Age, BMI, and inflammation: Associations with emotion recognition.

Experimental studies show that inflammation impairs the ability to interpret the mental state of another person, denoted theory of mind (ToM). The current study attempted a conceptual replication in states associated with elevated low-grade inflammation, i.e., high body weight and advanced age. Ninety young (M = 26.3 years, SD = 4.1) or older (M = 70.7 years, SD = 4.0) participants with either a normal body mass index (BMI) (M = 22.4, SD = 2.2) or high BMI (M = 33.1, SD = 3.8) completed the Reading the Mind in the Eyes Test (RMET) to assess emotion recognition. Plasma interleukin-6 (IL-6) level was measured to index low-grade inflammation. As anticipated, elevated IL-6 levels were found with higher BMI, although not with increased age. IL-6 was associated with poorer task performance, independent of potential demographic and health confounders (e.g., sex, education, smoking status, alcohol intake, presence of medical conditions, and medication intake). Analyses also revealed an interaction whereby young individuals with a high BMI showed worse RMET performance compared to their normal BMI counterparts, whereas the opposite pattern was found in older individuals. The present observational study replicated experimental results showing that elevated low-grade inflammation is correlated with a lower ability to infer the mental states of others. These findings suggest that also naturalistic conditions of (protracted) low-grade inflammation may alter emotion recognition.

Low-grade inflammation decreases emotion recognition - Evidence from the vaccination model of inflammation.

The ability to adequately interpret the mental state of another person is key to complex human social interaction. Recent evidence suggests that this ability, considered a hallmark of 'theory of mind' (ToM), becomes impaired by inflammation. However, extant supportive empirical evidence is based on experiments that induce not only inflammation but also induce discomfort and sickness, factors that could also account for temporary social impairment. Hence, an experimental inflammation manipulation was applied that avoided this confound, isolating effects of inflammation and social interaction. Forty healthy male participants (mean age = 25, SD = 5 years) participated in this double-blind placebo-controlled crossover trial. Inflammation was induced using Salmonella Typhi vaccination (0.025 mg; Typhim Vi, Sanofi Pasteur, UK); saline-injection was used as a control. About 6 h 30 m after injection in each condition, participants completed the Reading the Mind in the Eyes Test (RMET), a validated test for assessing how well the mental states of others can be inferred through observation of the eyes region of the face. Vaccination induced systemic inflammation, elevating IL-6 by +419% (p < .001), without fever, sickness symptoms (e.g., nausea, light-headedness), or mood changes (all p's > .21). Importantly, compared to placebo, vaccination significantly reduced RMET accuracy (p < .05). RMET stimuli selected on valence (positive, negative, neutral) provided no evidence of a selective impact of treatment. By utilizing an inflammation-induction procedure that avoided concurrent sicknesses or symptoms in a double-blinded design, the present study provides further support for the hypothesis that immune activation impairs ToM. Such impairment may provide a mechanistic link explaining social-cognitive deficits in psychopathologies that exhibit low-grade inflammation, such as major depression.

Learning through authentic assessment: an evaluation of a new development in the undergraduate midwifery curriculum.

Assessment is a powerful influence on learning, and can form an important strategy amongst a variety of teaching and learning approaches. Authentic assessment activities are designed to mimic the complexity of 'real world' situations that students may encounter in professional life, and require the application of a combination of skills related to knowledge, skills and attitude. We undertook a small-scale evaluation using a qualitative descriptive design to explore the feasibility and usefulness of an authentic assessment item that focused on a common clinical scenario in midwifery practice, female catheterisation. Seven third year Bachelor of Midwifery students and three teaching staff volunteered to participate in the project. During the process the students videoed the scenario for peer assessment, developed marking criteria, completed an online survey and participated in a focus group. The findings demonstrated that the students' confidence, knowledge and skills improved as a result of participating in the assessment item and they rated it positively for use in the Bachelor of Midwifery curriculum as a means of increasing real world assessment activities. It is anticipated that this learning strategy will be further refined and integrated in various ways into other clinical midwifery subjects in the midwifery curriculum.

'Creating a safety net': Women's experiences of antenatal depression and their identification of helpful community support and services during pregnancy.

OBJECTIVE: to explore the feelings of depression during pregnancy of a local sample of women living in an area of socio-economic deprivation, and to identify the support mechanisms that they report as personally or potentially helpful for antenatal depression. DESIGN: a retrospective study using a qualitative approach, informed by constructivism, to explore the participants' individual experiences of depression during pregnancy. Data were collected via tape-recorded semi-structured interviews. SETTING: a socio-economically deprived area in North London, UK, identified as a Sure Start Local Programme providing local services specifically designed for socially disadvantaged families with children aged 0-4 years. PARTICIPANTS: a self-selected sample of nine women aged 23-40 years, from a variety of ethnic backgrounds, who retrospectively admitted to feeling low or depressed during pregnancy. All the participants had had a baby more than 6 weeks previously and less than 1 year before the start of the study. FINDINGS: despite different cultural and ethnic backgrounds, the participants shared similar feelings of emotional isolation that seemed to contribute largely to their experience of antenatal depression. Partner support (or lack of it) seemed to be crucial to the women's psychological well-being during pregnancy. For some of these women, the research interview was the first opportunity to talk about their needs and feelings during pregnancy. Potentially helpful mechanisms for support were identified by the participants and were judged to be relatively simple to introduce, involving connecting with other women via peer support and having 'somewhere to go' to meet others during pregnancy. IMPLICATIONS FOR PRACTICE: some women do not disclose their feelings of depression during pregnancy, with potentially damaging effects on both the family and the baby. Feelings of loss and emotional isolation may occur, which could be partly alleviated by providing models of midwifery care that offer continuity of carer. Isolated and vulnerable women require increased midwifery resources, and partners may also have particular needs for support and adjustment, which currently remain unmet and need further research. Many 'low tech' interventions aimed at supporting women with antenatal depression could be developed, including peer support, which may offer realistic models of social capital and community empowerment in the new Children's Centres in England and Wales.