Wednesday, September 18, 2019

End of Life & Finding the Right Words to Stop Cancer Screening in Older Adults

Finding the Right Words to Stop Cancer Screening in Older Adults. Rebecca Voelker. JAMA, September 18, 2019. doi:10.1001/jama.2019.14732

During her geriatric medicine fellowship in 2012, Nancy Schoenborn, MD, took notice of the American Geriatrics Society’s new guideline on caring for older adults with multimorbidity. Its advice for clinicians to incorporate prognosis into their clinical decision-making “really made a lot of sense to me…and it was supported by evidence,” said Schoenborn, an associate professor in the Division of Geriatric Medicine and Gerontology at the Johns Hopkins School of Medicine.

But when she considered how physicians should implement that advice, she didn’t have the words for it. Literally. “[I]t wasn’t clear how we should talk about it,” she said. The issue was particularly salient in cancer screening guidelines, which often use life expectancy of less than 10 years as the time to stop screening. Especially in primary care settings, where most cancer screening takes place, Schoenborn struggled with how physicians should tell healthy older patients they no longer need a mammogram, prostate-specific antigen test, or other routine cancer screening.

“If they pointed to the [guideline] and said, ‘Look, it says don’t screen if you have less than 10 years to live,’…that’s not going to go over very well,” she said. So Schoenborn went straight to the front lines. She and her colleagues interviewed older adults and primary care clinicians about how to discuss life expectancy in clinical decision-making and stopping cancer screening. In their most recent study, the investigators compared perspectives from both sides.

The study’s “good news is that there are several common themes that both the physicians and the patients agreed upon,” said Alexia Torke, MD, associate professor of medicine at the Indiana University School of Medicine, who has published research on cancer screening cessation. “That provides a good, brief framework for starting off this conversation,” added Torke, who wasn’t involved in the study.


Benefits vs Harms

Clinicians and older adults agree that talks about stopping cancer screening should include a discussion of the benefits and harms. “Every screening test has risks,” noted Elizabeth Eckstrom, MD, MPH, chief of geriatrics at the Oregon Health & Science University. “Mammography is a perfect example because there are so many false-positives. [W]ith colonoscopy…you could perforate the colon at a time when the person should never have had the procedure in the first place.”

When they’re armed with information about the pros and cons of screening, older adults in the study said the decision on whether to have the test should be their own. Clinicians agreed. Said one clinician who was interviewed: “I tell them that we are a team, so I explain the information and…then I leave it up to them.” But if older patients forgo screening, they also don’t want to feel that they’re receiving less care. “I would not want to just [stop screening] and then just not do anything else,” an older adult in the study said.

Perhaps the chief worry among clinicians was that by suggesting it’s time to stop cancer screenings, patients could become angry and feel their physician was giving up on them. “That was really a major concern and barrier” for clinicians, Schoenborn said. Added Eckstrom: “It’s a big deal emotionally for a lot of doctors.”

But older patients said they wouldn’t think badly of their physician for suggesting it’s time to stop screening. “They were actually not as reluctant as the doctors thought,” Schoenborn noted. “Many of them were willing, some had already stopped, and if they trusted their doctor it was not necessarily perceived as a negative thing.” In fact, patients in the study hoped clinicians would find that perception reassuring, she added.


Between a Rock and the Guidelines

The hurdle is talking about life expectancy with older adults. “When people go in for a routine checkup and you’re going to talk about whether they should get a mammogram or a colonoscopy, they’re not expecting a decision about how long they’re going to live,” Torke said. “That’s something we need to consider if we’re even going to bring up that topic.”

In her study, Schoenborn said discussing life expectancy “did not really resonate with them…nobody liked that.” But when the subject was raised a little differently during the study—talking about ending cancer screening in terms of age, health status, and functional abilities—adults in the study were far more receptive. “Everyone thought that was a great idea,” she noted.

“So there was a disconnect in their perception between the inputs that we use to calculate life expectancy and the idea in the words of life expectancy itself,” Schoenborn said. “They didn’t really think about life expectancy as this conglomerate measure of their age, health, and function.”

That puts clinicians in a tough spot, she added. “They’re giving these guidances on what the ‘right thing to do’ is, but it’s in a language that they can’t just directly tell the patients very easily.”

Rather than use the guidelines’ blunt phrasing about life expectancy, clinicians can frame the message for older patients whose other health issues are of greater concern than cancer screening. For example, Eckstrom noted, explaining to an older woman that finding ways to help prevent her frequent falls is a priority over mammography.

Focusing on other health priorities “hopefully would give [clinicians] some place to start to have that conversation,” Schoenborn said. Eckstrom also has another strategy. “Sometimes I say, ‘You get to graduate from cancer screening; it’s a good thing. You don’t need this anymore,’” she explained. Some of her patients are relieved to learn they no longer need cancer screening tests. “Who wants another colonoscopy in their 80s?” she said.

But even if clinicians find the right words, institutional barriers can get in their way. Some insurance companies offer incentives for physicians to screen patients, but “they’re not putting upper age limits on it,” Eckstrom said. So instead of being made to feel their performance is subpar, physicians order the tests.

Automated computer systems in clinics and hospitals where physicians “have to click through a lot of things not to do something” also pose obstacles, Schoenborn said. And then there are radiology departments that send routine reminders about mammograms, she added. So some patients who had decided to stop screening for breast cancer go in for a mammogram because a reminder told them they’re due.


The Flip Side of Success

Decades of public health messages have emphasized the importance of cancer screening. “We have these very clear, consistent messages that sit on the side of a [mailbox] or on a billboard: get your colonoscopy,” Torke said.

Clinicians and patients get into the routine of regular screening, and advocacy groups sport pink ribbons to encourage mammograms. “There is a lot of emotional attachment to doing that,” Schoenborn said. “It’s part of being a good citizen.”

But the time may be ripe for a “more public health approach to raise awareness in the public that stopping screening can be the right thing,” she added. “Maybe a first step is just to raise awareness that it’s not something we all have to do until we die.”

The Lure of Counterfactual Curiosity: We are willing to seek information about how much they could have won, even at a cost, and even though it has a negative emotional impact (it leads to regret)

FitzGibbon, Lily, Asuka Komiya, and Kou Murayama. 2019. “The Lure of Counterfactual Curiosity: People Incur a Cost to Experience Regret.” OSF Preprints. September 18. doi:10.31219/osf.io/jm3uc

Abstract: After making a decision, it is sometimes possible to seek information about how things would be if one had acted otherwise. In the current study we investigated the seductive lure of this counterfactual information, namely counterfactual curiosity. We demonstrate in a set of five experiments using an adapted Balloon Analogue Risk Task with varying costs of information, that people are willing to seek information about how much they could have won, even at a cost, and even though it has a negative emotional impact (it leads to regret). We go on to show that despite its lack of utility, people increased their risk-taking after receiving information about large missed opportunities, leading to poorer future outcomes. This suggests that information about counterfactual alternatives has incentive salience properties – people simply cannot help seeking it.

Educational attainment and achievement: Heritability is generally higher at greater equality levels, suggesting that inequality stifles the expression of educationally relevant genetic propensities

Genes and Gini: What inequality means for heritability. Fatos Selita and Yulia Kovas. Journal of Biosocial Science, Volume 51, Issue 1, January 2019, pp. 18-47. https://doi.org/10.1017/S0021932017000645

Summary: Research has established that genetic differences among people explain a greater or smaller proportion of the variation in life outcomes in different environmental conditions. This review evaluates the results of recent educationally relevant behavioural genetic studies and meta-analyses in the context of recent trends in income and wealth distribution. The pattern of results suggests that inequality and social policies can have profound effects on the heritability of educational attainment and achievement in a population (Gene–Gini interplay). For example, heritability is generally higher at greater equality levels, suggesting that inequality stifles the expression of educationally relevant genetic propensities. The review concludes with a discussion of the mechanisms of Gene–Gini interplay and what the findings mean for efforts to optimize education for all people.

Rolf Degen summarizing: The sensory brain responds at first more strongly to expected events, then to the unexpected

Press, Clare, Peter Kok, and Daniel Yon. 2019. “The Perceptual Prediction Paradox.” PsyArXiv. August 14. doi:10.31234/osf.io/hdsmz

Abstract: From the noisy information bombarding our senses our brains must construct percepts that are veridical – reflecting the true state of the world – and informative – conveying the most important information for adjusting our beliefs and behaviour. Influential theories in the cognitive sciences suggest that both of these challenges are met through mechanisms that use expectations about the likely state of the world to shape what we perceive. However, current models explaining how expectations render perception either veridical or informative are mutually incompatible. Given the multitude of domains applying these conflicting models, it is essential that we consider whether and how this paradox can be resolved. We contend that ideas from the research on learning and inference may offer a resolution.

Tribalism and tribe survival: Governments and other entities sponsoring mass weddings

Here Comes the Bride. And the Bride. And the Bride. Mass Weddings Boom in Lebanon. Ben Hubbard. The New York Times, Sept. 15, 2019. https://www.nytimes.com/2019/09/15/world/middleeast/lebanon-weddings.html

BKERKE, Lebanon — Classical music swelled as the bride stepped from a white sedan onto a red carpet, took the arm of her tuxedoed groom and walked down the aisle, both grinning as their relatives cheered nearby.

The next bride did the same. And the next. And the next. And the next.

Once the couples — 34 that day — reached their seats, the patriarch of the Maronite Church, dressed in crimson robes and gripping a scepter topped with a golden cross, led Mass and declared the whole lot husbands and wives.

It was Lebanon’s fourth mass wedding in three weeks, representing a social phenomenon that has been growing here and across the Middle East.

In a region where marriage remains highly valued but economic pressures and costly celebrations have priced many couples out, powerful benefactors have stepped in, sponsoring large-scale ceremonies to make sure that young people get hitched.

[Image Nineteen couples gathered at a resort in Jiyeh, Lebanon, last month for a mass wedding organized by Oasis of Hope, a group linked to a Shiite political party.CreditDalia Khamissy for The New York Times]

Politics, faith and Lebanon’s complicated demographics play a role too, in this country with 18 officially recognized sects.

Political parties sponsor weddings for young members to reinforce their loyalty, and gratitude. Religious and ethnic minorities — which means everyone in splintered Lebanon — consider marriage and procreation essential to their long-term survival. And armed groups encourage their fighters to marry so that their children can become the fighters of the future.

A few weeks before the Maronite nuptials, Hezbollah, the Shiite militant group and political party, oversaw a similar enormous wedding for 31 couples. That was tiny compared with a mass wedding in Lebanon earlier this year that brought together 196 couples and was sponsored by the Palestinian Authority president, Mahmoud Abbas.

But the nearby Gaza Strip — where an Egyptian-Israeli blockade keeps people poor and locked in — beats them all, often because of competition between foreign sponsors eager to win friends by expediting marriages.

In 2015, the United Arab Emirates sponsored a mass wedding there for 200 couples. Two months later, Turkey seriously upped the ante, bankrolling a ceremony for 2,000 couples that was attended by officials from Hamas, the militant group that rules the territory.

[Image Part of the Maronite ceremony in Bkerke. Most couples join mass weddings for financial reasons, because they cannot afford their own celebrations.CreditDalia Khamissy for The New York Times]

Mass weddings hold a lot of appeal for couples who cannot afford their own celebrations, or want to spend their money on other things, like building homes or starting businesses.

“They take care of everything, God bless them,” said Roni Abu Zeid, 35, who got married in the Maronite mass wedding, which was held in Bkerke, a town near the Mediterranean coast, north of Beirut. It is the headquarters of the Maronite Church.

Mr. Zeid is a soldier, and with his salary it was difficult to save the $20,000 he needed to outfit a home and host his own wedding party. So he gladly joined the mass wedding.

“If we got married elsewhere, we would have suffered,” he said.

His wedding was sponsored by the Maronite League, a nonprofit group associated with the church. Maronites are the largest of the Christian groups that make up about 36 percent of Lebanon’s population.

Fadi Gerges, an official with the league, said it was natural for minorities to encourage their youths to procreate in a country where demographics affect power.

“When any ethnic group feels they are in danger, they pull together,” he said. “When they see the numbers going up on the other side, they think maybe they can place a pebble to prevent a landslide.”

This year’s mass wedding was the group’s 10th in 11 years, bringing the number of couples it has married to 274. So far, those unions have resulted in only three divorces and more than 100 children.
Image
After dinner in Jiyeh, the families took photos of a large, tiered cake.CreditDalia Khamissy for The New York Times

To be part of the league’s group ceremony, couples must apply. At least one of the couple must be a Maronite, and the groom must have a house and a job.

Accepted couples get a free suit for the groom, a dress for the bride, invitations, flowers, photos, $2,000 in cash and a blessing from the patriarch — a big bonus for the devout.

During the ceremony, the couples came forward one by one to say their “I dos” while their families clapped and ululated from the audience. A camera on a crane shot footage for a television broadcast while a drone zoomed about filming the proceedings.

The league once provided refreshments, but unfortunate jostling between families for drinks and snacks put an end to that, Mr. Gerges said.

[Image Oasis of Hope, a group that sponsored the wedding in Jiyeh, also helped the couples set up homes, giving them furniture and appliances.CreditDalia Khamissy for The New York Times]

The league gives couples marital support as needed while encouraging procreation. This year, it will outfit a nursery for the first 10 couples to give birth. Other religious and political groups provide different perks.

The same week as the wedding in Bkerke, 19 couples gathered at a resort in Jiyeh, a beachfront town south of Beirut, for another mass wedding organized by Oasis of Hope, a volunteer group linked to the Amal Movement, a Shiite political party.

Tables adorned with white cloths, candles and appetizers filled the lawn and surrounded the swimming pool, rare luxuries for the mostly poor families who came to see their young people wed.

Fatima Qabalan, an organizer, said the group had married about 300 couples in 12 mass weddings over the years. It not only provided them with a fancy celebration they could not otherwise afford, but helped them set up homes, giving them furniture and appliances.

[Image Ghassan Mohsen taking a photograph of his new wife, Huda Mallah, by the sea in Jiyeh.CreditDalia Khamissy for The New York Times]

The group gave precedence to the children of party members who had been wounded or killed in Lebanon’s wars, but also to the poor, to help their marriages get off the ground.

“If we didn’t help them start and set up their home, they would be going into debt and heading for failure,” Ms. Qabalan said.

While waiters in starched shirts distributed trays of grilled meat and piles of rice and fish, party officials gave speeches and a prominent journalist took to the microphone to remind the couples of the importance of childbearing to the “resistance,” or the struggle against Israel.

A dance troupe stormed in, banging drums, chanting and waving flaming batons and giant red hearts. Then the couples proceeded through the crowd, the grooms in black suits and ties, and the brides in white dresses with attached hair veils. Their relatives snapped photos as they passed.

Ali Ala’ideen, a groom whose hair was slicked back like Elvis’s, said that he and his new wife could not afford a honeymoon, but that he was grateful to be married.

“If it wasn’t a group wedding,” he said, “we wouldn’t have been able.”

After dinner, the families took photos of a large, tiered cake. Fireworks boomed over the Mediterranean, there was a bit of dancing, and the couples left to start their lives together.

One groom, Abdullah Dbouk, said his wife had caught his eye when he was hospitalized for appendicitis and saw her working as a nurse. Once he was out, he tracked down her family.

“As soon as I could walk, I went to see them,” he said.

The couple visited and chatted on Facebook for months before getting engaged, but lacked the money for a big wedding party. So they asked officials from the Amal Movement if they could join the mass wedding.

“It was fate,” said the bride, Nour Awarkeh, 20.

“Thank God for the appendicitis!” said the 26-year-old groom.

Follow Ben Hubbard on Twitter: @NYTBen

Hwaida Saad contributed reporting.

A version of this article appears in print on Sept. 15, 2019, Section A, Page 8 of the New York edition with the headline: Here Come the Brides. (This Time, 34 of Them.).

Diners paying with cash received either $1 or $6 of change over the correct amount; in 128 out of 192 tables, the diners did not return the excessive change; women returned the extra change much more often than men

The cost of being honest: Excessive change at the restaurant. Chp 4.2 in Dishonesty in Behavioral Economics - Perspectives in Behavioral Economics and the Economics of Behavior, 2019, Pages 267-288. Ofer H. Azar, Shira Yosef, Michael Bar-Eli. https://doi.org/10.1016/B978-0-12-815857-9.00015-7

Abstract: In a field experiment conducted in an Israeli restaurant, diners paying with cash received either 10 or 40 Shekels (about €2 or €8) of change over the correct amount. In 128 out of 192 tables, the diners did not return the excessive change. Women returned the extra change much more often than men, especially among repeated customers. Interestingly, a table with a woman and a man resembles a male table and not a female table. Repeated customers returned the excessive change much more often than one-time customers. Tables with two diners were not significantly more likely to return the excessive change than tables with one diner. We hypothesized that customers will return more often 10 extra Shekels than 40, but found a strong pattern in the opposite direction. This implies that in some situations the psychological cost of dishonest behavior increases more rapidly than the amounts involved.

People dislike telling lies; Business and Economics (B&E) students are significantly less lie averse than others; female B&E students tell the truth least often, whereas female students from other majors do so most often

Do economists lie more? Chp 3.1 in Perspectives in Behavioral Economics and the Economics of Behavior, 2019, Pages 143-162. Raúl López-Pérez, Eli Spiegelman. https://doi.org/10.1016/B978-0-12-815857-9.00003-0

Abstract: Experimental evidence suggests that some people dislike telling lies, and tell the truth even at a cost. We also use experiments, to study the sociodemographic covariates of such lie aversion. We find political ideology and religiosity to be without predictive value; however, subjects’ major is predictive: Business and Economics (B&E) subjects are significantly less lie averse than other majors. This is true even after controlling for subjects’ beliefs about the overall rate of deception, which predict behavior very well. Although B&E subjects expect most others to lie in our decision problem, the effect of the field of study remains. Regarding gender, females and males are equally likely to be lie-averse. In a more disaggregated analysis, however, we also observe that female B&E students tell the truth least often, whereas female students from other majors do so most often. These differences between female students, not observed for the males, seem in fact to drive the larger part of the differences between B&E and the other students.

Reward, pleasure, threat, fear, and disgust are emotional labels that we often use with confidence, as if we knew the identity of their corresponding psychological processes

A Liking Versus Wanting Perspective on Emotion and the Brain. Kent C Berridge. Chp 12 of The Oxford Handbook of Positive Emotion and Psychopathology, June Gruber (Ed.). 2019

Abstract: Reward, pleasure, threat, fear, and disgust are emotional labels that we often use with confidence, as if we knew the identity of their corresponding psychological processes. Those psychological processes of emotion are quite real and deeply grounded in brain systems shared by humans with many animals. But, the identity of fundamental psychological components within emotion are sometimes mistaken because only the final products are experienced, losing the identity of important psychological components that arise en route. Some of those components can have counterintuitive psychological features. For example, the experience of pleasant rewards actually contains distinct psychological processes of “liking” (hedonic impact) and “wanting” (incentive salience). Experience of fear-evoking threats hides distinct psychological components of passive reaction and an actively coping form of fearful salience. Perhaps most counterintuitively, the component of “fear” salience in threat shares a hidden psychological and neural relationship to that of “wanting” for rewards. These psychological components have implications both for ordinary emotions and for pathological disorders ranging from addiction to paranoia. Affective neuroscience studies in this way can produce surprises and insights into the psychological structure of emotions.

Keywords: emotion, affect, brain studies, wanting, liking, subjective feelings, emotional reactions



Tuesday, September 17, 2019

We model the increase of U.S. adult obesity since the 1990s as a legacy of increased consumption of excess sugars among children of the 1970s and 1980s

U.S. obesity as delayed effect of excess sugar. R. Alexander Bentley, Damian J. Ruck, Hillary N.Fouts. Economics & Human Biology, September 17 2019, 100818, https://doi.org/10.1016/j.ehb.2019.100818

Highlights
•  While many population health studies have invoked sugar as a major causal factor in the obesity epidemic, few have explicitly explored the temporal delay between increased sugar consumption and rising obesity rates.
•  We model the increase of U.S. adult obesity since the 1990s as a legacy of increased consumption of excess sugars among children of the 1970s and 1980s.
•  The model captures the generational time lag through a stochastic process of superfluous sugar calories increasing obesity rates over the lifespan of each birthyear cohort.
•  Driven by annual USDA sugar consumption figures, the two-parameter model replicates three aspects of the data: Delayed timing and magnitude of the national rise in obesity since 1970.
•  Profile of obesity rates by age group for a recent year.
•  Change in obesity rates by age group among pre-adults.
•  Our results indicate that past U.S. sugar consumption is at least sufficient to explain adult obesity change in the past 30 years.

Abstract: In the last century, U.S. diets were transformed, including the addition of sugars to industrially-processed foods. While excess sugar has often been implicated in the dramatic increase in U.S. adult obesity over the past 30 years, an unexplained question is why the increase in obesity took place many years after the increases in U.S. sugar consumption. To address this, here we explain adult obesity increase as the cumulative effect of increased sugar calories consumed over time. In our model, which uses annual data on U.S. sugar consumption as the input variable, each age cohort inherits the obesity rate in the previous year plus a simple function of the mean excess sugar consumed in the current year. This simple model replicates three aspects of the data: (a) the delayed timing and magnitude of the increase in average U.S. adult obesity (from about 15% in 1970 to almost 40% by 2015); (b) the increase of obesity rates by age group (reaching 47% obesity by age 50) for the year 2015 in a well-documented U.S. state; and (c) the pre-adult increase of obesity rates by several percent from 1988 to the mid-2000s, and subsequent modest decline in obesity rates among younger children since the mid-2000s. Under this model, the sharp rise in adult obesity after 1990 reflects the delayed effects of added sugar calories consumed among children of the 1970s and 1980s.

Keywords: ObesitySugarHigh-fructose corn syrupSocioeconomic status

Incidental processes shape discussion networks much more powerfully than purposive ones: We tend to report discussants with whom we share other relationships/characteristics, rather than expertise or political similarity

The Incidental Pundit: Who Talks Politics with Whom, and Why? William Minozzi et al. American Journal of Political Science, September 16 2019. https://doi.org/10.1111/ajps.12469

Abstract: Informal discussion plays a crucial role in democracy, yet much of its value depends on diversity. We describe two models of political discussion. The purposive model holds that people typically select discussants who are knowledgeable and politically similar to them. The incidental model suggests that people talk politics for mostly idiosyncratic reasons, as by‐products of nonpolitical social processes. To adjudicate between these accounts, we draw on a unique, multisite, panel data set of whole networks, with information about many social relationships, attitudes, and demographics. This evidence permits a stronger foundation for inferences than more common egocentric methods. We find that incidental processes shape discussion networks much more powerfully than purposive ones. Respondents tended to report discussants with whom they share other relationships and characteristics, rather than based on expertise or political similarity, suggesting that stimulating discussion outside of echo chambers may be easier than previously thought.


Attractive women augment their physical appeal via high heels; those heels may be a subtle indicator of dyadic sexual desire, & preferences for heels are stronger at times in the lifespan when mating competition is relatively intense

Using Sexual Selection Theories to Examine Contextual Variation in Heterosexual Women’s Orientation Toward High Heels. Christopher Watkins, Amanda Leitch. Archives of Sexual Behavior, September 16 2019. https://link.springer.com/article/10.1007/s10508-019-01539-3

Abstract: High heels are symbols of female sexuality and are “costly signals” if the risks of wearing them are offset by improving women’s attractiveness to men. From a functionalist perspective, the costs versus benefits of wearing heels may vary according to personal and contextual factors, such as her effectiveness at competing for mates, or at times when such motives are stronger. Here, we examined potential differences between women (self-rated attractiveness, dyadic versus solitary sexual desire, women’s age, competitive attitudes toward other women) and contextual variation (priming mating and competitive motives) in their responses to high heels. Study 1 (N = 79) and Study 2 (N = 273) revealed that self-rated attractiveness was positively related to orientation toward heeled shoes. When examining responses to two very attractive shoes (one higher heel, one lower heel) in Study 2, dyadic sexual desire, but not solitary sexual desire or intrasexual competitiveness, predicted their inclination to buy the higher-heeled shoe. In Study 3 (N = 142), young women chose high heels when primed with free choice of a designer shoe (95% CI [53.02 mm, 67.37 mm]) and preferred a heel 22 mm (0.87”) higher than older women (Study 4, N = 247). Contrary to predictions, priming mating or competitive motives did not alter women’s preference toward a higher heel (Studies 3 and 4). Our studies suggest that attractive women augment their physical appeal via heels. High heels may be a subtle indicator of dyadic sexual desire, and preferences for heels are stronger at times in the lifespan when mating competition is relatively intense.

Keywords: Sartorial appearance Fashion Footwear Sex drive Sexual selection

A brief natural history of the orgasm

A brief natural history of the orgasm. Thierry Lodé. Frontiers in Life Science, Volume 13, 2019 - Issue 1, Pages 34-44. Sep 12 2019. https://doi.org/10.1080/21553769.2019.1664642

Abstract: Why the sexual climax, in humans, results in a pleasurable experience remains an important biological question. Analysis of evolutionary traits in numerous Vertebrates suggests that orgasm evolved through three phylogenetic stages during the transition from external to internal fertilization and viviparity. First, orgasm is directly dependent on ejaculation in males and the expulsion of fluids from the ovarian and urethral glands (Skene’s) in females. I propose that sexual orgasm could come from the primitive reflex of discharging gametes to ensure reproduction. Thus, the understanding of orgasm should not be reduced to a penis- or a clitoris-centred paradigm. Secondly, orgasm has evolved to stimulate sexual activity because the evolutionary transition from external fertilization to internal fertilization has been accompanied in numerous species with a lessening in reproductive rates. Because sexual activity encourages reproduction, it can be argued that orgasm has evolved to increase sexual activity, particularly in viviparous species with low reproductive rates. Third, internal fertilization in the genital tract of females weakens the visibility of the putative success of fertilization. Female sexual fluids and proteins can bias fertilization in favour of preferred males. Because orgasm could promote a better choice of partner, I argue that female orgasm may have evolved as a post-copulatory selection tactic by which females can increase their control of mates.

KEYWORDS: Orgasm, ovarian fluids, mate choice, post-copulatory selection, sexual conflict, unrelated males

Introduction
Why the sexual climax, in humans, leads to the experience of pleasure remains an important biological question. While the male cannot transfer gametes without experiencing an orgasm, in the human species, the female orgasm seems completely decoupled from reproduction (Cabanac 1971 Cabanac M. 1971. Physiological role of pleasure. Science. 173:1103–1107. doi: 10.1126/science.173.4002.1103; Hrdy 1996 Hrdy SB. 1996. The evolution of female orgasms: logic please but no atavism. Anim Behav. 52:851–852. doi:10.1006/anbe.1996.0230; Wallen and Lloyd 2008 Wallen K, Lloyd E. 2008. Clitoral variability compared with penile variability supports non-adaptation of female orgasm. Evol Dev. 10:1e2.). Although orgasm could result from the point that individuals with an orgasm are more successful, Wheatley and Puts (2015 Wheatley JR, Puts DA. 2015. Evolutionary science of female orgasm. In: The evolution of sexuality, 123–148. Springer) argued that there is actually little evidence to suggest that female orgasm can promote a better reproduction. If orgasm had a selective role, then it is difficult to understand why females show such variability in their ability to reach a climax. Analysing the evolutionary history of the sexual climax from its phylogenetic origin, we can draw some new conclusions that can shed light on the function of orgasm.

Indeed, orgasm could only be regarded as a direct selective trait if individuals with this evolutionary trait have the best reproduction. Associated with ejaculation in males, orgasm is characterized by changes in blood pressure, increased heart rate, rhythmic respiratory pattern, involuntary body movements and, in females, by spontaneous colour changes of the labia minora which engorge to twice their size, and by vaginal and anal spasms (Masters and Johnson 1966 Masters WH, Johnson VE. 1966. Human sexual response. Boston: Little Brown. ; Berman et al. 1999 Berman JR, Berman L, Goldstein I. 1999. Female sexual dysfunction, incidence, pathophysiology, evaluation, and treatment options. Urology. 54:385–391. doi: 10.1016/S0090-4295(99)00230-7). The orgasm is directed by the autonomic nervous system and the spinal cord but activates numerous cortical zones through the vagus nerves mediation (Komisaruk et al. 2004 Komisaruk BR, Whipple B, Crawford A, Grimes S, Liu WC, Kalnin A, Mosier C. 2004. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Res. 1024:77–88. doi: 10.1016/j.brainres.2004.07.029).

Although the definition of orgasm is rather uncertain, Bancroft (2005 Bancroft J. 2005. The endocrinology of sexual arousal. J End. 186:411–427. doi: 10.1677/joe.1.06233) described it as ‘a state motivated toward the experience of sexual pleasure’. In males, it is associated with ejaculation and rhythmic muscle contractions of the perineal muscles, in females, with clitoral retraction, rhythmic muscle contractions of the perineum and vagina. Orgasm also releases some neuropeptides, dopamine, oxytocin and prolactin, which cause a deep sense of well-being. Here, orgasm is defined as the culmination of sexual arousal activating the reward circuit. The increase in dopamine, oxytocin and prolactin concentration can, therefore, be considered as a signal of sexual arousal. All mammals have the physiological capacity for orgasm (Fox and Fox 1971 Fox CA, Fox BA. 1971. A comparative study of coital physiology, with special reference to the sexual climax. J Rep Fert. 24:319–336. doi: 10.1530/jrf.0.0240319) and numerous vertebrates are known to experience orgasm-like states such as primates i.e. bonobo, chimpanzee, gorilla, orangutan, proboscis monkey, macaques (Chevalier-Skolnikoff 1974 Chevalier-Skolnikoff S. 1974. Male–female, female–female, and male–male sexual behavior in the stumptail monkey, with special attention to the female orgasm. Archiv Sex Behav. 3:95. doi:101007/BF01540994; Allen and Lemon 1981 Allen ML, Lemon WB. 1981. Orgasm in female primates. Am J Primatol. 1:15–34. doi: 10.1002/ajp.1350010104; Troisi and Carosi 1998 Troisi A, Carosi M. 1998. Female orgasm rate increases with male dominance in Japanese macaques. Anim Behav. 56:1261–1266. doi:101006/anbe19980898; Murai 2006 Murai T. 2006. Mating behaviors of the proboscis monkey (Nasalis larvatus). Am J Primatol. 68:832–837. PMID: 16847976. doi: 10.1002/ajp.20266; de Waal 2011 de Waal F. 2011. Le singe en nous, Fayard/Pluriel, Paris. ; Grueter and Stoinski 2016 Grueter CC, Stoinski TS. 2016. Homosexual behavior in female mountain gorillas: reflection of dominance, affiliation, reconciliation or arousal? PLoS ONE. 11(5):e0154185. doi: 10.1371/journal.pone.0154185), carnivores and rodents (Adler 1969 Adler NT. 1969. The effect of males’ copulatory behaviour on successful pregnancy of the female rat. J Comp Phys. 69:613; Heeb and Yahr 1996 Heeb MM, Yahr P. 1996. . c-Fos immunoreactivity in the sexually dimorphic area of the hypothalamus and related brain regions of male gerbils after exposure to sex-related stimuli or performance of specific sexual behaviors. Neuroscience. 72:1049–1071 doi: 10.1016/0306-4522(95)00602-8; Coolen et al. 1997 Coolen LM, Olivier B, Peters HJ, Veening JG. 1997. Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT. Physiol Behav. 62:881–891. doi: 10.1016/S0031-9384(97)00258-8; Kollack-Walker and Newman 1997 Kollack-Walker S, Newman SW. 1997. Mating-induced expression of c-fos in the male Syrian hamster brain: role of experience, pheromones, and ejaculations. J Neurobiol. 1997(32):481–501.doi: 10.1002/(SICI)1097-4695(199705)32:5<481::AID-NEU4>3.0.CO;2-1; Tenk et al. 2009 Tenk CM, Wilson H, Zhang Q, Pitchers KK, Coolen LM. 2009. Sexual reward in male rats: effects of sexual experience on conditioned place preferences associated with ejaculation and intromissions. Horm Behav. 55:93–97. doi: 10.1016/j.yhbeh.2008.08.012; Pavlicev and Wagner 2016 Pavlicev M, Wagner G. 2016. The evolutionary origin of female orgasm. J Exp Zool B Mol Dev Evol. 326B:326–337. doi:101002/jezb22690, birds and reptiles (Cabanac 1971 Cabanac M. 1971. Physiological role of pleasure. Science. 173:1103–1107. doi: 10.1126/science.173.4002.1103; Winterbottom et al. 1999 Winterbottom M, Burke T, Birkhead TR. 1999. A stimulatory phalloid organ in a weaver bird. Nature. 399:28. doi: 10.1038/19884; Ball and Balthazart 2011 Ball GF, Balthazart J. 2011. Sexual arousal, is it for mammals only? Horm Behav. 59:645–655. doi: 10.1016/j.yhbeh.2010.11.001) and fishes (Petersson and Jarvi 2001 Petersson E, Jarvi T. 2001. ‘False orgasm’ in female brown trout: trick or treat? Anim Behav. 61:497–501. doi: 10.1006/anbe.2000.1585). It has even been demonstrated that ejaculation provoked by the activation of Crz-expressing neurons is rewarding to male flies (Zer-Krispil et al. 2018 Zer-Krispil S, Zak H, Shao L, Ben-Shaanan S, Tordjman L, Bentzur A, Shmueli A, Shohat-Ophir G. 2018. Ejaculation induced by the activation of Crz neurons is rewarding to Drosophila males. Curr Biol. 28:1445–1452.e3. doi: 10.1016/j.cub.2018.03.039). Thus, orgasm seems a critical component of reproductive process for many species (Balcombe 2009 Balcombe J. 2009. Animal pleasure and its moral significance. App Anim Behav Sci. 118:212. doi:101016/japplanim200902012).

There are two main theories that provide an explanation for the manifestation of orgasm. It has been firstly hypothesized that orgasm would favour the persistence of bonds to ensure the best care for the offspring (Alcock 1987 Alcock J. 1987. Ardent adaptation. Nat Hist. 96:4. ) or serve as a secondary reinforcement linking sexual behaviours and partner affiliation (Prause 2011 Prause N. 2011. The human female orgasm: critical evaluations of proposed psychological sequelae. Sex Relat Ther. 26:315–328. doi: 10.1080/14681994.2011.651452; Fleischman 2016 Fleischman DS. 2016. An evolutionary behaviorist perspective on orgasm. Socioaffect Neurosci Psychol. 6:32130. doi:103402/snpv632130). However, in many species, the male provides virtually no care to the young, which reduces the interest in this hypothesis. Moreover, the strengthening of the couple’s bonds is clearly refuted by the Coolidge effect (Brown 1974 Brown RE. 1974. Sexual arousal, the Coolidge effect and dominance in the rat Rattus norvegicus. Anim Behav. 22:634–637. doi:101016/S0003–34727480009–6), which leads many males, and to a lesser extent some females (Lester and Gorzalka 1988 Lester GL, Gorzalka BB. 1988. Effect of novel and familiar mating partners on the duration of sexual receptivity in the female hamster. Behav Neural Biol. 49:398–405. doi:101016/s0163–10478890418–9), to increase sexual activity by adopting a greater diversity of partners. In monkeys, females that mated with high-ranking males showed the highest frequency of orgasms (Zumpe and Michael 1968 Zumpe D, Michael RP. 1968. The clutching reaction and orgasm in the female rhesus monkey (Macaca mulatta). J End. 40:117. doi: 10.1677/joe.0.0400117; Chevalier-Skolnikoff 1974 Chevalier-Skolnikoff S. 1974. Male–female, female–female, and male–male sexual behavior in the stumptail monkey, with special attention to the female orgasm. Archiv Sex Behav. 3:95. doi:101007/BF01540994), suggesting a role in partner preference. Finally, among the hypotheses tending to interpret orgasm as a reproductive enhancing effect, it has been assumed that female orgasm would have evolved for the selection of a partner, thus enhancing the chance of the best fertilization (Thornhill et al. 1995 Thornhill R, Gangestad SX, Comer R. 1995. Human female orgasm and mate fluctuating asymmetry. Anim Behav. 50:1601–1615. doi:101016/0003–34729580014–X). Thus, Fox et al. (1970 Fox CA, Wolff HS, Baker JA. 1970. Measurement of intra-vaginal and intra-uterine pressures during human coitus by radio-telemetry. J Rep Fert. 22:243–251. doi:101530/jrf00220243) hypothesized that the orgasmic spasms cause contractions that may endorse sperm retention in the female genital tract, thus increasing the probability of fertilization. Fertilization of male gametes is stimulated by rhythmic contractions of the striated muscles during orgasm. The allegation that female orgasms may increase conception and progeny remains controversial (Zietsch and Santtila 2013 Zietsch BP, Santtila P. 2013. No direct relationship between human female orgasm rate and number of offspring. Anim Behav. 86:253–255; Wheatley and Puts 2015 Wheatley JR, Puts DA. 2015. Evolutionary science of female orgasm. In: The evolution of sexuality, 123–148. Springer) since female orgasms do not appear to have an active role in sperm transport during coitus (Levin 2011 Levin RJ. 2011. Can the controversy about the putative role of the human female orgasm in sperm transport be settled with our current physiological knowledge of coitus? J Sex Med. 8:1566–1578. doi: 10.1111/j.1743-6109.2010.02162.x). Nonetheless, cervical excitations produce contractions of the oviduct and fallopian tubes (Komisaruk et al. 2004 Komisaruk BR, Whipple B, Crawford A, Grimes S, Liu WC, Kalnin A, Mosier C. 2004. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Res. 1024:77–88. doi: 10.1016/j.brainres.2004.07.029), probably via prostaglandins and are essential for sperm transport and fertilization (Adler 1969 Adler NT. 1969. The effect of males’ copulatory behaviour on successful pregnancy of the female rat. J Comp Phys. 69:613. ; Adler and Zoloth 1970 Adler NT, Zoloth SR. 1970. Copulatory behaviour can inhibit pregnancy in female rats? Science. 168:1480–1482. doi: 10.1126/science.168.3938.1480Wildt et al. 1998 Wildt L, Kissler S, Licht P, Becker B. 1998. Sperm transport in the human female genital tract and its modulation by oxytocin as assessed by hysterosalpingoscintigraphy, hysterotonography, electrohysterography and Doppler sonography. Hum Reprod Update. 4:655–666. doi: 10.1093/humupd/4.5.655

The second theory claims that female orgasm has no selective role and must be understood as a simple by-product of ontogenesis since the embryonic development of the male penis and female clitoris remains very comparable (Symons 1979 Symons D. 1979. The evolution of human sexuality. Oxford: Oxford University Press; Gould 1987 Gould SJ. 1987. Freudian slip. Nat Hist. 96:14–21; Wallen and Lloyd 2008 Wallen K, Lloyd E. 2008. Clitoral variability compared with penile variability supports non-adaptation of female orgasm. Evol Dev. 10:1e2).

Paradoxically, the published literature on the psychological consequences of lottery wins has found almost no evidence that winners become happier; we found otherwise

Lottery Wins and Satisfaction: Overturning Brickman in Modern Longitudinal Data on Germany. Andrew J. Oswald, Rainer Winkelmann. The Economics of Happiness pp 57-84, September 14 2019. https://link.springer.com/chapter/10.1007/978-3-030-15835-4_3

Abstract: Paradoxically, the published literature on the psychological consequences of lottery wins has found almost no evidence that winners become happier. This famous puzzle was originally documented by the psychologist Philip Brickman and colleagues. Using new German panel data, we offer results that are more in accord with common sense and economic theory. We have been particularly influenced by the pioneering work of Richard Easterlin: in this paper we explicitly consider the idea of ‘domain’ satisfaction levels. First, our estimates show that lottery wins raise people’s satisfaction with their overall income. Second, lottery wins’ increase people’s satisfaction with life. The effects documented here are, as might be expected, especially pronounced for big wins. One of the advantages of our data set is that it allows access to a greater number of large winners than has typically been possible in the published literature.

Monday, September 16, 2019

Optimal ultra-short copulation duration in a sexually cannibalistic spider in which females want to be half-virgin

Optimal ultra-short copulation duration in a sexually cannibalistic spider. Braulio A. Assis, Matthias W. Foellmer. Behavioral Ecology and Sociobiology, September 2019, 73:117. August 3 2019. https://link.springer.com/article/10.1007/s00265-019-2733-5

Abstract: Sexual conflict has been shown to shape many behaviors in the reproductive context, such as the duration of copulation, across a broad taxonomic range. In spiders, copulation duration is one of the most variable reproductive traits, ranging from seconds to hours. Some species in the araneid genus Argiope exhibit very short copulations of a few seconds per pedipalp insertion. This has been hypothesized to be the result of cannibalistic females imposing selection on males to escape the attack by reducing insertion duration to a minimum. However, copulation duration is positively correlated with the number of sperm transferred and fertilization success in many species. Thus, given the tradeoff between sperm transfer and the risk of being cannibalized, males may optimize the duration of copulation to maximize lifetime reproductive success. Here we test whether males in the orb-weaver Argiope aurantia, which exhibits the shortest copulation in any spider and rivals the honey bee for shortest copulation reported for any arthropod with internal genital coupling, are optimizing the insertion duration of the first pedipalp to maximize the number of sperm transferred and eggs fertilized. We analyzed total sperm transferred to the female, and male fertilization success as a function of the first insertion’s duration, using data collected in previous staged-mating experiments and determined optimal copulations of 3–4 s, which is close to the averages of the source populations. Thus, we present evidence for sexual cannibalism as a driver of the extremely short copulations in A. aurantia.

Significance statement: Females and males often conflict over mating frequency. In spiders, both sexes have paired reproductive organs and can remain half virgin if only one of the two possible copulations are completed. In the orb-weaver Argiope aurantia, males place mating plugs and females almost always immediately attack males in copula, probably to prevent them from achieving both copulations and to be able to upgrade to a second mate. We find an optimal duration of 3–4 s for males to terminate copulation, which reduces the risk of being killed, while at the same time maximizing sperm transfer and fertilization success because copulation duration is positively related to the number of sperm transferred and allows males to achieve the second copulation. The optimal duration detected here is very close to average copulation durations in nature. Hence, we document the adaptive value of the shortest copulation known for any spider.

Keywords: Sexual cannibalism Copulation duration Sexual conflict Araneae Sexual size dimorphism Mating plug


Once considered a uniquely human memory phenomenon, the creation of false memories in lower animals can be seen; & evidence of “implanted” misinformation has also been obtained

False memory in nonhuman animals. Paula M. Millin and David C. Riccio. Learning & Memory, 2019. 26: 1-6. http://www.learnmem.org/cgi/doi/10.1101/lm.050054.119

Abstract: This paper examines recent evidence from behavioral and neuroscience research with nonhuman animals that suggests the intriguing possibility that they, like their human counterparts, are vulnerable to creating false memories. Once considered a uniquely human memory phenomenon, the creation of false memories in lower animals can be seen especially readily in studies involving memory for source, or contextual attributes. Furthermore, evidence of “implanted” misinformation has also been obtained. Here, we review that research and consider its relevance to our empirical understanding of false memories, as well as speculate about its potential clinical implications for trauma memory.