Patient-centered relationship increases pain tolerance

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A doctor-patient relationship built on trust and empathy doesn't just put patients at ease - it actually changes the brain's response to stress and increases pain tolerance, according to new findings from a Michigan State University research team.

Medical researchers have shown in recent studies that doctors who listen carefully have happier patients with better health outcomes, but the underlying mechanism was unknown, said Issidoros Sarinopoulos, professor of radiology at MSU. "This is the first study that has looked at the patient-centered relationship from a neurobiological point of view," said Sarinopoulos, the lead researcher. "It's important for doctors and others who advocate this type of relationship with the patient to show that there is a biological basis."

The study involved randomly assigning patients to one of two types of interview with a doctor before undergoing an MRI scan. In the patient-centered approach, doctors addressed any concerns participants had about the procedure and asked open-ended questions allowing them to talk freely about their jobs, home life and other psychological and social factors affecting health. The other patients were asked only specific questions about clinical information such as their medical history and what drugs they were taking. As expected, those who had the patient-focused interview reported greater satisfaction and confidence in their doctor in a post interview questionnaire.

The participants then were placed in the MRI scanner and given a series of mild electric shocks, similar to the discomfort of having an IV needle inserted, while looking at a photo of a doctor who they were told was supervising the procedure. The scans measured activity in the anterior insula - the part of the brain that makes people aware of pain - in anticipation of the shocks and when they actually occurred.

The brain scans revealed those who had the patient-centered interview showed less activity in the anterior insula when they were looking at a photo of the interviewing doctor than when the doctor in the photo was unknown. Those participants also self-reported less pain when the photos showed the known doctor.

Sarinopoulos said the study had a small sample of just nine women and will need to be replicated on a larger scale. "We need to do more research to understand this mechanism," he said, "but this is a good first step that puts some scientific weight behind the case for empathizing with patients, getting to know them and building trust."

"Medicine has for too long focused just on the physical dimensions of the patient," said Smith, who co-authored the paper. "Those clinical questions are important and necessary, but we're trying to demonstrate that when you let patients tell their story in an unfettered way, you get more satisfied patients who end up healthier."

In this research, not only the difference of the questions they asked, but also the doctors' attitudes toward the patients such as tone, manner and non-verbal cues would be one of the influential factors that affected satisfaction in their doctors. This article does not mention whether they controlled non-verbal cues or not. However, for the more correct result, they should control non-verbal cues, as well as verbal interview questions.
Also there is a possibility that the patient felt less pain just because they saw a picture of someone they know. In other words, if the researchers show the patients pictures of someone they know other than their doctors, such as their family members or friends, the result might be similar. For this study to be more clear and stronger, they need to compare when they show the picture of the doctor and when they show the picture of someone the patient know other than their doctors.
In addition, like this article mentions, the study had a small sample of just nine women and will need to be replicated on a larger scale to get more solid result.

Women and Men See Things Differently

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According to Nationalgeographic, when University of Bristol researchers asked 52 men and women to study various images, gender differences emerged in terms of where the subjects focused their attention and in how much of a picture they explored.

The 26 female and 26 male study participants--ranging in age from 19 to 47--tended to focus on anywhere from one to five "hot spots" in still images made from films and taken of artwork. The images included scenes from movies such as The Sound of Music, Inside Man, and The Blue Planet, and artwork including "People in the Sun" by Edward Hopper and "Three Graces" by David Bowers.

This diagram shows the most eye-catching areas of the photo above for women (red) and men (blue). Illustration courtesy Felix Mercer Moss

Most of the hot spots involved the faces of people in the pictures, especially eyes, as well as other body parts, such as hands. Women, however, explored more of an image than men did, often focusing on nonfacial areas and places slightly below where men fixed their gaze.

Lead author Felix Mercer Moss, a vision researcher and doctoral student at the University of Bristol in the United Kingdom, speculates that risk aversion may explain some of the differences. In Western culture, a direct gaze can be construed as threatening. "Women may be attaching more risk to looking people in the eye," Mercer Moss noted, which is why they may focus their gaze on a lower part of the face than men do.

This research concluded that men and women gaze things differently, and this is for avoiding the risk of a direct gaze. Also women may be attaching more risk to looking people in the eye, which is why they may focus their gaze on a lower part of the face than men do. However, this research couldn't explain why women tent to gaze on a lower part of face than men do. They need a further research to explore 'why'.

This research used eye-tracking method. This kind of experiment may have distorted gender ratio or stereotypes. Because this method includes both computer science where male are dominant and psychology department where female are dominant. For this reason, this research might not be broadly applicable.

Questionnaire about attributes toward the use of laptop

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I got an assignment from one of my classes and I needed to interview or survey a subculture group which is different from my background. I decided to conduct a survey about the use of laptop and social influence on their purchase decision making. I made 12 questions and conducted the survey with five Malaysian female students at the University of Minnesota via email. For this assignment, I needed to survey only five people. However, the number of my sample was too small to generalize the population of the subculture group. If there is a chance to survey more Malaysian female students, I want to conduct a further survey about this subject matter. Also I want to ask more questions about the difference between their social relationship with Malaysian and with American.

1. Which brand's laptop do you own?

2. What is your favorite laptop brand? If you don't have any specific favorite brand, say "I don't have any".

3. If you have your favorite brand, why do you like the brand the most?
a. Good design
b. Reasonable price
c. Convenient after-sale service
d. Favorable brand image
e. Great specs
f. Others (Specify: )

4. When you buy a laptop, what is the most important consideration factor?
a. Brand name
b. Price
c. Specs
d. Design
e. Others (Specify: )

5. Where did you buy your laptop?
a. The U.S.
b. Malaysia
c. Another place (Specify: )

6. Which channel did you use when you bought your laptop?
a. The brand's own website
b. Online retail stores (Amazon, e-bay, etc.)
c. Electronics retail stores (Best Buy etc.)
d. Warehouse stores (Walmart, Target, K-mart, etc.)
e. Others (Specify: )

7. What was the most influential factor that affected your choice when you bought your laptop? (Choose all that apply)
a. Friends
b. Family members
c. Advertisements
d. Sales person
e. Brand image
f. Product reviews
g. Special deal
h. Others (Specify: )

8. Please rate your personal feelings toward the following laptop brands on a scale of 1-5
(1=very negative, 2=negative, 3=neutral, 4=positive, 5=very positive):
a. Apple:
b. Samsung:
c. Dell:
d. HP:
e. LG:
f. Toshiba:
g. Sony:
h. Asus:

9. Do you think that which brand's laptop you own affects your social image?
a. Yes
b. Somewhat
c. No

10. Do you think which factor is more important when you buy a laptop?
a. The brand image of a laptop
b. The specs or price of a laptop

11. Do you have Malaysian friends more than American friends in the U.S.?
a. Yes
b. No

12. Do you feel more comfortable with your Malaysian friends than American friends?
a. Yes
b. Sometimes
c. No

A focus group interview without group dynamic

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This video shows a focus group interview about a music video. The interviewees answered the questions in the same order of how they seat from the left to the right for the whole time. They did not seat around a round table rather they sat in a row horizontally on separate desk chairs. So they did not see each other the whole time and just looked at somewhere else while others are answering. There is no group dynamic at all which is one of the pros for group interview, encouraging participants to answer more actively and getting fresh insights from them. They looked boring the whole time, and I can't tell the mediator is promoting group dynamic in this focus group interview. He is neither in the middle of them nor close to them. This focus interview couldn't maximize the pros of group interview method.

According to koreatimes, fathers of only daughter have been found to most believe that men and women are equal. The state-run Korea Women's Development Institute reported Monday that fathers of only daughter scored 76.76 on average in a survey of consciousness of gender equality for 1,800 parents of elementary, middle and high school students last July.

The figure is higher than the 74.92 by mothers of two daughters and the 73.72 by mothers of only daughter. The gap is quite wider with fathers of one child or more other than the only daughter. The lowest scorers are fathers of the only son with 60.68, 16 points less than highest scorers. Fathers with one son and one daughter came ninth with 63.32 and fathers of the only daughter seventh with 60.05.

On the part of parents, mothers are more understandable about gender equality than fathers at 71.5:64.81. In terms of children, parents of daughters scored higher than those with sons at 73.38: 68.19. Ahn Sang-soo, senior researcher at the institute, has focused on Ddal Babo or "Fool to daughters " meaning those who blindly love their daughters. Gender equality has mainly affected parents whose children are daughters or not.

"Even fathers with general conception experience gender inequality in an indirect manner, while rearing their daughters," said Ahn. "Daughter's life affected fathers' mindset about women positively as they always worry about or expect much from their daughters."

This research asked 12 questions including 'Men, as a patriarch, should get more salary than women', 'It does not look good when a man work in a lower level of position than a woman', and 'It does not look good when a man cook in the kitchen' on a 4 scale and converted into a 100 scale.

The 4 scale seems like a little narrow to measure the degree of agreement exactly. However, overall it was interesting research about fathers' attitudes toward gender-equality and the method they used, Likert scale, was appropriate.

Importance of a moderator

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This Youtube video shows the importance of a moderator in a focus group interview. This guy is not ready for this interview at all. He does not know the medical terms or background of the product even thought it was a focus group interview about a technology being used in health care industry. Also he embarrassed a participant. This could make participants express their opinion passively. As professor Jennifer stressed in class, a moderator is a very important role in a focus group interview. A moderator should be fully prepared with background information about the subject matter of a focus group interview, and encourage participants so they can participate actively and come up with as many insights as they can.

An Invitation to participate in a survey

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For one of my group project, we conducted an online survey about attitudes toward the use of smartphone and Samsung galaxy's advertising strategy. We ended up this survey with 42 participants, which was more than what we expected. Since larger sample sizes reduce sampling error, we could generalize the population more correctly.
However, for the question 'Rank the order of importance for the factors you are influenced by when making a cell phone purchase?', we could have put 'Price' as one of the choices along with Design, Advertising, Store/Online salesmen, Smartphone capabilities and Friends/Family. The result shows that most of people are not loyal to a specific brand. After watch a Samsung galaxy ad which mocks Apple fanboys, most of people had more positive attitudes toward Samsung than Apple.

1. Do you own a smartphone?

2. If you answered yes to the previous question, what brand do you own?

3. Do any members of your immediate family own a smartphone?

4. If you answered yes to the previous question, what brand (s) do they own?

5. Rank the order of importance for the factors you are influenced by when making a cell phone purchase?
Store/Online salesmen
Smartphone capabilities

6. Are you planning to purchase a smartphone in the future?
Yes, 1-6 months
Yes, 7-12 months
Yes, 13+ months
I don't know

7. When purchasing a cell phone, are you loyal to a specific brand?

8. If you answered yes to the previous question, please specify the brand.

9. Please open the video link in a new tab and watch the ad before answering all other questions. Do not close this window as all data will be lost.

10. Without viewing the ad again, what do you remember? (can be visual or vocal)

11. What brands do you believe are identified in the ad?

12. Please rate the ad you just viewed on the following attributes.

1 2 3 4 5 6 7
Bad= 1,Good =7
Unfavorable=1, Favorable =7

13. Please rate your thoughts towards Samsung after viewing the ad.

1 2 3 4 5 6 7
Bad=1, Good=7
Discreditable=1, Credible=7
Negative=1, Positive=7

14. Please rate your thoughts towards the competing brand displayed in the ad.

1 2 3 4 5 6 7
Bad=1, Good=7
Discreditable=1, Credible=7
Negative=1, Positive=7

15. After viewing the ad, has your willingness to purchase a smartphone changed?

16. If you answered yes to the previous question, in what time frame are you planning to purchase a smartphone?
1-6 months
7-12 months
13+ months

17. What is your gender?
Prefer not to answer

18. What is your age?
46 +
Prefer not to answer

19. What is your annual income?
Less than $5,000
$5,001 - $10,000
$30,001- $40,000
$40,001- $50,000
$50,001 +
Prefer not to answer

Hormone may keep men from cheating

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According to a new study from Germany, the "love hormone" oxytocin may help maintain romantic relationships by prompting men to keep their distance from attractive women.

In the study, men in monogamous relationships who were given an oxytocin nasal spray stayed about four to six inches farther away from an attractive, woman they didn't know, compared with men in monogamous relationships who received a placebo. The oxytocin spray had no effect on the distance that single men chose to keep between themselves and the attractive woman. The results suggest the hormone promotes fidelity in humans, said study researcher Dr. René Hurle­mann, of the University of Bonn. The findings agree with previous research conducted on prairie voles, which suggested the hormone plays a role in pair-bonding.

The study involved 57 heterosexual males, about half of whom were in monogamous relationships. After receiving either a dose of oxytocin or placebo, participants were introduced to a female experimenter who they later described as "attractive." During the encounter, the experimenter moved towards or away from the men, and they were asked to indicate when she was at an "ideal distance" away, as well as when she moved to a distance that felt "slightly uncomfortable."

The effect of oxytocin on the attached men was the same regardless of whether the female experimenter maintained eye contact, or averted her gaze. Oxytocin also had no effect on the men's attitude toward the female experimenter - whether men received the oxytocin or the placebo, they rated her as being equally attractive.

In this experiment, the men were asked to indicate when she was at an "ideal distance" away, as well as when she moved to a distance that felt "slightly uncomfortable". When they asked, they might be mindful of the procedure and the result of the experiment. In other words, since they knew this experiment was about the ideal distance between him and a woman, they might answered "ideally", probably not showing their "real ideal distance" especially when they are married. This might be the one reasons why men in monogamous relationships were affected by oxytocin, but the oxytocin spray had no effect on the distance of the single men.

Also the female experimenter's marital status or age might affect the men's attitude or answers. This experiment does not include how oxitocin act on the brain to affect the behavior. More research about the way oxytocin worka on the brain should be conducted.

Coffee May Protect Women's Memory

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For women older than 65, drinking that extra cup of joe may protect thinking and memory skills, according to a new study published Monday in the journal Neurology.

Women who drank more than three cups of coffee -- or the equivalent amount of tea -- per day showed less decline in performance over time on memory tests than women who drank only one cup or less of coffee.

"We looked at the relationship between coffee drinking and cognitive decline, and we found that there was a relationship," said Karen Ritchie, an epidemiological and clinical researcher at La Colombiere Hospital in Montpellier, France. "It was clear -- the more coffee, the less the decline. We then had to adjust for other factors, and we found that the more we adjusted, the greater the effect."

The study observed 7,000 people over age 65 whose memory skills and caffeine consumption were monitored for four years. Since most people get their daily dose of caffeine in a cup (or three) of coffee, the number of times participants enjoyed this beverage daily was used as a measure of how much caffeine they took in daily -- though the chemical also exists in tea, soda, chocolate and other foods in smaller amounts.

The researchers found that not only did heavy coffee-drinkers have less memory decline, but the benefits increased with age. Women over the age of 80 who drank four or more cups of coffee were 70 percent less likely to have a decline in memory.

The benefits of increased coffee intake are significant for women, but caffeine's mind-preserving effects were not seen in men, causing researchers to wonder why.

The researchers said that although they are not sure exactly how caffeine, a stimulant, seems to decrease memory loss, they think it may put the brakes on the chemical changes in the brain that are thought to eventually lead to Alzheimer's disease.

This study observed 7,000 people over age 65 for four years. Since this is a huge number of sample and a long time period study, there might be a lot of participants who forgot to record their consumption of coffee daily and correctly. Also, there is no control group. They just compared people's memory skills and caffeine consumption in the same sample. They need to observe those who do not drink any kind of caffeine at all for more concrete result. They don't explain why women show more significant benefits than men and why the benefits increased with age. They need to conduct more experiments with men group and different age groups so that they can infer the reason why the benefits are different according to sex and age.

Insulin reduces food consumption

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Puffs of insulin administered through the nose reduced food consumption by 11.7% in non-diabetic men compared with a placebo, but the insulin had no effect on their feelings of hunger, according to a study in the journal Diabetes. Previous research suggests insulin is among several hormones used by the brain to adjust and control energy levels and body weight in humans.

The study compared energy metabolism in the brain and food intake in experiments involving 15 German men in their mid-20s. In one, subjects received four puffs of intranasal insulin before breakfast and, in the other, they received a placebo substance, also through the nose. Following both experiments, subjects were instructed to eat as much breakfast as they wanted. Before and after eating, subjects underwent a type of imaging that measures cellular or metabolic activity in the brain.

Levels of adenosine triphosphate, an indicator of cerebral energy, were significantly elevated in subjects within 10 minutes of receiving insulin compared with the placebo, results showed. Intranasal insulin also raised phosphocreatine levels, another brain-energy indicator, but glucose and insulin levels in the rest of the body and feelings of hunger didn't change throughout the study. Intake of carbohydrates and protein were lowered the most, results showed. Intranasal insulin may be useful in treating obesity, researchers said.

The study sample,15 German men in their mid-20s, was too small to generalize the population. Also this study didn't include women or different age groups. They need to conduct both men and women and more diverse age groups for more generalized, solid result. In this study, they had a control group which was received a placebo substance through the nose instead of real insulin. This control group made the causal relationship more clearly, helping the researchers can be sure that the variable is causing the changes not by something else.