Exploring the mechanisms underlying conflict adaptation

Human cognition is remarkedly flexible and can inhibit unwanted actions as well as alter behaviours to successfully navigate rapidly changing social environments. Laboratory tasks such as the Stroop test can gauge one’s ability to suppress task-irrelevant information on a given trial. Yet the congruency-sequencing effect (Gratton et al., 1992) reveals that such performance is not constant throughout the task and fluctuates on a trial-by-trial basis. The reduced Stroop effect following an incongruent trial is considered an adaptive behaviour intended to minimise the experience of subsequent conflict and, therefore, is also known as conflict adaptation. Although well documented, the precise mechanisms underpinning conflict adaptation are unknown, although three key accounts emerge: Conflict Monitoring (Botnivick et al., 2001); Repetition Expectancy (Gratton et al., 1992; Egner, 2007), and Feature-Integration (Hommel, 1998; Hommel et al., 2004). The first two are top-down accounts that suggest the dorsolateral prefrontal cortex (DLPFC) is responsible for attentional adjustments to facilitate successful performance. They differ in that the Conflict-Monitoring model is a reactive account that proposes the DLPFC is recruited via conflict detection from the anterior cingulate cortex (ACC) and therefore, upregulation of attentional control towards either the task-relevant or task-irrelevant stimulus is determined by the conflict experienced on the previous trial. Whereas the Repetition Expectancy Model is a proactive account that proposes an anticipatory recruitment of the DLPFC via gated-dopamine release (Braver et al., 2007). Finally, the Feature-Integration account suggests that the task-relevant and task-irrelevant stimulus on each trial form an episodic memory file and it is the complete or partial repetition of one or both the stimulus features that produces the congruency-sequencing effect

Impact of sociodemographic status and UTI symptoms on women's health-seeking and management in England: findings from an e-survey conducted during the first year of the COVID-19 pandemic

Background Multiple factors may influence women’s experiences of urinary tract infection (UTI) and its clinical management. Aim To explore how women’s background, symptoms, and severity of symptoms influence UTI reporting and management. Design & setting Internet questionnaire targeting women in England, focusing on UTI symptoms, care seeking, and management. Method A total of 1096 women aged ≥16 years with UTI symptoms in the previous year completed the questionnaire in March and April 2021. Multivariable logistic regression was ued to estimate the odds of relevant outcomes while adjusting for background characteristics. Results Women with children in their household, who were aged under 45 years, or who were married or cohabitating were more likely to experience UTI symptoms. The odds of antibiotic prescribing were lower if women reported dysuria (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] = 0.49 to 0.85), frequency (AOR = 0.63, 95% CI = 0.48 to 0.83), or vaginal discharge (AOR = 0.69, 95% CI = 0.50 to 0.96), but higher if reporting haematuria (AOR = 2.81, 95% CI = 1.79 to 4.41), confusion (AOR = 2.14, 95% CI = 1.16 to 3.94), abdominal pain (AOR = 1.35, 95% CI = 1.04 to 1.74), or systemic symptoms (AOR = 2.04, 95% CI = 1.56 to 2.69). Those with abdominal pain or two or more of nocturia, dysuria, or cloudy urine had lower odds of receiving a delayed antibiotic, while those with incontinence, confusion, unsteadiness, or low temperature had higher odds of a delayed prescription. Increasing symptom severity was associated with greater odds of receiving antibiotics. Conclusion Except for reduced prescribing if a woman had dysuria and frequency, antibiotic prescribing followed an expected pattern, aligning generally with national guidance. Symptom severity and the likelihood of systemic infection probably influenced care seeking and prescribing. Sexual intercourse and childbirth may be key times to target women with messages about UTI prevention

Impact of menopausal status and recurrent UTIs on symptoms, severity, and daily life: findings from an online survey of women reporting a recent UTI

Introduction: Current UKHSA UTI diagnostic guidance advises empirical antibiotics if two of the following symptoms are present: cloudy urine, dysuria, and new onset nocturia. Hormonal changes during menopause may impact UTI symptoms, and qualitative studies suggest women with recurrent UTIs may present with different UTI symptoms. This study aims to assess whether menopausal status and the presence of recurrent UTIs impact UTI symptoms in women. Methods: An e-survey was conducted between 13 March 2021 and 13 April 2021. Women aged 16 years or older with a history of a UTI in the last year were eligible for inclusion. We defined menopause as those aged 45–64 years; pre-menopause as those less than 45 years; and post-menopause as those 65 years and older. Recurrent UTIs were defined as three or more UTIs in the last year. The data were weighted to be representative of the UK population. Crude unadjusted and adjusted odds ratios were estimated using logistic regression. Results: In total, 1096 women reported a UTI in the last year. There were significant differences in UTI symptoms based on menopausal status and the presence of recurrent UTIs. Post-menopausal women self-reported more incontinence (OR 2.76, 95% CI 1.50,5.09), whereas menopausal women reported more nocturia. Women with recurrent UTIs reported less dysuria, more severe symptoms (OR 1.93 95% CI 1.37,2.73) and a greater impact on daily life (OR 1.68, 95% CI 1.19,2.37). Conclusions: This survey provides evidence that acute UTIs present differently based on menopausal status and in women with recurrent UTIs. It is important that healthcare professionals are aware of these differences when assessing women presenting with an acute UTI and, therefore, further research in this area is needed

Can a 'rewards-for-exercise app' increase physical activity, subjective well-being and sleep quality? An open-label single-arm trial among university staff with low to moderate physical activity levels.

Funder: Universität Bielefeld (3146)BACKGROUND: This study examined the impact of a 'rewards-for-exercise' mobile application on physical activity, subjective well-being and sleep quality among 148 employees in a UK university with low to moderate physical activity levels. METHODS: A three-month open-label single-arm trial with a one-year follow-up after the end of the trial. Participants used the Sweatcoin application which converted their outdoor steps into a virtual currency used for the purchase of products available at the university campus' outlets, using an in-app marketplace. The primary outcome measure was self-reported physical activity. Secondary measures included device-measured physical activity, subjective well-being (i.e., life satisfaction, positive affect, negative affect), and self-reported sleep quality. RESULTS: The findings show an increase in self-reported physical activity (d = 0.34), life satisfaction (d = 0.31), positive affect (d = 0.29), and sleep quality (d = 0.22) during the three-month trial period. CONCLUSION: The study suggests that mobile incentives-for-exercise applications might increase physical activity levels, positive affect, and sleep quality, at least in the short term. The observed changes were not sustained 12 months after the end of the trial

Can a 'rewards-for-exercise app' increase physical activity, subjective well-being and sleep quality? An open-label single-arm trial among university staff with low to moderate physical activity levels.

Funder: Universität Bielefeld (3146)BACKGROUND: This study examined the impact of a 'rewards-for-exercise' mobile application on physical activity, subjective well-being and sleep quality among 148 employees in a UK university with low to moderate physical activity levels. METHODS: A three-month open-label single-arm trial with a one-year follow-up after the end of the trial. Participants used the Sweatcoin application which converted their outdoor steps into a virtual currency used for the purchase of products available at the university campus' outlets, using an in-app marketplace. The primary outcome measure was self-reported physical activity. Secondary measures included device-measured physical activity, subjective well-being (i.e., life satisfaction, positive affect, negative affect), and self-reported sleep quality. RESULTS: The findings show an increase in self-reported physical activity (d = 0.34), life satisfaction (d = 0.31), positive affect (d = 0.29), and sleep quality (d = 0.22) during the three-month trial period. CONCLUSION: The study suggests that mobile incentives-for-exercise applications might increase physical activity levels, positive affect, and sleep quality, at least in the short term. The observed changes were not sustained 12 months after the end of the trial