Rébecca Shankland

Premedication for neonatal endotracheal intubation: results from the epidemiology of procedural pain in neonates study.

Objectives: To describe the frequency and nature of premedications used prior to neonatal endotracheal intubation; to confront observed practice with current recommendations; and to identify risk factors for the absence of premedication. Design, Setting, and Patients: Data concerning intubations were collected prospectively at the bedside as part of an observational study collecting around-the-clock data on all painful or stressful procedures performed in neonates during the first 14 days of their admission to 13 tertiary care units in the region of Paris, France, between 2005 and 2006. Intervention: Observational study. Measurements and Main Results: Specific premedication prior to endotracheal intubation was assessed. Ninety one intubations carried out on the same number of patients were analyzed. The specific premedicationrate was 56% and included mostly opioids (67%) and midazolam (53%). Compared with recent guidance from the American Academy of Pediatrics, used premedications could be classified as “preferred” (12%), “acceptable” (18%), “not recommended” (27%), and “not described” (43%). In univariate analysis, infants without a specific premedication compared with others were younger at the time of intubation (median age: 0.7 vs. 2.0 days), displayed significantly more frequent spontaneous breathing at the time of intubation (31% vs. 12%) and a higher percentage of analgesia for all other painful procedures (median values: 16% vs. 6%). In multivariate analysis, no factor remained statistically significant. Conclusions: Premedication use prior to neonatal intubation was not systematically used and when used it was most frequently inconsistent with recent recommendations. No patient- or center-related independent risk factor for the absence of premedication was identified in this study.

Some like it hot: Testosterone predicts laboratory eating behavior of spicy food

In the present study, we analyzed the relationship between eating behavior of spicy food and endogenous testosterone. Participants included 114 males between the ages of 18 and 44 recruited from the community. They were asked to indicate their preferences regarding spicy food and were then asked to season a sample of mashed potatoes with pepper sauce and salt (control substance) prior to evaluating the spiciness of the meal. A positive correlation was observed between endogenous salivary testosterone and the quantity of hot sauce individuals voluntarily and spontaneously consumed with a meal served as part of a laboratory task. In contrast, significant correlations were not observed between testosterone and behavioral preference for salty foods. This study suggests that behavioral preference for spicy food among men is related to endogenous testosterone levels.

Preliminary study on the role of alternative educational pathways in promoting the use of problem-focused coping strategies

Coping styles are generally considered to be environmentally driven. Up to now, research has mainly focused on family influences. However, some studies underline the effect of educational settings on the development of problem-focused coping strategies. Consistently with previous reports on the enhancement of autonomy and problem-solving in alternative schools, and the relationship established by self-determination theory between autonomy-supportive climates and positive coping, we hypothesized that alternative school students develop more problem-focused coping styles. This hypothesis was tested on 80 traditional school students and 50 alternative school students (Steiner, Montessori and New schools), during their last secondary school year, using the Coping Inventory for Stressful Situations (Endler & Parker, 1990a). We also assessed psychological factors which can influence coping styles measures (anxiety and depression), using the State-Trait Anxiety Inventory (Spielberger, 1983), and the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). The proportion of problem-focused coping strategies was compared in traditional and alternative settings, adjusting for potential confounding factors, using logistic regression. Results show that the proportion of students using predominantly problem-focused coping strategies is higher in the population of alternative schools. Directions for further research on alternative schools are highlighted concerning coping as well as autonomy-supportive class climates.RésuméLes recherches concernant l’impact de l’environnement sur le style de coping se sont principalement intéressées à l’influence de la famille. Cependant, quelques études soulignent l’effet de méthodes pédagogiques sur le développement des stratégies de “coping“. A partir des études concernant le soutien de l’autonomie (théorie de l’autodétermination), nous avons émis l’hypothèse selon laquelle les élèves d’écoles alternatives utilisent davantage un coping centré sur le problème. Cette hypothèse a été testée sur une population de 130 élèves (80 du système scolaire traditionnel, 50 d’écoles alternatives), au cours de leur dernière année de lycée, en utilisant l’Inventaire de Coping pour Situations Stressantes (Endler & Parker, 1990a). D’autres facteurs psychologiques pouvant influencer la mesure du style de coping (anxiété et dépression) ont été évalués, à l’aide de l’Inventaire d’Anxiété Trait et Etat (Spielberger, 1983), et l’Inventaire de Dépression de Beck (Beck et al., 1961). La proportion d’élèves utilisant des stratégies de coping centrées sur le problème est comparée (écoles traditionnelles vs. alternatives), après ajustement sur les facteurs de confusion, par régression logistique. Les résultats montrent que la proportion d’élèves utilisant majoritairement des stratégies de coping centrées sur le problème est plus importante dans la population des écoles alternatives. Des pistes de recherche sont proposées concernant le coping ainsi que le climat de classe.

Omega-3 supplements reduce self-reported physical aggression in healthy adults

There is emerging evidence that Omega-3 polyunsaturated fatty acids (PUFA) supplements can decrease aggression. However, experimental studies with adults from non-specific populations are scarce. We hypothesized that Omega-3 supplements would decrease self-reported aggression among non-clinical participants. In a double-blind randomized trial, two groups of participants (N = 194) aged 18-45 from the general population followed a 6-weeks treatment with 638mg docosahexaenoic acid (DHA) and 772mg eicosapentaenoic acid (EPA) per day or the equivalent quantity of copra oil (placebo). Self-reported aggressiveness was measured at baseline and after the 6-week treatment period. Findings showed that Omega-3 supplements significantly decreased self-reported aggressiveness at the end of the 6-week period (d = 0.31). In conclusion, this experiment indicates that Omega-3 administration has beneficial effects in reducing aggression among the general population.

Reducing Current Limitations in Order to Enhance the Quality of Subjective Well-Being Research: The Example of Mindfulness

Biases are numerous in the literature on subjective well-being. This is true for measures of life satisfaction as well as for measures related to it, for instance mindfulness . Reviewing the literature on mindfulness measures, we identified eleven self-report questionnaires measuring trait mindfulness and three measuring state mindfulness . However, several limitations of these measures have been recently highlighted. First of all, these scales aim at capturing different constructs although they use the same name (mindfulness). Second, among the scales that aim at measuring the same construct (following the same definition of mindfulness), most of them measure a selection of dimensions of mindfulness, thereby limiting the relevance of comparisons between studies. Third, there are concerns about the vocabulary used. Because they were initially conceived to measure effects of mindfulness practices on state or trait mindfulness, these tools are composed of items which participants may find strange or hard to understand before knowing what mindfulness is (i.e., during preprogram measures). While the CHIME was designed to help reduce these vocabulary problems, it does not address a third major limitation of all these measures, namely the difference in insight between participants who have never undertaken any form of mindfulness practice, compared to those who already have some experience. When participants complete questionnaires before taking part in a mindfulness-based intervention, they may have a biased (over-optimistic) vision of their attentional competences and their automatic behaviors, precisely because these are mainly unconscious in nature. This chapter presents current mindfulness measurement tools and further research perspectives in this field.