Preliminary development and validation of a new endof-life patient-reported outcome measure assessing the ability of patients to finalise their affairs at the end of life

Introduction:The ability of patients to finalise their affairs at the end of life is an often neglected aspect of quality of life (QOL) measurement in palliative care effectiveness research despite compelling evidence of the high value patients place on this domain. Objective: This paper describes the preliminary development and evaluation of a new, single-item, end-of-life patientreported outcome measure (EOLPRO) designed to capture changes in the ability of patients to finalise their affairs at the end of life. Methods: Cognitive interviews with purposively sampled Australian palliative care patients (N = 9) were analysed thematically to explore content validity. Simultaneously, secondary analysis of data from a randomised controlled trial comparing ketamine and placebo for the management of cancer pain (N = 185) evaluated: construct validity; test-retest reliability; and responsiveness. Results:Preliminary findings suggest patients interpret the new measure consistently. The EOLPRO captures the ability to complete physical tasks and finalise practical matters although it is unclear whether emotional tasks or resolution of relationship issues are considered. Personal and financial affairs should be separated to allow for differences in ability for these two types of affairs. The significant correlation between performance status and EOLPRO scores (r = 0.41, p,<.01, n = 137) and expected relationships between EOLPRO and proximity to death and constipation demonstrated construct validity. Pre-and post-treatment EOLPRO scores moderately agreed (n = 14, k = 0.52 [95% CI 0.19, 0.84]) supporting reliability. The measure's apparent lack of sensitivity to discriminate between treatment responders and non-responders may be confounded. Conclusion:Based on the preliminary findings, the EOLPRO should be separated into 'personal' and 'financial' affairs with further testing suggested, particularly to verify coverage and responsiveness. Initial evaluation suggests that the single-item EOLPRO is a useful addition to QOL outcome measurement in palliative care effectiveness research because common palliative care specific QOL questionnaires do not include or explicitly capture this domain. © 2014 McCaffrey et al

Hippocampal-dependent appetitive control is impaired by experimental exposure to a Western-style diet

Animals fed a Western-style diet (WS-diet) demonstrate rapid impairments in hippocampal function and poorer appetitive control. We examined if this also occurs in humans. One-hundred and ten healthy lean adults were randomised to either a 1-week WS-diet intervention or a habitual-diet control group. Measures of hippocampal dependent learning and memory (HDLM) and of appetitive control were obtained pre- and post-intervention. HDLM was retested at 3-weeks follow-up. Relative to controls, HDLM performance declined in the WS-diet group (d=0.43), but was not different at follow-up. Appetitive control also declined in the WS-diet group (d=0.47) and this was strongly correlated with HDLM decline (d=1.01). These findings demonstrate that a WS-diet can rapidly impair appetitive control in humans - an effect that could promote overeating in consumers of a WS-diet. The study also suggests a functional role for the hippocampus in appetitive control and provides new evidence for the adverse neurocognitive effects of a WS-diet

A high-fat high-sugar diet predicts poorer hippocampal-related memory and a reduced ability to suppress wanting under satiety

Animal data indicate that greater intake of fats and sugars prevalent in a Western diet impairs hippocampal memory and tests of behavioral inhibition known to be related to hippocampal function (e.g., feature negative discrimination tasks). It has been argued that such high fat high sugar diets (HFS) impair the hippocampus, which then becomes less sensitive to modulation by physiological state. Thus retrieval of motivationally salient memories (e.g., when seeing or smelling food) occurs irrespective of state. Here we examine whether evidence of similar effects can be observed in humans using a correlational design. Healthy human participants (N = 94), who varied in their habitual consumption of a HFS diet, completed the verbal paired associate (VPA) test, a known hippocampal-dependent process, as well as liking and wanting ratings of palatable snack foods, assessed both hungry and sated. Greater intake of a HFS diet was significantly associated with a slower VPA learning rate, as predicted. Importantly, for those who regularly consumed a HFS diet, while reductions in liking and wanting occurred between hungry and sated states, the reduction in wanting was far smaller relative to liking. The latter effect was strongly related to VPA learning rate, suggestive of hippocampal mediation. In agreement with the animal literature, human subjects with a greater intake of a HFS diet show deficits in hippocampal-dependent learning and memory, and their desire to consume palatable food is less affected by physiological state – a process we suggest that is also hippocampal related

Chemosensory abilities in consumers of a western-style diet

People vary in their habitual diet and also in their chemosensory abilities. In this study we examined whether consumption of a Western-style diet, rich in saturated fat and added sugar, is associated with either poorer or different patterns of chemosensory perception, relative to people who consume a healthier diet. Participants were selected based on a food frequency questionnaire, which established whether they were likely to consume a diet either higher or lower in saturated fat and added sugar. Eighty-seven participants were tested for olfactory ability (threshold, discrimination, identification), gustatory ability (PROP sensitivity, taste intensity, quality and hedonics), and flavour processing (using dairy fat-sugar-odour mixtures). A Western-style diet was associated with poorer odour identification ability, greater PROP sensitivity, poorer fat discrimination, different patterns of sweetness taste enhancement, and hedonic differences in taste and flavour perception. No differences were evident for odour discrimination or threshold, in perception of taste intensity/quality (excluding PROP) or the ability of fats to affect flavour perception. The significant relationships were of small to moderate effect size, and would be expected to work against consuming a healthier diet. The discussion focuses on whether these diet-related differences precede adoption of a Western-style diet and/or are a consequence of it

Disgust sensitivity is not associated with health in a rural Bangladeshi sample.

Disgust can be considered a psychological arm of the immune system that acts to prevent exposure to infectious agents. High disgust sensitivity is associated with greater behavioral avoidance of disease vectors and thus may reduce infection risk. A cross-sectional survey in rural Bangladesh provided no strong support for this hypothesis. In many species, the expression of pathogen- and predator-avoidance mechanisms is contingent on early life exposure to predators and pathogens. Using childhood health data collected in the 1990s, we examined if adults with more infectious diseases in childhood showed greater adult disgust sensitivity: no support for this association was found. Explanations for these null finding and possible directions for future research are discussed

Metal Accumulation and Metallothionein Response in Fucus spiralis

Abstract -Seaweeds are established sentinels for metal contamination and are utilised for biomonitoring. Metallothionein (MT) is a protein that is induced by metal exposure, and has been widely used as a biomarker for metal pollution. MT has not been reported in spiral wrack (Fucus spiralis), but has been identified in bladder wrack (Fucus vesiculosus), where it has been suggested as a protective mechanism against metal exposure. This study aimed to evaluate the potential use of MT in F. spiralis as a biomarker for metal pollution for the first time. Samples were collected from Poole Harbour, UK, over a year-long period, from January to October 2015. MT and metal concentrations were quantified during winter, spring, summer, and autumn seasons. Linear regression analysis showed few relationships between MT and metal concentrations, apart from in summer. During summer, significant positive relationships existed between MT concentrations and iron (R 2 = 0.631), nickel (R 2 = 0.486), tin (R 2 = 0.579), and lead (R 2 = 0.415). It is possible that for most of the year, metal concentrations in Poole Harbour are not high enough to elicit a MT response in F. spiralis, as it is a metal tolerant species. However, during summer, rates of photosynthesis and growth increase, which may increase metal toxicity, due to the inhibition of photosynthesis and growth. Thus, MT may be induced in order to prevent disruption. This study suggests that the use of MT as a biomarker for metal pollution in F. spiralis may not be a sensitive biomarker at low levels of metal pollution. However, MT concentrations in F. spiralis may respond to metal exposure when natural processes are vulnerable to pollution. The potential for MT to be used as a biomarker in Fucus spp. has been highlighted, warranting further research to develop a promising cosmopolitan bioindicator for metal pollution

Chronic inhibition, self-control and eating behavior: test of a 'resource depletion' model

The current research tested the hypothesis that individuals engaged in long-term efforts to limit food intake (e.g., individuals with high eating restraint) would have reduced capacity to regulate eating when self-control resources are limited. In the current research, body mass index (BMI) was used as a proxy for eating restraint based on the assumption that individuals with high BMI would have elevated levels of chronic eating restraint. A preliminary study (Study 1) aimed to provide evidence for the assumed relationship between eating restraint and BMI. Participants (N = 72) categorized into high or normal-range BMI groups completed the eating restraint scale. Consistent with the hypothesis, results revealed significantly higher scores on the weight fluctuation and concern for dieting subscales of the restraint scale among participants in the high BMI group compared to the normal-range BMI group. The main study (Study 2) aimed to test the hypothesized interactive effect of BMI and diminished self-control resources on eating behavior. Participants (N = 83) classified as having high or normal-range BMI were randomly allocated to receive a challenging counting task that depleted self-control resources (ego-depletion condition) or a non-depleting control task (no depletion condition). Participants then engaged in a second task in which required tasting and rating tempting cookies and candies. Amount of food consumed during the taste-and-rate task constituted the behavioral dependent measure. Regression analyses revealed a significant interaction effect of these variables on amount of food eaten in the taste-and-rate task. Individuals with high BMI had reduced capacity to regulate eating under conditions of self-control resource depletion as predicted. The interactive effects of BMI and self-control resource depletion on eating behavior were independent of trait self-control. Results extend knowledge of the role of self-control in regulating eating behavior and provide support for a limited-resource model of self-control. © 2013 Hagger et al

Why are we not flooded by involuntary thoughts about the past and future? Testing the cognitive inhibition dependency hypothesis

© The Author(s) 2018In everyday life, involuntary thoughts about future plans and events occur as often as involuntary thoughts about the past. However, compared to involuntary autobiographical memories (IAMs), such episodic involuntary future thoughts (IFTs) have become a focus of study only recently. The aim of the present investigation was to examine why we are not constantly flooded by IFTs and IAMs given that they are often triggered by incidental cues while performing undemanding activities. One possibility is that activated thoughts are suppressed by the inhibitory control mechanism, and therefore depleting inhibitory control should enhance the frequency of both IFTs and IAMs. We report an experiment with a between-subjects design, in which participants in the depleted inhibition condition performed a 60-min high-conflict Stroop task before completing a laboratory vigilance task measuring the frequency of IFTs and IAMs. Participants in the intact inhibition condition performed a version of the Stroop task that did not deplete inhibitory control. To control for physical and mental fatigue resulting from performing the 60-min Stroop tasks in experimental conditions, participants in the control condition completed only the vigilance task. Contrary to predictions, the number of IFTs and IAMs reported during the vigilance task, using the probe-caught method, did not differ across conditions. However, manipulation checks showed that participants’ inhibitory resources were reduced in the depleted inhibition condition, and participants were more tired in the experimental than in the control conditions. These initial findings suggest that neither inhibitory control nor physical and mental fatigue affect the frequency of IFTs and IAMs.Peer reviewedFinal Published versio

Age shall not weary us: Deleterious effects of self-regulation depletion are specific to younger adults

Self-regulation depletion (SRD), or ego-depletion, refers to decrements in self-regulation performance immediately following a different self-regulation-demanding activity. There are now over a hundred studies reporting SRD across a broad range of tasks and conditions. However, most studies have used young student samples. Because prefrontal brain regions thought to subserve self-regulation do not fully mature until 25 years of age, it is possible that SRD effects are confined to younger populations and are attenuated or disappear in older samples. We investigated this using the Stroop color task as an SRD induction and an autobiographical memory task as the outcome measure. We found that younger participants (<25 years) were susceptible to depletion effects, but found no support for such effects in an older group (40–65 years). This suggests that the widely-reported phenomenon of SRD has important developmental boundary conditions casting doubt on claims that it represents a general feature of human cognition