The role of performance anxiety in the development and maintenance of sexual dysfunction in men and women

The current study evaluated the association between attitudes toward sex, stress, relationship quality, performance anxiety, and sexual dysfunction among 157 men (114 dysfunctional, 43 functional) and 186 women (84 dysfunctional, 102 functional). The results demonstrate that the main factors related to all types of sexual dysfunction among men were attitudes toward sex, conflict in their relationship, and performance anxiety. For women, the main factors related to all types of sexual dysfunction were attitudes toward sex, relationship quality, and performance anxiety. These results demonstrate the central role of performance anxiety in either the development or maintenance of sexual dysfunction among both men and women. Clearly, this is an area that has to be considered in any treatment program for sexual dysfunction. (PsycINFO Database Record (c) 2008 APA, all rights reserve

It's not only rock and roll: rockumentary, direct cinema and performative display

The documentary form commonly referred to as rockumentary has become, since its inception in the early 1960s, a staple of American direct cinema. In keeping with its associations with observational direct cinema, rockumentary emphasizes showing over telling; that is, rockumentary privileges the visual capacities of documentary over patterns of exposition. While the ‘documentary display’ of rockumentary is comparable to certain features of  the early ‘cinema of attractions’ it exceeds such features in its focus on  performance. Typically, an emphasis within documentary theory on unmediated and unreconstructed access to the real as the basis of documentary film has not admitted a place for notions of performance before the camera. Rockumentary, with its relentless foregrounding of the performing body and the performance of musicians, revises this  understanding. This essay examines rockumentary within the context of direct cinema as a mode centred on a documentary performative display as it operates within selected works from the 1960s to the present. The film theorist Brian Winston has claimed that ‘[d]irect cinema made the rock performance/tour movie into the most popular and commercially viable documentary form thus far.’ The inverse of this assessment may be closer to the mark: the rockumentary turned direct cinema into a commercially and widely available form, one which the rockumentary has at times returned to and superseded in its scopic attention to performative display.

Playful learning : Melville's artful art in Moby-Dick

It remains one of the great ironies of American literary history that Melville's Moby-Dick struggled so long for critical and popular recognition. It is a peculiar text (but, then, so are Hawthorne's novels), a romance of the whale fishery that involves such explorations of language itself, of words, metaphor, symbol, allegory and the processes (and significance) of narrative construction. This article analyses its 'peculiarities' as fundamental indicators of Melville's 'playful art' to argue the usefulness of a concept of 'play' to its appreciation. That Moby-Dick is allusive and multi-layered is well known. But for what apparent purpose and to what effect? Here, a claim is made that Melville simultaneously constructs and deconstructs meaning by demonstrating that things ('in complex subjects') never come simply or singly. The later Barthes and Derrida become part of this ship's crew and Moby-Dick is a postmodernist novel avant la lettre.

Freud, civilization, religion and stoicism

Freud's debt to stoicism has been seldom discussed. His attitude toward science had a distinct ethical slant taken from the ancient world, via Freud's humanistic education. Freud's method involved detachment but did not imply moral coldness and indifference any more than stoicism did. The stoics wanted to be therapists of the mind just as physicians cared for the body. For both Freud and the stoics, reason was in battle with the passions and required clear sight to have a chance of prevailing over them. In contrasting religious worldviews with the scientific approach, Freud failed to see his own approach as ethical. Freud made extensive forays at individual and collective levels but in the years since Freud's death, the psychoanalytic vision has narrowed. At 150 years after his birth, the authors can still admire Freud's exceptional ethical courage and recognize that if psychoanalysis is to survive, it needs to regain his cultural range and spirit of critical inquiry

Insulin signaling after exercise in insulin receptor substrate-2-deficient mice

The period immediately after exercise is characterized by enhanced insulin action in skeletal muscle, and on the molecular level, by a marked increase in insulin-stimulated, phosphotyrosine-associated phosphatidylinositol (PI) 3-kinase activity. Because the increase in PI 3-kinase activity cannot be explained by increased insulin receptor substrate (IRS)-1 signaling, the present study examined whether this effect is mediated by enhanced IRS-2 signaling. In wild-type (WT) mice, insulin increased IRS-2 tyrosine phosphorylation (2.5-fold) and IRS-2-associated PI 3-kinase activity (3-fold). Treadmill exercise, per se, had no effect on IRS-2 signaling, but in the period immediately after exercise, there was a further increase in insulin-stimulated IRS-2 tyrosine phosphorylation (3.5-fold) and IRS-2-associated PI 3-kinase activity (5-fold). In IRS-2-deficient (IRS-2-/-) mice, the increase in insulin-stimulated, phosphotyrosine-associated PI 3-kinase activity was attenuated as compared with WT mice. However, in IRS-2-/- mice, the insulin-stimulated, phosphotyrosine-associated PI 3-kinase response after exercise was slightly higher than the insulin-stimulated response alone. In conclusion, IRS-2 tyrosine phosphorylation and associated PI 3-kinase activity are markedly enhanced by insulin in the immediate period after exercise. IRS-2 signaling can partially account for the increase in insulin-stimulated phosphotyrosine-associated PI 3-kinase activity after exercise.

Endurance training in humans leads to fiber type-specific increases in levels of peroxisome proliferator-activated receptor-[gamma] coactivator-1 and peroxisome proliferator-activated receptor-[alpha] in skeletal muscle

The peroxisome proliferator-activated receptor (PPAR)-γ coactivator-1 (PGC-1) can induce mitochondria biogenesis and has been implicated in the development of oxidative type I muscle fibers. The PPAR isoforms α, β/δ, and γ control the transcription of genes involved in fatty acid and glucose metabolism. As endurance training increases skeletal muscle mitochondria and type I fiber content and fatty acid oxidative capacity, our aim was to determine whether these increases could be mediated by possible effects on PGC-1 or PPAR-α, -β/δ, and -γ. Seven healthy men performed 6 weeks of endurance training and the expression levels of PGC-1 and PPAR-α, -β/δ, and -γ mRNA as well as the fiber type distribution of the PGC-1 and PPAR-α proteins were measured in biopsies from their vastus lateralis muscle. PGC-1 and PPAR-α mRNA expression increased by 2.7- and 2.2-fold (P < 0.01), respectively, after endurance training. PGC-1 expression was 2.2- and 6-fold greater in the type IIa than in the type I and IIx fibers, respectively. It increased by 2.8-fold in the type IIa fibers and by 1.5-fold in both the type I and IIx fibers after endurance training (P < 0.015). PPAR-α was 1.9-fold greater in type I than in the II fibers and increased by 3.0-fold and 1.5-fold in these respective fibers after endurance training (P < 0.001). The increases in PGC-1 and PPAR-α levels reported in this study may play an important role in the changes in muscle mitochondria content, oxidative phenotype, and sensitivity to insulin known to be induced by endurance training.

Trial application of a model of resource utiliztion, costs, and outcomes for stroke (MORUCOS) to assist priority setting in stroke.

Background and Purpose— Cost-effectiveness data for stroke interventions are limited, and comparisons between studies are confounded by methodological inconsistencies. The aim of this study was to trial the use of the intervention module of the economic model, a Model of Resource Utilization, Costs, and Outcomes for Stroke (MORUCOS) to facilitate evaluation and ranking of the options.

Methods— The approach involves using an economic model together with added secondary considerations. A consistent approach was taken using standard economic evaluation methods. Data from the North East Melbourne Stroke Incidence Study (NEMESIS) were used to model "current practice" (base case), against which 2 interventions were compared. A 2-stage process was used to measure benefit: health gains (expressed in disability-adjusted life years [DALYs]) and filter analysis. Incremental cost-effectiveness ratios (ICERs) were calculated, and probabilistic uncertainty analysis was undertaken.

Results— Aspirin, a low-cost intervention applicable to a large number of stroke patients (9153 first-ever cases), resulted in modest health benefits (946 DALYs saved) and a mean ICER (based on incidence costs) of US $1421 per DALY saved. Although the health gains from recombinant tissue-type plasminogen activator (rtPA) were less (155 DALYs saved), these results were impressive given the small number of persons (256) eligible for treatment. rtPA dominates current practice because it is more effective and cost-saving.

Conclusions— If used to assess interventions across the stroke care continuum, MORUCOS offers enormous capacity to support decision-making in the prioritising of stroke services.

Genetic albation of the c-Cbl ubiquitin ligase domain results in increased energy expenditure and improved insulin action

Casitas b-lineage lymphoma (c-Cbl) is a multiadaptor protein with E3-ubiquitin ligase activity residing within its RING finger domain. We have previously reported that c-Cbl–deficient mice exhibit elevated energy expenditure, reduced adiposity, and improved insulin action. In this study, we examined mice expressing c-Cbl protein with a loss-of-function mutation within the RING finger domain (c-Cbl^A/– mice). Compared with control animals, c-Cbl^A/– mice display a phenotype that includes reduced adiposity, despite greater food intake; reduced circulating insulin, leptin, and triglyceride levels; and improved glucose tolerance. c-Cbl^A/– mice also display elevated oxygen consumption (13%) and are protected against high-fat diet–induced obesity and insulin resistance. Unlike c-Cbl^A/– mice, mice expressing a mutant c-Cbl with the phosphatidylinositol (PI) 3-kinase binding domain ablated (c-Cbl^F/F mice) exhibited an insulin sensitivity, body composition, and energy expenditure similar to that of wild-type animals. These results indicate that c-Cbl ubiquitin ligase activity, but not c-Cbl–dependent activation of PI 3-kinase, plays a key role in the regulation of whole-body energy metabolism.

Assessing adult adjustment to relationship separation : the Psychological Adjustment to Separation Test (PAST)

Relationship separation is associated with substantial adult adjustment problems. The Psychological Adjustment to Separation Test (PAST) was developed as a self-report measure of 3 key dimensions of separation adjustment problems: lonely negativity, ex-partner attachment and coparenting conflict. Two independent samples (n = 219 and n = 169, respectively) of recently separated adults, 60% of whom had children, completed the PAST and other measures of general adjustment. Exploratory and confirmatory factor analyses demonstrated a replicable 3-factor structure, with each factor showing satisfactory test–retest and internal reliability and good convergent and discriminant validity. The PAST meets initial criteria for a potentially useful new measure of adult separation adjustment.

Experimental study of ostensibly shamanic journeying imagery in naďve participants I: antecedents

The purpose of the present study was to investigate experimentally the antecedents of ostensibly shamanic journeying imagery associated with the Lower World in naïve participants. Forty six participants completed a composite questionnaire consisting of demographic items and the Tellegen Absorption Scale (Tellegen and Atkinson 1974). Participants were randomly assigned to one of five conditions: Harner's (1990) shamanic journeying to the Lower World instructions coupled with monotonous percussion drumming at either 4 or 8 beats-per-second for either 10 or 15 minutes; and sitting quietly with eyes closed for 15 minutes. Participants' phenomenology was retrospectively assessed using the Phenomenology of Consciousness Inventory (Pekala 1991) and a mental imagery checklist. The results indicated that there was a statistically significant difference between conditions with regards to the number of ostensibly shamanic journeying images. After adjusting for Harner's (1990) instructions, a significant main effect was found for both beats-per-second and time with regards to the number of ostensibly shamanic journeying images reported. There was a statistically significant relationship between condition and the tendency to report mental imagery associated with rocky ravines, predatory creatures, and rivers. Religious devotion was found to be a significant predictor of the number of ostensibly shamanic journeying images reported. Religious exposure and trait absorption were significant predictors of altered experience. Implications of the findings are discussed and suggestions for future research advanced.

Economic evaluation of Australian stroke services: a prospective, multicenter study comparing dedicated stroke units with other care modalities

Background and Purpose: Level I evidence from randomized controlled trials demonstrates that the model of hospital care influences stroke outcomes; however, the economic evaluation of such is limited. An economic appraisal of 3 acute stroke care models was facilitated through the Stroke Care Outcomes: Providing Effective Services (SCOPES) study in Melbourne, Australia. The aim was to describe resource use up to 28 weeks poststroke for each model and examine the cost-effectiveness of stroke care units (SCUs). Methods: A prospective, multicenter, cohort study design was used. Costs and outcomes of stroke patients receiving 100% treatment in 1 of 3 inpatient care models (SCUs, mobile service, conventional care) were compared. Health-sector resource use up to 28 weeks was measured in 1999. Outcomes were thorough adherence to a suite of important clinical processes and the number of severe inpatient complications. Results: The sample comprised 395 participants (mean age 73 [SD 14], 77% first-ever strokes, males 53%). When compared with conventional care (n=84), costs for mobile service (n=209) were significantly higher (P=0.024), but borderline for SCU (n=102, P=0.08; $AUD12 251; $AUD15 903; $AUD15 383 respectively). This was primarily explained by the greater use of specialist medical services. The incremental cost-effectiveness of SCUs over conventional care was $AUD9867 per patient achieving thorough adherence to clinical processes and $AUD16 372 per patient with severe complications avoided, based on costs to 28 weeks. Conclusions: Although acute SCU costs are generally higher, they are more cost-effective than either mobile service or conventional care.

Shamanic journeying imagery, constructivism and the affect bridge technique

Shamanic journeying imagery arguably occurs across cultures and historical epochs. However, to what extent is the content of the journeying imagery a construction of the shaman's cultural milieu, belief structures, autobiographical memories, and so forth. The present article finds the literature inconclusive on this question. It is suggested that attempts to answer it face a fundamental methodological problem: how to detect contextual influences on imagery that the shaman cannot report on because they are outside his/her present consciousness and memory. The authors propose a partial solution: Watkins' (1971) Affect Bridge, a memory “uncovering” technique used in hypnosis. A non-hypnotic version of the technique developed by one of the authors for inquiry into shamanic journeying imagery is then described.

Experimental study of ostensibly shamanic journeying imagery in naďve participants II: phenomenological mapping and modified affect bridge

This study develops the methodological framework advanced in Rock, Baynes, and Casey's (2005) experimental study of ostensibly shamanic journeying imagery in naïve participants. Specifically, the present study experimentally investigates the impact of the word landscape, featured in Harner's (1990) shamanic journeying to the Lower World instructions, on the number of landscape-related images reported; examines the origins of ostensibly shamanic journeying images; and maps the phenomenological state effects of shamanic journeying to the Lower World. Sixtyeight naïve participants were randomly assigned to one of three conditions: either the original or a revised version of Harner's (1990) instructions coupled with monotonous percussion drumming at 8 beats-per-second for 15 minutes, or sitting quietly with eyes open for 15 minutes. Each participant's subjective experience was retrospectively assessed using the Phenomenology of Consciousness Inventory (PCI) (Pekala 1991) and a mental imagery checklist. Subsequently, participants were administered the Modified Affect Bridge for the purpose of exploring the origins of mental imagery experienced during the experimental conditions. The results indicated that there was a statistically significant difference between conditions with regard to the number of ostensibly shamanic journeying images reported, but not between treatment conditions with regard to the number of landscaperelated images reported. There were no significant relationships between condition and mental imagery derived from autobiographical memories. There were statistically significant differences between conditions with regard to the PCI dimensions of fear, altered state of awareness, and arousal.

Casitas b-lineage lymphoma-deficient mice are pretected against high-fat diet-induuced obesity and insulin resistance

Casitas b-lineage lymphoma (c-Cbl) is a multiadaptor protein with E3-ubiquitin ligase activity involved in regulating the degradation of receptor tyrosine kinases. We have recently reported that c-Cbl^–/– mice exhibit a lean phenotype and enhanced peripheral insulin action likely due to elevated energy expenditure. In the study reported here, we examined the effect of a high-fat diet on energy homeostasis and glucose metabolism in these animals. When c-Cbl^–/– mice were fed a high-fat diet for 4 weeks, they maintained hyperphagia, higher whole-body oxygen consumption (27%), and greater activity (threefold) compared with wild-type animals fed the same diet. In addition, the activity of several enzymes involved in mitochondrial fat oxidation and the phosphorylation of acetyl CoA carboxylase was significantly increased in muscle of high-fat–fed c-Cbl–deficient mice, indicating a greater capacity for fat oxidation in these animals. As a result of these differences, fat-fed c-Cbl^–/– mice were 30% leaner than wild-type animals and were protected against high-fat diet–induced insulin resistance. These studies are consistent with a role for c-Cbl in regulating nutrient partitioning in skeletal muscle and emphasize the potential of c-Cbl as a therapeutic target in the treatment of obesity and type 2 diabetes.