I(41/4689)

ntended pregnancies and unintended pregnancies: distinct categories or opposite ends of a continuum?  (+info)

A role for somatosensory cortices in the visual recognition of emotion as revealed by three-dimensional lesion mapping. (42/4689)

Although lesion and functional imaging studies have broadly implicated the right hemisphere in the recognition of emotion, neither the underlying processes nor the precise anatomical correlates are well understood. We addressed these two issues in a quantitative study of 108 subjects with focal brain lesions, using three different tasks that assessed the recognition and naming of six basic emotions from facial expressions. Lesions were analyzed as a function of task performance by coregistration in a common brain space, and statistical analyses of their joint volumetric density revealed specific regions in which damage was significantly associated with impairment. We show that recognizing emotions from visually presented facial expressions requires right somatosensory-related cortices. The findings are consistent with the idea that we recognize another individual's emotional state by internally generating somatosensory representations that simulate how the other individual would feel when displaying a certain facial expression. Follow-up experiments revealed that conceptual knowledge and knowledge of the name of the emotion draw on neuroanatomically separable systems. Right somatosensory-related cortices thus constitute an additional critical component that functions together with structures such as the amygdala and right visual cortices in retrieving socially relevant information from faces.  (+info)

Emotion, decision making and the orbitofrontal cortex. (43/4689)

The somatic marker hypothesis provides a systems-level neuroanatomical and cognitive framework for decision making and the influence on it by emotion. The key idea of this hypothesis is that decision making is a process that is influenced by marker signals that arise in bioregulatory processes, including those that express themselves in emotions and feelings. This influence can occur at multiple levels of operation, some of which occur consciously and some of which occur non-consciously. Here we review studies that confirm various predictions from the hypothesis. The orbitofrontal cortex represents one critical structure in a neural system subserving decision making. Decision making is not mediated by the orbitofrontal cortex alone, but arises from large-scale systems that include other cortical and subcortical components. Such structures include the amygdala, the somatosensory/insular cortices and the peripheral nervous system. Here we focus only on the role of the orbitofrontal cortex in decision making and emotional processing, and the relationship between emotion, decision making and other cognitive functions of the frontal lobe, namely working memory.  (+info)

Saccadic eye movement disturbances in whiplash patients with persistent complaints. (44/4689)

In order to analyse the possible basis of subjective complaints following whiplash injury, horizontal eye movements were examined in subjects with persistent complaints ('symptomatic group') and subjects who had completely recovered ('recovered group'). The results for the symptomatic and recovered groups were compared with those for age-matched, healthy volunteers (control group). A battery of different saccade paradigms was employed: two were reflexive saccade tasks including a gap and an overlap task, and two were intentional saccade tasks consisting of an antisaccade and a memory-guided saccade task. In addition, the symptomatic and recovered groups also underwent psychiatric evaluation in a structured clinical interview, and all groups were assessed for emotional functioning using the Beck Depression Inventory (BDI). The recovered group did not differ significantly from the control group in saccade performance and emotional functioning. The symptomatic group showed dissociation of their performances of reflexive and intentional saccade tasks: performance in reflexive saccade tasks was normal, but in intentional saccade tasks the symptomatic group showed significantly impaired inhibition of unwanted reflexive saccades, impaired saccade triggering (i.e. increased latency) and a higher percentage error in amplitude in memory-guided saccades. Based on clinical interviews, no signs of major depression or dysthymia were found in any of the groups. Compared with the other two groups, the symptomatic group had significantly higher overall BDI scores, but these resulted from BDI dimensions that were non-specific to depression, viz. 'physiological manifestations' (e.g. fatigue, sleep disturbance) or 'performance difficulty' (e.g. work inhibition). In summary, in the symptomatic group the pattern of eye movement disturbances together with normal performance in reflexive saccade tasks and impaired performance in the intentional saccade tasks, especially impaired inhibitory function, suggests dysfunction of prefrontal and frontal cortical structures.  (+info)

Measuring the quality of life in patients with venous ulcers. (45/4689)

PURPOSE: This prospective study aimed to validate a newly designed specific measure of quality of life for patients with venous ulcers. METHODS: The study was set in a London teaching hospital and surrounding community clinics. Items for the questionnaire were selected by means of patient interviews, a literature review, and expert opinion. The questionnaire and the Short Form 36-item (SF-36) Health Survey were given to a prospective consecutive cohort of 98 patients with proven venous ulcers that were diagnosed by means of clinical and color duplex examination. Fifty-eight of the patients were women (60%), and the median age of patients was 76 years. The questionnaire was assessed for reliability, validity, and responsiveness. RESULTS: The ulcer-specific questionnaire showed good reliability, as assessed by means of the internal consistency (Cronbach alpha = 0.93) and test-retest analysis (r = 0.84). Factor analysis identified four important health factors: social function, domestic activities, cosmesis, and emotional status. Validity was demonstrated by means of a high correlation with all eight domains of the SF-36 general health measure (r > 0.55, P <.001). Responsiveness was demonstrated by means of a significant reduction in the score on the ulcer questionnaire as ulcers healed at 6 and 11 weeks (P <.05). CONCLUSION: Good evidence exists that a clinically derived measure for patients with venous ulcers has validity to measure the quality of life.  (+info)

The effects of successful intervention on quality of life in patients with varying degrees of lower-limb ischaemia. (46/4689)

OBJECTIVES: to assess the quality of life after successful intervention among patients with varying degrees of lower-limb ischaemia in comparison with healthy controls and the respondents>> degree of sense of coherence. MATERIALS AND METHODS: one hundred and twelve patients and 102 healthy controls were assessed for quality of life (Nottingham Health Profile) and sense of coherence. MAIN RESULTS: successful angioplasty or surgical intervention led to an improved quality of life at 6 months, in particular with regard to pain, sleep, physical mobility, hobbies and holiday and to a level similar to healthy controls in sleep, social isolation, paid employment and family relationships. It remained at a significantly lower level than that of healthy controls with regard to pain, emotional reactions, physical mobility, energy, housework, hobbies, holidays, sex and social life. Critical ischaemia patients did not reach the same level of quality of life as the claudicants or the healthy controls. CONCLUSION: successful treatment for chronic limb ischaemia improved the quality of life significantly, more so in claudicants than in patients with critical ischaemia. The degree to which the quality of life improved was associated with the patients>> sense of coherence and their ankle pressure.  (+info)

Categorization of unilaterally presented emotional words: an ERP analysis. (47/4689)

This study is intended to clarify the functional role of different ERP components as indicators of the processing of emotions. The effect of emotional connotation of words on hemispheric lateralization is also explored. Visual ERPs were recorded to unilaterally presented positive, negative, and neutral words that should be categorized according to their emotional connotation. The P2 amplitude was larger to positive than to negative words whereas P3 amplitude was larger to positive words compared with neutral ones. The slow positive wave (SPW) was influenced by words emotionality at anterior and posterior sites differently. The amplitude of the N1 component was larger in the left hemisphere to contralaterally presented words. The P2 and P3 components were larger over the left hemisphere whereas the N3 and N4 components were larger over the right hemisphere to ipsilateral stimulation. The results support our hypotheses on the functional role of positive ERP components in the processing of an affective words connotation: the P2 wave reflects a general evaluation of emotional significance, the P3 a task-related decision, and the SPW an additional decision control in the context of the emotional experience of an individual. Neither the "right hemisphere hypothesis" nor "valence hypothesis" on lateralization of the processing of emotions were confirmed. Each hemisphere seems to exert its effect on emotion through specific hemispheric resources that are unequally allocated along the different stages of task processing and may cause alternation of hemispheric dominance.  (+info)

Communicating genetic risk: pros, cons, and counsel. (48/4689)

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. This case is of a woman with a personal, and a strong family history of breast cancer, who considered genetic testing for mutations in the BRCA1 and BRCA2 genes. The details of the case have been altered to protect the patient's anonymity. The patient was very anxious and there was disagreement between her healthcare providers about the potential benefits of genetic testing. The discussion of the case focused on several controversial issues, particularly the ownership of genetic information, and who is responsible for disseminating information to the family members at risk. The difficulties in communicating risk, providing emotional support and coping with the continuing uncertainties about screening and intervention are reviewed with an overview of the molecular biology, inheritance, and epidemiology of the BRCA1 and BRCA2 genes.  (+info)