Three-factor structure and psychometric properties of Witte's Risk Behaviour Diagnosis Scale: A French version adapted to diabetes.

The aim of this study was to verify the psychometric properties and the factorial structure of Witte's Risk Behaviour Diagnosis (RBD). This article shows the results of a French version of the RBD adapted to diabetes screening. An exploratory factor analysis was carried out in order to understand the number of underlying factors, a confirmatory factor analysis was performed and the four-factor model proposed by the author and alternative models were compared. The concurrent validity was tested by a correlational analysis with the Perceived Fear Emotions Scale. The results confirmed a stable factor structure for the 12-item version, with three factors reflecting total efficacy, severity of and susceptibility to threat. The value of having a psychometrically valid instrument to assess the impact of fear appeal-based campaigns is linked to the current lack of a comprehensive assessment tool and the importance of preventing health risk behaviours.

The power of a handshake: neural correlates of evaluative judgments in observed social interactions.

Effective social interactions require the ability to evaluate other people's actions and intentions, sometimes only on the basis of such subtle factors as body language, and these evaluative judgments may lead to powerful impressions. However, little is known about the impact of affective body language on evaluative responses in social settings and the associated neural correlates. This study investigated the neural correlates of observing social interactions in a business setting, in which whole-body dynamic stimuli displayed approach and avoidance behaviors that were preceded or not by a handshake and were followed by participants' ratings of these behaviors. First, approach was associated with more positive evaluations than avoidance behaviors, and a handshake preceding social interaction enhanced the positive impact of approach and diminished the negative impact of avoidance behavior on the evaluation of social interaction. Second, increased sensitivity to approach than to avoidance behavior in the amygdala and STS was linked to a positive evaluation of approach behavior and a positive impact of handshake. Third, linked to the positive effect of handshake on social evaluation, nucleus accumbens showed greater activity for Handshake than for No-handshake conditions. These findings shed light on the neural correlates of observing and evaluating nonverbal social interactions and on the role of handshake as a way of formal greeting.

Impact on mental health of deploying as an individual augmentee in the U.K. Armed Forces.

Armed Forces personnel who deploy as individual augmentees (IAs), with a unit other than their formed unit, often fill shortages or provide specialized knowledge or skill sets. This article examined the effect of deploying as an IA on mental health outcomes and unit cohesion. A U.K. military cohort study was used to compare IAs (n = 1352) with personnel who had deployed with a formed unit (n = 2980). Differences between the groups in questionnaire assessed symptoms of post-traumatic stress disorder (PTSD Checklist-Civilian Version), common mental disorders (General Health Questionnaire-12) and alcohol misuse (Alcohol Use Disorders Identification Test) were examined with logistic and negative-binomial regression analyses. There was no difference between IAs and those who deployed with a formed unit in level of unit cohesion, symptoms of post-traumatic stress disorder or common mental disorder. Deployment as an IA was associated with less alcohol misuse (Odds Ratio 0.77, 95% Confidence Interval 0.63-0.94). IAs appeared able to integrate with the group they deployed with as levels of unit cohesion were similar to personnel who deployed with a formed unit. IAs were also at a lower risk of alcohol misuse compared to personnel who deployed with a formed unit.

Brain imaging investigation of the neural correlates of observing virtual social interactions.

The ability to gauge social interactions is crucial in the assessment of others' intentions. Factors such as facial expressions and body language affect our decisions in personal and professional life alike (1). These "friend or foe" judgements are often based on first impressions, which in turn may affect our decisions to "approach or avoid". Previous studies investigating the neural correlates of social cognition tended to use static facial stimuli (2). Here, we illustrate an experimental design in which whole-body animated characters were used in conjunction with functional magnetic resonance imaging (fMRI) recordings. Fifteen participants were presented with short movie-clips of guest-host interactions in a business setting, while fMRI data were recorded; at the end of each movie, participants also provided ratings of the host behaviour. This design mimics more closely real-life situations, and hence may contribute to better understanding of the neural mechanisms of social interactions in healthy behaviour, and to gaining insight into possible causes of deficits in social behaviour in such clinical conditions as social anxiety and autism (3).

Implementation of MADIT and MUSTT in clinical practice: results of an international survey.

BACKGROUND: The long-awaited dramatically positive outcome of the Multicenter Automatic Defibrillator Implantation Trial (MADIT II), just published by Moss et al.,(14) has generated cardiologists' interest on the implementation into clinical practice of that trial. Important lessons may be learned by examining the clinical implementation of two preceding randomized, prospective, prophylactic ICD trials: the original MADIT trial, published late 1996, and the Multicenter Unsustained Tachycardia Trial (MUSTT), published late 1999. Both demonstrated that implantable cardioverter defibrillators reduce all-cause mortality by over 50% in high risk patients without previous sustained arrhythmias. METHODS: In early 2000, we surveyed 133 active electrophysiology centers (47 American, 81 European, 5 Canadian) to determine the extent to which these practices have been implemented in clinical practice during 1999, and the responses were compared to a similar survey for the year 1998. RESULTS: ICDs implanted for MADIT or MUSTT criteria accounted for 18% of new ICD implants in 1999, 65% greater than in 1998, increasing from 6% to 11% in Europe, and from 15% to 24% in America. During 1999, 53% of patients receiving ICDs for these indications were inpatients identified during hospitalization, 27% were outpatients referred specifically for MADIT/MUSTT indications, and 20% were identified by routine screening. Per the survey, in 1999 68% of responders were "somewhat (10-20%)" and 14% were "considerably (>20%)" more likely to implant ICDs for all indications. CONCLUSIONS: Extrapolating the results of this survey to all initial ICD implants for 1999, we estimate that 8500 implants for MADIT/MUSTT criteria took place in 1999, with the overall number of such implants substantially increased over the previous year, irrespective of geographic location, and influenced significantly by the publication of MUSTT. However, screening and implant practices between centers continue to vary over a broad spectrum. It will be interesting to observe whether similar patterns will follow with MADIT II.

Holter recordings with continuous marker annotation to evaluate pacemaker function.

BACKGROUND: Pacemaker marker annotations facilitate the interpretation of device behavior in addition to ECG recordings. However, they are only available in conjunction with a programmer. We studied the diagnostic value of a prototype Telemetry Holter Decoder (THD), providing continuous marker annotations on a conventional Holter. METHODS: The study included 20 patients with VDD or DDDR pacemakers. A 24-hour Holter was performed using the THD. Marker annotations are transmitted from the pacemaker to the THD, which transforms them into analog signals, which are recorded on one of the Holter channels. RESULTS: During a total recording time of 458 hours, high quality marker annotations were retrieved for every patient. Artefacts disturbed the recordings during 184 min (0.67%). The THD provided information not discernible on the ECG: intermittent atrial undersensing during sinus rhythm (1096 times). Atrial tachycardias, not visible on the ECG, were detected in 2 patients. The activation of tachycardia response algorithms was clearly annotated in 11,516 events. A total of 8875 PVC's occurred, 57.8% of which were classified incorrectly in the event counters as conducted or fusion beats. Atrial far-field sensing or VA conduction was demonstrated 4294 times. Electromagnetic interferences, not visible on the ECG, could be seen three times. CONCLUSION: Recording of continuous high-quality marker annotation on a conventional Holter is feasible. The THD provides important information on device behavior, even in patients assumed to have regular device function, and shows to be clearly superior to ECG interpretation alone. Such data can be used for improved programming, troubleshooting and for the validation of new algorithms.