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Background: Fatigue is common in both Sjögren's syndrome (SS) and rheumatoid arthritis (RA) and can restrict functioning.Aims: We tested the convergent validity of the Profile of Fatigue (ProF) using the Multidimensional Fatigue Inventory (MFI) in SS and RA.Methods: The 16-item ProF and the 20-item MFI were completed by 82 White-British women aged 35-79 years (mean 60.4 years). Thirty-four had been diagnosed with SS for a mean of 7.0 years and 48 had been diagnosed with RA for a mean of 14.5 years. The ProF measures four somatic facets of fatigue and two mental facets; the MFI contains one mental and four somatic facets. The structures of the items from both measures were tested by principal component factor analysis using varimax rotation.Results: No significant differences in fatigue were found between the women with SS or RA. Five factors explained a total of 76% of the variance of the MFI; six factors explained 94% of the variance of the ProF. Mental fatigue items from both questionnaires loaded onto separate factors from somatic fatigue items; the two original facets of mental fatigue in the ProF were replicated. The four somatic fatigue facets of the ProF were generally replicated but the somatic facets of the MFI did not replicate as clearly. Equivalent facets correlated well between the two questionnaires (r >/= 0.65).Conclusions: Both the ProF and the MFI distinguish between somatic and mental fatigue in SS and RA but the ProF appears better at resolving somatic facets of fatigue. Copyright (c) 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract Background Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). Although the pathogenesis of MS remains unknown, it is widely regarded as an autoimmune disease mediated by T-lymphocytes directed against myelin proteins and/or other oligodendrocyte epitopes. Methods In this study we investigated the gene expression profiles of peripheral blood cells from patients with RRMS during the relapse and the remission phases utilizing gene microarray technology. Dysregulated genes encoded in regions associated with MS susceptibility from genomic screens or previous trancriptomic studies were identified. The proximal promoter region polymorphisms of two genes were tested for association with disease and expression level. Results Distinct sets of dysregulated genes during the relapse and remission phases were identified including genes involved in apoptosis and inflammation. Three of these dysregulated genes have been previously implicated with MS susceptibility in genomic screens: TGFβ1, CD58 and DBC1. TGFβ1 has one common SNP in the proximal promoter: -508 T>C (rs1800469). Genotyping two Australian trio sets (total 620 families) found a trend for over-transmission of the T allele in MS in females (p < 0.13). Upregulation of CD58 and DBC1 in remission is consistent with their putative roles in promoting regulatory T cells and reducing cell proliferation, respectively. A fourth gene, ALOX5, is consistently found over-expressed in MS. Two common genetic variants were confirmed in the ALOX5 putatve promoter: -557 T>C (rs12762303) and a 6 bp tandem repeat polymorphism (GGGCGG) between position -147 and -176; but no evidence for transmission distortion found. Conclusion The dysregulation of these genes tags their metabolic pathways for further investigation for potential therapeutic intervention.

Abstract Background Multiple sclerosis (MS) is a disorder of the central nervous system (CNS) characterised by inflammation and neuronal degeneration. It is believed to result from the complex interaction of a number of genes, each with modest effect. Chemokines are vital to the migration of cells to sites of inflammation, including the CNS, and many are implicated in MS pathogenesis. Most of the CC chemokine genes are encoded in a cluster on chromosome 17q11.2-12, which has been identified in a number of genome wide screens as being potentially associated with MS. Methods We conducted a two-stage analysis to investigate the chemokine gene cluster for association with MS. After sequencing the chemokine genes in several DNA pools to identify common polymorphisms, 12 candidate single-nucleotide polymorphisms (SNPs) were genotyped in a cohort of Australian MS trio families. Results Marginally significant (uncorrected) transmission distortion was identified for four of the SNPs after stratification for several factors. We also identified marginally significant (uncorrected) transmission distortion for haplotypes encompassing the CCL2 and CCL11 genes, using two independent cohorts, which was consistent with recent reports from another group. Conclusion Our results implicate several chemokines as possibly being associated with MS susceptibility, and given that chemokines and their receptors are suitable targets for therapeutic agents, further investigation is warranted in this region.

The public's trust in the science of avoiding unhealthy weight depends on a radical reform of the design and execution of weight loss programmes and their clinical trials. This Perspective reiterates the longstanding argument for measuring the effectiveness of each component of an intervention on obesity. Body energy content change results from a difference in rates between input and output. These rates are determined by the frequencies of specific patterns of dietary behaviour, physical activity and thermal comfort, plus the cost of resting metabolism. Since fat-free mass changes alongside fat mass, the amount of change in weight from a change in the frequency of a behaviour pattern comes to an asymptote. That step change in weight per unit of behaviour change is measured by regression from the change in frequency of the behaviour that has been maintained from baseline to follow-up. For hard evidence, weight loss programme participants' own words must be used to specify behaviour. In RCTs of multiple-component programmes, sequences of the behaviour patterns to be changed are randomised among groups. The resulting evidence on effective slimming practices can be delivered directly into therapeutic services and public health interventions for the culture investigated., (© 2022. The Author(s).)

Suboptimality of decision making needs no explanation. High-level accounts of suboptimality in diverse tasks cannot add up to a mechanistic theory of perceptual decision making. Mental processes operate on the contents of information brought by the experimenter and the participant to the task, not on the amount of information in the stimuli without regard to physical and social context.

Some individuals have a neurogenetic vulnerability to developing strong facilitation of ingestive movements by learned configurations of biosocial stimuli. Condemning food as addictive is mere polemic, ignoring the contextualised sensory control of the mastication of each mouthful. To beat obesity, the least fattening of widely recognised eating patterns needs to be measured and supported.

Dietary guidelines for the general public aim to lower the incidence of nutrition-related diseases by influencing habitual food choices. Yet little is known about how well the guidelines are matched by the actual practices that people regard as healthy or unhealthy. In the present study, British residents were asked in a cognitive interview to write a description of an occasion when either they ate in an unhealthy way or the eating was healthy. The reported foods and drinks, as well as sort of occasion, location, people present and time of day, were categorised by verbal and semantic similarities. The number of mentions of terms in each category was then contrasted between groups in exact probability tests. Perceived unhealthy and healthy eating occasions differed reliably in the sorts of foods and the contexts reported. There was also full agreement with the national guidelines on eating plenty of fruit and vegetables, eating small amounts of foods and drinks high in fat and/or sugar, drinking plenty of water, and cutting down on alcohol. There was a tendency to regard choices of bread, rice, potatoes, pasta and other starchy foods as healthy. Reported healthy and unhealthy eating did not differ in incidences of meat, fish, eggs, beans and other non-dairy sources of protein or of dairy foods and milk. These results indicate that operationally clear recommendations by health professionals are well understood in this culture but members of the public do not make clear distinctions in the case of foods that can be included in moderate amounts in a healthy diet., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This paper reviews all the published evidence on the theory that the act of selecting a piece of food or drink structurally coordinates quantitative information across several sensory modalities. The existing data show that the momentary disposition to consume the item is strengthened or weakened by learnt configurations of stimuli perceived through both exteroceptive and interoceptive senses. The observed configural structure of performance shows that the multimodal stimuli are interacting perceptually, rather than merely combining quantities of information from the senses into the observed response.

Food intake can be increased by learning to anticipate the omission of subsequent meals. We present here a new theory that such anticipatory eating depends on an associative process of instrumental reinforcement by the nutritional repletion that occurs when access to food is restored. Our evidence over the last decade from a smooth-brained omnivore has been that food after deprivation rewards intake even when those reinforced ingestive responses occur long before the physiological signals from renewed assimilation. Effects of food consumed after self-deprivation might therefore reward extra eating in human beings, through brain mechanisms that could operate outside awareness. That would have implications for efforts to reduce body weight. This food reward mechanism could be contributing to the failure of the dietary component of interventions on obesity within controlled trials of the management or prevention of disorders such as hypertension, atherosclerosis and type 2 diabetes., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Interactions between the processing of emotion expression and form-based information from faces (facial identity) were investigated using the redundant-target paradigm, in which we specifically tested whether identity and emotional expression are integrated in a superadditive manner (Miller, Cognitive Psychology 14:247-279, 1982). In Experiments 1 and 2, participants performed emotion and face identity judgments on faces with sad or angry emotional expressions. Responses to redundant targets were faster than responses to either single target when a universal emotion was conveyed, and performance violated the predictions from a model assuming independent processing of emotion and face identity. Experiment 4 showed that these effects were not modulated by varying interstimulus and nontarget contingencies, and Experiment 5 demonstrated that the redundancy gains were eliminated when faces were inverted. Taken together, these results suggest that the identification of emotion and facial identity interact in face processing.

Rats can learn to anticipate the omission of subsequent meals by increasing food intake. Our previous reports have analysed group means at each trial but that does not allow for rats learning at different speeds. This paper presents instead a rat-by-rat analysis of all the raw data from previous experiments. The re-analysis supports the published evidence that the capacity for reinforcement generated by withholding of food is greater after a longer fast than after a shorter fast, but that the learning is quicker after the shorter fast. The individualised analyses also extend the evidence that the pattern of learning, extinction and re-learning with shorter fasts is similar to that with longer fasts. These findings indicate that, contrary to our previous interpretation, a single learning mechanism can explain the effects of both durations of food deprivation., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Endothelial colony-forming cells (ECFCs) isolated from umbilical cord blood (CBECFCs) are highly proliferative and form blood vessels in vivo. The purpose of this investigation was to isolate and characterize a population of resident ECFCs from the chorionic villi of term human placenta and provide a comparative analysis of their proliferative and vasculogenic potential with CBECFCs. ECFCs were isolated from umbilical cord blood and chorionic villi from placentas obtained by caesarean deliveries. Placental ECFCs (PECFCs) expressed CD144, CD31, CD105, and KDR and were negative for CD45 and CD34, consistent with other ECFC phenotypes. PECFCs were capable of 28.6 ± 6.0 population doublings before reaching senescence (vs. 47.4 ± 3.2 for CBECFCs, p < 0.05, n = 4). In single cell assays, 46.5 ± 1.2% underwent at least one division (vs. 51.0 ± 1.8% of CBECFCs, p = 0.07, n = 6), and of those dividing PECFCs, 71.8 ± 0.9% gave rise to colonies of >500 cells (highly proliferative potential clones) over 14 days (vs. 69.4 ± 0.7% of CBECFCs, p = 0.07, n = 9). PECFCs formed 5.2 ± 0.8 vessels/mm(2) in collagen/fibronectin plugs implanted into non-obese diabetic/severe combined immunodeficient (NOD/SCID) mice, whereas CBECFCs formed only 1.7 ± 1.0 vessels/mm(2) (p < 0.05, n = 4). This study demonstrates that circulating CBECFCs and resident PECFCs are identical phenotypically and contain equivalent quantities of high proliferative potential clones. However, PECFCs formed significantly more blood vessels in vivo than CBECFCs, indicating that differences in vasculogenic potential between circulating and resident ECFCs exist.

This study started to characterise the cognitive processes by which physical effects on the senses are transformed into quantitative judgments about conceptualised aspects of a food. Using words provided by assessors, discriminations of a shortbread biscuit's fracturing patterns during eating from each assessor's internal norm were measured for the initial steps of denting, biting and crushing the material. The haptic concept of dentability (lack of crispness) often discriminated cracks in the biscuit that were the lowest in force, but was also sensitive to high-force cracks and frequency of cracks. How hard it was to bite through the sample was most often sensitive to the force of snapping the biscuit and to high-force cracks. Frequency of cracks usually dominated how "crunchy" the biscuits were rated to be. Interactions among the normed discrimination functions accounted for judgments of overall distance from the personal norm for the complex overall texture of the biscuit and revealed each assessor's cognitive strategies in reaching those integrative judgments. Use of the haptic concepts tended to shift mentation from control of the integrative texture ratings directly by sensory stimulation to the relating of those concepts to the sensed patterns, i.e., to describing texture., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Associative conditioning of satiety indicates that concentrated maltodextrin (cMD) may induce a mildly aversive visceral signal within 20 min of its ingestion, as well as satiating normally. Individuals' awareness of this adverse state was tested on ratings of statistically distinct descriptions of factors liable to suppress hunger, whether distressing or comfortably satisfying. Wanted amount of a food and the pleasantness of eating it correlated highly for each of five foods, once again refuting the widespread presumption that "pleasant" refers to sensory pleasure; hence, as in previous reports, suppression of hunger was measured as a reduction of the averaged pleasantness of functionally related foods. At 20 min after the start of ingestion of a small meal on a near-empty stomach, cMD reliably reduced hunger. The greatest influence on hunger, besides normal sating, was thirst, but there were also tendencies to nausea and bloat, although all less than after a full sized meal. Visceral processes shortly after a meal can create dissociable conscious states, only one of which is satiety for food., (2010 Elsevier Inc. All rights reserved.)

This paper argues that the rise in obesity can be slowed only by universal education based on a type of evidence that does not yet exist. On top of literacy and numeracy, people need the ability to preempt the fattening effect of a decrease in habitual physical activity by altering familiar patterns of eating, drinking and exercise in ways that are both maintainable within the individual's social and physical environment and also effective at decreasing weight to the asymptote for each sustained change. Hence the prevention of obesity requires locally valid evidence on which changes to specific customary habits actually do avoid unhealthy fattening. Interventions need to focus on antecedents to individuals' common lapses from the healthy changes in these customs. Yet no research has been funded into the public's descriptions of feasible changes that cause a step down in weight, let alone into the environmental conditions for individuals' maintenance of those changes. As a result, public health policies on obesity lack scientific basis. When will a start be made on systematic identification of cultural supports to readily executed patterns of lifestyle behaviour which improve health to extents that have been directly measured?, (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The paper presents an innovative theory of perception of multiple features across and within modalities. Each step is illustrated by an aspect of data from diverse experiments. The theory is that a template or norm of previously configurated features is used to perceive an object in a situation, such as consuming an item of food or drink. A mouthful usually stimulates sight first and then touch, taste and smell, with thermal, irritative, kinaesthetic and auditory patterns often also involved. The visual information also typically includes meanings of words, numbers and pictures. Attended sensory and symbolic features of the situation are integrated by the individual into a multidimensional distance from the norm. Dimensions are calibrated in units of the response's discrimination between levels of each stimulus feature. This approach to perceptual performance is expounded for sensed and/or conceived visual features of drinks and foods, and their tasted or smelt constituents, or felt and heard cracking during a bite. In addition, the conceptual process that informs an analytical judgment can influence another judgment. Applying the concept to a stimulus forms a descriptive process. A concept may also be applied to another concept or to a description, giving greater depth of meaning to an integrative judgment. Furthermore, a description can be applied to an environmental source of stimulation, creating a percept that presumably is conscious, whereas unconceptualised stimulation may be subconscious.

This paper illustrates how perception is achieved through interactions among the psychophysical functions of judged features of an object. The theory is that the perceiver places processed features in a multidimensional space of discriminal processes. Each dimension is scaled in units of discrimination performance. The zero coordinate of each feature is its level in an internal standard (norm) established by previous experience of that category of object in context. Experiments are reported which show that one, two, or three concurrent single-featured objects matched the multiple features of another object in two ways. Either stimulation from the two objects had discrimination distances from norm that added, or the stimulation by one object was processed through a concept describing stimulation by the other object. It follows that, in this case, perception via a receptor for the multi-featured object can be replaced by a point of balance among receptors for each single feature. The object with its own receptor is the gustatory stimulant L-glutamic acid as its monosodium salt. The features that stimulate diverse gustatory receptors of their own are sodium chloride, citric acid, sucrose, and caffeine. A more complex approach to dimensional coding was developed earlier for photoreceptors in colour judgments. The present approach is modality independent, mathematically simple, and economical in experimental data.

This short overview considers a prospect that claims to boost satiety are used to prescribe or sell materials to dieters that do not slow their daily rate of energy intake, thereby worsening their problems with body weight and even perhaps increasing the prevalence of obesity. Implying that a drug or a food contributes to weight control by providing extra satiety is a mistake in two ways. First, the notion of a hormone analogue or a food constituent having a specifiable satiating power is scientifically incoherent. Secondly, a slimming satiety is a particular pattern of eating and drinking, in which substances have no fixed roles. Such a dietary custom has to be shown to produce a larger step decrease in weight with the medication or food product than without it. Suppression of food intake at a usual time for eating does not imply reduction in the eater's total intake of energy in a calendar period and hence lower weight while the material is still used within that eating pattern. It is the maintained pattern of behaviour that slims and prevents regain, not a satiety-augmenting substance. Regulators should not allow incomprehension of the basic science of energy balance to be exploited by advocacy of a food or medication for "satiety" believed by consumers to be a means of avoiding unhealthy fatness., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This brief report presents illustrative findings from the first implementation for recognition of an aroma of individualised analysis of cognition as normed discriminations. Two assessors compared mixtures of four odorants with a fresh strawberry in overall aroma, its intensity and balance, and in the smell of each odorant conceptualised in their own words. By the second session, each assessor's judgments of overall likeness of a mixture to strawberry focused on one of the six mental processes tested. One assessor acquired a configural conceptualisation of all the odorants as smelling the same as strawberry. The other asssessor learnt to rate strawberriness by conceptualising the four odorants separately in judgments of both intensity and balance. Even this modest amount of data provides insights into mental mechanisms by which an individual perceives the complex profile of odorants released by a familiar material., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

In this study, we separated for the first time the learned liking for a particular level of sweetness in a familiar drink from the infantile delight in sweetness as such ("the sweeter, the better"). It is widely assumed that sensing a liked food or drink evokes a pleasurable experience, but the only psychological evidence for this assumption has been tongue movements that are elicited specifically by sweet taste in animals and human neonates. We found that adults felt such movements in response to drinking juice at both their personally preferred level of sweetness and levels they deemed so sweet as to be undrinkable. Yet only the intolerably strong level of sweetness elicited enjoyment of the experienced movements, elevation of mood, and a sense of smiling. Hence, the pleasure that adults experience during ingestion could be exclusively linked with the congenital sweetness reflex that sends mother's milk down an infant's throat.

We present the first experiment that was based on a novel analysis of the mental processes of choice. Sensed material characteristics such as the sweetness of a drink and symbolic attributes such as the source of sweetness stated on the label are put into the same units of influence on the response. Most users of low-calorie drinks thought about the energy in a drink quite differently from the way they decided how sweet and how low in calories they liked the drink to be. Also the female diet drink users thought about energy content differently from most of the male users of sugar drinks. In both groups' ratings of likelihood of choice and in sugar drink users' estimates of energy content, sweetness and labelled calories were usually treated as separate stimuli or ideas. In contrast, some female diet drink users treated sweetness and perceived calories as the same, whereas no male sugar drink user did. Such findings illustrate how this approach spans the gap between sensory perception and conceptualised knowledge., (2010 Elsevier Ltd. All rights reserved.)

Objectives: Fatigue is a prominent symptom in many rheumatic diseases and has a substantial impact on many outcomes. In previous research, fatigue has been linked with poor sleep and discomfort, including joint pain and sicca symptoms. The aim of the present study was to investigate prospectively the daily variations in fatigue and the roles of discomfort and adequacy of sleep the previous night in that fatigue for people with primary Sjögren's syndrome (pSS) or rheumatoid arthritis (RA)., Methods: Thirty-nine women with pSS or RA reported their discomfort and fatigue for 35 days using the Profile of Fatigue and Discomfort. Sleep was monitored with wrist actigraphy, and the quantity and quality of the night's sleep was reported in a diary each morning., Results: The pattern of fatigue did not differ significantly between women with pSS and women with RA. For participants with either condition, both somatic and mental fatigue increased steadily throughout the day. Multi-level regressions indicated that evenings of worse discomfort were followed by poorer reported quantity/quality of sleep and worse sleep efficiency (percentage of time asleep when in bed). In addition, a night of worse discomfort and poor sleep was followed by more severe fatigue compared with the individual's average., Conclusions: Fatigue management for people with rheumatic disease could include strategies for coping with discomfort at night and difficulties in sleeping. Further research into ameliorating fatigue should include assessments of persistent discomfort or periods of insomnia and identify disease-specific needs that require targeted intervention.

The current strength of a person's appetite for food can be observed in any graded expression of the disposition to take a mouthful of food. For this quantitative judgment to measure an influence on hunger/satiety, however, the source of that influence has to be varied independently of other influences at the moment the rating is made.

Many experiments on the role of learning in the amount eaten at a distinctive test meal have been claimed to observe "conditioned satiety." None published from outside this author's group has used either the necessary design of the contingencies to be learnt or the measurements that distinguish a sating effect from other loss of interest in food. One experiment has just been published without an adequate design but giving the best evidence yet from another group for the conditioning of sensory-gastric satiety; yet the authors conclude for changes in sensory preference with no learnt gastric involvement in the meal size response. To encourage correct use of the demonstrations in rats, monkeys and people of conditioned satiety and its mechanism, this paper briefly reviews publications that attribute control of meal size to learnt satiety.

Several recent experiments have provided evidence that the ingestion of a distinctive food by rats can be a learnt instrumental act as well as an associatively conditioned reaction. In the previous work, maintenance food was withheld for shorter and longer durations on different days following access to the training food. Extra eating before the longer fast was interpreted as avoidance of hunger. This interpretation was based on the evidence showing that extra eating as a result of classical conditioning comes from pairing food stimuli with the presence of little or no hunger because of repletion with energy nutrients. The theory that the extra eating arose from a response-depletion contingency was tested in the present experiment by training rats on only a long fast or only a short fast. Greater increase in intake was seen before the longer fast. The results also replicated previously seen cycles of increase, decrease, and renewed increase in putative deficit-avoidant eating over about three trials, indicating that the extra eating reduces the response-reinforcing hunger and that the consequent part-extinction restores reinforcement. The shape of the learning curve was consistent with these cycles occurring from the start of training, further supporting the view that the increase in food intake before a long delay in refeeding is hunger-reinforced instrumental behaviour.

As reviewed by [Cooper, S. J. (2008). From Claude Bernard to Walter Cannon: emergence of the concept of homeostasis. Appetite 51, 419-27.] Claude Bernard's idea of stabilisation of bodily states, as realised in Walter B. Cannon's conception of homeostasis, took mathematical form during the 1940s in the principle that externally originating disturbance of a physiological parameter can feed an informative signal around the brain to trigger counteractive processes--a corrective mechanism known as negative feedback, in practice reliant on feedforward. Three decades later, enough was known of the physiology and psychology of eating and drinking for calculations to show how experimentally demonstrated mechanisms of feedforward that had been learnt from negative feedback combine to regulate exchanges of water and energy between the body and the surroundings. Subsequent systemic physiology, molecular neuroscience and experimental psychology, however, have been traduced by a misconception that learnt controls of intake are 'non-homeostatic', the myth of biological 'set points' and an historic failure to address evidence for the ingestion-adapting information-processing mechanisms on which an operationally integrative theory of eating and drinking relies.

Fatigue is a systemic feeling of exhaustion that is a common symptom of many chronic illnesses, including the autoimmune inflammatory disease rheumatoid arthritis (RA). We examined predictors of levels of fatigue among people with RA using Leventhal's Common-Sense Model (CSM), which states that cognitive representations of an illness spur (or halt) people's efforts to cope and thereby influence outcomes of the illness. Our use of the CSM was designed in the light of evidence in the literature specific to fatigue in RA. Current fatigue was reported on a 100 mm visual analogue scale (with anchors "No fatigue" and "Unbearable fatigue") by 114 people (73.7% women) with RA at baseline and 1 year later. Baseline employment status, pain, impact of disability, sleep disruption frequency, depressed mood, perceptions of consequences, arthritis self-efficacy and attempts to cope by praying/hoping were also self-reported. Duration of RA and a haematological measure of systemic inflammation (erythrocyte sedimentation rate; ESR) were obtained from hospital records. Unexpectedly, RA duration did not predict fatigue after 1 year, although lower baseline inflammation did (controlling for baseline fatigue and other disease impact variables). This may be due to sampling flares of RA at baseline. Baseline perceptions that RA has severe consequences and is uncontrollable also predicted greater fatigue after 1 year but this relationship was not mediated by praying/hoping. Targeted psychological care to modify perceptions of severe consequences may therefore improve later fatigue for people with RA even when the condition is longstanding, but the mechanisms of any benefit require further investigation.

Anticipatory hunger is a learnt increase in intake of food having a flavour or texture that predicts a long fast. This learning was studied in rats trained on a single food or a choice between protein-rich and carbohydrate-rich foods, presented for 1.5 h after 3 h without maintenance food at the start of the dark phase. Eight training cycles provided a pseudo-random sequence of 3 h and 10 h post-prandial fasts with a day on maintenance food between each training fast. The measure of anticipatory hunger is the difference over one 4-day cycle between the intake of test food having an odour predictive of the longer fast (TL) and intake of food with an odour cuing to the shorter fast (TS). Previous experiments showed that conditioning of preference for the odour before the shorter fast competes with learning to avoid hunger during the longer fast (anticipatory hunger), generating a cubic or quartic contrast. TL minus TS showed a strong cubic trend over 8 training cycles with both single and choice meals. There was a switch from preference for the short-fast odour at cycle 2 (TL-TS=-0.86 g) to a peak of anticipatory hunger at cycle 6 (TL-TS=1.57 g). We conclude that anticipatory hunger is learnt when a choice is given between protein-rich and carbohydrate-rich foods as well as on a single food. In addition, since anticipatory hunger extinguishes itself, such learning improves on negative-feedback homeostasis with a feed-forward "hyper-homeostatic" mechanism.

Objectives: Using the transactional model of stress and coping, the present study investigated whether specific coping resources act as buffers of the relationship between perceived stress and psychological well-being among rheumatoid arthritis (RA) patients., Design: A longitudinal observational study was carried out with assessments at baseline, 6 months and 1 year., Methods: Measures of perceived stress, coping resources (optimism/pessimism, social support and explicit active coping strategies) and psychological well-being (anxiety, depression and life satisfaction) were completed by 134 RA patients. Demographics, RA duration, pain, fatigue, functional disability, antidepressant use and physical comorbidities were recorded and statistically controlled for., Results: Perceived stress had the strongest relationship with psychological well-being at baseline, and affected anxiety after 6 months. Optimism and pessimism predicted psychological well-being across 1 year. Active behavioural coping buffered an association of stress with depression at baseline, while baseline active cognitive coping buffered the effect of baseline stress on life satisfaction after 6 months., Conclusions: Patients with RA under greater perceived stress who do not use active coping strategies appear to be at risk of psychological comorbidity and may therefore benefit from interventions teaching specific active coping strategies. Larger observational studies and interventions are required to confirm and extend these findings.

Background: Sleep is an important daily process that can be disrupted by chronic illnesses including rheumatoid arthritis (RA)., Aims: We tested whether demographic, medical and psychological factors act as predictors of change in frequency of sleep disruption associated with RA., Methods: A cohort of 129 White British people with RA (mean duration of RA 7.19 years; mean age 55.40 years; 75% women) was followed for one year. Self-report questionnaires were employed to record demographic information and assess participants' sleep disruption (on a 4-point frequency scale), morning stiffness (duration), pain and fatigue (visual analogue scales), impact of disability, anxiety, depression, stress, coping, illness perceptions and self-efficacy. Hospital notes were reviewed for duration of RA, antidepressant use and comorbidity., Results: Participants were split into those with sleep disruption that was consistently infrequent or decreasing in frequency (n = 56; 43%) and those with sleep disruption that was consistently frequent or increasing in frequency (n = 73; 57%). Results of a logistic regression demonstrated that greater perceived stress at baseline predicted sleep disruption that was consistently frequent or increasing in frequency over the year. Change in sleep disruption frequency was not predicted by any other assessed variable. Perceived stress at the end of the year was not predicted by change in frequency of sleep disruption., Conclusions: Self-reported frequency of sleep disruption among people with RA relates to perceived stress. Psychoeducational programmes that help people with RA manage their stress may be a non-pharmacological method of improving sleep quality and therefore merits testing in specific interventional studies.

Diverse customary patterns of eating, drinking or movement are hypothesised to be effective in weight control based on laboratory experiments or theoretical calculations, in some cases supported by ecologically valid evidence. This method is applicable to healthy members of the public and to patients at high risk of and from obesity such as those having type-2 diabetes or chronic arthritis. Weight-reducing behaviour not adequately identified in current best practice educational messages includes: integration of exercise into desk-based employment; uses of stairs; uncompensated vigorous activity or reduction in amount eaten at a meal; protein level and carbohydrate timing in meals; having a "snack". This paper presents the scientific parts of a request for funds to integrate a suite of research methods based on theoretical models that can be applied to identify further, culturally and locally specific eating customs that avoid overweight and reduce obesity and can be iterated in a continuous (re)development of evidence-based expert advice and self-care practices in health and chronic disease.

Recent evidence indicates that rats can learn to avoid aversive consequences of several hours of food deprivation by eating more of food having orosensory characteristics that predict a protracted fast. Two new studies tested if macronutrient composition of a flavoured meal before the reinforcing fast influences this acquisition of anticipatory hunger/satiety in a smooth-brained mammal. In one study, female Sprague-Dawley rats were trained for 11 cycles of 4 days with experimental meals of either carbohydrate or protein flavoured with either grape or cherry, with one odour followed by a 3-h fast and the other by 10 h of food deprivation. Both nutrient groups acquired anticipatory hunger. Then that learnt increase in meal size started to extinguish the hunger-avoidance response to the longer fast. The other study tested if this finding extended to experimental meals that combined carbohydrate and protein, and had vanilla or chicken flavours, to fasts of 4 and 12 h and to male rats as well as females within a training period of 6 cycles of 4 days. Evidence of anticipatory hunger early in training was clear only in the males. The combined results from the two experiments indicate that either carbohydrate or protein is sufficient for negative reinforcement of flavour-specific anticipatory hunger when the shorter fast lasts for 3 h. This food-discriminative anticipatory adjustment of meal size could be an automatically learnt part of hunger management for socially scheduled eating in human beings.

A rapid method of discrimination scaling was used to measure individuals' acuity for levels of a complex stimulus perceived through several sensory modalities at once in a familiar context. The stimulus was a replacement for fresh milk used in vended coffee. The two experiments reported here compared the performance of ratings of the coffee's milkiness and creaminess when assessors were limited to the use of visual and/or olfactory cues. Better discrimination by milkiness ratings was observed during normal drinking and in a visual-only condition than when only oronasal or oral cues were available. Ratings relative to each assessor's ideal level of milkiness or creaminess showed diversity between assessor-preferred visual and oral characteristics of the milk substitute. However, instructing the assessor to attend to a particular aspect of the sample did not prevent the use of a better-discriminated characteristic if available to the senses. These results showed that the acceptability of a beverage or food depends more on the perceptible material than on efforts to direct attention to particular aspects.

This study examined the multivariate relationships of psychosocial factors with well-being in rheumatoid arthritis (RA). Fifty-five patients with early RA (seven years) completed questionnaires on psychosocial factors and psychological and physical well-being. Illness perceptions related to worse depression and life satisfaction (especially in early RA) and to longer morning stiffness (especially in intermediate RA). Optimism related to lower pain in early and intermediate RA. Social support related to lower fatigue in established RA. Indications for interventions targeted by disease duration are discussed.

Objectives: To examine whether patients with rheumatoid arthritis (RA) with co-morbid cardiovascular disease (CVD) have different psychological morbidity (and psychosocial risk factors for it) compared with RA patients without co-morbid CVD., Methods: Patients with RA and co-morbid CVD (n = 44; hypertension alone for n = 27) were compared with RA patients without CVD (n = 110). Differences in psychological morbidity (depression and anxiety) and psychosocial risk factors for this (arthritis self-efficacy, acceptance, social support and optimism) were examined while controlling statistically for medical and demographic covariates., Results: Groups did not differ on RA duration, RA activity, marital status or socioeconomic status, but RA patients with co-morbid CVD were older, less likely to be female and less likely to be in employment than those without CVD. RA patients with co-morbid CVD had significantly higher depression and were more likely to score above cut-offs for depression than RA patients without CVD. No differences existed in anxiety, although anxiety appeared to be more common than depression. Low optimism was identified as a possible psychosocial risk factor for depression., Conclusions: RA patients with co-morbid CVD have higher depression than RA patients without CVD; low optimism is a potentially modifiable risk factor that may mediate this difference. RA patients with co-morbid CVD may benefit from systematic screening for depression and targeted intervention if necessary.

Two studies of the influences of specific patterns of eating and exercising behaviour on body weight in English Midlands women were re-analysed using correlations as the measure of effect size. As predicted from computational modelling of hunger-sating mechanisms, avoiding energy-containing drinks and foods at the ends of and between meals was the behaviour most influencing year-long weight loss. However, although eating between meals is often called snacking, the term 'snack' appeared to be too ambiguous in this culture for its use in helping efforts to control weight. Avoidance of particular sorts of fat-rich foods was also associated with longer-term weight loss. Attempts at severe restriction of intake at mealtimes were associated with weight loss during a period of intensive dieting, but did not contribute to maintenance of that weight reduction. Using diet formulae to attain rapid weight loss was associated with significant weight gain over a year. These results support the suggestion that the first line of defence against weight gain is avoiding all sources of energy during drink breaks, with personally relevant advice on lower fat versions of particular foods also being important. Continued neglect of the behaviour-specific correlational approach to gaining evidence for less fattening habits does nothing to slow the rise in obesity.

Objective: Fatigue is a prominent symptom in primary Sjögren's syndrome (PSS). We set out to compare existing instruments and a new tool for measuring fatigue and general discomfort in PSS, with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and healthy controls., Methods: Groups of female Caucasian PSS patients completed a new questionnaire developed from PSS patients' own vocabulary, as well as the SF-36, WHOQOL-BREF and HAD scales. For comparison, the questionnaire was also completed by groups of SLE and RA patients and healthy controls., Results: Each disease group differed significantly from healthy controls on each facet of fatigue and general discomfort in the new tool. Somatic fatigue was worst in RA, while mental fatigue was worst in PSS and SLE. The facets of somatic fatigue and discomfort in the new tool correlated well with comparable domains in existing scales., Conclusions: Fatigue in PSS can be measured using this new Sjögren's-based psychometric instrument. The new questionnaire tool was more sensitive than the SF-36, WHOQOL-BREF and HAD at distinguishing the three rheumatic disorders from controls.