Although canine identification of body odor (BO) has been widely used as forensic evidence, the concept of nosewitness identification by human observers was only recently put to the test. The results indicated that BOs associated with male characters in authentic crime videos could later be identified in BO lineup tests well above chance. To further evaluate nosewitness memory, we assessed the effects of lineup size (Experiment 1) and retention interval (Experiment 2), using a forced-choice memory test. The results showed that (...) nosewitness identification works for all lineup sizes (3, 5, and 8 BOs), but that larger lineups compromise identification performance in similarity to observations from eye- and earwitness studies. Also in line with previous eye- and earwitness studies, but in disagreement with some studies on odor memory, Experiment 2 showed significant forgetting between shorter retention intervals (15 min) and longer retention intervals (1-week) using lineups of five BOs. Altogether this study shows that identification of BO in a forensic setting is possible and has limits and characteristics in line with witness identification through other sensory modalities. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Multiple Sclerosis is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation, may be protective against enactment of maladaptive (...) risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients newly diagnosed with MS. Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness. (shrink)

The coefficients of internal consistency and retest reliability had been rarely investigated within the methodology of dream content analysis. Analyzing a dream series of elderly, healthy persons obtained from weekly telephone interviews, the internal consistency of a series of 20 dreams and retests after 4 or 22 weeks, respectively, had been computed. The findings indicate that dream recall and dream length are quite stable, but dream characteristics such as bizarreness and emotional tone underlie large intraindividual fluctuations. In order to (...) obtain reliable measures for these variables which will be important for correlational studies, including waking-life trait measures, one has to obtain as many dreams as possible (about 20) in a very short time period. Further research is needed to extend the present findings to diary dreams and laboratory dreams. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

This study investigated the differences between past and future temporal discounting in terms of neural activity in relation to temporal distance. Results show that brain regions are engaged differently in past and future temporal discounting. This is likely because past temporal discounting requires memory reconstruction, whereas future temporal discounting requires the processing of uncertainty about the future. In past temporal discounting, neural activity differed only when preferences were made between rewards received one hour prior and rewards received further in the (...) past. The peak amplitudes of P2 and P3 varied as the temporal distance increased from 2 weeks to 50 years. In future temporal discounting, neural activity differed only when preferences were evaluated between two delayed rewards. The delay conditions and had a significant influence on P2 and N2. Findings indicate the existence of different decision-making systems operating in past and future temporal discounting. (shrink)

Transcutaneous auricular vagus nerve stimulation, a non-invasive alternative to vagus nerve stimulation with implantable devices, has shown promise in treating disorders such as depression, migraine, and insomnia. Studies of these disorders with resting-state functional magnetic resonance imaging have found sustained changes in resting-state functional connectivity in patients treated with low frequency taVNS. A recent study has reported reductions in pain scores in patients with rheumatoid arthritis after a 12-week treatment of high-frequency sub-threshold taVNS. However, no studies to date have examined (...) the effects of high-frequency sub-threshold taVNS on rsFC. The objective of this study was to determine whether high-frequency sub-threshold taVNS induces changes in rsFC using seed regions from the cingulate cortex and insula, brain regions that play a key role in interoception and processing of pain. With a single-blind placebo-controlled repeated measures experimental design, rsfMRI scans were acquired before and after 15 min of either sub-threshold taVNS treatment or a sham control. Significant taVNS-related changes in functional connections to the cingulate cortex were detected between the anterior cingulate cortex and right superior temporal gyrus and between the midcingulate cortex and right inferior parietal lobule. In addition, significant changes in functional connections to the insula were detected between the posterior insula and right precuneus and between the anterior insula and right cuneus gyrus. These results suggest that high-frequency sub-threshold taVNS can lead to sustained effects on the rsFC of brain regions involved in interoception and processing of pain in a cohort of healthy subjects. This study lays the foundation for future rsfMRI studies of high-frequency sub-threshold taVNS in clinical populations. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

Objective: While behavioral recommendations regarding physical activity commonly focus on reaching demanding goals by proposing ‘thresholds’, little attention has been paid to the question of how much of a behavioral change is needed to make people feel that they have changed. The present research investigated this relation between actual and felt behavior change. Design: Using data from two longitudinal community samples, Study 1 and 2 comprised 614 (63 % women) and 398 participants (61 % women) with a mean age of (...) 40.9 years (SD = 13.6) and 42.5 years (SD = 13.4), respectively. Using a stage-approach, participants were classified into four groups by asking them at the respective second measurement to indicate whether they had become more physically active since their last participation six months ago (“Changers”), had tried but did not succeed in becoming more physically active (“Attempters”), were already physically active on a regular basis (“Regular Actives”), or had not tried to become more physically active (“Non-Attempters”). Physical activity was measured using the International Physical Activity Questionnaire (IPAQ), and fitness level was assessed as physical working capacity (PWC) via bicycle ergometry. Mixed ANOVAs including Time and Perceived Change as within and between factors were conducted, followed up by simple effect analyses. Results: Participants stating to have become more active in the past six months (Changers) showed a significant increase in vigorous physical activity but not in moderate physical activity, with an average of 6.8 (Study 1) and 10.6 (Study 2) MET-h per week in vigorous activity. Corroborating these findings, objective fitness also significantly increased in the group of Changers. No systematic change in moderate or vigorous physical activity was observed for the three other ‘non-changer’ groups (regular actives, attempters, non-attempters). Conclusion: The intensity of physical activity is the crucial variable for people’s perception of change in physical activity. Moderate physical activity seems not to be perceived as an effective means for behavior change. It thus might fail to unfold sufficient motivational impact, despite its known positive effects on health. (shrink)

A re-examination of the anonymous Commentary on the Theaetetus, henceforth abbreviated K, is overdue. It may yet prove to be the most important document we possess for plotting the course of pre-Plotinian Platonism, and is by far the largest surviving portion of a pre-Plotinian commentary on a complete work of Plato. It offers us insights into the issues of the first century B.C. which are unparalleled in other extant Middle Platonist works, either because of the subject of the work and (...) its consequent tendency to bring to mind the epistemological debates between Philo of Larissa, Antiochus of Ascalon, and Aenesidemus, or because the author, whom we may call A, is writing at a time comparatively close to those debates. (shrink)

This paper presents four different understandings of the family and their concomitant views of the authority of the family in pediatric medical decision making. These different views are grounded in robustly developed, and conflicting, worldviews supported by disparate basic premises about the nature of morality. The traditional worldviews are often found within religious communities that embrace foundational metaphysical premises at odds with the commitments of the liberal account of the family dominant in the secular culture of the West. These disputes (...) are substantial and ultimately irresolvable by sound rational argument because of the failure to share common foundational premises and rules of evidence. It is in light of these fundamental disagreements that there is a need to evaluate critically the claims and agenda advanced by the Convention on the Rights of the Child. (shrink)

This essay provides evidence to support a promising conceptual and potentially practical set of ideas at once both principled and effective found in the work of Max Weber and Alfred Schutz addressed to the issue of ‘adequacy’ as a goal in social research. Efforts to achieve adequacy beyond the epistemological conditions required by Weber’s demand that evidence meet both causal adequacy and adequacy on the level of meaning were significantly refocused by Schutz’s later concern, responding specifically to Weber, that the (...) social sciences also address themselves to his postulate of adequacy. It states that “Each term used in a scientific system referring to human action must be so constructed that a human act performed within the life-world by an individual actor in the way indicated by the typical construction would be reasonable and understandable for the actor himself, as well as for his fellow men”. A serious attempt to implement a more expansive notion of adequacy by practically activating this postulate in the ways suggested can be beneficial not only for the social research situation but in everyday life as well. (shrink)

Long-term care is controversial because it involves foundational disputes. Some are moral-economic, bearing on whether the individual, the family, or the state is primarily responsible for long-term care, as well as on how one can establish a morally and financially sustainable long-term-care policy, given the moral hazard of people over-using entitlements once established, the political hazard of media democracies promising unfundable entitlements, the demographic hazard of relatively fewer workers to support those in need of long-term care, the moral hazard to (...) responsibility of shifting accountability to third parties, and the bureaucratic hazard of moving from individual and family choice to bureaucratic oversight. These disputes are compounded by controversies regarding the nature of the family (Is it to be regarded primarily as a socio-biological category, a fundamental ontological category of social reality, or a construct resulting from the consent of the participants?), as well as its legal and moral autonomy and authority over its members. As the disputes show, there is no common understanding of respect and human dignity that will easily lead out of these disputes. The reflections on long-term care in this issue underscore the plurality of moralities defining bioethics. (shrink)

In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that (...) it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism. (shrink)

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general (...) custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms. (shrink)

Rather than revealing itself as a single, unified, ecumenical faith, Christianity is sundered with Christians united neither in one communion nor in one baptism. Christian Bioethics seeks to examine the traditional content-full moral commitments which the Christian faiths bring to life, sexuality, suffering, illness and death within the contexts of medicine and health care. Seeking to understand the differences which separate the bioethics of Roman Catholics, Protestants, and the Orthodox, Christian Bioethics explores the manners in which the faiths diverge. The (...) failure of the Enlightenment project to disclose a content-full communality that would bind mankind has left much to be reconsidered by Christians who face new ethical dilemmas in the novel guise of advances in health care technologies. (shrink)

Popper’s view of scientific activity appears to take its social and communitarian features largely for granted. Rather than making this inter-subjectivity the basic problematic in his work, he wanted to move beyond language without, however, foreclosing the possibility that communication may often be a source of confusion in research and related scientific activity. Popper feared that the study of science, no less than scientific activity itself, may be led astray by an overly reflexive approach and focus. There are aspects of (...) his views on this matter which bear a considerable resemblance to Bacon, even though Popper is clearly a Cartesian deductivist rather than a Baconian inductivist, for reasons that become apparent in The Logic of Scientific Discovery. According to Popper, no such practice or method of discovery exists, either in science or anywhere else. (shrink)

The current debate on health care resource allocation in the Netherlands is characterized by a social context in which two values are generally and traditionally accepted as being equally fundamental: solidarity and equity. We will present an outline of the distinctive features of the Dutch health care system, and analyze the present state of affairs in the resource allocation debate. The presuppositions of the political call for constraint and (renewed) government supervision and the role of the specific value context in (...) recent proposals for reconstruction of the Dutch health care system will be evaluated. (shrink)