Penalty Versus Premium: Social Disposition Differentiates Life Satisfaction Among Living-Alone Immigrant and Native-Born Older Adults-Findings From the Canadian Longitudinal Study on Aging (CLSA).

Using data from the Canadian Longitudinal Study on Aging, in this study we provide an alternative explanation for the gap of life satisfaction between living-alone immigrants and Canadian-born older adults. Based on the Big-Five personality traits, we use the latent class analysis to generate two types of social dispositions, social independence and social dependence. With social dispositions taken into account, living alone contributes to life satisfaction in opposite ways for immigrant and Canadian-born older adults, by playing a negative role for the former group and a positive role for the latter. The trend of higher life satisfaction among the living-alone Canadian-born are mainly among the socially independent, whereas for immigrants, socially dependent older adults experience the lowest level of life satisfaction when living alone. Therefore, while socially independent Canadian-born older adults gain a "living-alone premium" in life satisfaction; their socially dependent immigrant counterparts experience a "living-alone penalty" in life satisfaction.

Relationship between intended force and actual force: comparison between athletes and non-athletes.

This cross-sectional study aimed to investigate whether athletes (ATHL) and non-athletes (NON-ATHL) individuals had similar accuracy in matching intended to actual force during ballistic (BAL) and tonic (TON) isometric contractions. In this cross-sectional study, the subjects were divided into ATHL (n = 20; 22.4 ± 2.3 yrs; 73.2 ± 15.7 kg; 1.76 ± 0.08 m) and NON-ATHL (n = 20; 24.6 ± 2.4 yrs; 68.2 ± 15.0 kg; 1.73 ± 0.1 m) groups. The isometric quadriceps strength was measured with a load cell applied to a custom-built chair. For each condition, subjects performed at first three maximal voluntary isometric contractions (MVIC) as reference. Then, subjects had to match three intended force intensities expressed in percentage of the MVIC (i.e., 25%, 50%, and 75%) without any external feedback. Subjects performed three trials for each force intensity. The accuracy (AC) was calculated as the absolute difference in percentage between the intended and the actual force. A Likert scale was administered for each trial to assess the subjective matching between the intended and the actual force. Statistical analysis showed that the ATHL group was more accurate (p < 0.001) than the NON-ATHL group. In contrast, the AC (p < 0.001) was lower when the force intensities increased independently from the group. Moreover, significantly higher AC (p < 0.001) and lower aggregate Likert scores (p < 0.001) were found in BAL than TON conditions. These results suggest that (i) sports practice could enhance muscle recruitment strategies by increasing the AC in the isometric task; (ii) differences between intended and actual force appeared to be intensity-dependent with lower AC at high force intensities; (iii) different control systems act in modulating BAL and TON contractions.

Risk self-perception and occupational accidents.

INTRODUCTION: This study analyzes the relationship between measures of occupational accidents and workers' perception of risk in the workplace using nationally representative data on workers' characteristics and a complete record of occupational accidents. METHODS: Regression analyzes addressing both the ordinal nature of the dependent variable and causality were conducted to control for different sociodemographic factors influencing workers' perceptions of occupational risks. Special attention was paid to the risk level of the worker's workgroup, existence of family responsibilities, organizational safety culture, and measures of accident rates. RESULTS: Individuals showed different perceptions of risk based on their personal and work characteristics. Significant associations were observed between each variable of interest and risk perception. Overall, the results remain robust across specifications addressing both simultaneity and ordinality. CONCLUSIONS: Employees' "reading" of hazards was not fully aligned with objective information on occupational accidents but depended on individual characteristics. Having family responsibilities or being unionized increased workers' risk perception, whereas belonging to a workgroup with higher accident rates reduced it. PRACTICAL APPLICATIONS: Knowing how workers perceive risk and how this perception deviates from statistical information on accidents are essential for management to accurately design safety measures. In this regard, specific characteristics such as age, having dependents in the family, or the typology of the workers' workgroup should be taken into account. Greater knowledge of preventive measures will improve the way workers perceive risk, and ultimately contribute to reducing the likelihood of occupational accidents.

Mental health in China: exploring the impacts of built environment, work environment, and subjective perception.

Introduction: The shifting living and working conditions have profound impacts on the residents' mental health. However, current research in this field has not remarkable investigated. Methods: This study used the China Labor-force Dynamic Survey (CLDS) dataset from 2018 and relied on a regression model to examine the effects of the built environment, work environment, and subjective perception on the mental health of Chinese citizens. It also considers the circumstances of both migrants and local residents. Results: This study revealed significant correlations between mental health and greening space rate, road network density, commuting time, work feelings, community trust, economic satisfaction, and other factors. Additionally, the mental health of local residents was shown to be significantly affected by community security, while it shows no significance in migrants. Furthermore, a significant spatial autocorrelation was found in terms of mental health within the central and eastern regions of China. Discussion: The findings of this study offer valuable insights that can be used to facilitate measures aimed at improving the mental health of residents and promoting the development of healthy cities.

Poor self-rated health is associated with faster cognitive decline and greater small vessel disease in older adults with type 2 diabetes.

OBJECTIVE: Self-rated health (SRH) is a predictor for poor health outcomes and cognition. Older adults with type 2 diabetes mellitus (T2D) have multi-morbidity and greater cognitive impairment. In the present study we investigated the association of SRH with cognitive decline and brain pathology in older adults with T2D. METHODS: Participants (n = 1122) were from the Israel Diabetes and Cognitive Decline study, and SRH was categorised as low (n = 202), moderate (n = 400) or high (n = 520). Cognition was measured by four cognitive domains: episodic memory, executive functions, language, and attention/working memory. Global cognition was the average of the cognitive domains. Statistical models adjusted for sociodemographic, cardiovascular, and clinical variables. In a randomly selected subsample (n = 230) that had magnetic resonance imaging, we examined relationships between baseline SRH and brain characteristics (white matter hyperintensities [WMHs], hippocampal, and total grey matter [GM] volumes). RESULTS: Low SRH was associated with a decline in executive functions, which accelerated over time when compared to high SRH (est = -0.0036; p = <0.001). Compared to high SRH, low SRH was associated with a faster decline in global cognition (est = -0.0024; p = 0.009). Low SRH at baseline was associated with higher volumes of WMHs (est = 9.8420; p < 0.0008). SRH was not associated with other cognitive domains, or with hippocampal and total GM. CONCLUSIONS: Low SRH is associated with cognitive decline in T2D older adults and may serve as a risk assessment. WMHs may represent an underlying mechanism.

Comparison of the plaque-removal efficacy of ultra-soft single-headed, triple-headed, and T-shaped toothbrushes and the subjective perceptions of users.

PURPOSE: To compare the plaque-removal efficacy of ultra-soft single-headed, triple-headed, and T-shaped toothbrushes and the subjective perceptions of users. METHODS: In this randomized, single-blind, crossover study, 30 healthy adult participants were randomly divided into three groups of 10, who tested the three types of toothbrushes in differing order, with a 1-week washout period between the tests. Dental plaque scores were recorded before and after toothbrushing, and questionnaires on subjective perceptions after toothbrushing were collected. RESULTS: The participants included 16 female participants and 14 male participants (average age: 29.4 ± 6.7 years). All three toothbrush types were effective in reducing dental plaque by 36-46%; however, the cleaning effect of the ultra-soft single-headed toothbrush was inferior to that of the triple-headed and T-shaped toothbrushes, the difference being statistically significant. The users' subjective perceptions suggested that the ultra-soft single-headed toothbrush was significantly superior to the other two toothbrush types. Plaque scores for the lower posterior tooth surfaces were higher than those for the upper posterior tooth surfaces, particularly on the left side, for both the ultra-soft single-headed and T-shaped toothbrushes. CONCLUSION: Healthcare practitioners should identify the type of toothbrush bristles used by individuals and provide appropriate oral health information.

Successful Aging in the Indian Socio-cultural Milieu.

There is a growing recognition of the importance of subjective definitions of successful aging from a clinical and policy perspective, and for their social and cultural relevance. However, the voices of older Indians remain largely underrepresented in the emerging body of qualitative literature on successful aging. Given this gap, and India's burgeoning older population, the present study set out to examine their subjective perception of successful aging. Using convenience sampling, data was collected from older men and women (N = 63, M Age = 71.21) living in the community, and in old age homes in Delhi NCR, through face-to-face interviews and focus group discussions. Reflexive thematic analysis resulted in four primary themes and eight sub-themes - Successful Aging as Personal Well-being, Tensions between Agency and Fatalism, comprising three sub-themes viz. the person as an active agent, co-existence of agency and fatalism, and negotiating with the invisible powers; Linked Lives comprising two sub-themes viz. the aging parent and the adult child, and spousal interrelationship; and The Social and Built Environment comprising three sub-themes, viz. complexity of social life: the health interface, social life in the neighborhood, and the good house. These findings provide a culture-specific view of successful aging in the Indian context, and reveals the multifaceted conceptualization of successful aging of older Indians - one that encompasses various biopsychosocial components.

Resting-state neural correlates of visual Gestalt experience.

Subjective perceptual experience is influenced not only by bottom-up sensory information and experience-based top-down processes, but also by an individual's current brain state. Specifically, a previous study found increased prestimulus insula and intraparietal sulcus (IPS) activity before participants perceived an illusory Gestalt (global) compared with the non-illusory (local) interpretation of a bistable stimulus. That study provided only a snapshot of the brain state that favors the illusory interpretation. In the current study, we tested whether areas that differentiate between the illusory and non-illusory perception, immediately before stimulus onset, are also associated with an individual's general tendency to perceive it, which remains stable over time. We examined individual differences in task-free functional connectivity of insula and IPS and related them to differences in the individuals' duration of the two stimulus interpretations. We found stronger connectivity of the IPS with areas of the default mode and visual networks to be associated with shorter local perceptual phases, i.e. a faster switch to an illusory percept, and an opposite effect for insula connectivity with the early visual cortex. Our findings suggest an important role of IPS and insula interactions with nodes of key intrinsic networks in forming a perceptual tendency toward illusory Gestalt perception.

Discrepancy of the subjective perception of the nasal appearance between independent individuals and patients undergoing functional rhinoplasty (fRPL).

PURPOSE: Satisfaction with the nasal appearance is a crucial outcome parameter in functional rhinoplasty (fRPL). The visual analogue scale is a suitable instrument not only for the preoperative patient assessment, but also as a patient-reported outcome measure in fRPL. In this study, we analyzed whether a high discrepancy in the preoperative subjective perception of the nasal appearance between patients and other individuals predicts a lower level of satisfaction with the postoperative result and hence a worse outcome of fRPL. METHODS: Standardized facial pictures of patients (n = 80) who underwent fRPL were taken preoperatively, 3 and 12 months postoperatively. In addition, patients were asked to complete the German version of the Utrecht Outcome Assessment Questionnaire in Aesthetic Rhinoplasty (D-OAR). The standardized facial pictures of the patients were presented to surgeons as well as to examiners without a medical background, and they were asked to evaluate the patients' nasal appearance using the visual analogue scale. RESULTS: The external evaluation of patient's nasal appearance was 1.7 points higher in median than the patient's subjective perception (range -5.7-7.00). A large discrepancy between self- and external estimation significantly correlates with higher D-OAR values (r = 0.539, p < 0.001). Patients with high scores in the D-OAR trick questions, indicating a body dysmorphic disorder, show a significant larger discrepancy between the external- and the self-assessment (2.8 ± 0.5 vs. 1.4 ± 0.3, mean ± SEM, p = 0.017). CONCLUSIONS: Large discrepancies between the self and external assessment of the nasal appearance are associated with a high-perceived influence of the appearance of the nose on the quality of life in patients undergoing functional rhinoplasty. That might be an indicator for unrealistic expectations concerning the postoperative outcome. Knowledge about this factor helps to identify the need for intensive discussion about possibilities and limitations of the planned procedure to avoid postoperative dissatisfaction.

All-or-none neural mechanisms underlying face categorization: evidence from the N170.

Categorization of visual stimuli is an intrinsic aspect of human perception. Whether the cortical mechanisms underlying categorization operate in an all-or-none or graded fashion remains unclear. In this study, we addressed this issue in the context of the face-specific N170. Specifically, we investigated whether N170 amplitudes grade with the amount of face information available in an image, or a full response is generated whenever a face is perceived. We employed linear mixed-effects modeling to inspect the dependency of N170 amplitudes on stimulus properties and duration, and their relationships to participants' subjective perception. Consistent with previous studies, we found a stronger N170 evoked by faces presented for longer durations. However, further analysis with equivalence tests revealed that this duration effect was eliminated when only faces perceived with high confidence were considered. Therefore, previous evidence supporting the graded hypothesis is more likely to be an artifact of mixing heterogeneous "all" and "none" trial types in signal averaging. These results support the hypothesis that the N170 is generated in an all-or-none manner and, by extension, suggest that categorization of faces may follow a similar pattern.

The psychology of income wealth threshold estimations: A registered report.

How do people estimate the income that is needed to be rich? Two correlative survey studies (Study 1 and 2, N = 568) and one registered experimental study (Study 3, N = 500) examined the cognitive mechanisms that are used to derive an answer to this question. We tested whether individuals use their personal income (PI) as a self-generated anchor to derive an estimate of the income needed to be rich (= income wealth threshold estimation, IWTE). On a bivariate level, we found the expected positive relationship between one's PI and IWTE and, in line with previous findings, we found that people do not consider themselves rich. Furthermore, we predicted that individuals additionally use information about their social status within their social circles to make an IWTE. The findings from study 2 support this notion and show that only self-reported high-income individuals show different IWTEs depending on relative social status: Individuals in this group who self-reported a high status produced higher IWTEs than individuals who self-reported low status. The registered experimental study could not replicate this pattern robustly, although the results trended non-significantly in the same direction. Together, the findings revealed that the income of individuals as well as the social environment are used as sources of information to make IWTE judgements, although they are likely not the only important predictors.

Psychological, Pain, and Disability Factors Influencing the Perception of Improvement/Recovery from Physiotherapy in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional Study.

OBJECTIVES: The aim of this study was to identify the possible relationships between psychological, pain, and disability variables with respect to the perception of change/recovery from physiotherapy in patients with chronic musculoskeletal pain (CMP). METHODS: A cross-sectional observational study was performed with 150 patients. All patients completed a series of self-administered questionnaires and a series of self-reports to quantify the perception of change with respect to the physiotherapy they underwent, the level of disability and pain intensity, the level of fear of movement, the level of catastrophism, the degree of self-efficacy, the level of therapeutic alliance and their adherence to the physiotherapy. RESULTS: The strongest correlations were between the subjective perception of change and the number of sessions, treatment beliefs, self-efficacy, pain intensity, collaboration, and bonding. The linear regression model showed that the number of sessions, treatment beliefs, self-efficacy, compliance, pain intensity, and bonding were predictors of subjective perception of improvement, with 50% of the variance. CONCLUSIONS: Treatment beliefs, therapeutic alliance, degree of self-efficacy, and pain intensity have been shown to be predictors of a subjective perception of improvement in patients with CMP. In turn, multimodal treatments had the greatest positive impact on the subjective perception of improvement.

Impact of Subjective and Objective Factors on Subway Travel Behavior: Spatial Differentiation.

People's perceptions and understanding of the built environment can shape and regulate travel intention and behavior. From the perspective of urban design, improving the built urban environment is an important way to encourage green travel. This study determined the impact path from the built environment to subway travel behavior, considering the intermediate effect of psychological factors. The impact path could provide feedback for optimizing the built environment, thereby improving the ratio of subway travel. In this study, the impact path hypothesis of "objective environment-subjective psychological-travel behavior" was first proposed, taking travelers' psychological perceptions as the intermediary variable. Second, questionnaires and geographic information were used to measure the objective environment and subjective psychological perceptions. Third, a structural equation model was constructed to verify the proposed path hypothesis. Finally, multiscale geographically weighted regression was used to analyze the influence of subjective and objective factors on travel behavior and its spatial differences. The empirical case sampled 405 residents of Zhengzhou, China. The results verified the proposed impact path hypothesis and revealed spatial heterogeneity in its impact on travel behavior. The research explains how travel behavior is generated and could support the optimization of the urban built environment.

Subjective Perception of Work and the Home Care Workers' Depression.

The care crisis has become a global trend, and the demand for child and elderly care is increasing worldwide. The increasing number of home care workers plays a significant role in meeting this demand in developing countries. The mental health of these workers is associated with the quality of care they provide, which has rarely been studied. This paper explored the factors that affect home care workers' depression, including their socio-demographic characteristics, working environment, relationship with clients, social support networks, economic burden, and subjective perceptions of discrimination and work. It utilized data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over a period ranging from May to September 2021. The results show that the variables of marriage, education, self-reported health, relationship with client, economic burden, and subjective perceptions of discrimination and care work are significantly associated with home care workers' level of depression. However, the variables of gender, age, household registration, and work environmental factors have no significant effect on their level of depression, which differs from the findings of previous studies on care workers in other institutions.

Percepción subjetiva del COVID-19: Una medida de evaluación integral para adolescentes y jóvenes / Subjective perception of COVID-19: A comprehensive assessment measure for adolescents and young people

Resumen La pandemia por COVID-19 es un evento adverso y factor de riesgo para la salud integral de los adolescentes y jóvenes, asociado a trastornos de estrés, ansiedad y depresión, sin embargo, la perspectiva ecológica plantea que la percepción del evento o situación juega un papel central en la adaptación y salud mental. Por otra parte, la detección de factores de riesgo-protección es la base de una intervención efectiva. El objetivo de este estudio fue construir una medida multidimensional válida y confiable para explorar la percepción subjetiva y las respuestas psicológicas de los adolescentes y jóvenes ante la pandemia por COVID-19. Se realizó un estudio instrumental en el que participaron 727 adolescentes de 13 a 24 años (M= 18.36; DE= 2.9) de la Ciudad de México. Se elaboró la Encuesta de Percepción Juvenil del COVID-19 (EPJ COVID-19) que fue aplicada en línea. Un análisis factorial por componentes principales (n= 410) arrojó una solución de ocho factores: Miedo y preocupaciones, Indicadores de estrés, Presiones escolares, Conductas preventivas, Cambios de rutinas, Dinámica familiar, Relajación y esparcimiento, y Socialización virtual (VE = 59.07%). Un análisis factorial confirmatorio con el método de máxima verosimilitud (n= 317) corroboró un modelo de ocho factores mostrando índices aceptables de ajuste, el cual también presentó una buena consistencia interna (α total= .863). Los resultados sugieren que la EPJ COVID-19 es una medida válida y confiable que puede ser usada para valorar de manera integral la percepción y respuestas de los adolescentes y jóvenes ante la pandemia para diseñar intervenciones basadas en evidencia.

Abstract The COVID-19 pandemic is an adverse event and risk factor for the integral health of adolescents and young people, associated with stress disorders, anxiety, and depression; however, the ecological-transactional perspective supposed that the perception of the event or situation plays a central role in adaptation and mental health. Likewise, detecting risk-protective factors is the basis for effective intervention The purpose of this study was to develop a valid and reliable multidimensional measure to explore the perception and psychological responses of young people to the pandemic. An instrumental study was carried out and 727 adolescents aged 13 to 24 years (M= 18.36; SD= 2.9) from Mexico City participated. The COVID-19's Youth Perception Survey (COVID 19's YPS) was constructed which was applied online. A factor analysis using the principal components (n= 410) yielded a solution of eight factors: Fear and worries, Stress indicators, School pressures, Preventive behaviors, Changes in routine, Family dynamics, Relaxation and leisure, and Virtual socialization (EV= 59.07%). A confirmatory factor analysis using the maximum likelihood method (n= 317) corroborated an eight-factor model showing acceptable fit index, and it also shows a good internal consistency (α total= .863). These results suggest that the Survey is a valid and reliable measure that can be used to comprehensively assess adolescents and youth perception and responses to the pandemic, providing data to designing evidence-based intervention.

[Guilt for perceiving oneself as a burden: A relevant variable associated with the psychological distress of older adults]. / Culpa por percibirse como una carga. Una variable relevante asociada al malestar psicológico de las personas mayores.

AIMS: To analyze the relationship between guilt for perceiving oneself as a burden and negative self-perceptions of aging, perceived control and anxious and depressive symptomatology in older people without cognitive or functional limitations. METHODS: Participants were 351 community-dwelling people over 60 years without explicit cognitive or functional limitation. Indirect effet analysis were conducted that examined the indirect effect of negative self-perceptions of aging through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology in guilt for perceiving oneself as a burden. RESULTS: Both models showed an indirect relationship between negative self-perceptions of aging and guilt for perceiving oneself as a burden through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology, explaining 26.37% of anxious symptomatology, 48.51% of depressive symptomatology and 13.73% and 14.44% of guilt for perceiving oneself as a burden, respectively. DISCUSSION: The results obtained suggest that higher negative self-perceptions of aging is associated with a lower perception of control and greater psychological distress (anxiety and depression), and this process increases the feeling of guilt for perceiving oneself as burden to family members in older people without functional or cognitive limitations.

Sympathetic skin response as an objective tool to estimate stimulus-associated arousal in a human model of hyperalgesia.

BACKGROUND: Pain is a private experience, whose assessment relies on subjective self-reporting. Inaccurate communication renders pain evaluation unreliable in individuals with alteration of consciousness, lack of verbal interaction, cognitive dysfunction or simple malingering, hence the importance of developing reliable objective assessment tools. OBJECTIVES: Since pain is associated with autonomic arousal, here we used readouts of autonomic activity to assess objectively the arousing effect of somatic stimuli in a human model of hyperalgesia. METHODS: We used topical capsaicin to induce cutaneous hypersensitivity in the right arm of 20 healthy volunteers, and recorded sympathetic skin responses (SSR) and numerical perceptive ratings (NRS) to stimulation of the sensitized region and its homologous contralateral site, using brush (Aß), pinprick (Aδ) and laser (C-Warmth) stimuli. RESULTS: Both subjective ratings and SSRs were significantly enhanced to stimulation of the sensitized region, and their respective ratios of maximal enhancement were positively correlated. At individual level, a significant association was observed between SSR and NRS behavior (χ2(1)= 11.03; p < 0.001), with a positive predictive value of 87% (CI95 [77-97%]) for SSR increase predicting enhancement of subjective reports. A "lie experiment" asking subjects to simulate elevated NRS failed to enhance SSRs. Significant habituation of SSRs appeared when stimuli were repeated at ∼15s intervals, hence decreasing their negative predictive value when several consecutive stimuli were averaged (NPV=46%; CI95 [30-62%]). CONCLUSION: The SSR may represent a rapid and reliable procedure to assess cutaneous hypersensitivity, simple to use in clinical practice and resistant to simulation. Rapid habituation is a drawback that can be countered by using few repetitions and low stimulus rates.

The ICHOM Standard Set for Pregnancy and Childbirth - Translation and Linguistic Adaptation for Germany.

Introduction The gathering of health and quality-of-life issues that matter most to patients over so-called patient-reported outcomes (PROs) is a key aspect of patient-centered healthcare. In obstetrics, this approach has the potential to expand the current understanding of what quality entails by including patient perspectives. The International Consortium for Health Outcome Measures (ICHOM), founded in 2012, is a global organization which aims to standardise the collection of PROs and make the results comparable worldwide. A PRO Set for obstetrics, "Pregnancy and Childbirth", was published in 2018. The aim of our work was to translate the instruments of this set that are not yet available in German into German. Methods The instruments were translated from English into German using the Functional Assessment of Chronic Illness Therapy (FACIT) translation method. The translated instruments consisted of the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), the Mother-to-Infant Bonding Scale (MIBS), and the Birth Satisfaction Scale - Revised (BSS-R) as well as a number of individual questions (items). Results The final version of the German translations were found to be easily comprehensible by the target group. During the cognitive debriefing, it became clear that pregnant women and women who had just given birth often used a number of medically incorrect terms to refer to their symptoms or complaints. In the translations great care was taken to ensure that the wording was as close as possible to the general usage of the language while at the same time the terminology was medically correct. To achieve a precise but comprehensible translation, the response structure of the BSES-SF also had to be adapted. Conclusions The instruments of the ICHOM Standard Set "Pregnancy and Childbirth", which were not previously available in German, were successfully translated into German. This meant dealing with a few challenges such as adapting questions or response structures. The cultural and linguistic comprehensibility of the German translations were confirmed during the subsequent cognitive debriefing. The translations offer the possibility of implementing the complete ICHOM Set for Pregnancy and Childbirth. This would provide an opportunity to expand the existing understanding of quality by including the subjective experience of women during and after childbirth and, in future, to compare outcomes with those of other hospitals across the world.

Review: Subjective Time Perception, Dopamine Signaling, and Parkinsonian Slowness.

The association between idiopathic Parkinson's disease, a paradigmatic dopamine-deficiency syndrome, and problems in the estimation of time has been studied experimentally for decades. I review that literature, which raises a question about whether and if dopamine deficiency relates not only to the motor slowness that is an objective and cardinal parkinsonian sign, but also to a compromised neural substrate for time perception. Why does a clinically (motorically) significant deficiency in dopamine play a role in the subjective perception of time's passage? After a discussion of a classical conception of basal ganglionic control of movement under the influence of dopamine, I describe recent work in healthy mice using optogenetics; the methodology visualizes dopaminergic neuronal firing in very short time intervals, then allows for correlation with motor behaviors in trained tasks. Moment-to-moment neuronal activity is both highly dynamic and variable, as assessed by photometry of genetically defined dopaminergic neurons. I use those animal data as context to review a large experimental experience in humans, spanning decades, that has examined subjective time perception mainly in Parkinson's disease, but also in other movement disorders. Although the human data are mixed in their findings, I argue that loss of dynamic variability in dopaminergic neuronal activity over very short intervals may be a fundamental sensory aspect in the pathophysiology of parkinsonism. An important implication is that therapeutic response in Parkinson's disease needs to be understood in terms of short-term alterations in dynamic neuronal firing, as has already been examined in novel ways-for example, in the study of real-time changes in neuronal network oscillations across very short time intervals. A finer analysis of a treatment's network effects might aid in any effort to augment clinical response to either medications or functional neurosurgical interventions in Parkinson's disease.