Placebo expectancy effects in the relationship between glucose and cognition

The present study investigated the extent of expectancy in the ability of glucose to affect cognitive performance. Using a within-subjects design, subjects (n 26) completed four experimental sessions (in counterbalanced order and after an initial practice session) during which they were given a 500 ml drink 30 min prior to completing a cognitive assessment battery. In addition, all subjects completed a baseline practice session during which they were given no drink. During two of the sessions, subjects were given a drink containing 50 g glucose and on the other two they were given a drink containing aspartame. A balanced placebo design was used, such that for half the sessions subjects were accurately informed as to the content of the drink (glucose or aspartame), whereas in the other two sessions they were misinformed as to the content of the drink. The task battery comprised a 6 min visual analogue of the Bakan vigilance task, an immediate verbal free-recall task, an immediate verbal recognition memory task and a measure of motor speed (two-finger tapping). Blood glucose and self-reported mood were also recorded at several time points during each session. Glucose administration was found to improve recognition memory times, in direct contrast to previous findings in the literature. Glucose administration also improved performance on the Bakan task (relative to the control drink), but only in sessions where subjects were informed that they would receive glucose and not when they were told that they would receive aspartame. There were no effects either of the nature of the drink or expectancy on the other measures. These results are interpreted in terms of there being some contribution of expectancy concerning the positive effects of glucose on cognition in studies which have not used an equi-sweet dose of aspartame as a control drink.

Placebo expectancy effect of consuming psychoactive beverages on cognition and mood

Energy drinks have become very popular over the past few years with over half the student population in colleges and universities consuming them at least once a month (Malinauskas et al., 2007). It has been reported that the most common reasons why students consume energy drinks are to maintain alertness, reduce symptoms of hangover, increase energy, to help with driving and to prevent sleepiness (Attila and Cakir, 2011; Malinauskas et al., 2007). Previous research has suggested that energy drinks enhance sensorimotor speed, behaviour, and reduce levels of fatigue (Alford et al., 2001; Horne and Reyner, 2001; Howard and Marczinski, 2010; Kennedy and Scholey, 2004; Smit et al., 2004). The two key ingredients found in energy drinks are caffeine and glucose which have been examined together and alone, which have indicated enhanced reaction times, improvement in both verbal memory and sustained attention and more recently there is evidence to show that expectancy may play a key role in predicting intentions of future consumption (Adan and serra-Grabulosa, 2010). According to Kirsch (1997) people have specific expectations when they consume psychoactive substances that trigger physiological and psychological reactions, which tend to be independent of the psychoactive substance ingested. The concept of expectancy effects can be unambiguous especially when the information provided to the participants prior to the experimental study is specific to a possible outcome response. This thesis investigated the extent of expectancy effect on cognition and mood when psychoactive drinks containing caffeine and glucose were consumed in comparison to non-psychoactive drinks. The investigation commenced with examining the independent effects of caffeine and glucose, followed by the combination of caffeine and glucose as an energy drink on mood and cognition. The investigation advanced by comparing drink presentation effects (i.e., consuming the experimental drink from a branded bottle versus from a glass) irrespective of drink content on mood and cognition. Finally, the investigation lead to exploring what factors may predict expectancy effects when participants’ consumed psychoactive drinks among healthy adults. This was done by applying the Theory of Planned Behaviour model (TPB) (Azjen, 1991) to explore the contribution of specific attitudes, subjective norms and perceived behavioural control to the extent of expectancy effects as well as to behavioural intention, with additional variables including; beliefs, habits, past-behaviour, selfidentity. Self-identity representing someone who drinks energy drinks regularly. The level of internal consistency for Cronbach’s alpha was conducted for each variable within the TPB model and for the additional variables included for test reliability. This thesis consisted of four studies, which found that consumption of caffeine and glucose independently and also in combination resulted in psychoactive effects on mood and cognition. Experiment 2 was the only study, which indicated an expectancy effect for immediate verbal recall task and the mood subscale tension. Conversely, for experiment 4 there was a reverse effect found for the immediate verbal recall task. However, there were significant expectancy and psychoactive effects found for mood subscales throughout the four studies. It was also found that the TPB model had two significant variables past-behaviour and self-identity predicted intentions suggesting that participants who regularly consume psychoactive beverages have salient beliefs about consuming psychoactive drinks and the TPB model can be utilised to predict their intentions. Furthermore, the Theory of planned behaviour model found that habit and self-identity significantly predicted participants’ expectancy effects on the vigour. Indicating consumers of energy drinks are familiar with expected outcome response. This model was unsuccessful in predicting expectancy response for cognitive performance. Thus, overall the findings from the four studies indicated that caffeine and glucose have cognitive enhancing properties, which also positively improve mood. However, expectancy effects have been identified for mood only, whereas the overall findings within this thesis were unable to identify significant predictors of expectancy effect and response.

Pre-existent expectancy effects in the relationship between caffeine and performance

The present study investigated the impact of pre-existent expectancy regarding the effects of the caffeine load of a drink and the perception of the caffeine content on subjective mood and vigilance performance. Caffeine deprived participants (N=25) were tested in four conditions (within subjects design), using a 2 × 2 design, with caffeine load and information regarding the caffeine content of the drink. In two sessions, they were given caffeinated coffee and in two were given decaffeinated coffee. Within these two conditions, on one occasion they were given accurate information about the drink and on the other they were given inaccurate information about the drink. Mood and vigilance performance were assessed post ingestion. Caffeine was found to enhance performance, but only when participants were accurately told they were receiving it. When decaffeinated coffee was given, performance was poorer, irrespective of expectancy. However, when caffeine was given, but participants were told it was decaffeinated coffee, performance was as poor as when no caffeine had been administered. There were no easily interpretable effects on mood. The pharmacological effects of caffeine appear to act synergistically with expectancy. © 2010.

Factors affecting e-payment adoption in Nigeria

The payment system of a country plays a crucial role in its economy; however, despite the benefits of e-Payment and efforts by financial authorities, Nigeria still has a low e-Payment adoption rate. In this regard, there is an urgent need to investigate the factors that affect individuals’ intention to adopt e-Payment. Drawing on the unified theory of acceptance and use of technology (UTAUT) model, this paper develops a theoretical model for e-Payment adoption in Nigeria. Additionally, a survey was conducted on 500 respondents with 213 complete responses received to test the model, and results show that perceived benefits, effort expectancy, social influence, trust, awareness, and demographic variables affected individuals’ intention to adopt e-Payments. Based on the findings, managerial and theoretical implications are deliberated.

Community-Based Study of the Association of High Myopia in Children with Ocular and Systemic Disease

Purpose. High myopia in childhood is associated with important ocular and systemic conditions. However in the UK, high myopia in early childhood is not specifically identified in current ophthalmology, optometry, or orthoptic protocols for screening, referral, or investigation. An ongoing study in the West Midlands, UK, is investigating high myopia presenting to community health care clinics with the aim of compiling guidelines for assessment and subsequent referral. Methods. Children with high myopia were identified from community optometric and orthoptic sources and invited for an ophthalmology and optometry examination to ascertain possible ocular or systemic disease. Results. High myopia with no associated ocular or systemic condition was present in 15 (56%) of the children. In seven children (25%), associated ocular problems were found including unrecognized retinal dystrophies and amblyopia. Systemic disorders associated with high myopia were found in five children (19%) and included Sticklers syndrome, Weill-Marchesani syndrome, and homocystinuria. In one child, the diagnosis made before this study was found to be incorrect, and in another child, the results were inconclusive. In two cases, the diagnosis of a systemic condition in the child led to the identification of the disease in at least one relative. Conclusions. There is a high prevalence of ocular and systemic abnormality in young children seen in the community. Optometric and ophthalmologic assessment of children less than 10 years with myopia ≥5 D is likely to identify significant ocular or systemic disease, a proportion of which will respond to medical intervention. Detection and prompt referral of these cases by community health care services may be expected to prolong vision and possibly life expectancy.

Neurological and ocular abnormalities in patients with Down's syndrome

Down's syndrome, first described by J. Langdon Down in 1866, is the most common chromosomal abnormality to occur in the human population. Its incidence is approximately 1/650 of all births although the risk of having a Down's child increases markedly with the age of the mother. It occurs with equal frequency in all racial groups. The risk to a mother 16-26 years old is 1 in 1,300 but the risk increases to 1 in 30 for a mother 45-47 years old. The life expectancy of people with Down's syndrome has risen since the 1920s and many individuals are now living to the 5th decade or beyond. Consequently optometrists are increasingly likley to see Down's patients of all ages in the practice.

The growth and awareness of health and safety at work, 1780-1900

This thesis examines the growth and awareness of health and safety at work between 1780 and 1900. In this period the hazards at work were increased by the intensification of production brought about by the Industrial Revolution, and new risks to health arose from the wider range of toxic substances in use by manufacturing industry. There is discussion in the thesis of the extent to which the problems were identified in an age of short life expectancy and limited medical knowledge. The sources studied have been largely medical, governmental, trade and press reports. The emphasis is on the first effects seen and recommendations made, and where possible, the extent of the problem and the effectiveness of any preventative measures adopted and examined. There is discussion of the growing involvement of the Government in industrial health and safety. The subject is viewed in the light of modern thinking on industrial health but uses a classification appropriate to historical resources. Psychological and minor afflictions, neglected in the 19th century, are not considered. The available literature is reviewed in each section. Three detailed case studies conclude the thesis, two on the notoriously dangerous occupations of metal grinding and pottery, and one on occupational eye injuries. Each study is based on a different type of source material. The thesis overall shows that there was extensive concern for health and safety at work, but no systematic approach and only ad hoc implementation of preventative measures; and that the rate at which conditions improved varied between different industries and different categories of workers . However, some modern principles of health and safety at work can be seen emerging, and the period laid the necessary medical, technical and legal foundations for developments in the present century.

Task classification and decision processes in monitoring behaviour

Task classification is introduced as a method for the evaluation of monitoring behaviour in different task situations. On the basis of an analysis of different monitoring tasks, a task classification system comprising four task 'dimensions' is proposed. The perceptual speed and flexibility of closure categories, which are identified with signal discrimination type, comprise the principal dimension in this taxonomy, the others being sense modality, the time course of events, and source complexity. It is also proposed that decision theory provides the most complete method for the analysis of performance in monitoring tasks. Several different aspects of decision theory in relation to monitoring behaviour are described. A method is also outlined whereby both accuracy and latency measures of performance may be analysed within the same decision theory framework. Eight experiments and an organizational study are reported. The results show that a distinction can be made between the perceptual efficiency (sensitivity) of a monitor and his criterial level of response, and that in most monitoring situations, there is no decrement in efficiency over the work period, but an increase in the strictness of the response criterion. The range of tasks exhibiting either or both of these performance trends can be specified within the task classification system. In particular, it is shown that a sensitivity decrement is only obtained for 'speed' tasks with a high stimulation rate. A distinctive feature of 'speed' tasks is that target detection requires the discrimination of a change in a stimulus relative to preceding stimuli, whereas in 'closure' tasks, the information required for the discrimination of targets is presented at the same point In time. In the final study, the specification of tasks yielding sensitivity decrements is shown to be consistent with a task classification analysis of the monitoring literature. It is also demonstrated that the signal type dimension has a major influence on the consistency of individual differences in performance in different tasks. The results provide an empirical validation for the 'speed' and 'closure' categories, and suggest that individual differences are not completely task specific but are dependent on the demands common to different tasks. Task classification is therefore shovn to enable improved generalizations to be made of the factors affecting 1) performance trends over time, and 2) the consistencv of performance in different tasks. A decision theory analysis of response latencies is shown to support the view that criterion shifts are obtained in some tasks, while sensitivity shifts are obtained in others. The results of a psychophysiological study also suggest that evoked potential latency measures may provide temporal correlates of criterion shifts in monitoring tasks. Among other results, the finding that the latencies of negative responses do not increase over time is taken to invalidate arousal-based theories of performance trends over a work period. An interpretation in terms of expectancy, however, provides a more reliable explanation of criterion shifts. Although the mechanisms underlying the sensitivity decrement are not completely clear, the results rule out 'unitary' theories such as observing response and coupling theory. It is suggested that an interpretation in terms of the memory data limitations on information processing provides the most parsimonious explanation of all the results in the literature relating to sensitivity decrement. Task classification therefore enables the refinement and selection of theories of monitoring behaviour in terms of their reliability in generalizing predictions to a wide range of tasks. It is thus concluded that task classification and decision theory provide a reliable basis for the assessment and analysis of monitoring behaviour in different task situations.

A systems approach to students' motivation and academic achievement

This research followed earlier work (reported in a thesis presented in 1970) on factors associated with the academic performance of a sample of technical college students, which recommended the further study of students' motivation. The technical college then became part of a polytechnic, but the courses chosen for the continuation of the research were all of a specifically vocational character. The approach was influenced by Angyal (1941) in seeking to relate symbolic processes to broader behaviour patterns within a systems framework. Forms of semantic differential were developed to obtain the students' responses to words representing various activities and various people both within and outside the academic environment. Also, a "!growth motivation questionnaire" was produced using ideas from self-actualisation, job satisfaction and expectancy theory and examination marks were recorded. From pre-coded responses to the growth motivation questionnaire, scores on a 'study satisfaction' factor were calculated, and subsamples of students were taken at the extremes of this scale. Wriitten responses from the same questionnaire and semantic differential factor scores showed contrasting patterns between the two subsamples. Interpretation of these patterns suggested a diversity of approach to academic work among the students which calls for greater flexibility in the educational system serving them.

Building cliques and alliances as practices to 'make things happen' in complex networks

The Roma population has become a policy issue highly debated in the European Union (EU). The EU acknowledges that this ethnic minority faces extreme poverty and complex social and economic problems. 52% of the Roma population live in extreme poverty, 75% in poverty (Soros Foundation, 2007, p. 8), with a life expectancy at birth of about ten years less than the majority population. As a result, Romania has received a great deal of policy attention and EU funding, being eligible for 19.7 billion Euros from the EU for 2007-2013. Yet progress is slow; it is debated whether Romania's government and companies were capable to use these funds (EurActiv.ro, 2012). Analysing three case studies, this research looks at policy implementation in relation to the role of Roma networks in different geographical regions of Romania. It gives insights about how to get things done in complex settings and it explains responses to the Roma problem as a „wicked‟ policy issue. This longitudinal research was conducted between 2008 and 2011, comprising 86 semi-structured interviews, 15 observations, and documentary sources and using a purposive sample focused on institutions responsible for implementing social policies for Roma: Public Health Departments, School Inspectorates, City Halls, Prefectures, and NGOs. Respondents included: governmental workers, academics, Roma school mediators, Roma health mediators, Roma experts, Roma Councillors, NGOs workers, and Roma service users. By triangulating the data collected with various methods and applied to various categories of respondents, a comprehensive and precise representation of Roma network practices was created. The provisions of the 2001 „Governmental Strategy to Improve the Situation of the Roma Population‟ facilitated forming a Roma network by introducing special jobs in local and central administration. In different counties, resources, people, their skills, and practices varied. As opposed to the communist period, a new Roma elite emerged: social entrepreneurs set the pace of change by creating either closed cliques or open alliances and by using more or less transparent practices. This research deploys the concept of social/institutional entrepreneurs to analyse how key actors influence clique and alliance formation and functioning. Significantly, by contrasting three case studies, it shows that both closed cliques and open alliances help to achieve public policy network objectives, but that closed cliques can also lead to failure to improve the health and education of Roma people in a certain region.

Requirement for and optimisation of premium intraocular lenses

Premium intraocular lenses (IOLs) aim to surgically correct astigmatism and presbyopia following cataract extraction, optimising vision and eliminating the need for cataract surgery in later years. It is usual to fully correct astigmatism and to provide visual correction for distance and near when prescribing spectacles and contact lenses, however for correction with the lens implanted during cataract surgery, patients are required to purchase the premium IOLs and pay surgery fees outside the National Health Service in the UK. The benefit of using toric IOLs was thus demonstrated, both in standard visual tests and real-world situations. Orientation of toric IOLs during implantation is critical and the benefit of using conjunctival blood vessels for alignment was shown. The issue of centration of IOLs relative to the pupil was also investigated, showing changes with the amount of dilation and repeat dilation evaluation, which must be considered during surgery to optimize the visual performance of premium IOLs. Presbyopia is a global issue, of growing importance as life expectancy increases, with no real long-term cure. Despite enhanced lifestyles, changes in diet and improved medical care, presbyopia still presents in modern life as a significant visual impairment. The onset of presbyopia was found to vary with risk factors including alcohol consumption, smoking, UV exposure and even weight as well as age. A new technique to make measurement of accommodation more objective and robust was explored, although needs for further design modifications were identified. Due to dysphotopsia and lack of intermediate vision through most multifocal IOL designs, the development of a trifocal IOL was shown to minimize these aspects. The current thesis, therefore, emphasises the challenges of premium IOL surgery and need for refinement for optimum visual outcome in addition to outlining how premium IOLs may provide long-term and successful correction of astigmatism and presbyopia.

Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making

Background Abnormalities in incentive decision making, typically assessed using the Iowa Gambling Task (IGT), have been reported in both schizophrenia (SZ) and bipolar disorder (BD). We applied the Expectancy-Valence (E-V) model to determine whether motivational, cognitive and response selection component processes of IGT performance are differentially affected in SZ and BD. Method Performance on the IGT was assessed in 280 individuals comprising 70 remitted patients with SZ, 70 remitted patients with BD and 140 age-, sex-and IQ-matched healthy individuals. Based on the E-V model, we extracted three parameters, 'attention to gains or loses', 'expectancy learning' and 'response consistency', that respectively reflect motivational, cognitive and response selection influences on IGT performance. Results Both patient groups underperformed in the IGT compared to healthy individuals. However, the source of these deficits was diagnosis specific. Associative learning underlying the representation of expectancies was disrupted in SZ whereas BD was associated with increased incentive salience of gains. These findings were not attributable to non-specific effects of sex, IQ, psychopathology or medication. Conclusions Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits. © 2012 Cambridge University Press.

Public sector efficiency, foreign aid and small island development states

This paper examines the efficiency of public sector expenditures and foreign aid at achieving social sector outcomes in Small Island Developing States (SIDS). Efficiency is estimated using a Stochastic Production Function (SPF) approach and panel data since 1990. A second stage of the analysis examines the determinants of efficiency. Results indicate that the efficiency of aid and public sectors at improving life expectancy has deteriorated during the 1990s but efficiency at improving school enrolments has increased. Higher levels of governance are associated with higher efficiency. There is also evidence to suggest that efficiency is lower in SIDS, as well as in Sub-Saharan Africa.

Counter-stereotypes reduce emotional intergroup bias by eliciting surprise in the face of unexpected category combinations

In three experiments we investigated the impact that exposure to counter-stereotypes has on emotional reactions to outgroups. In Experiment 1, thinking about gender counter-stereotypes attenuated stereotyped emotions toward females and males. In Experiment 2, an immigrant counterstereotype attenuated stereotyped emotions toward this outgroup and reduced dehumanization tendencies. Experiment 3 replicated these results using an alternative measure of humanization. In both Experiments 2 and 3 sequential meditational analysis revealed that counter-stereotypes produced feelings of surprise which, in turn, elicited a cognitive process of expectancy violation which resulted in attenuated stereotyped emotions and an enhanced use of uniquely human characteristics to describe the outgroup. The findings extend research supporting the usefulness of counter-stereotype exposure for reducing prejudice and highlight its positive impact on intergroup emotions.

Diabetes in the very elderly:need for an individualised approach

Background: Intensive risk factor management is recommended for individuals with diabetes. However, it is not known if such an approach is appropriate in the elderly with multiple comorbidities and limited life expectancy. The aim of this study was to characterise a cohort of very elderly individuals with diabetes and assess the impact of known risk factors on mortality. Methods: This was a retrospective audit approved by the clinical audit lead. All patients aged >80 years who attended diabetes outpatient clinics 2 years prior to the date of the audit (April 2012) were identified from clinic records. A detailed history including demographics, comorbidities and treatment were collected. Blood pressure readings, HbA1c, cholesterol and renal function were extracted and the mean of these readings was recorded. Survival status at 2 years was recorded for all patients. Statistical analysis was performed using SPSS19. Results: Data were available for 864 (381 male, 483 female) patients. The majority (75%) lived in their own home. More than 60% had multiple comorbidities and 25% had a prior history of cardiovascular disease. Two-thirds of the patients had more than one hospital admission in 2 years and a third had more than three admissions. 60% were on either insulin or a sulfonylurea. Mean HbA1c was 7.6%, cholesterol 4.2mmol/l, systolic blood pressure 145mmHg and eGFR 53ml/min. Over 2 years, 174 (20%)had died. Age, creatinine and previous coronary heart disease were significant predictors of death. Conclusion: The benefits of intensive diabetes management appear to be uncertain in very elderly patients. The need for intensive treatment must therefore be individualised to each patient.