Opioidergic and GABAergic mechanisms in the rostral ventromedial medulla modulate the nociceptive response of vocalization in guinea pigs

Vocalization generated by the application of a noxious stimulus is an integrative response related to the affective-motivational component of pain. The rostral ventromedial medulla (RVM) plays an important role in descending pain modulation, and opiates play a major role in modulation of the antinociception mediated by the RVM. Further, it has been suggested that morphine mediates antinociception indirectly, by inhibition of tonically active GABAergic neurons. The current study evaluated the effects of the opioids and GABA agonists and antagonists in the RVM on an affective-motivational pain model. Additionally, we investigated the opioidergic-GABAergic interaction in the RVM in the vocalization response to noxious stimulation. Microinjection of either morphine (4.4 nmo1/0.2 mu l) or bicuculline (0.4 nmo1/0.2 mu l) into the RVM decreased the vocalization index, whereas application of the GABA(A) receptor agonist, musci-mol (0.5 nmo1/0.2 mu l) increased the vocalization index during noxious stimulation. Furthermore, prior microinjection of either the opioid antagonist naloxone (2.7 nmo1/0.2 mu l) or muscimol (0.25 nmo1/0.2 mu l) into the RVM blocked the reduction in vocalization index induced by morphine. These observations suggest an antinociceptive and pro-nociceptive role of the opioidergic and GABAergic neurotransmitters in the RVM, respectively. Our data show that opioids have an antinociceptive effect in the RVM, while GABAergic neurotransmission is related to the facilitation of nociceptive responses. Additionally, our results indicate that the antinociceptive effect of the opioids in the RVM could be mediated by a disinhibition of tonically active GABAergic interneurons in the downstream projection neurons of the descending pain control system; indicating an interaction between the opioidergic and GABAergic pathways of pain modulation. (C) 2010 Elsevier Inc. All rights reserved.

Role of cholinergic, opioidergic and GABAergic neurotransmission of the dorsal hippocampus in the modulation of nociception in guinea pigs

Aims: Several physiological, pharmacological and behavioral lines of evidence suggest that the hippocampal formation is involved in nociception. The hippocampus is also believed to play an important role in the affective and motivational components of pain perception. Thus, Our aim was to investigate the participation of cholinergic, opioidergic and GABAergic systems of the dorsal hippocampus (DH) in the modulation of nociception in guinea pigs. Main methods: The test used consisted of the application of a peripheral noxious stimulus (electric shock) that provokes the emission of a vocalization response by the animal. Key findings: Our results showed that, in guinea pigs, microinjection of carbachol, morphine and bicuculline into the DH Promoted anti nociception, while muscimol promoted pronociception. These results were verified by a decrease and all increase, respectively, in the vocalization index in the vocalization test. This antinociceptive effect of carbachol (2.7 nmol) was blocked by previous administration of atropine (0.7 nmol) or naloxone (1.3 nmol) into the same site. In addition, the decrease in the vocalization index induced by the microinjection of morphine (2.2 nmol) into the DH was prevented by pretreatment with naloxone (1.3 nmol) or muscimol (0.5 nmol). At doses of 1.0 nmol, muscimol microinjection caused pronociception, while bicuculline promoted antinociception. Significance: These results indicate the involvement of the cholinergic, opioidergic and GABAergic systems of the DH in the modulation of antinociception in guinea pigs. In addition, the present study suggests that cholinergic transmission may activate the release of endorphins/enkephalin from interneurons of the DH, Which Would inhibit GABAergic neurons, resulting in antinociception. (C) 2008 Elsevier Inc. All rights reserved.

High levels of anxiety and depression have a negative effect on quality of life of women with chronic pelvic pain

Chronic pelvic pain (CPP) is a common and complex disease whose cause is often clinically inexplicable, with consequent difficulty in diagnosis and treatment. Patients with CPP have high levels of anxiety and depression, with a consequent impairment of their quality of life. The objective of this study was to determine the prevalence of anxiety and depression and their impact on the quality of life of women with CPP. A cross-sectional controlled study was conducted on 52 patients with CPP and 54 women without pain. Depression and anxiety were evaluated by the Hospital Anxiety and Depression Scale, and quality of life was evaluated by the World Health Organization Quality of life Whoqol-bref questionnaire. Data were analysed statistically by the Mann-Whitney U-test, the Fisher exact test, chi-square test and Spearman correlation test. The prevalence of anxiety was 73% and 37% in the CPP and control groups, respectively, and the prevalence of depression was 40% and 30% respectively. Significant differences between groups were observed in the physical, psychological and social domains. Patients with higher anxiety and depression scores present lower quality of life scores. The fact that DPC is a syndromic complex, many patients enter a chronic cycle of search for improvement of medical symptoms. The constant presence of pain may be responsible for affective changes in dynamics, family, social and sexual. Initially the person is facing the loss of a healthy body and active, to a state of dependence and limitations. In this study, patients with higher scores of anxiety and depression scores had lower quality of life and patients with lower scores of anxiety and depression had scores of quality of life. These results show that perhaps the depression and anxiety may be related to the negative impact on quality of life of these patients. In view of this association, we emphasise the importance of a specific approach to the treatment of anxiety and depression together with clinical treatment to improve the quality of life of these patients.

Production of atypical category exemplars in patients with schizophrenia

Previous studies have revealed semantic memory impairments in patients with schizophrenia, and suggested that certain of these impairments were related to thought disorganization. One explanation offered for this is a broadening of the boundaries of semantic categories in schizophrenia. We selected 16 semantic categories, and required a sample of 41 schizophrenia patients and 43 healthy control subjects to produce one exemplar from each category. The typicality of the subjects` responses was rated. The exemplars produced by the patients were on average less typical than those produced by the healthy controls. No significant association between typicality of the response and thought disorganization was revealed in the patient sample. Affective flattening, alogia, and anhedonia were significantly and inversely associated with the typicality score, that is, higher ratings of these symptoms were associated with more typical responses. Our results suggest that a broadening of semantic category boundaries is observed in patients with schizophrenia, but is unrelated to thought disorganization. This semantic abnormality is not a feature of the patients with high ratings of certain negative symptoms. (JINS, 2010, 16, 822-828.)

Blink startle modulation during anticipation of pleasant and unpleasant stimuli

The present research investigated blink startle modulation during the anticipation of pleasant, unpleasant, or neutral pictures. In Experiment 1 (N = 18), participants were presented with three different tone-picture pairings. Tones differed in pitch and were followed by pleasant, neutral or unpleasant pictures. Acoustic blink reflexes were elicited during some tones and during stimulus free intervals. Blink facilitation during tones that preceded pleasant and unpleasant pictures was larger than during the tone that preceded neutral pictures. Experiment 2 (N = 10) assessed whether this difference was due to a difference in the presentation frequency of the three conditions. No difference in blink facilitation between the conditions was found when pictures of flowers and mushrooms replaced the pleasant and unpleasant pictures, indicating that picture content was instrumental in causing the differential blink facilitation in Experiment 1. The results from Experiment 1 seem to indicate that startle modulation during the anticipation of pictorial material reflects the interest in or the arousal associated with the pictures rather than picture valence.

The future of cognitive and behavioral therapies in the prevention and early management of psychosis: Opportunities and risks

Behavioral and cognitive interventions for people with psychosis have a long and distinguished history, although the evidence for their application to young people remains limited. We anticipate that the next decades will show substantial research into psychological intervention for this population. Important targets will include the management of environmental stressors, reduction of substance misuse, and promotion of early treatment. Psychological management of positive symptoms, depression, and suicidal behavior will continue to be critical objectives. Important secondary prevention goals will be the retention of cognitive functioning, vocational options, social skills, and social network support, including appropriate family support. We expect primary prevention to include both universal programs and interventions for adolescents at particularly high risk. Technical innovations will include increasing use of Internet-based intervention and behavior cueing devices. Pressures for intervention brevity will continue, as will problems with the systematic delivery of effective procedures.

Effect of instructed extinction on verbal and autonomic indices of Pavlovian learning with fear-relevant and fear-irrelevant conditional stimuli

We investigated the effects of conditional stimulus fear-relevance and of instructed extinction on human Pavlovian conditioning as indexed by electrodermal responses and verbal ratings of conditional stimulus unpleasantness. Half of the participants (n = 64) were trained with pictures of snakes and spiders (fear-relevant) as conditional stimuli, whereas the others were trained with pictures of flowers and mushrooms (fear-irrelevant) in a differential aversive Pavlovian conditioning procedure. Half of the participants in each group were instructed after the completion of acquisition that no more unconditional stimuli were to be presented. Extinction of differential electrodermal responses required more trials after training with fear-relevant pictures. Moreover, there was some evidence that verbal instructions did not affect extinction of second interval electrodermal responses to fear-relevant pictures. However, neither fear-relevance nor instructions affected the changes in rated conditional stimulus pleasantness. This dissociation across measures is interpreted as reflecting renewal of Pavlovian learning.

The residual effects of cooperative-learning experiences: A two-year follow-up

The author investigated how training in small-group and interpersonal behaviors affected children's behavior and interactions as they worked in small groups 2 years later. The authors assigned 52 fifth graders, who had been trained 2 years previously in cooperative group behaviors, to the trained condition and 36 fifth graders, who had not previously been trained, to the untrained condition. Both were reconstituted from the pool of students who had participated previously in group activities. The results showed a residual training effect, with the children in the trained groups being more cooperative and helpful than their untrained peers.

Minor physical anomalies and quantitative measures of the head and face in patients with psychosis

Background: The aim of this study was to examine minor physical anomalies and quantitative measures of the head and face in patients with psychosis vs healthy controls. Methods: Based on a comprehensive prevalence study of psychosis, we recruited 310 individuals with psychosis and 303 controls. From this sample, we matched 180 case-control pairs for age and sex. Individual minor physical anomalies and quantitative measures related to head size and facial height and depth were compared within the matched pairs. Based on all subjects, we examined the specificity of the findings by comparing craniofacial summary scores in patients with nonaffective or affective psychosis and controls. Results: The odds of having a psychotic disorder were increased in those with wider skull bases (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.02-1.17), smaller lower-facial heights (glabella to subnasal) (OR, 0.57; 95% CI, 0.44-0.75), protruding ears (OR, 1.72; 95% CI, 1.05-2.82), and shorter (OR, 2.29; 95% CI, 1.37-3.82) and wider (OR, 2.28; 95% CI, 1.43-3.65) palates. Compared with controls, those with psychotic disorder had skulls that were more brachycephalic. These differences were found to distinguish patients with nonaffective and affective psychoses from controls. Conclusions: Several of the features that differentiate patients from controls relate to the development of the neuro-basicranial complex and the adjacent temporal and frontal lobes. Future research should examine both the temporal lobe and the middle cranial fossa to reconcile our anthropomorphic findings and the literature showing smaller temporal lobes in patients with schizophrenia. Closer attention to the skull base may provide clues to the nature and timing of altered brain development in patients with psychosis.

Is emotional intelligence training for leaders justified?

In this paper, we present the results of a qualitative study of subordinate perceptions of leaders. The study represents a preliminary test of a model based on Affective Events Theory, which posits that leaders who are seen to be effective shape the affective events that determine employees' attitudes and behaviours in the workplace. Within this framework, we argue that effective leaders ameliorate employees' hassles by providing frequent, small emotional uplifts. The resulting positive affective states are then proposed to lead to more positive employee attitudes and behaviours, and more positive regard for the leader. Importantly, leaders who demonstrate these ameliorating behaviours are likely to require high levels of emotional intelligence, defined in terms of the ability to recognise, understand, and manage emotions in self and others. To investigate this model, we conducted interviews and focus groups with 10 leaders and 24 employees. Results confirmed that these processes do indeed exist in the workplace. In particular, leaders who were seen by employees to provide continuous small emotional uplifts were consistently held to be the most effective. Study participants were especially affected by negative events (or hassles). Leaders who failed to deal with hassles or, worse still, were the source of hassles, were consistently seen to be less effective. We conclude with a discussion of implications for practicing managers, and suggest that our exploratory findings provide justification for emotional intelligence training as a means to improve leader perceptions and effectiveness. [Abstract from author]

"O que fazer quando o coração aperta?" A dinâmica conjugal pós-infarto

O trabalho investigou a dinâmica das relações conjugais após ocorrência de Infarto Agudo do Miocárdio em um dos cônjuges, a fim de identificar possíveis alterações na interação e no papel de cada cônjuge. Foram entrevistados 06 casais (30 a 53 anos casamento): 03 homens enfartados, 03 mulheres enfartadas (ocorrência entre 1,5 a 8 anos), com roteiros diferenciados para o (a) enfartado e o (a) companheiro. Nas entrevistas priorizamos: interações pessoais e conjugais pós-infarto/ diferenças de gênero. A análise de conteúdo evidenciou que predominaram nas relações conjugais aspectos que remetem ao papel tradicional de gênero, embora a dinâmica conjugal tenha sofrido algumas alterações frente ao impacto do infarto, por exemplo: aumento da divisão de tarefas domésticas, homens tornaram-se mais caseiros, mulheres começaram a participar da administração financeira, maior aproximação afetiva entre o casal. Tais considerações apontam que a ocorrência do infarto foi avaliada positivamente pelas mulheres em função das alterações de papéis e negativamente pelos homens frente às limitações e dependência.

Pais adolescentes : vivência e significação

Foram investigadas mudanças ocorridas na vida de pais adolescentes e identificados os significados da paternidade e da maternidade para esses jovens. Oito participantes com idades de 16 a 21 anos foram entrevistados com base em roteiro focalizando: mudanças decorrentes da paternidade; significados da paternidade e da maternidade; práticas parentais. Entre as mudanças referidas destacaram-se a perda de liberdade e a inserção no mercado de trabalho. Para eles ser pai significa, principalmente, trabalhar para prover as necessidades da criança e também educar, dar carinho e atenção. A mãe é aquela que cuida e dá carinho, sacrifica-se e é a figura mais importante na vida da criança. As práticas parentais mais mencionadas estavam relacionadas com lazer e brincadeiras. Os dados indicaram a permanência de forte vínculo com os modelos tradicionais de parentalidade, embora tenham mostrado também a emergência de relações afetivas significativas entre pais e filhos.

Avaliação assistida informatizada : indicadores do potencial cognitivo de crianças com deficiência

A identificação e a avaliação de crianças com desenvolvimento atípico configuram um processo muito importante para subsidiar as estratégias de ensino voltadas para a promoção do potencial de aprendizagem. O interesse em relação ao prognóstico de crianças com deficiência tem impulsionado o desenvolvimento de novas tecnologias e pesquisas relacionadas à avaliação, prevenção e intervenção. Nesse contexto, torna-se relevante verificar com instrumentos adequados indicadores linguísticos, cognitivos e comportamentais, para assim traçar metas a partir daquilo que as crianças podem aprender. Dessa forma, esta pesquisa teve por objetivo verificar se a avaliação assistida informatizada se apresenta como uma modalidade de diagnóstico mais prescritivo do desenvolvimento cognitivo, quando comparada à avaliação psicométrica, na aplicação em crianças com deficiência. Na modalidade assistida há ajuda do examinador para conduzir a criança a um melhor nível de desempenho cognitivo. Participaram 11 crianças que frequentam uma instituição de atendimento clínico, em saúde, para crianças com deficiência, na Grande Vitória. Na avaliação psicométrica foram utilizados a Escala de Maturidade Mental Colúmbia computadorizada – Colúmbiacomp e o Teste de Vocabulário por Imagens Peabody - TVIPcomp. Na avaliação assistida informatizada foram aplicadas três provas voltadas para as habilidades de classificação e raciocínio analógico: Exclusão de Objetos, Exclusão de Figuras Geométricas e Jogo de Analogia de Figuras, no ambiente informatizado SINDAPSI. Protocolos de registro de fatores afetivo-motivacionais e de operações cognitivas foram utilizados durante as tarefas assistidas. Na avaliação do comportamento, o Child Behavior Checklist – CBCL foi respondido pelas mães. Dados documentais e dos instrumentos foram submetidos à análise estatística descritiva para verificar o desempenho das crianças nas duas formas de avaliação informatizada (psicométrica e assistida). Nos testes psicométricos, 64% das crianças alcançaram índice “abaixo da média” no TVIPcomp, e 55% “médio-inferior” no Colúmbiacomp. Em relação ao perfil de desempenho cognitivo, na Prova de Exclusão de Objetos computadorizada 55% das crianças foram avaliadas como “não-mantenedoras”. Na Prova de Exclusão de Figuras Geométricas computadorizada 55% da amostra foi classificada no perfil “alto-escore”, e no Jogo de Analogias de Figuras computadorizado 45% apresentou o perfil “ganhador”. A amostra demonstrou níveis de dificuldade na realização dos testes,tanto na modalidade psicométrica quanto assistida. Contudo, o desempenho nos testes assistidos foi relativamente melhor, evidenciando que o grupo se beneficiou da mediação,implementada na fase de assistência, para melhorar as habilidades cognitivas. Além disso, a apresentação informatizada dos testes apresentou-se como fator motivador para a realização e persistência nas tarefas.

Por uma clínica dos poros: conhecimento e práticas em saúde a partir do exercício de um corpo sensível

Tendo em vista a atual configuração do trabalho em saúde, entende-se que nos espaços de formação desta área torna-se relevante a realização de intervenções que se dediquem ao desenvolvimento de tecnologias relacionais. Tais tecnologias referem-se à produção de vínculo como instrumento de realização nas linhas de cuidado. Esta pesquisa objetivou compreender como essas tecnologias se corporificam a partir da utilização de clínicas em experimentações corporais. Foi utilizado como cenário para o estudo o grupo de pesquisa Rizoma: Saúde Coletiva e Instituições, vinculado ao Programa de Pós Graduação em Saúde Coletiva da Universidade Federal do Espírito Santo. Os sujeitos do estudo foram profissionais e pesquisadores de diversas áreas da saúde que participam do referido grupo. Como instrumentos de produção do material, utilizou-se de registros fotográficos, diário de campo, co-análises sobre o trabalho, experimentações com movimentos de consciência corporal e mobilização de cargas afetivas. A análise do material se deu a partir de uma leitura esquizoanalítica. As clínicas criaram espaços de reflexão para aumentar a capacidade dos participantes em afetar e serem afetados. Tais experimentações geraram estratégias para um cuidado de si e dos outros. Desta forma os participantes relataram maior capacidade de atenção às suas relações cotidianas e de trabalho, aumento de sensibilidades e transformação de comportamentos padronizados em novas formas de se articular.