Haemangioblastomas are uncommon tumours that usually occur in the cerebellum and, less commonly, in the intramedullary spinal cord. The extramedullary spinal canal is an uncommon location for these tumours. Also haemangioblastoma at this site is not known to be associated with polycythemia. We present the clinical, imaging, and histological findings of an adult patient with extramedullary spinal haemangioblastoma and reactive polycythemia. Radiography and computed tomography (CT) revealed a medium-sized tumour that most likely arose from an extramedullary spinal nerve root. This tumour appeared to be slow growing as evidenced by the accompanying well-defined bony resorption with a sclerotic rim and mild neural foraminal widening. Magnetic resonance imaging revealed prominent flow voids consistent with tumoural hypervascularity. CT-guided biopsy was performed. Although preoperative angiographic embolisation was technically successful, excessive intraoperative tumour bleeding necessitated tumour debulking rather than complete tumour resection. Histology of the resected specimen revealed haemangioblastoma. Seven months postoperatively, the patients back pain and polycythemia have resolved.
The factors that underlie pelvic pain are poorly understood. Specifically, the relative influence of dysmenorrhea and psychological factors in the etiology of noncyclic pelvic pain conditions, such as interstitial cystitis and irritable bowel syndrome, is unknown. To further characterize pelvic pain, we compared the frequency of menstrual, somatosensory, and psychological risk factors between women with and without severe noncyclic pelvic pain symptoms.
A total of 1012 reproductive-aged women completed a 112-item questionnaire with domains including mood, fatigue, physical activity, somatic complaint, and pain. Questionnaire items included existing items for menstrual distress and newly written items derived from qualitative interviews. The relationship of dysmenorrhea and noncyclic pelvic pain complaints (dyspareunia, dyschezia, or dysuria) was modeled using quantile regression.
Among women who menstruate regularly, those with dysmenorrhea had disproportionally more severe noncyclic pelvic pain (54/402, 13%) than women without dysmenorrhea (5/432, 1%; odds ratio, 13; 95% confidence interval, 5–33). In a multivariate-adjusted model, dysmenorrhea (β = .17), activity capability (β = .17), somatic complaint (β = .17), and bodily pain (β = .12) were the primary predictors of noncyclic pelvic pain. Depression (β = .03) and anxiety (β = .01) were not significantly predictive. The presence of dysmenorrhea, somatic complaint, and low activity capability predicted 90% of the cases of women with noncyclic pelvic pain.
The association between dysmenorrhea and noncyclic pelvic pain suggests that menstrual pain is an etiological factor in noncyclic pelvic pain, whereas depression and anxiety may be secondary effects. Longitudinal studies are needed to determine whether dysmenorrhea causally influences development of noncyclic pelvic pain or shares common underlying neural mechanisms.
dysmenorrhea; interstitial cystitis; irritable bowel syndrome; pelvic pain
Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs) for epileptic seizures (ES) is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs) with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder.
Epilepsy; Psychogenic nonepileptic paroxysmal episodes; Pseudoseizures; Factitious disorder; Video-EEG
The biological clock affects aging through ras-1 (bd) and lag-1, and these two longevity genes together affect a clock phenotype and the clock oscillator in Neurospora crassa. Using an automated cell-counting technique for measuring conidial longevity, we show that the clock-associated genes lag-1 and ras-1 (bd) are true chronological longevity genes. For example, wild type (WT) has an estimated median life span of 24 days, while the double mutant lag-1, ras-1 (bd) has an estimated median life span of 120 days for macroconidia. We establish the biochemical function of lag-1 by complementing LAG1 and LAC1 in Saccharomyces cerevisiae with lag-1 in N. crassa. Longevity genes can affect the clock as well in that, the double mutant lag-1, ras-1 (bd) can stop the circadian rhythm in asexual reproduction (i.e., banding in race tubes) and lengthen the period of the frequency oscillator to 41 h. In contrast to the ras-1 (bd), lag-1 effects on chronological longevity, we find that this double mutant undergoes replicative senescence (i.e., the loss of replication function with time), unlike WT or the single mutants, lag-1 and ras-1 (bd). These results support the hypothesis that sphingolipid metabolism links aging and the biological clock through a common stress response
Aging; bd; biological clock; lag-1; Neurospora crassa; ras-1
This report aims to study the age related T1rho and T2 relaxation time changes in lumbar intervertebral disc. Lumbar sagittal magnetic resonance imaging (MRI) was performed with a 3 Tesla scanner in 52 subjects. With a spin-lock frequency of 500 Hz, T1rho was measured using a rotary echo spin-lock pulse embedded in a 3D balanced fast field echo sequence. A multi-echo turbo spin echo sequence was used for T2 mapping. Regions-of-interest were drawn over the T1rho and T2 maps, including nucleus pulposus and annulus fibrosus. For L1/2-L4/5 discs, results showed the age associated reduction of T1rho of nucleus pulposus had a of slope of –1.06, the reduction of T2 of nucleus pulposus had a slope of –1.47, the reduction of T1rho of annulus fibrosus had a slope of –0.25, and the reduction of T2 of annulus fibrosus had a slope of –0.18, with all the slopes significantly non-zero. In nucleus pulposus the slope of T2 was slightly steeper than that of T1rho (P=0.085), while in annulus fibrosus the slope of T1rho was slightly steeper than that of T2 (P=0.31). We conclude that significant age related reduction of T1rho and T2 magnetic resonance relaxation times of lumbar intervertebral disc was observed, however, the relative performances of T1rho vs. T2 were broadly similar.
Magnetic resonance imaging (MRI); disc; degeneration; T1rho; T2; nucleus pulposus; annulus fibrosus; relaxation time
The “Multidisciplinary Approach to the Study of Chronic Pelvic Pain” (MAPP) Research Network was established by the NIDDK to better understand the pathophysiology of urologic chronic pelvic pain syndromes (UCPPS), to inform future clinical trials and improve clinical care. The evolution, organization, and scientific scope of the MAPP Research Network, and the unique approach of the network’s central study and common data elements are described.
The primary scientific protocol for the Trans-MAPP Epidemiology/Phenotyping (EP) Study comprises a multi-site, longitudinal observational study, including bi-weekly internet-based symptom assessments, following a comprehensive in-clinic deep-phenotyping array of urological symptoms, non-urological symptoms and psychosocial factors to evaluate men and women with UCPPS. Healthy controls, matched on sex and age, as well as “positive” controls meeting the non-urologic associated syndromes (NUAS) criteria for one or more of the target conditions of Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS) or Irritable Bowel Syndrome (IBS), were also evaluated. Additional, complementary studies addressing diverse hypotheses are integrated into the Trans-MAPP EP Study to provide a systemic characterization of study participants, including biomarker discovery studies of infectious agents, quantitative sensory testing, and structural and resting state neuroimaging and functional neurobiology studies. A highly novel effort to develop and assess clinically relevant animal models of UCPPS was also undertaken to allow improved translation between clinical and mechanistic studies. Recruitment into the central study occurred at six Discovery Sites in the United States, resulting in a total of 1,039 enrolled participants, exceeding the original targets. The biospecimen collection rate at baseline visits reached nearly 100%, and 279 participants underwent common neuroimaging through a standardized protocol. An extended follow-up study for 161 of the UCPPS participants is ongoing.
The MAPP Research Network represents a novel, comprehensive approach to the study of UCPPS, as well as other concomitant NUAS. Findings are expected to provide significant advances in understanding UCPPS pathophysiology that will ultimately inform future clinical trials and lead to improvements in patient care. Furthermore, the structure and methodologies developed by the MAPP Network provide the foundation upon which future studies of other urologic or non-urologic disorders can be based.
ClinicalTrials.gov identifier: NCT01098279 “Chronic Pelvic Pain Study of Individuals with Diagnoses or Symptoms of Interstitial Cystitis and/or Chronic Prostatitis (MAPP-EP)”. http://clinicaltrials.gov/show/NCT01098279
Urologic chronic pelvic pain syndromes; Interstitial cystitis; Chronic prostatitis; Urine biomarkers; Plasma biomarkers; Non-urologic associated syndromes; Quantitative sensory testing (QST); Neuroimaging
A novel delivery method is described that incorporates taste stimuli into edible strips for determining n-propylthiouracil (PROP) taster status. Edible strips that contained 400 or 600nanomoles of PROP were prepared for psychophysical studies. Using these strips, we measured taste intensity, taste hedonics, and taste quality responses in a sample of healthy volunteers (n = 118). Participants were also asked to assess a single NaCl strip, a quinine strip, 3 NaCl solutions, and 3 PROP solutions. All psychophysical data were subsequently analyzed as a function of TAS2R38 genotype. The use of PROP strips for distinguishing between individuals with at least 1 PAV allele and individuals with other genotypes was assessed and compared with the use of PROP solutions for making this same distinction. For the 2 PROP strips and PROP solutions, individuals who expressed at least 1 PAV allele could perceive the bitter taste of PROP. Individuals who expressed 2 AVI alleles responded similarly to 400nanomole PROP strips and blank strips. Furthermore, individuals with 2 AVI alleles responded to 0.032 and 0.32mM PROP solutions at intensities that were similar to water, though intensity ratings to 3.2mM PROP solution exceeded water. In general, those with at least 1 PAV allele rated the bitter taste of PROP as unpleasant in both delivery methods (strips or solutions). Psychophysical data from PROP strips and solutions were consistent with TAS2R38 genotype. These results support the validity of edible taste strips as a method for assessing PROP taste perception in humans.
bitter taste; gustation; NIH Toolbox; PROP; taste blindness; taste strip; taste test
Mr. OS (Hong Kong) and Ms. OS (Hong Kong) represent the first large scale prospective population based studies conducted on bone health in elderly (≥65 yrs) Chinese men (n=2000) and women (n=2000). The current study investigated the prevalence of lumbar disc space narrowing (DSN) in these subjects, and identified the potential relationship between DSN and gender, bone mineral density (BMD), and other demographic and clinical data.
On lumbar lateral radiographs, L1/L2-L4/L5 disc space was classified to 4 categories: 0= normal; 1= mild narrowing; 2= moderate narrowing; 3= severe narrowing. Demographic and clinical data between subjects with and without sum of DSN score ≥ 3 were compared.
DSN was more common in elderly women than in men. The average DSN score for the four discs was 2.71±2.21 for men, and 3.08±2.50 for women (P<0.0001). For the three age groups of 65~69, 70~79, ≥80 (yrs), average DSN score increased with increasing age in both men and women, and to a greater degree in women than men. Average DSN score difference between women and men was 0.12, 0.40, and 0.90 respectively in the three age groups. For both men and women, DSN ≥ 3 was associated with older age, higher spine and hip BMD, low back pain, and restricted leg mobility.
Prevalence and severity of DSN is higher in elderly women than elderly men. With increasing age, DSN progresses at a greater rate in females than males. DSN ≥ 3 is associated with higher spine and hip BMD.
lumbar; disc; gender; elderly; bone mineral density
The NIH Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox) is a set of brief measures for the assessment of cognitive function, emotional health, motor function, and sensory function for use in clinical trials and in epidemiologic and longitudinal studies. Gustatory perception is assessed as 1 of 6 areas of sensory function. A team of 11 scientists with expertise in taste perception selected 2 gustatory measures, 1 of which can be used in young pediatric populations. The measure selected for young pediatric populations assesses sucrose (sweet) taste preference and can also be used across the age span of 5 to 85 years. For adult populations, the selected measure is a regional test, which assesses variability in perceived intensity of quinine hydrochloride (bitter) when applied to the tongue tip as well as perceived with the whole mouth. The team also recommends the regional test for assessing other tastants, such as sodium chloride (salty). Validation studies have demonstrated that the measures modified for the NIH Toolbox correlate with more traditional assessments, and can identify known population differences in gustation.
One of the goals of the NIH Toolbox for Assessment of Neurological and Behavioral Function was to identify or develop brief measures of emotion for use in prospective epidemiologic and clinical research. Emotional health has significant links to physical health and exerts a powerful effect on perceptions of life quality. Based on an extensive literature review and expert input, the Emotion team identified 4 central subdomains: Negative Affect, Psychological Well-Being, Stress and Self-Efficacy, and Social Relationships. A subsequent psychometric review identified several existing self-report and proxy measures of these subdomains with measurement characteristics that met the NIH Toolbox criteria. In cases where adequate measures did not exist, robust item banks were developed to assess concepts of interest. A population-weighted sample was recruited by an online survey panel to provide initial item calibration and measure validation data. Participants aged 8 to 85 years completed self-report measures whereas parents/guardians responded for children aged 3 to 12 years. Data were analyzed using a combination of classic test theory and item response theory methods, yielding efficient measures of emotional health concepts. An overview of the development of the NIH Toolbox Emotion battery is presented along with preliminary results. Norming activities led to further refinement of the battery, thus enhancing the robustness of emotional health measurement for researchers using the NIH Toolbox.
Pain is an important component of health and function, and chronic pain can be a problem in its own right. The purpose of this report is to review the considerations surrounding pain measurement in the NIH Toolbox, as well as to describe the measurement tools that were adopted for inclusion in the NIH Toolbox assessment battery.
Instruments to measure pain in the NIH Toolbox were selected on the basis of scholarly input from a diverse group of experts, as well as review of existing instruments, which include verbal rating scales, numerical rating scales, and graphical scales.
Brief self-report measures of pain intensity and pain interference were selected for inclusion in the core NIH Toolbox for use with adults. A 0 to 10 numerical rating scale was recommended for measuring pain intensity, and a 6-item Patient Reported Outcome Measurement Information System (PROMIS) short form for measuring pain interference. The 8-item PROMIS Pediatric Pain Interference measure was recommended as a supplemental measure. No specific measure was recommended for measuring pain intensity in children.
Core and supplemental measures were recommended for the NIH Toolbox. Additional measures were reviewed for investigators who seek tools for measuring pain intensity in pediatric samples.
Touch sensation is one element of sensory function. As such, somatosensation is one of the sensory domains included in the NIH Toolbox, which is an assessment battery for measuring a range of human functions including emotional health, sensation, cognition, and motor function. We evaluated a variety of methods for inclusion in the NIH Toolbox main battery. In a convenience sample of 409 participants, we evaluated aspects of kinesthesia, pain, and tactile discrimination. We present results on these measures across the lifespan and discuss implications for future studies that use the NIH Toolbox and these measures.
The NIH Toolbox project has assembled measurement tools to assess a wide range of human perception and ability across the lifespan. As part of this initiative, a small but comprehensive battery of auditory tests has been assembled. The main tool of this battery, pure-tone thresholds, measures the ability of people to hear at specific frequencies. Pure-tone thresholds have long been considered the “gold standard” of auditory testing, and are normally obtained in a clinical setting by highly trained audiologists. For the purposes of the Toolbox project, an automated procedure (NIH Toolbox Threshold Hearing Test) was developed that allows nonspecialists to administer the test reliably. Three supplemental auditory tests are also included in the Toolbox auditory test battery: assessment of middle-ear function (tympanometry), speech perception in noise (the NIH Toolbox Words-in-Noise Test), and self-assessment of hearing impairment (the NIH Toolbox Hearing Handicap Inventory Ages 18–64 and the NIH Toolbox Hearing Handicap Inventory Ages 64+). Tympanometry can help differentiate conductive from sensorineural pathology. The NIH Toolbox Words-in-Noise Test measures a listener's ability to perceive words in noisy situations. This ability is not necessarily predicted by a person's pure-tone thresholds; some people with normal hearing have difficulty extracting meaning from speech sounds heard in a noisy context. The NIH Toolbox Hearing Handicap Inventory focuses on how a person's perceived hearing status affects daily life. The test was constructed to include emotional and social/situational subscales, with specific questions about how hearing impairment may affect one's emotional state or limit participation in specific activities. The 4 auditory tests included in the Toolbox auditory test battery cover a range of auditory abilities and provide a snapshot of a participant's auditory capacity.
Clinical researchers make use of experimental models for mental disorders. In many cases, these models use stimuli that are relevant to the disorder under scrutiny, which allows one to experimentally investigate the factors that contribute to the development of the disorder. For example, one might use spiders or spider-like stimuli in the study of specific phobia. More broadly, researchers often make use of real-world stimuli such as images of animals, geometrical shapes or emotional words. However, these stimuli are often limited in their experimental controllability and their applicability to the disorder in question. We present a novel set of animal-like stimuli, called Fribbles, for use within behavioural research. Fribbles have desirable properties for use in research because they are similar to real-world stimuli, but due to their novelty, participants will not have had previous experience with them. They also have known properties that can be experimentally manipulated. We present an investigation into similarity between Fribbles in order to illustrate their utility in research that relies on comparisons between similar stimuli. Fribbles offer both experimental control and generalisability to the real world, although some consideration must be made concerning the properties that influence similarity between Fribbles when selecting them along a dimension of similarity.
attention; memory; anxiety; phobia; generalization; behaviour; avoidance; stimuli
Though there is a considerable amount of research supporting the association between stressful life events and major depression, there is a paucity of research concerning a range of other life stress constructs, non-depressive disorders, the role of stable personality traits, and gender differences. This study addresses these deficits by: (a) focusing on the association between interpersonal and non-interpersonal chronic life stress (CLS) and both depressive and anxiety disorders, (b) examining the roles of neuroticism and low extraversion in these associations, and (c) assessing gender differences. Participants were 603 adolescents from a study examining risk factors for emotional disorders. Depression and social phobia were associated with interpersonal CLS, with neuroticism partially accounting for these associations. Low extraversion partially accounted for the association between social phobia and interpersonal CLS. Depression was also associated with non-interpersonal CLS, but only in females. This study provides preliminary evidence for the importance of personality variables in explaining shared associations between stress and depression. Additionally, the stress-social phobia relationship is highlighted, with no evidence supporting an association between other anxiety disorders and CLS.
anxiety; depression; chronic life stress; extraversion; neuroticism; adolescents
This study investigated the effects of nitrate on bone mineral density (BMD) and bone marrow perfusion in ovariectomized (OVX) female rats, and also the effects of nitrate on in vitro osteoblastic activity and osteoclastic differentiation of murine monocyte/macrophage RAW 264.7 cells. Female Sprague–Dawley rats were divided into OVX + nitrate group (isosorbide-5-mononitrate, ISM, 150 mg/kg/ day b.i.d), OVX + vehicle group, and control group. Lumbar spine CT bone densitometry and perfusion MRI were performed on the rats at baseline and week 8 post-OVX. The OVX rats’ BMD decreased by 22.5% ± 5.7% at week 8 (p < 0.001); while the OVX + ISM rats’ BMD decreased by 13.1% ± 2.7% (p < 0.001). The BMD loss difference between the two groups of rats was significant (p = 0.018). The OVX rats’ lumbar vertebral perfusion MRI maximum enhancement (Emax) decreased by 10.3% ± 5.0% at week 8 (p < 0.005), while in OVX + ISM rats, the Emax increased by 5.5% ± 6.9% (p > 0.05). The proliferation of osteoblast-like UMR-106 cells increased significantly with ISM treatment at 0.78 µM to 50 μM. Treatment of UMR-106 cells with ISM also stimulated the BrdU uptake. After the RAW 264.7 cells were co-treated with osteoclastogenesis inducer RANKL and 6.25 μM ~ 100 μM of ISM for 3 days, a trend of dose-dependent increase of osteoclast number was noted.
nitrates; osteoporosis; DCE MRI; bone mineral density; osteoblast; osteoclast
T1rho relaxation measurement has the potential to identify early biochemical changes in the intervertebral disc. Traditionally, multiple spin-lock times (SLT), often ~5 SLTs, are used to ensure the accuracy and robustness of T1rho mapping. It will be advantageous to use fewer SLT points if comparable accuracy of T1rho mapping can be achieved. In this study, the feasibility of using 3 SLT points to measure intervertebral disc T1rho relaxation time is explored.
Materials and methods
The lumbar spine of 12 subjects (age range: 30-75 years, disc =60) were studied on 3-T MRI. For T1rho measurement, a rotary echo spin-lock pulse was implemented in a 3D balanced fast field echo (b-FFE) sequence. Spin-lock frequency was set as 500 Hz and the SLTs of 1, 10, 20, 40, and 60 ms were acquired. T1rho maps were generated by fitting each pixel’s intensity as a function of SLT using a non-negative least-square fitting algorithm. Images were analysed in the mid-sagittal section. T1rho maps were re-constructed using all 5 SLT points of 1, 10, 20, 40, and 60 ms, and three SLT points of 1, 20, and 60 ms respectively. ROIs included nucleus pulposus (NP), anterior annulus fibrosus (AF) and posterior annulus fibrosus. Values of anterior AF and posterior AF were averaged as the value for AF. Agreement of T1rho measurements using different SLT points was assessed using intra-class correlation coefficient (ICC) on absolute agreement as well as Bland and Altman plot.
There was no significant difference for T1rho values by 5-SLT measurement and 3-SLT measurement in both NP (P=0.63) and AF (P=0.31). The ICC for 5-SLT T1rho measurement vs. 3-SLT T1rho measurement was 0.991 and 0.981 respectively for NP and AF T1rho time. The Bland and Altman plots for the comparison showed a mean difference of 3.14 and 1.83 for NP and AF respectively. Polling the T1rho values for NP and AF in 60 discs together, the ICC for 5-SLT T1rho measurement vs. 3-SLT T1rho measurement was 0.993, and the Bland and Altman analysis showed a mean difference of 2.56.
This study suggests that adopting 3 SLTs of 1, 20, and 60 ms can be an acceptable alternative for the disc T1rho measurement.
Magnetic resonance imaging; disc; T1rho; spin-lock time
This study investigated whether overgeneral autobiographical memory (OGM) predicts the course of depression in adolescents. As part of a larger longitudinal study of risk for emotional disorders, 55 adolescents with a past history of major depressive disorder or minor depressive disorder completed the Autobiographical Memory Test. Fewer specific memories predicted the subsequent onset of a major depressive episode (MDE) over a 16-month follow-up period, even when covarying baseline depressive symptoms. This main effect was qualified by an interaction between specific memories and chronic interpersonal stress: Fewer specific memories predicted greater risk of MDE onset over follow-up at high (but not low) levels of chronic interpersonal stress. Thus, our findings suggest that OGM, in interaction with chronic interpersonal stress, predicts the course of depression among adolescents, and highlight the importance of measuring interpersonal stress in OGM research.
Autobiographical memory; Memory specificity; Depression; Stress
Although considerable evidence shows that affective symptoms and personality traits demonstrate moderate to high relative stabilities during adolescence and early adulthood, there has been little work done to examine differential stability among these constructs or to study the manner in which the stability of these constructs is expressed. The present study used a three-year longitudinal design in an adolescent/young adult sample to examine the stability of depression symptoms, social phobia symptoms, specific phobia symptoms, neuroticism, and extraversion. When considering one-, two-, and three-year durations, anxiety and personality stabilities were generally similar and typically greater than the stability of depression. Comparison of various representations of a latent variable trait-state-occasion (TSO) model revealed that whereas the full TSO model was the best representation for depression, a trait stability model was the most parsimonious of the best-fitting models for the anxiety and personality constructs. Over three years, the percentages of variance explained by the trait component for the anxiety and personality constructs (73– 84%) were significantly greater than that explained by the trait component for depression (46%). These findings indicate that symptoms of depression are more episodic in nature, whereas symptoms of anxiety are more similar to personality variables in their expression of stability.
anxiety; depression; personality; stability; longitudinal
Gustation; taste test; PROP; taste blindness; bitter taste
Lack of methodology to assess taste in children limits its measurement in research studies that include pediatric populations. We used the Monell 2-series, forced-choice tracking method to measure sucrose preferences of a racially/ethnically diverse sample (n = 949) of children, adolescents, and adults. Reliability was assessed by comparing the results of the first series with the second series. Validity was assessed by relating participants’ sucrose preferences to their preferences for foods varying in sweetness. The task required, on average, 7 presentations of aqueous sucrose solution pairs. Children and adolescents preferred more concentrated sweetness than adults (P < 0.001). Black children/adolescents preferred a more concentrated sucrose solution than did White children/adolescents even when gender, parental education level, and family income were used as covariates. Data from a single series were sufficient to detect age-related differences but insufficient to detect racial/ethnic differences in sweet preferences. Level of sweetness preferred significantly correlated with the sugar content of favorite cereals (P < 0.001) and beverages (P < 0.02). This method is brief and has evidence of reliability and external validity. Although a single series will yield useful information about age-related differences in taste preferences, the 2-series version should be considered when differences in race/ethnicity are of interest.
ethnicity; food preference; methodology; race; sugars; table salt
The importance of health literacy has grown considerably among researchers, clinicians, patients and policymakers. Better instruments and measurement strategies are needed. Our objective was to develop a new health literacy instrument using novel health information technology and modern psychometrics. We designed Health LiTT as a self-administered multimedia touchscreen test based on item response theory (IRT) principles. We enrolled a diverse group of 619 English-speaking primary care patients in clinics for underserved patients. We tested three item types (prose, document, quantitative) that worked well together to reliably measure a single dimension of health literacy. The Health LiTT score meets psychometric standards (reliability of 0.90 or higher) for measurement of individual respondents in the low to middle range. Mean Health LiTT scores were associated with age, race/ethnicity, education, income and prior computer use (p<0.05). We created an IRT-calibrated item bank of 82 items. Standard setting needs to be performed to classify and map items onto the construct and to identify measurement gaps. We are incorporating Health LiTT into an existing online research management tool. This will enable administration of Health LiTT on the same touchscreen used for other patient-reported outcomes, as well as real-time scoring and reporting of health literacy scores.
► We examined the effects of mindfulness on the relation between neuroticism and depression. ► Neuroticism predicts current depressive symptoms even when assessed six years apart. ► Dispositional mindfulness moderates this relationship. ► High levels of dispositional mindfulness protect against negative effects of neuroticism.
Negative emotional reactivity as measured by neuroticism has been shown to be an important risk factor for the development of depressive symptoms. This study investigated whether the ability to be mindful can protect against the negative effects of this temperamental vulnerability. An English community sample of N = 144 individuals who had completed a neuroticism questionnaire six years previously were assessed for current depressive symptoms and dispositional levels of mindfulness at points of assessment approximately one year apart. Dispositional mindfulness moderated the relation between neuroticism and current depressive symptoms: Neuroticism was significantly related to depression in those with low to medium levels of dispositional mindfulness but not in those with relatively high levels of mindfulness. Further analyzes focusing on particular mindfulness skills indicated that this effect was carried mostly by the ability to describe inner experience. The results suggest that dispositional mindfulness and particularly the ability to describe inner experience are helpful in dealing with negative emotional reactivity in a way that reduces the likelihood of depressive symptoms to develop.
Mindfulness; Neuroticism; Depression; Moderator; Cognitive reactivity
The anterior cruciate ligament (ACL) is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament. However, the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament. This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL, particularly magnetic resonance imaging.
Magnetic resonance; Knee; Anterior cruciate ligament; Tear
A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.
Anxiety Sensitivity; anxiety; depression; hierarchical model