Excess use of general practitioners by obese adults: does health-related quality of life account for the association?

As general practitioners (GP) are seeing, and are likely to continue to see, increasing numbers of obese patients in their practices, it is relevant to know with which needs these patients enter general practice. The present study aims to determine whether besides physical comorbidities, health-related quality of life (HRQOL) accounts for associations of obesity with GP use. In a general population survey in Augsburg, Germany (KORA-Survey S4 1999/2001), anthropometric body mass (BMI in kg/(m(2))), physical comorbidities, HRQOL (the 12-item Short Form; SF-12), and visits to GP were assessed, and analyzed by logistic and zero-truncated negative binomial regressions (two-part model). Gender, age, socio-economic status, marital status, health insurance, and place of residence were adjusted for. The sample consisted of N = 942 residents aged 25 - 74, who had been randomly sampled from 17 cluster-sampled communities, and were either normal-weight, overweight, moderately obese, or severely obese. The moderately obese group had higher odds than the normal-weight to report any GP use; however, while being predictive, neither physical comorbidity nor HRQOL mediated this. In contrast, with regard to number of GP visits among users, the severely obese group (BMI >/= 35) reported significantly more visits than the normal-weight group, and both physical comorbidity and physical (but not mental) HRQOL accounted for this. In conclusion, physical comorbidity and HRQOL mediate excess use of GP by severely obese users in terms of number of visits. Thus, for this group, subjective physical health seems to be important besides physical comorbidities, suggesting for general practice to focus both on evaluated and perceived needs of these patients.     

The effects of wording on the understanding and use of uncertainty information in a threshold forecasting decision

Many believe that information about small chances of severe weather would be useful to the general public for precautionary action. What is the best way to explain this kind of information to a non‐expert audience? The studies reported here investigated effects of framing (negative vs. positive), format (frequency vs. probability), likelihood (low vs. high) and compatibility (task‐match) on interpretation of verbal expressions of forecast uncertainty and on subsequent forecasting decisions. The crucial factor was the match between the verbal expression and the overall task goal. Errors increased when there was a mismatch between the expression (e.g. winds less than 20 knots) and the task (e.g. post an advisory when winds will exceed 20 knots). However, framing and format had little impact. We conclude that consideration of user expectations arising from the overall task goal is crucial in explaining uncertainty information to a naïve audience. Global expectations overpower other potential effects. Copyright © 2008 John Wiley & Sons, Ltd.     

Analysis of the Talmudic Argumentum A Fortiori Inference Rule (Kal Vachomer) using Matrix Abduction

We motivate and introduce a new method of abduction, Matrix Abduction, and apply it to modelling the use of non-deductive inferences in the Talmud such as Analogy and the rule of Argumentum A Fortiori. Given a matrix \({\mathbb {A}}\) with entries in {0, 1}, we allow for one or more blank squares in the matrix, say a _i,j =?. The method allows us to decide whether to declare a _i,j = 0 or a _i,j = 1 or a _i,j =? undecided. This algorithmic method is then applied to modelling several legal and practical reasoning situations including the Talmudic rule of Kal-Vachomer. We add an Appendix showing that this new rule of Matrix Abduction, arising from the Talmud, can also be applied to the analysis of paradoxes in voting and judgement aggregation. In fact we have here a general method for executing non-deductive inferences.     

The aftermath of 9/11: effect of intensity and recency of trauma on outcome

Does trauma exposure have a long-term impact on the brain and behavior of healthy individuals? The authors used functional magnetic resonance imaging to assess the impact of proximity to the disaster of September 11, 2001, on amygdala function in 22 healthy adults. More than three years after the terrorist attacks, bilateral amygdala activity in response to viewing fearful faces compared to calm ones was higher in people who were within 1.5 miles of the World Trade Center on 9/11, relative to those who were living more than 200 miles away (all were living in the New York metropolitan area at time of scan). This activity mediated the relationship between group status and current symptoms of posttraumatic stress disorder. In turn, the effect of group status on both amygdala activation (fearful vs. calm faces) and current symptoms was statistically explained by time since worst trauma in lifetime and intensity of worst trauma, as indicated by reported symptoms at time of the trauma. These data are consistent with a model of heightened amygdala reactivity following high-intensity trauma exposure, with relatively slow recovery.     

What do eye movements reveal about the role of memory in visual search?

Horowitz and Wolfe (1998, 2003) have challenged the view that serial visual search involves memory processes that keep track of already inspected locations. The present study used a search paradigm similar to Horowitz and Wolfe's (1998), comparing a standard static search condition with a dynamic condition in which display elements changed locations randomly every 111 ms. In addition to measuring search reaction times, observers' eye movements were recorded. For target-present trials, the search rates were near-identical in the two search conditions, replicating Horowitz and Wolfe's findings. However, the number of fixations and saccade amplitude were larger in the static than in the dynamic condition, whereas fixation duration and the latency of the first saccade were longer in the dynamic condition. These results indicate that an active, memory-guided search strategy was adopted in the static condition, and a passive “sit-and-wait” strategy in the dynamic condition.     

Decade breaks in the mental number line? Putting the tens and units back in different bins.

Most models of number recognition agree that among other number representations there is a central semantic magnitude representation which may be conceptualized as a logarithmically compressed mental number line. Whether or not this number line is decomposed into different representations for tens and units is, however, controversial. We investigated this issue in German participants in a magnitude comparison (selection) task in which the larger of two visually presented Arabic two-digit numbers had to be selected. Most importantly, we varied unit-decade-compatibility: a number pair was defined as compatible if the decade magnitude comparison and the unit magnitude comparison of the two numbers would lead to the same response (e.g. 52 and 67) and as incompatible if this was not the case (e.g. 47 and 62). While controlling for overall numerical distance, size and other variables, we consistently found compatibility effects. A control experiment showed that this compatibility effect was not due to perceptual presentation characteristics. We conclude that the idea of one single number line representation that does not additionally assume different magnitude representations for tens and units is not sufficient to account for the data. Finally, we discuss why decade effects were not found in other experimental settings.     

Employment counseling and life stressors: coping through expressive writing

Job loss can be one of life's most traumatic experiences, especially if the unemployment is extended. In addition to more common interventions used by employment counselors and others dedicated to assisting clients in the search for work, it can be helpful to assist clients in expressing their negative feelings through writing. Expressive writing is a powerful technique used successfully to confront traumatic life events. Beneficial effects of expressive writing include understanding why feelings occur. Factors that favorably influence expressive writing and specific procedures for implementation in the employment counseling context are discussed.