (e.g., Paul McCartney) that incorporates visual changes across decades, rather than multiple age-specific representations. These findings make novel predictions for state-of-the-art algorithms (e.g., Deep Convolutional Neural Networks).     

Religion and the Limits of Liberalism

This is the editors' preface to a special issue of Philosophia on 'Religion and Limits of Liberalism'. It begins by noting the challenges which the 'return' of religions to liberal democracies poses to the liberal commitment to respect citizens’ freedom and equality. Then, with particular reference to Rawls' theory of liberal politics, it situates the papers in relation to three different senses of liberal ‘respect’ that are challenged by contemporary religions – one understood in terms of the justification of political power, another as tolerance of diversity, and the third in terms of freedom from interference.