Self-regulation and protective health behaviour: how regulatory focus and anticipated regret are related to vaccination decisions

OBJECTIVE

We examined how individual motivational orientations and anticipated regret are related to the protective health decision of vaccination behaviour.

DESIGN

The proposed relations were examined in a large-scale sample (N = 3168) and three medium-sized samples (N = 151, N = 194, N = 208). Questionnaires were applied to assess regulatory focus, anticipated regret and vaccination behaviour.

RESULTS

Increased prevention-focused self-regulation - which is represented by concerns about security-related goals, responsibilities and obligations - was related to a greater likelihood of vaccination. Prevention-focused individuals' higher likelihood of getting vaccinated seems at least in part to be a consequence of anticipated regret for not vaccinating. Study 3 suggests that regulatory focus is less related to vaccination decisions when regret is increased by the decision-making context; that is, when information highlighting vaccination effectiveness and a low likelihood of adverse responses is provided.

CONCLUSION

Prevention-focused self-regulation is related to a greater likelihood of engaging in health-protective behaviour. This can be explained by prevention-focused individuals' greater tendency to anticipate regret about getting ill as a consequence of not adopting protective measures. If people perceive a protective measure such as a vaccination as highly effective, anticipated regret for not adopting it is generally increased, and individual differences in regulatory focus no longer predict the decision.

Regulatory fit effects on perceived fiscal exchange and tax compliance

Paying taxes can be considered a contribution to the welfare of a society. But even though tax payments are redistributed to citizens in the form of public goods and services, taxpayers often do not perceive many benefits from paying taxes. Information campaigns about the use of taxes for financing public goods and services could increase taxpayers' understanding of the importance of taxes, strengthen their perception of fiscal exchange and consequently also increase tax compliance. Two studies examined how fit between framing of information and taxpayers' regulatory focus affects perceived fiscal exchange and tax compliance. Taxpayers should perceive the exchange between tax payments and provision of public goods and services as higher if information framing suits their regulatory focus. Study 1 supported this hypothesis for induced regulatory focus. Study 2 replicated the findings for chronic regulatory focus and further demonstrated that regulatory fit also affects tax compliance. The results provide further evidence for findings from previous studies concerning regulatory fit effects on tax attitudes and extend these findings to a context with low tax morale.

Framing of information on the use of public finances, regulatory fit of recipients and tax compliance

Information campaigns to increase tax compliance could be framed in different ways. They can either highlight the potential gains when tax compliance is high, or the potential losses when compliance is low. According to regulatory focus theory, such framing should be most effective when it is congruent with the promotion or prevention focus of its recipients. Two studies confirmed the hypothesized interaction effects between recipients' regulatory focus and framing of information campaigns, with tax compliance being highest under conditions of regulatory fit. To address taxpayers effectively, information campaigns by tax authorities should consider the positive and negative framing of information, and the moderating effect of recipients' regulatory focus.

Studies in organic archaeometry VII--differentiation of wood and bark pitches by pyrolysis capillary gas chromatography (PY-CGC)

Tars and pitches were prepared from wood and bark of various deciduous trees and conifers and analysed with the intention to distinguish between various starting materials. All this was done before the background of an archaeometrical problem: to provide a basis for the chemical identification of those pitches which are frequently found in archaeological excavations. Intending to extend the already existing possibilities for such analyses the present paper is dealing with the application of pyrolysis coupled with capillary gas chromatography and by subsequent chemometric studies. It could be shown that by this technique indeed not only tars and pitches prepared from deciduous trees and from conifers could clearly be differentiated, but that even respective species could be identified. Thus a fundament is provided for future studies aiming to identify the starting material of real archaeological finds by a novel method which requires by far less quantities of sample material as compared to the methods hitherto used by us.

The patient's perspective and rheumatoid arthritis disease activity indexes

BACKGROUND

Monitoring disease activity in rheumatoid arthritis (RA) patients by composite indexes is regarded as obligatory when following the recent recommendations for therapy. Whether these recommendations and the patient's perspective are in congruence is a crucial question with respect to the patient's compliance. The aim of the study was to obtain information on the patient's perspective with respect to the disease activity indexes used most often.

METHODS

Two hundred and seven RA patients (157 female, 50 male; mean age 59.03 yr, 17-86 yr) were enrolled in this cross-sectional evaluation. The patients' satisfaction [PATSAT (Austrian school mark system) 1 = excellent to 5 = unsatisfactory] and the patients' attitude to therapy (PATATT 1 = reduction, 2 = no change, 3 = increase) were assessed and related to the 28-joint Disease Activity Score (DAS28), the Simplified Disease Activity Index (SDAI) and the Modified Health Assessment Questionnaire (M-HAQ). Statistical evaluation was carried out by applying the Mann-Whitney U test, calculating chi2 and ANOVA.

RESULTS

According to the DAS28 and the M-HAQ, patients were at a moderately active disease stage and had low functional deficiency. PATSAT was significantly correlated to the disease activity indexes (all PS < or = 0.002). The mean DAS28 (2.56) at PATSAT 1 was within the remission range, whereas at PATSAT 5 a mean of 5.52 indicated highly active disease. PATATT was found to be related to PATSAT, but did not completely parallel it. Reduction of therapy was intended at a mean DAS28 of 2.87, whereas a request for an increase did not occur before a mean DAS28 of 4.92.

CONCLUSION

The patients' therapeutic attitudes are somewhat in line with their satisfaction, which mirrors disease activity to a great extent, though not with the common therapeutic recommendations. The DAS28 proved to be superior to both other indexes taking account of the patient's perspective. These results may provide guidance in patient care and education as well as therapeutic strategies.

Alternative splicing variants of dual specificity tyrosine phosphorylated and regulated kinase 1B exhibit distinct patterns of expression and functional properties

The dual specificity tyrosine phosphorylated and regulated kinase (DYRK) family of protein kinases is a group of evolutionarily conserved protein kinases that have been characterized as regulators of growth and development in mammals, Drosophila and lower eukaryotes. In the present study, we have characterized three splicing variants of DYRK1B (DYRK1B-p65, DYRK1B-p69 and DYRK1B-p75) with different expression patterns and enzymic activities. DYRK1B-p65 and DYRK1B-p69 exhibited similar, but not identical, patterns of expression in mouse tissues, with the highest protein levels found in the spleen, lung, brain, bladder, stomach and testis. In contrast, DYRK1B-p75 was detected specifically in skeletal muscles, in the neuronal cell line GT1-7 and also in differentiated, adipocyte-like 3T3-L1 cells, but not in undifferentiated 3T3-L1 preadipocytes. A comparison of the mouse and human Dyrk1b genomic and cDNA sequences defined the alternative splicing events that produce the variants of DYRK1B. In DYRK1B-p75, transcription starts with exon 1B instead of exon 1A, generating a new translation start, which extends the open reading frame by 60 codons. This gene structure suggests that alternative promoters direct the expression of DYRK1B-p69 and DYRK1B-p75. Both splicing variants exhibited kinase activity in vitro and contained phosphotyrosine when expressed in COS-7 cells. Owing to differential recognition of the 3'-splice site in exon 9, DYRK1B-p65 differs from DYRK1B-p69 by the absence of 40 amino acids within the catalytic domain. DYRK1B-p65 lacked kinase activity in vitro and did not contain phosphotyrosine. DYRK1B-p69 and DYRK1B-p75 stimulated reporter gene activity driven by the f or kh ead in r habdosarcoma (FKHR)-dependent glucose-6-phosphatase promoter more strongly when compared with DYRK1B-p65, indicating that the DYRK1B splicing variants exhibit functional differences.

[Interdisciplinary endoscopic outpatient management of connatal dacryocystoceles]

Dacryocystocele may represent a rare type of connatal stenosis of the lacrimal duct. If conservative measures fail and in case of secondary inflammation, probing or regular surgery is usually recommended. We report on 15 neonates suffering from 18 connatal dacryocystoceles which were presented to the clinic of ophthalmology at the 16th (6 - 44) day of life. There was a definite female preponderance (65 %). Conservative treatment (external massage, at times i. v. antibiotic therapy) had proven to be ineffective. The neonates were subjected to outpatient nasal endoscopy and the ballooning cyst of the inferior nasal meatus was managed by endoscopic marsupialization in 14 cases applying local anesthesia. Two nasal cysts had to be operated on in general anesthesia due to obstructing local anatomy which obviated endoscopical microsurgery. Three additional dacryocystoceles have been detected incidentally in 2 neonates being subjected to surgery in general anesthesia for choanal atresia and lacrimal probing respectively. The corresponding dacryocystoceles were managed by concomitant endonasal microsurgery. We advocate interdisciplinary (ophthalmological and rhinological) outpatient examination in all neonates with suspected dacryocystoceles. Diagnosis is based on palpation, probing and nasal endoscopy applying local anesthesia together with mucosal decongestion. Microsurgical marsupialization immediately follows and will lead to persisting relief of symptoms.

Embryonic lethality caused by apoptosis during gastrulation in mice lacking the gene of the ADP-ribosylation factor-related protein 1

ADP-ribosylation factor (ARF)-related protein 1 (ARFRP1) is a membrane-associated GTPase with significant similarity to the family of ARFs. We have recently shown that ARFRP1 interacts with the Sec7 domain of the ARF-specific guanine nucleotide exchange factor Sec7-1/cytohesin and inhibits the ARF/Sec7-dependent activation of phospholipase D in a GTP-dependent manner. In order to further analyze the function of ARFRP1, we cloned the mouse Arfrp1 gene and generated Arfrp1 null-mutant mice by gene targeting in embryonic stem cells. Heterozygous Arfrp1 mutants developed normally, whereas homozygosity for the mutant allele led to embryonic lethality. Cultured homozygous Arfrp1 null-mutant blastocysts were indistinguishable from wild-type blastocysts. In vivo, they implanted and formed egg cylinder stage embryos that appeared normal until day 5. Between embryonic days 6 and 7, however, apoptotic cell death of epiblast cells occurred in the embryonic ectoderm during gastrulation, as was shown by histological analysis combined with terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling. Epiblast cells that would normally differentiate to mesodermal cells detached from the ectodermal cell layer and were dispersed into the proamniotic cavity. In contrast, the development of extraembryonic structures appeared unaffected. Our results demonstrate that ARFRP1 is necessary for early embryonic development during gastrulation.

Focus on psychiatry in Poland. Past and present

The German occupation of Poland in 1939 was accompanied by the destruction of the existing medical system, and the first victims of the Nazi terror were psychiatric patients in hospitals – around 15 000 were exterminated and about 10 000 died as a result of malnourishment.

Specificity determinants of substrate recognition by the protein kinase DYRK1A

DYRK1A is a dual-specificity protein kinase that is thought to be involved in brain development. We identified a single phosphorylated amino acid residue in the DYRK substrate histone H3 (threonine 45) by mass spectrometry, phosphoamino acid analysis, and protein sequencing. Exchange of threonine 45 for alanine abolished phosphorylation of histone H3 by DYRK1A and by the related kinases DYRK1B, DYRK2, and DYRK3 but not by CLK3. In order to define the consensus sequence for the substrate specificity of DYRK1A, a library of 300 peptides was designed in variation of the H3 phosphorylation site. Evaluation of the phosphate incorporation into these peptides identified DYRK1A as a proline-directed kinase with a phosphorylation consensus sequence (RPX(S/T)P) similar to that of ERK2 (PX(S/T)P). A peptide designed after the optimal substrate sequence (DYRKtide) was efficiently phosphorylated by DYRK1A (K(m) = 35 microM) but not by ERK2. Both ERK2 and DYRK1A phosphorylated myelin basic protein, whereas only ERK2, but not DYRK1A, phosphorylated the mitogen-activated protein kinase substrate ELK-1. This marked difference in substrate specificity between DYRK1A and ERK2 can be explained by the requirement for an arginine at the P -3 site of DYRK substrates and its presumed interaction with aspartate 247 conserved in all DYRKs.

Alpha-galactosidase of Bifidobacterium adolescentis DSM 20083

Bifidobacterium adolescentis was grown anaerobically in medium enriched with alpha-D-galactosides. alpha-Galactosidase (EC 3.2.1. 22) was released from the cells by ultrasonic treatment and purified 36-fold by ultrafiltration, ammonium-sulphate precipitation, anion-exchange chromatography, and size-exclusion chromatography. Two protein bands were consistantly observed after sodium-dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE). Electrophoretically homogeneous alpha-galactosidase was only obtained by electroelution. The enzyme had an apparent molecular mass of 344 kDa and 79 kDa as judged by size-exclusion chromatography and SDS-PAGE, respectively. Activity-staining after nondenaturing SDS-PAGE indicated an apparent molecular mass of 145 kDa. Thus, a tetrameric structure of the protein is suggested. The alpha-galactosidase showed optimal activity at pH 5.5 and 55 degrees C. Lower pH values and higher temperatures rapidly inactivated alpha-galactosidase. The enzyme hydrolyzed specifically alpha-galactosidic linkages, and alpha-(1-3)-linkages were hydrolyzed at a higher rate compared to alpha-(1-6)-linkages. Hydrolysis of galactosides followed normal saturation kinetics; KM-values for p-nitrophenyl-alpha-galactopyranoside (p-NPG) and raffinose were calculated with 0.957 mM and 4.12 mM, respectively.

Cloning and characterization of DYRK1B, a novel member of the DYRK family of protein kinases

The DYRK1A gene on human chromosome 21 encodes a protein kinase presumed to be involved in the pathogenesis of mental retardation in Down's syndrome. Here we describe a highly similar homolog, DYRK1B, which is, in contrast to DYRK1A, predominately expressed in muscle and testis. The human DYRK1B gene was mapped to chromosome 19 (19q12-13.11) by radiation hybrid analysis. The amino acid sequences of DYRK1A and DYRK1B are 84% identical in the N-terminus and the catalytic domain but show no extended sequence similarity in the C-terminal region. DYRK1B contains all motifs characteristic for the DYRK family of protein kinases. In addition, the sequence comprises a bipartite nuclear localization motif. A green fluorescent protein (GFP) fusion protein of DYRK1B was found mainly in the nucleus of transfected COS-7 cells. These data suggest that DYRK1B is a muscle- and testis-specific isoform of DYRK1A and is involved in the regulation of nuclear functions.

[Bilateral occlusion of the internal carotid arteries. Analysis of a series of 19 patients]

The natural history of patients suffering from bilateral internal carotid occlusion is poorly known. We report a study of 19 patients presenting such a vascular condition as demonstrated by angiography. In all our cases, cardio-vascular risk factors were frequently found. Smoking was particularly frequent and present in 18 patients (95%). Presenting neurological episodes included either transient ischemic attack (8/19) or stroke (9/19). Associated arterial lesions were diffusely distributed on the other cerebral vessels, frequently involving the extra-cranial part of the vertebral arteries. Collateral circulation feeding the intracranial carotid system mainly, or exclusively, originated from the vertebro-basilar system. Ischemic strokes were frequently detected by cerebral CT scan. They were located in the middle cerebral territory or at the junctions between 2 major cerebral arteries. A radiological aspect of cortical atrophy was noted in 9 patients among 19. Regional cerebral blood flow assessed by Xe133 inhalation was usually normal at rest (16/19), but hyporeactivity to acetazolamide was found in 10 patients among 19. The latter was more frequent in patients suffering from arterial hypertension or diabetes mellitus. Our results confirm that the patients suffering atheromatous bilateral occlusion of the internal carotid arteries may survive with minimal neurological deficits. Collateral circulation is mainly provided by the vertebro-basilar system allowing to frequently maintain normal cerebral blood flow at rest.

[Unemployment and health]

Reviews of the literature on the relationship between unemployment and psychological and physical health point clearly to the fact, that loss of employment has a negative influence on the state of health of the unemployed and increases the signs of pathology. The negative influence of unemployment on health is seen mainly among the long-term unemployed, for young people who cannot find a job after finishing their education and for their family members. The range and extent of the negative consequences are various. They depend on socio-demographic, personality, situation and time factors and on the existing social support systems. A number of theoretical concepts (eg. of stress, life events, inability to fulfil latent psychological functions, the role of social structures etc.) are used to explain the mechanisms of the negative psychophysiological changes, connected with unemployment. However, it is possible, that the main role is played by an interaction of various factors, which influence the development of social and health related pathology. This indicates the necessity of creating detailed and varied programmes for prophylactics and treatment, based on scientific research. This is particularly important in Poland. Here the percentage of unemployment is very high. Unfortunately neither the Community, nor the political and administrative organs (including the Health Service) are equipped to cope with this new problem. To this must be added the lack of sufficient research, and inadequate knowledge about how unemployment spreads and about its consequences.

Cervical dystonia: clinical findings and associated movement disorders

We studied 300 patients, 61% women, with mean age 49.7 years and mean duration of dystonia 7.8 years, to determine the demographic and clinical characteristics of cervical dystonia (CD) and its relationships to other movement disorders. Torticollis was present in 82%, laterocollis in 42%, retrocollis in 29%, and anterocollis in 25%; however, the majority (66%) had a combination of these abnormal postures. Scoliosis was present in 39%, local pain reported by 68%, and 32% had evidence of secondary cervical radiculopathy. In addition to CD, 16% of patients had oral dystonia, 12% mandibular dystonia, 10% hand/arm dystonia, and 10% had blepharospasm. Tremor was noted in 71% of patients; head-neck tremor was present in 60%, and tremor in other body regions was present in 32%. A family history of a movement disorder was present in 44% of the CD patients. Tardive dystonia was the cause in 6%; 11% had posttraumatic dystonia. Anticholinergic drugs provided moderate improvement in 33% of patients, but local intramuscular botulinum toxin injections relieved CD, local pain, or both in over 90% of all treated patients.

Impact of dental conditions on patients' quality of life

Quality of life measures have rarely been used in dentistry to assess oral health status. The purpose of this paper is to assess the utility of using standard indicators to measure the impacts of dental conditions on patients' quality of life. Quality of life was conceptualized as a multidimensional construct including three major aspects: social functioning, measured by the Sickness Impact Profile; well-being, measured by the Gill Well-Being Scale, Spielberger State/Trait Anxiety Scale, and the Corah Dental Anxiety Scale; and symptoms, measured by the Kiyak Oral Functioning Scale, the McGill Pain Questionnaire, and the West Haven Multidimensional Pain Inventory. 152 patients were recruited from private dental practices consisting of 48 TMJ, 33 periodontal, 23 denture, and 48 recall patients. Patients in the first three groups reported numerous impacts on quality of life and the impacts were particularly severe for the TMJ patients. The indicators used were sensitive to differences among the four groups and hold promise for further development of quality of life indicators for use in epidemiologic surveys and clinical dental trials.

[The patient in psychotherapy]

Within the process of individual psychotherapy the author stresses the importance of understanding the initial everyday life view of "what is about being sick" for to establish a working, and cooperative setting. Thus, a three step procedure has been developed to guide the patient to a self responsible attitude toward conflicts and disease well at variance with common beliefs about healing, and the roles of the professional and his client herein.

[Sociodynamic aspects of psychotherapy]

Definitions of psychotherapy are determined by sociocultural and epistemological factors, which, in turn, influences the objectives and practical consequences of the use of psychotherapy (for example, selection, indication, and method used). The current state of knowledge and social needs tend to modify views of the role and functions of psychotherapy in medical and extramedical fields and areas, which sociodynamic aspects of psychotherapeutic processes and their applications being considered and utilized differently. It is within the framework of different social orders that potentially equivocal functions and ways of making use of psychotherapy can be either promoted or inhibited. Consequently, it is desirable to try to clarify corresponding prerequisites and conditions, which has been attempted by the author in his present paper.