Visually induced analgesia in a deep tissue experimental pain model: A randomised crossover experiment.

BACKGROUND: Visualizing one's own painful body part appears to have an effect on reported pain intensity. Furthermore, it seems that manipulating the size of the viewed image can determine the direction and extent of this phenomenon. When visual distortion has been applied to clinical populations, the analgesic effects have been in opposition to those observed in some experimental pain models. To help resolve this problem, we explored the effect of visualisation and magnification of the visual image on reported pain using a delayed onset muscle soreness (DOMS) pain model. METHODS: We induced DOMS in the quadriceps of 20 healthy volunteers. Forty-eight hours later, participants performed a series of painful contractions of the DOMS-affected muscle under four randomised conditions: (1) Viewing the injured thigh; (2) Viewing the contralateral thigh; (3) Viewing a neutral object; and (4) Viewing the injured thigh through magnifying glasses. For each condition, participants rated their pain intensity during a series of painful contractions. RESULTS: We observed that direct visualisation of the injured thigh had no effect on pain intensity when compared to viewing the contralateral thigh or neutral object. However, magnification of the DOMS-affected leg during the performance of painful contractions caused participants to report more pain than when viewing the injured thigh normally. CONCLUSIONS: These results further demonstrate that the effect of visualisation varies between different pain conditions. These results may have implications for the integration of visual feedback into clinical practice. SIGNIFICANCE: We present delayed onset muscle soreness as a model for exploring visually induced analgesia. Our findings suggest that this phenomenon is expressed differently in exogenous and endogenous experimental pain models. Further exploration may offer a potential pathway for the integration of visual analgesia into the management of clinical pain.

[Competent and diverse. Portrayal of older adults in Dutch television commercials ten years later]. / Competent en veelzijdig. Representatie van ouderen in de ster-reclame tien jaar later.

The present study replicates our study of older adults' portrayal in Dutch television commercials conducted in 1993. The central question is whether older adults are being portrayed more visibly in Dutch television commercials and whether this portrayal has become more diverse compared to ten years ago. Based on a list of descriptions of all commercials broadcasted by public television channels in 2003 (N= 4767) 117 commercials featuring older adults were selected. By means of a quantitative content analysis it was examined whether and how older men and women are portrayed. It was concluded that although older adults are not more prevalent compared to ten years ago, their portrayal is more diverse with respect to their roles and the advertised products. Older adults were portrayed as more competent and less age-stereotypical in television commercials.

Meaninglessness in the second half of life: the development of a construct.

A new construct of meaninglessness in the second half of life was presented. We found that four theoretically based components of the construct of meaninglessness were expressed in the self- and life-descriptions of 95 percent of 153 Dutch independently living aged adults (age between 58 to 90 years old). The self- and life-descriptions were assessed by a content analysis of participants' answers on a sentence completion questionnaire for personal meaning (SELE). With respect to the content of the components of meaninglessness, we found that a lack of goals and an impoverishment of meaning was responsible for most motivational meaninglessness. On the affective level, meaninglessness is far more characterized by dejection-related emotions, than by agitation-related emotions. Alienation from one's self, others, or society appeared to be characteristic for most of the cognitive component of meaninglessness. The self-evaluative component was mainly characterized by low self-esteem. A tentative explanation was presented for the differences in proportion of each of the components, pointing to the cumulative character of the construct itself. Meaninglessness correlates positively with the Geriatric Depression Scale (GDS) (r = .37, p < .01) and negatively with the Sense of Coherence Questionnaire (SOCQ) (r = -.31, p < .01), which contributes to the cross-validation of the construct.

[The elderly in TV commercials: ridiculous or respectable?]. / Ouderen in tv-reclamespots: Lachwekkend of respectabel?

This study on images of elderly (over 55 years old) in Dutch commercials involved a content-analysis of 1003 commercials. Older adults were shown in only 28 commercials. Elderly persons, and especially older women, appeared to be highly underrepresented. Only a few commercials (i.e., health support products) are directed at older adults as a target-group. Elderly persons are mostly represented in roles that create a pleasant atmosphere, such as grandparent or a retired enjoyer of life. Besides, aging is used as a metaphor for quality and tradition. For men, aging involves authority and life-experience. Apart from these positive links with old age, commercials were found that present the elderly as physically weak or incompetent. A considerable amount of commercials were humoristic. The authors interpret the results as characteristic of a predominantly negative portrayal of the elderly.

Preventing the recurrence of atonic postpartum hemorrhage: a double-blind trial.

BACKGROUND: We conducted a double-blind randomized controlled trial to compare a conventional regimen of oxytocin and ergometrine with administration of the prostaglandin E2 analogue, sulprostone, for prophylaxis of postpartum hemorrhage in high-risk women. METHODS: Women with a history of postpartum hemorrhage > or = 1000 were assigned to two coded prophylactic regimens. Drugs, given respectively at delivery of the anterior shoulder and after delivery of the placenta, were oxytocin and ergometrine in the control group, and sulprostone and placebo in the experimental group. Eighty-one women, 69 of whom actually participated in the trial, were investigated. Both the women and the caregivers were unaware of treatment allocation. RESULTS: Although the trial was terminated prematurely there was a slight, but not statistically significant, preference for the sulprostone regimen in terms of blood loss and use of blood transfusion. No serious adverse effects were noted with either of the two regimens. CONCLUSION: Prostaglandins may be more effective for preventing recurrence of severe postpartum hemorrhage than the oxytocin and ergometrine combination, but they do not eliminate the risk entirely.

Detection of fetomaternal haemorrhage associated with cordocentesis using serum alpha-fetoprotein and the Kleihauer technique.

Fetomaternal haemorrhage (FMH) was studied after 46 cordocenteses. alpha-Fetoprotein (AFP) concentration and Kleihauer staining of maternal blood, taken both before and after the procedure, revealed increases in AFP values of more than 40 per cent in 30 per cent of the patients examined; fetal haemorrhage of more than 0.25 ml was detected in 46 per cent of the cases by the Kleihauer test. In the second trimester of pregnancy both techniques are comparable, while in the third trimester the Kleihauer technique appears to be more sensitive in detecting FMH after cordocentesis. An anterior position of the placenta is a risk factor for FMH.

Maternal hydrops syndrome: a review.

The maternal hydrops syndrome (Ballantyne syndrome, mirror syndrome, pseudotoxemia, triple edema) is a preeclampsia-like disease observed in some pregnancies with severe fetal and/or placental hydrops. We describe three pregnancies with severe immunological fetal-placental hydrops resulting in fetal death, in spite of intrauterine transfusions. The mothers suffered severe hydrops syndrome, one of which was complicated by an eclamptic convulsion. All three women had anemia, low hematocrit, and elevated plasma uric acid levels. It is suggested that low hematocrit is an important pathophysiological feature in maternal hydrops syndrome.