Estrogen and Neural Plasticity

Converging clinical evidence suggests that postmenopausal estrogen therapy in women is associated with improved cognition and a reduced incidence of Alzheimer's disease. In experimental work, investigators have found estrogen to promote changes in synaptic plasticity within the nervous system. In this article, we review both the clinical and the experimental literature, and consider mechanisms of action of estrogen on neurons and synaptic plasticity, and how they might protect against the cognitive impairments of old age.     

生物芯片技术与缩微实验室

基于微加工技术发展起来的生物芯片,可以把成千上万乃至几十万个生命信息集成在一个很小的芯片上,对基因、抗原和活体细胞等进行分析和检测。用这些生物芯片制作的各种生化分析仪和传统仪器相比较具有体积小、重量轻、便于携带、无污染、分析过程自动化、分析速度快、所需样品和试剂少等诸多优点。这类仪器的出现将给生命科学研究、疾病诊断和治疗、新药开发、生物武器战争、司法鉴定、食品卫生监督、航空航天等领域带来一场革命。     

Preference for leisure items over edible items in individuals with dementia: A replication

We replicated previous research in which adults with dementia tended to show a preference for leisure items over edible items when presented in the same array. Additionally, we conducted engagement analyses with the highest, middle, and lowest preference leisure items to determine whether relative preference corresponded to engagement in the natural environment. The most highly preferred stimulus for 6 out of 7 participants was a leisure item, and for each of those six the top 3 preferred stimuli were leisure stimuli. For 4 participants, the most preferred stimulus also produced the longest duration of engagement. We discuss the issues we encountered when conducting preference assessments with adults with intact vocal verbal repertoires, and suggest potential explanations for the displacement of edibles by leisure stimuli in older adults with dementia.     

Opening the closed heart: affect-focused clinical work with the victims of early trauma

This paper begins with the understanding that early trauma leads to powerful dissociative defenses which injure the capacity to feel. It further explores ways to restore this capacity through body-centred attention to affect-in-the-moment in the psychoanalytic situation. Using the author’s personal experience while in analysis as well as a case of severe early trauma, he demonstrates the consciousness-killing effect of primitive defenses and shows how body-sensitive techniques hold the promise of restoring the patient’s sense of aliveness and hence, opening the unconscious to those affect-images that are the building blocks of the human imagination. A final section focuses on the neglect of feeling in Jungian psychology and suggests that the “creation of consciousness” which Jung described as his personal myth, is quintessentially a process of emotional transformation – of bringing unconscious suffering into consciousness – as feelings.     

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.     

Spouses' responses to the dietary nonadherence of their partners managing diabetes

The association between patients' dietary nonadherence and spouses' involvement in patients' diabetes diet was examined, with spouses' anxiety about nonadherence considered as a mediator of this association. Daily diary data from 128 older adult patients with type 2 diabetes and their spouses were analyzed using multilevel models. Results revealed that on days when patients reported less adherence to their diabetes diet than usual, spouses reported greater anxiety about patients' diabetes management, which, in turn, was related to greater spousal persuasion and pressure the same day. The association between patients' nonadherence and diet‐related support on the same day was not mediated, however, through spouses' anxiety. The findings contribute to an understanding of spouses' responses to patients' nonadherence to their diabetes regimen.     

Repressive coping style and autonomic reactions to two experimental stressors in healthy men and women

Autonomic and affective responses to two different stress tasks were measured in 45 males and 74 females, categorized as repressive, true low-anxious, true high-anxious, and defensive high-anxious. Electrodermal activity (EDA) was used as a measure of sympathetic activity and the high frequency (HF) spectral component of heart rate variability as a measure of parasympathetic activity. Contrary to our predictions, reactivity of repressors did not differ from the reactivity of true low-anxious participants. The results draw attention to previous inconsistent findings within the literature on repressive coping style and autonomic nervous system dysregulation. It is suggested that future research could benefit from the use of more consistent operationalizations of the repressive coping construct and from comparing alternative measures of repressive coping within the same study.     

Category and letter fluency in semantic dementia, primary progressive aphasia, and Alzheimer's disease

This study examined the impact of various degenerative dementias on access to semantic knowledge and the status of semantic representations. Patients with semantic dementia, primary progressive aphasia, and Alzheimer's disease were compared with elderly controls on tasks of category and letter fluency, with number of words generated, mean lexical frequency and errors recorded. The findings are consistent with the view that category and letter fluency rely on both common and unique cognitive processes. Fluency tasks, with the richness of data obtained, are valuable in distinguishing different dementia syndromes from one another.     

Ethics,policy, and rare genetic disorders: the case of Gaucher disease in Israel

Gaucher disease is a rare, chronic,ethnic-specific genetic disorder affecting Jewsof Eastern European descent. It is extremelyexpensive to treat and presents difficultdilemmas for officials and patients in Israelwhere many patients live. First, high-cost,high-benefit, but low volume treatment forGaucher creates severe allocation dilemmas forpolicy makers. Allocation policies driven bycost effectiveness, age, opportunity or needmake it difficult to justify funding. Processoriented decision making based on terms of faircooperation or decisions invoking the ``rule ofrescue' risk discriminating against minoritieswho may already suffer from inequitabledistribution of heath care resources. Apartfrom cost, Gaucher disease prompts questionsabout abortion. Unlike severe geneticdisorders, Gaucher offers no grounds forabortion and, in many ways, is analogous togender based abortions that are prohibitedregardless of fetal age. Finally, Gaucherraises concerns about the disclosure of geneticinformation. These affect potential carriersasked to participate in population studies andcarriers and patients who must considerdisclosure to others. These concerns weigh theright to privacy against communal interests andbilateral commitments.     

Depression and Anxiety in Persons with Parkinson's Disease With and Without “On–Off” Phenomena

On–off phenomena in Parkinson's disease (PD) are unpredictable motor fluctuations associated with long-term levodopa use. Mood fluctuations have been found to coincide with the motor fluctuations in that depression and anxiety increase while the person with PD is in the off state. What has been relatively unexplored is whether those persons with PD who have on–off phenomena differ psychologically in fundamental ways from those who do not have on–off phenomena. In the present study, depression and anxiety symptoms were assessed in 36 persons with PD (n = 14 with on–off phenomena, n = 22 without on–off phenomena). All those with on–off phenomena were assessed in their on state. Those persons with PD with on–off phenomena had significantly higher levels of anxiety than those without on–off phenomena. However, both groups, regardless of on–off status, were mildly depressed. Neurobiological interpretations of the results implicate the locus coeruleus in the pathogenesis of both on–off phenomena and anxiety, whereas psychological interpretations of the results involve the issues of learned helplessness and control over health symptoms in PD.