At the heart of optimal reading experiences: Cardiovascular activity and flow experiences in fiction reading

Fiction reading is a popular leisure activity associated with a variety of pleasurable experiences, including suspense, narrative transportation, and—as indicated by recent empirical studies—also flow. In the context of fiction reading, flow—generally defined as a pleasurable state of mind experienced during an optimally stimulating activity—is specifically related to an optimal balance between text-driven challenges and the reader’s capabilities in constructing a mental story model. The experimental study reported here focused on the psychophysiological underpinnings of flow in the reading context. Cardiovascular data were collected from 84 participants both during a relaxation baseline prior to reading and during reading. Participants were randomly assigned to read one of three versions of a chapter from Homer’s Odyssey. According to statistical readability indices, these versions were low, intermediate, or high in readability, and hence in cognitive challenge. Flow was measured immediately after reading with a self-report scale that was tailored to assess reading-specific flow experiences. Regression analyses revealed that cardiovascular activation patterns measured before reading that are reflective of parasympathetic dominance—that is, an inner state associated with relaxation and cognitive fluency—moderated flow experiences during reading. In line with the stipulations of flow theory in regard to matching challenge levels being the key determinant for flow, this pattern supported subsequent flow experiences only in response to text versions of high or intermediate, but not of low cognitive challenge. Differences in cardiac vagal tone during reading were, however, not sensitive to our experimental modifications and not predictive of flow experiences

Incorporating stakeholder perspectives into model-based scenarios: Exploring the futures of the Dutch gas sector

Several model-based, analytical approaches have been developed recently to deal with the deep uncertainty present in situations for which futures studies are conducted. These approaches focus on covering a wide variety of scenarios and searching for robust strategies. However, they generally do not take the multiplicity of stakeholder perspectives into account in analytic terms, which could bring in diverse opinions and views, not only on possible futures but also on values and interests. In this study, we present an approach to incorporate stakeholder perspectives into model-based scenarios for exploring the future dynamics of the Dutch gas sector. The results demonstrate that the scenario space can be demarcated according to the perspectives. This allows for a systematic comparison of the perspectives and provides a basis for identification of robust strategies. Also, the analysis shows that incompatible elements between the model and perspectives, or within perspectives can be identified. This provides insights about the problem complexity and potential barriers to the futures envisioned by the perspectives. Future research can strengthen this approach by involving stakeholders in modelling and in the model-based representation of the perspective narratives to enhance learning and credibility, and can extend the analysis to identify (socially) robust policies

Association between cognitive performance and cortical glucose metabolism in patients with mild Alzheimer's disease

Background: Neuronal and synaptic function in Alzheimer's disease (AD) is measured in vivo by glucose metabolism using positron emission tomography (PET). Objective: We hypothesized that neuronal activation as measured by PET is a more sensitive index of neuronal dysfunction than activity during rest. We investigated if the correlations between dementia severity as measured with the Mini Mental State Examination (MMSE) and glucose metabolism are an artifact of brain atrophy. Method: Glucose metabolism was measured using {[}F-18]fluorodeoxyglucose PET during rest and activation due to audiovisual stimulation in 13 mild to moderate AD patients (MMSE score >= 17). PET data were corrected for brain atrophy. Results: In the rest condition, glucose metabolism was correlated with the MMSE score primarily within the posterior cingulate and parietal lobes. For the activation condition, additional correlations were within the primary and association audiovisual areas. Most local maxima remained significant after correcting for brain atrophy. Conclusion: PET activity measured during audiovisual stimulation was more sensitive to functional alterations in glucose metabolism in AD patients compared to the resting PET. The association between glucose metabolism and MMSE score was not dependent on brain atrophy. Copyright (C) 2005 S. Karger AG, Basel

Development of six PROMIS pediatrics proxy-report item banks

<p>Abstract</p> <p>Background</p> <p>Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks.</p> <p>Methods</p> <p>The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52.</p> <p>Results</p> <p>Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6 months prior to the</p> <p>interview. The PROMIS proxy sample scored similar or better on the other proxy instruments compared to normative samples.</p> <p>Conclusions</p> <p>The initial calibration data was provided by a diverse set of caregivers of children with a variety of common chronic illnesses and racial/ethnic backgrounds. The PROMIS pediatric proxy-report item banks include physical function (mobility n = 23; upper extremity n = 29), emotional distress (anxiety n = 15; depressive symptoms n = 14; anger n = 5), social peer relationships (n = 15), fatigue (n = 34), pain interference (n = 13), and asthma impact (n = 17).</p

Using the PedsQL™ 3.0 asthma module to obtain scores comparable with those of the PROMIS pediatric asthma impact scale (PAIS)

The National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS) has developed several scales measuring symptoms and function for use by the clinical research community. One advantage of PROMIS is the ability to link other scales to the PROMIS metric

Item response theory detects differential item functioning between healthy and ill children in QoL measures

To demonstrate the value of item response theory (IRT) and differential item functioning (DIF) methods in examining a health-related quality of life (HRQOL) measure in children and adolescents

Promising insights into the health related quality of life for children with severe obesity

Background Childhood obesity is a growing health concern known to adversely affect quality of life in children and adolescents. The Patient Reported Outcomes Measurement Information System (PROMIS) pediatric measures were developed to capture child self-reports across a variety of health conditions experienced by children and adolescents. The purpose of this study is to begin the process of validation of the PROMIS pediatric measures in children and adolescents affected by obesity. Methods The pediatric PROMIS instruments were administered to 138 children and adolescents in a cross-sectional study of patient reported outcomes in children aged 8–17 years with age-adjusted body mass index (BMI) greater than the 85th percentile in a design to establish known-group validity. The children completed the depressive symptoms, anxiety, anger, peer relationships, pain interference, fatigue, upper extremity, and mobility PROMIS domains utilizing a computer interface. PROMIS domains and individual items were administered in random order and included a total of 95 items. Patient responses were compared between patients with BMI 85 to < 99th percentile versus ≥ 99th percentile. Results 136 participants were recruited and had all necessary clinical data for analysis. Of the 136 participants, 5% ended the survey early resulting in missing domain scores at the end of survey administration. In multivariate analysis, patients with BMI ≥ 99th percentile had worse scores for depressive symptoms, anger, fatigue, and mobility (p < 0.05). Parent-reported exercise was associated with better scores for depressive symptoms, anxiety, and fatigue (p < 0.05). Conclusions Children and adolescents ranging from overweight to severely obese can complete multiple PROMIS pediatric measures using a computer interface in the outpatient setting. In the 5% with missing domain scores, the missing scores were consistently found in the domains administered last, suggesting the length of the assessment is important. The differences in domain scores found in this study are consistent with previous reports investigating the quality of life in children and adolescents with obesity. We show that the PROMIS instrument represents a feasible and potentially valuable instrument for the future study of the effect of pediatric obesity on quality of life