Women's Preferences for Treatment of Perinatal Depression and Anxiety : A Discrete Choice Experiment

Perinatal depression and anxiety (PNDA) are an international healthcare priority, associated with significant short- and long-term problems for women, their children and families. Effective treatment is available but uptake is suboptimal: some women go untreated whilst others choose treatments without strong evidence of efficacy. Better understanding of women's preferences for treatment is needed to facilitate uptake of effective treatment. To address this issue, a discrete choice experiment (DCE) was administered to 217 pregnant or postnatal women in Australia, who were recruited through an online research company and had similar sociodemographic characteristics to Australian data for perinatal women. The DCE investigated preferences regarding cost, treatment type, availability of childcare, modality and efficacy. Data were analysed using logit-based models accounting for preference and scale heterogeneity. Predicted probability analysis was used to explore relative attribute importance and policy change scenarios, including how these differed by women's sociodemographic characteristics. Cost and treatment type had the greatest impact on choice, such that a policy of subsidising effective treatments was predicted to double their uptake compared with the base case. There were differences in predicted uptake associated with certain sociodemographic characteristics: for example, women with higher educational attainment were more likely to choose effective treatment. The findings suggest policy directions for decision makers whose goal is to reduce the burden of PNDA on women, their children and families

Review of George Eliot\u27s Selected Essays, Poems and Other Writings

In 1963 Thomas Pinney published his edition of The Essays of George Eliot, a meticulous, scholarly and conservative selection. It was a major contribution to George Eliot studies, coming as it did in the wake of her rediscovery, more properly re-evaluation, through F.R. Leavis, Joan Bennett, Barbara Hardy, W.J. Harvey and others. Gordon Haight had discovered her for himself in the 1930\u27 s, and devoted the rest of his life to editing her letters, writing her biography, encouraging scholars and critics and initiating the Clarendon edition of her works. Pinney is in the immediate Haight tradition, clear, concise, admirably relevant: his introduction to the Essays is masterly, direct, consummately informed. It is no discredit to him to observe that this Penguin Classics selection does more than he did, for the editors have extended his brief, as will be apparent from the title

Lesions of the anteroventral or anteromedial thalamic nuclei impair working and reference memory in a twelve-arm radial maze

Controversy still surrounds the neural bases of diencephalic amnesia. Recent research in rats suggests that incidental damage to the anterior thalamus (AT) may be responsible for impairments following other experimental procedures such as dorsomedial thalamic (DM) lesions or pyrithiamine-induced thiamine deficiency (PTD). Part One of this study assessed the effects of small radio-frequency lesions, confined to either the anteroventral (AV) or anteromedial (AM) nuclei of the AT, on the performance of naive rats on a 12-arm radial maze procedure (8 arms baited). Both lesions impaired reference memory and working memory over an extended period of testing. Latency measures in the radial maze showed that these impairments were not due to general behavioural deficits. The only difference in te1ms of maze activity was that control rats, but not lesioned rats, took longer to run to the ends of previously baited arms. Concurrent testing in an activity chamber found only that control rats tended to show more marked within-session habituation. Part Two investigated the relative contributions of intramaze and extramaze cues to radial maze performance and showed that for all groups both working memory and reference memory were impaired following the removal of extramaze cues; the removal of the previous intramaze cues further impaired perf01mance relative to the original conditions. In the most restricted cue condition, reference memory pe1formance was reduced to chance whereas working memory performance was impaired yet still considerably better than chance. Given that all groups were affected in a similar fashion by the cue manipulations, it is possible that AT lesions produce a general deficit rather than a specific one (e.g. spatial/working memory). In general, this study showed that minor damage to the AT, comparable to that sustained incidentally following other experimental procedures was sufficient to impair pe1formance in the radial maze, a task known to be sensitive to damage to the hippocampal system. The impairments following AT lesions are likely to be due to disruptions of circuits involving the limbic cortex and hippocampal system

Is the fusiform face area specialized for faces, individuation, or expert individuation?

Several brain imaging studies have identified a region of fusiform gyrus (FG) that responds more strongly to faces than common objects. The precise functional role of this fusiform face area (FFA) is, however, a matter of dispute. We sought to distinguish among three hypotheses concerning FFA function: face specificity, individuation, and expert individuation. According to the face-specificity hypothesis, the FFA is specialized for face processing. Alternatively, the FFA may be specialized for individuating visually similar items within a category (the individuation hypothesis) or for individuating within categories with which a person has expertise (the expert-individuation hypothesis). Our results from two experiments supported the face-specificity hypothesis. Greater FFA activation to faces than Lepidoptera, another homogeneous object class, occurred during both free viewing and individuation, with similar FFA activation to Lepidoptera and common objects (Experiment 1). Furthermore, during individuation of Lepidoptera, 83% of activated FG voxels were outside the face FG region and only 15% of face FG voxels were activated. This pattern of results suggests that distinct areas may individuate faces and Lepidoptera. In Experiment 2, we tested Lepidoptera experts using the same experimental design. Again, the results supported the face-specificity hypothesis. Activation to faces in the FFA was greater than to both Lepidoptera and objects with little overlap between FG areas activated by faces and Lepidoptera. Our results suggest that distinct populations of neurons in human FG may be tuned to the features needed to individuate the members of different object classes, as has been reported in monkey inferotemporal cortex, and that the FFA contains neurons tuned for individuating faces