Attention Deficit Hyperactivity Disorder,differential diagnosis with blood oxygenation,beta/theta ratio,and attention measures

Attention Deficit Hyperactivity Disorder (ADHD) is one of the disorders causing the greatest impact, conditioning academic learning, quality of concentration, and capacity for self-regulation and control. The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV-TR) establishes the most commonly accepted criteria for diagnosis (Inattentive: ADHD-I, Hyperactive/impulsive: ADHD-HI, and Combined: ADHD-C), but currently, diverse studies disagree about whether to address it as a continuum with different degrees of intensity (subtype structure) or as specific disorders (counterposed profiles). Prior research has tested the hypothesis of differential categories with performance measures and cortical activation. The goal proposed herein is to confirm these results, incorporating a new measure, near-infrared hemoencefalography (nir-HEG), in order to control cortical activation through levels of blood oxygenation. For this purpose, we used a sample of 205 children between 8 and 13 years (105 control group, 28 with ADHD-I, 35 with ADHD-HI, and 37 with ADHD-C), administering a continuous performance test (TOVA), quantified electroencephalogram (Q-EEG), and nir-HEG. Results reflect the counterposed profiles hypothesis instead of the degrees of intensity, although the latter is more habitual and generalized.     

Five Books on Sacrifice: New Approaches in Sacrifice Studies

These books, each of which is grounded in familiarity with historical sources and at the same time alert to philosophical and theological questions, reveal that sacrificial studies are thriving. Grand theories have been enfeebled, but a rich repertory of hermeneutical strategies is being applied all the more freely to the vast material from many cultures. Bloodshed is no longer indisputably central, even in discussion of the classical and well‐documented traditions of India, Israel, and Greece. Past attempts to rationalize sacrifice, through spiritualization for example, are confuted by the sturdy texture of ritual. Despite the opacity of archaic rituals and texts, the social function of sacrificial customs and their potential pathologies are better understood, and interconnect with sacrificial dynamics in our own culture. The sacrificial interpretation of Calvary and the Eucharist is better appreciated as a rich and powerful New Testament construct, despite attempts to whittle it away. Yet those such as René Girard who urge a change of theological paradigm now have impressive critical resources at their disposal.     

Blood and organ donation: health impact,prevalence, correlates,and interventions

Abstract

Objective: Without a supply of blood, health services could not meet their clinical needs. Similarly, organs for transplantation save and transform lives. Donations are acts of generosity that are traditionally seen as altruistic, and accordingly, interventions to recruit and retain blood and organ donors have focused on altruism. We review the predictors, prevalence and correlates of these two behaviours, how effective interventions have been, and draw common themes.

Design: Narrative review.

Results: We highlight that both recipients and donors benefit, and as such neither blood nor organ donation is purely altruistic. We also highlight health problems associated with both types of donation. In evaluating interventions, we highlight that a move to an opt-out policy for organ donation may not be the simple fix it is believed to be, and propose interventions to enhance the effectiveness of an opt-in policy (e.g. social media updates). We show that incentives, text messaging, feedback and a focus on prosocial emotions (e.g. ‘warm-glow’, ‘gratitude’) may be effective interventions for both blood and organ donation. Interventions designed to reduce fainting (e.g. water pre-loading) are also effective for blood donation.

Conclusions: We conclude that affect is key to understanding both types of donation and in designing effective interventions.     

Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion

Objective: Preterm infants are frequently transfused with red blood cells based on standardized guidelines or clinical concerns that anemia taxes infants' physiological compensatory mechanisms and thereby threatens their health and well-being. The impact of various transfusion guidelines on long-term neurocognitive outcome is not known. The purpose of this study is to evaluate long-term neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines.

Methods: Neurocognitive outcomes were examined at school age for 56 preterm infants randomly assigned to a liberal (n?=?33) or restrictive (n?=?23) transfusion strategy. Tests of intelligence, achievement, language, visual-spatial/motor, and memory skills were administered. Between-group differences were assessed.

Results: Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency, visual memory, and reading.

Conclusions: Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels.     

What has fMRI told us about the Development of Cognitive Control through Adolescence?

Cognitive control, the ability to voluntarily guide our behavior, continues to improve throughout adolescence. Below we review the literature on age-related changes in brain function related to response inhibition and working memory, which support cognitive control. Findings from studies using functional magnetic resonance imaging (fMRI) indicate that processing errors, sustaining a cognitive control state, and reaching adult levels of precision, persist through adolescence. Developmental changes in patterns of brain function suggest that core regions of the circuitry underlying cognitive control are on-line early in development. However, age-related changes in localized processes across the brain, and in establishing long range connections that support top-down modulation of behavior, more effective neural processing for optimal mature executive function. While great progress has been made in understanding the age-related changes in brain processes underlying cognitive development, there are still important challenges in developmental neuroimaging methods and the interpretation of data that need to be addressed.     

Domain-specific anger expression assessment and blood pressure during rest and acute stress

Anger expression has been linked to hypertension, although assessment of anger expression has not accounted for situational influences. We predicted that anger expression style varies across social situations. Two studies assessed reported anger expression in three domains (home, work, and during free time) and compared findings to those obtained using a global assessment. Participants reported expressing anger more openly when at home and they tend to exert greater control when at work. The domain-specific assessment was also more sensitive to sex differences than the general assessment. The second study examined the influence of this domain-specific anger expression assessment on blood pressure (BP) at rest and during acute challenge. In addition to replicating the first study, the second study showed that open anger expression particularly at work was associated with elevated BP. These studies represent a first step towards improving assessment of anger expression and determining how anger might relate to hypertension risk.     

Psychophysiologic effects of applied tension on the emotional fainting response to blood and injury

OBJECTIVE: The present study was designed to investigate the psychophysiologic effects of "Applied Tension" (AT) on the emotional fainting response to blood and injury in a controlled experiment. METHOD: Twenty-two persons reporting to generally feel faint or to have fainted at the sight of blood or injury and 22 participants classified as Non-Fainters were randomly allocated to a treatment or control condition. Psychophysiologic responses were continuously monitored while individuals watched a video depicting open-heart surgery and a control film. Prior to the surgery film, participants in the treatment condition were instructed in the use of AT. RESULTS: All participants classified as Fainters showed a diphasic response pattern while watching the surgery film. This response, however, was significantly attenuated in Fainters in the treatment condition. CONCLUSIONS: These results suggest that AT provides an effective treatment strategy for the prevention of fainting responses in persons with a fear of blood and injury.     

The impact of courteous and discourteous drivers on physiological stress

Prior studies into road safety have concentrated largely on studying unsafe forms of driving behaviour such as aggressive, stressed, and risky driving. Little attention has been given to ‘positive’ driving behaviour, such as how pro-social driving may help to promote cooperation with other road users and decrease incidences of aggressive and stressful driving. This study aimed to compare the impact of courteous and discourteous driving on the immediate physical health of other drivers (blood pressure, heart rate, and markers of stress) whilst controlling for other recognized factors responsible for driver stress such as road infrastructure (e.g. roadworks, traffic lights, freeways) and driving maneuvers (e.g. merging, tail-gaiting, navigating roundabouts). Using actors in a deception study, a naturalistic driving scenario was created in a lab-based simulation. All participants (n = 10; 39 ± 14.5 years) drove the same route in a simulator and engaged with the same driving behaviours and other virtual road users on two separate occasions separated by 7 days. The difference between conditions was whether the participant interacted with other drivers who displayed: a) courteous or b) discourteous behaviours. Blood pressure, heart rate variability and salivary hormone concentrations (cortisol and alpha amylase) were measured before and immediately after each simulated drive. After interacting with the discourteous drivers, participants experienced significantly higher mean arterial blood pressure, systolic and diastolic pressure, central systolic and diastolic pressure, and heart rate, and lower heart rate variability (indicative of acute stress) compared to interacting with the courteous drivers. Conversely, these markers of stress were reduced after interacting with the courteous drivers. The results support courtesy on the road to provide short-term benefits for the recipient of the action, while also increasing road safety more generally.     

进展期胃癌术后生存质量影响因素探讨

胃癌是我国发病率和病死率较高的恶性肿瘤,且住院病例90％以上为中晚期。因此预后不佳。近年来在进展期胃癌诊断和治疗方面有较大进展,尤其是人们对术后生存质量的重视。本文初步探讨了进展期胃癌术后生存质量的影响因素：如患者一般状况、手术方式、术后辅助放化疗和中医药治疗等。     

无过错输血感染法律责任的承担

现行法律、法规规定,无过错输血感染的法律责任采取过错责任归责原则,意味着当医患双方均无过错而又造成输血感染的损害后果时,完全由患者承担损害后果,这种规定无法体现公平、公正的法律精神。无过错输血感染法律责任应当规定为公平责任,这样才能更好地既保护医方利益又保护患方利益。