Yawning and cortisol levels in multiple sclerosis: Potential new diagnostic tool.

Yawning is a significant behavioural response and, together with cortisol, is potentially a new diagnostic marker of neurological diseases. Evidence of an association between yawning and cortisol was found which supports the Thompson Cortisol Hypothesis and thermoregulation hypotheses, indication that brain cooling occurs when yawning. 117 volunteers aged 18-69 years were randomly allocated to experimentally controlled conditions to provoke yawning. Thirty-three had been diagnosed with multiple sclerosis. Saliva cortisol samples were collected before and after yawning or after stimuli presentation in the absence of yawning. Hospital Anxiety and Depression Scale, General Health Questionnaire, demographic and health details were collected. Comparisons were made of yawners and non-yawners, healthy volunteers and MS participants. EXCLUSION CRITERIA: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, stroke. Yawners had significant differences between saliva cortisol sample 1 and 2 among healthy participants (p < .007) and MS participants (p < .003). There was significant difference between the healthy versus MS non-yawners (P < .042) but not between yawners (p < .862). These results support the Thompson Cortisol Hypothesis suggesting that cortisol levels are elevated during yawning. Furthermore, this evidence suggests cortisol levels in the MS participants (non-yawners) are significantly different to those of healthy participants. Changes in cortisol levels may be similar in healthy and MS participants but when associated with observations of excessive yawning may become a new diagnostic tool in the early diagnosis of neurological symptoms. DRYAD DOI: https://doi.org/10.5061/dryad.r09m1.

Questionnaire study to gain an insight into the manufacturing and fitting process of artificial eyes in children: an ocularist perspective.

PURPOSE: To gain an insight into the manufacturing and fitting of artificial eyes in children and potential improvements to the process. METHOD: An online qualitative survey was distributed to 39 ocularists/prosthetists in Europe and Canada. Participants were recruited through purposive sampling, specifically maximum variation sampling from the researcher's contacts and an online search. RESULTS: The findings highlighted the current impression technique as being the most difficult yet most important part of the current process for both the ocularist and child patient. Negatively affecting obtaining a good impression, the child patients distress can be reduced by their parents by providing encouragement, reassurance, practicing the insertion and removal of the artificial eye and being matter of fact. Whilst improvements to the current process provided mixed views, the incorporation of current technology was perceived as not being able to meet the requirements to produce aesthetically pleasing artificial eyes. CONCLUSION: The current artificial eye process can be seen as an interaction with its success being dependent on the child patient's acceptance and adjustment which is dependent on the factors associated to the process. Investigation into the needs of the patient and whether technology can improve the process are the next steps in its advancement.

A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.

OBJECTIVE: Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. METHODS: A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. RESULTS: Studies using the PTSD Checklist-Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5-11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7-14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1-25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8-8.9, k = 9). Between-study heterogeneity was substantial (I(2) = 54-87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist-Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R(2) = 0.56, p < 0.05). DISCUSSION: The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Yawning, fatigue, and cortisol: expanding the Thompson Cortisol Hypothesis.

Yawning and its involvement in neurological disorders has become the new scientific conundrum. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. However, the link between yawning, fatigue, and cortisol has not been fully understood. Expansion of the Thompson Cortisol Hypothesis proposes that the stress hormone, cortisol, is responsible for yawning and fatigue especially in people with incomplete innervation such as multiple sclerosis. This informs our understanding of the functional importance of the brain stem region of the brain in regulating stress and fatigue.

Born to yawn? Cortisol linked to yawning: a new hypothesis.

Yawning has become an interesting and curious scientific conundrum. Links between several neurological disorders can be found through the commonality of yawning episodes and contagious yawning. However, the reasons why we yawn are uncertain. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. We do not know whether cortisol levels fluctuate during yawning. Potentially, yawning and cortisol levels may provide a valuable diagnostic tool and warning of untoward underlying neurological problems. A new hypothesis is proposed that links cortisol levels with yawning episodes.

The dawn of the yawn: is yawning a warning? Linking neurological disorders.

Yawning continues to pose as a scientist's conundrum. Evidence is presented of yawning and contagious yawning in a number of different neurological disorders. Explanations are discussed in the context of disparate neurological disorders together with proposals for how theses findings may be linked. Thus, greater understanding of yawning and of neurological disorders may be achieved by exploring common neuro-chemical pathways and the involvement of neurotransmitters that are implicated in these different disorders. Finally, contagious yawning is discussed in the context of the susceptibility of persons and the similarity this presents with our understanding of the mechanisms involved in hypnosis.

Nonquantum entanglement resolves a basic issue in polarization optics.

The issue raised in this Letter is classical, not only in the sense of being nonquantum, but also in the sense of being quite ancient: which subset of 4x4 real matrices should be accepted as physical Mueller matrices in polarization optics? Nonquantum entanglement or inseparability between the polarization and spatial degrees of freedom of an electromagnetic beam whose polarization is not homogeneous is shown to provide the physical basis to resolve this issue in a definitive manner.

A complete characterization of pre-Mueller and Mueller matrices in polarization optics.

The Mueller-Stokes formalism that governs conventional polarization optics is formulated for plane waves, and thus the only qualification one could require of a 4 x 4 real matrix M in order that it qualify to be the Mueller matrix of some physical system would be that M map Omega((pol)), the positive solid light cone of Stokes vectors, into itself. In view of growing current interest in the characterization of partially coherent partially polarized electromagnetic beams, there is a need to extend this formalism to such beams wherein the polarization and spatial dependence are generically inseparably intertwined. This inseparability brings in additional constraints that a pre-Mueller matrix M mapping Omega((pol)) into itself needs to meet in order to be an acceptable physical Mueller matrix. These additional constraints are motivated and fully characterized.

Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries.

OBJECTIVE: To evaluate a newly developed education programme for Parkinson's disease (PD) patients. METHODS: The programme consisted of eight sessions and aimed at improving knowledge and skills related to self-monitoring, health promotion, stress management, depression, anxiety, social competence, and social support, all with special reference to PD. The programme was formatively evaluated in seven European countries (Spain, Finland, Italy, The Netherlands, United Kingdom, Estonia, Germany) with 151 patients diagnosed with idiopathic PD. The evaluation included patients' ratings of the comprehensibility and feasibility of the programme as well as mood ratings before and after each session. Patients also completed questionnaires at the beginning and end of the programme to explore possible changes in disease-related psychosocial problems, quality of life, and depression. RESULTS: The programme was feasible to run, and patients were able to understand its elements. Patients reported mood elevations following individual sessions and reduced disease-related psychosocial problems after completing the programme. There were no substantial differences in results between cultures. CONCLUSION: Patient education appears to have potential as a useful and feasible intervention, complementing medical treatment in PD. PRACTICE IMPLICATIONS: The present programme will soon be available in seven European languages and can be tested in different health care systems.

An innovative education programme for people with Parkinson's disease and their carers.

Within a consortium of seven European countries, an education programme for people with Parkinson's disease (PD) and their carers was developed. Comprising eight 90-min sessions, the EduPark patient education programme deals with psychosocial problems often faced by people with PD and their carers. The implementation and initial evaluation in the UK of this innovative programme are described. The programme was favourably evaluated by participants, and resulted in short-term positive effects on their mood, although no statistically significant effects on quality of life and depression were found. The programme appears to provide a promising means for empowering people with PD and their carers to deal with psychosocial challenges.

A theoretical model of infant incubator dynamics.

A spatially lumped mathematical model was developed and used for a computer simulation of the neonate-incubator system for parametric analysis of the factors that influence neonatal thermo-regulation. The simulation examined the effects of the following parameters: (1) size of the infant; (2) respiratory rate; (3) metabolic rate; (4) heart rate; (5) thermal properties of the mattress; (6) specific heat capacity of the incubator wall; (7) air flow rate; (8) heater control mechanisms.