An integrative review of attention biases and their contribution to treatment for anxiety disorders

Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians.published_or_final_versio

The role of stimulus specificity and attention in the generalization of extinction

Exposure therapy for anxiety is effective but fear can still return afterward. This may be because the stimuli that people are exposed to are dissimilar from the stimuli to which fear was originally acquired. After pairing an animal-like image (A) with a shock stimulus (US), a perceptually similar stimulus (B) was presented without the US in extinction. Participants were then shown A (ABA), a second generalization stimulus (ABC) or B (ABB). Groups ABA and ABC evidenced a return of US expectancy relative to participants who were shown B (ABB). Participants in group ABC who self-reported high levels of attentional control evidenced greater return of expectancy relative to participants low in attentional control. Participants with a high level of attentional control also showed steeper extinction gradients. Attentional control may influence perceptions of similarity and the learning that follows. Making note of such differences may be valuable in exposure treatment for anxiety.postprin

Study-based registers of randomized controlled trials: starting a systematic review with data extraction or meta-analysis

Introduction: Despite years of use of study-based registers for storing reports of randomized controlled trials (RCTs), the methodology used in developing such registers/databases has not been documented. Such registers are integral to the process of scientific reviewing. We document and discuss methodological aspects of the development and use of study-based registers. Although the content is focused on the study-based register of randomized/controlled clinical trials, this work applies to developers of databases of all sorts of studies related to the human, animals, cells, genes, and molecules. Methods: We describe necessity, rationale, and steps for the development, utilization and maintenance of study-based registers as well as the challenges and gains for the organizations supporting systematic reviews of the published and unpublished literature. Conclusion: The ultimate goal of having a study-based register is to facilitate efficient production of systematic reviews providing rapid, yet accurate, evidence for the decision-makers. We argue that moving towards study-based registers is an inevitable welcome direction and that infrastructures are ready for such movement

Probability distributions of the work in the 2D-Ising model

Probability distributions of the magnetic work are computed for the 2D Ising model by means of Monte Carlo simulations. The system is first prepared at equilibrium for three temperatures below, at and above the critical point. A magnetic field is then applied and grown linearly at different rates. Probability distributions of the work are stored and free energy differences computed using the Jarzynski equality. Consistency is checked and the dynamics of the system is analyzed. Free energies and dissipated works are reproduced with simple models. The critical exponent $\delta$ is estimated in an usual manner.Comment: 12 pages, 6 figures. Comments are welcom

Olfactomedin 4 Serves as a Marker for Disease Severity in Pediatric Respiratory Syncytial Virus (RSV) Infection

Funding: Statement of financial support: The study was financially supported by the VIRGO consortium, an Innovative Cluster approved by the Netherlands Genomics Initiative and partially funded by the Dutch Government (BSIK 03012). The authors have indicated they have no personal financial relationships relevant to this article to disclose. Data Availability Statement: The data is accessible at http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE69606.Peer reviewedPublisher PD

Dialogical self strategies of self-organization: psychotherapy and restructuring of internal management

A identidade tem sido um conceito central na literatura em psicologia e na forma como as diferentes abordagens terapêuticas têm concebido os processos de mudança. Entre as inúmeras perspectivas desenvolvidas sobre essa dimensão do ser humano, destacamos o paradigma dialógico que tem vindo a influenciar de forma crescente a teoria e prática em psicoterapia. Segundo esta perspectiva, a funcionalidade psicológica está relacionada com o modo como os indivíduos conseguem articular e colocar em diálogo produtivo as suas várias vozes ou posições de identidade. Neste artigo apresentamos uma revisão da literatura sobre as estratégias que subjazem a essa capacidade auto-organizadora do sistema identitário e sobre as diretrizes que poderão orientar uma intervenção terapêutica dialógica quando essa capacidade se torna disfuncional.Self-concept has been playing a crucial role in psychological literature and in the way the different therapeutic approaches conceive the processes of change. From the diverse perspectives developed about this human dimension, we emphasise the dialogical paradigm that has been increasingly influential in the psychotherapeutic theory and practice. According to the dialogical perspective the psychological well-being is dependent on the way individuals articulate and maintain productive dialogues between the different voices of the self or “I-Positions”. In this paper we present a review of the literature on the strategies that underlie this self-regulatory ability of the self-system and the guidelines of the dialogical therapeutic intervention that could be used when these self-regulatory strategies become dysfunctional.(undefined

Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers

Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs

Molecular epidemiology of penicillin-nonsusceptible Streptococcus pneumoniae among children in Greece

A total of 145 penicillin-nonsusceptible Streptococcus pneumoniae strains were isolated from young carriers in Greece and analyzed by antibiotic susceptibility testing, serotyping, restriction fragment end labeling (RFEL), and penicillin-binding protein (PBP) genotyping. The serotypes 23A and 23F (54%), 19A and 19F (25%), 9V (5%), 15A, 15B, and 15C (4%), 6A and 6B (4%), and 21 (4%) were most prevalent in this collection. Fifty-three distinct RFEL types were identified. Sixteen different RFEL clusters, harboring 2 to 32 strains each, accounted for 82% of all strains. Eight of these genetic clusters representing 60% of the strains were previously identified in other countries. A predominant lineage of 66 strains (46%) harboring five RFEL types and the serotypes 19F and 23F was closely related to the pandemic clone Spain(23F)-1 (genetic relatedness of > or =85%). Another lineage, representing 11 strains, showed close genetic relatedness to the pandemic clone France(9V)-3. Another lineage of 8 serotype 21 strains was Greece specific since the RFEL types were not observed in an international collection of 193 genotypes from 16 different countries. Characterization of the PBP genes pbp1a, pbp2b, and pbp2x revealed 20 distinct PBP genotypes of which PBP type 1-1-1, initially observed in the pandemic clones 23F and 9V, was predominantly present in 11 RFEL types in this Greek collection of penicillin-nonsusceptible strains (55%). Sixteen PBP types covering 52 strains (36%) were Greece specific. This study underlines the strong contribution of penicillin-resistant international clones to the prevalence and spread of penicillin-nonsusceptible pneumococci among young children in Greece