Placebo and nocebo effects, positive and negative effects experienced after both real and sham interventions, putatively due to positive or negative outcome expectancies, can shape our sensory... Show morePlacebo and nocebo effects, positive and negative effects experienced after both real and sham interventions, putatively due to positive or negative outcome expectancies, can shape our sensory experience. Although placebo and nocebo effects are known to occur reliably in many individuals for sensations like pain and itch, our understanding of psychological learning processes and methodological factors that influence these effects remains limited. Chapters 2, 3, and 4 investigate this topic with meta-analysis, narrative review, and a behavioral study. Similarly, our characterization of the neural markers of nocebo effects is incomplete. A better grasp of how these effects form is necessary to contextualize them within the larger framework of bottom-up and top-down integration. Chapters 5, 6, and 7 investigate this topic in a series of EEG and fMRI studies. Advancing both psychological and neural accounts of placebo and nocebo effects will aid in applying findings from this field of study to everyday life; particularly in clinical settings, and potentially any setting in which expectations regarding one’s future experiences come into play. Show less
This PhD research dealt with neurobiological and behavioral aspects of pain. Previous research has demonstrated that pain sensitivity can be worsened as a result of learned negative expectations, a... Show moreThis PhD research dealt with neurobiological and behavioral aspects of pain. Previous research has demonstrated that pain sensitivity can be worsened as a result of learned negative expectations, a phenomenon termed nocebo hyperalgesia –a counterpart to placebo analgesia. This PhD dissertation describes neuroimaging and biobehavioral experimental studies as well as a review and a meta-analysis concerned with such learned effects on pain. The research adds to a growing literature that has been challenging antiquated understandings of pain as a bottom-up process. We conducted a series of biobehavioral studies to further our understanding of how bottom-up pain signaling can be influenced by top-down processing. We examined the types of experiences, such as receiving negative information or experiencing a negative effect first-hand, that may lead to stronger nocebo effects. Behavioral paradigms were used to model real-life pain experiences, through validated methods, novel learning manipulations, as well as a close examination of emotional correlates such as fear. Concurrently, innovative neuroscientific methods –including pharmacological manipulations– were used to examine the biobehavioral underpinnings of learned nocebo responses. Our findings add to the growing knowledgebase from the field of nocebo hyperalgesia, demonstrating that learning by experience can decisively influence the processing and perception of noxious stimuli. Show less
This chapter examines specifics of African contexts relevant for teaching in multilingual and multicultural environments. It starts with basics, pointing to a toxic cocktail of ideas that may have... Show moreThis chapter examines specifics of African contexts relevant for teaching in multilingual and multicultural environments. It starts with basics, pointing to a toxic cocktail of ideas that may have value in the North, but is counterproductive in Africa. Thus, it examines ideas of ‘language’ as applied to Africa proposing to distinguish between discerned and designed languages. If participation in education increases a tran-sition to using a limited number of designed languages as medium of instruction will become necessary and possible. This will overcome the current diglossic situation dominated by former colonial languages. On culture, the chapter proposes a non-essentialist definition. Recent research shows that the old ‘tribal’ categories have lost their meaning in many (though not all) parts of Africa. An appreciation is needed of the new cultural traditions that are emerging on the continent. Understanding Africa’s specificity will lead to a new research agenda and to new ideas on what teaching and learning in Africa’s multilingual and multicultural environments mean. Show less
As physician-scientists are able to connect research and practice, they are important to make advancements within medicine. Currently, the medical field is facing a physician-scientist shortage.... Show moreAs physician-scientists are able to connect research and practice, they are important to make advancements within medicine. Currently, the medical field is facing a physician-scientist shortage. Promoting student research engagement could be the solution. Following the need to identify how medical training could contribute to developing future physician-scientists, the general aim of this thesis was to provide insights into the impact early phases of medical training may have on cultivating physician-scientists, by elaborating on the role of motivation for research and extracurricular research programmes. By conducting quantitative and qualitative research, we showed that medical students are motivated for research at the start of medical school and that intrinsic motivation for research is related to actual research involvement. Furthermore, factors contributing to intrinsic motivation for research were identified: research self-efficacy beliefs, positive perceptions of research, curiosity, need for challenge, authentic research experiences, feelings of autonomy and relatedness, feelings of relevance or personal meaning, inspiring role models, and extracurricular research programme participation. Previous studies suggested that student research involvement is related to research involvement in professional practice. This thesis therefore emphasizes that first steps to cultivate physician-scientists could be made early on in medical school – ‘future physician-scientists: let’s catch them young!’ Show less
Film has been used for education ever since educators recognized its powerful potential for learning. But its educational application has been criticized throughout the decades for underuse of the... Show moreFilm has been used for education ever since educators recognized its powerful potential for learning. But its educational application has been criticized throughout the decades for underuse of the distinctive potential of film: to raise interest. To understand more fully film's potential for learning, we propose a dynamic model of viewer interest and its underlying cognitive and emotional mechanisms (film's interest raising mechanisms or FIRM model). In addition, we present an analysis method for assessing the interestingness of films in learning contexts. Our model marries interest theories from cognitive film theory and educational psychology and captures the dynamics of interestingness across a film as depending on a balance between challenge posed and coping potential provided. Show less
This thesis consists of three empirical chapters that investigate elements of human social behavior, adherence to and violations of social norms, and the computational and neurological... Show moreThis thesis consists of three empirical chapters that investigate elements of human social behavior, adherence to and violations of social norms, and the computational and neurological underpinnings thereof. I focus on three behavioral paradigms in particular – the attacker-defender contest, the trust game, and the ultimatum game – which model asymmetrical conflicts, generosity and reciprocity, and norms of fairness, respectively. Ultimately, each chapter acts as a building block contributing a different perspective to the study of human sociality. Using economic games, computational models based on the principle of utility, and model-based neuroimaging, my research contributes to the scientific endeavor working to crack the “elaborate and secret code that is written nowhere, known by none, and understood by all” (Sapir, 1927, p.137) Show less
Advanced endoscopic imaging is an emerging field in endoscopy practice, especially in optical diagnosis. Current technologies like virtual chromoendoscopy and small-field technologies allow... Show moreAdvanced endoscopic imaging is an emerging field in endoscopy practice, especially in optical diagnosis. Current technologies like virtual chromoendoscopy and small-field technologies allow visualization of subtle changes in mucosal and vascular patterns that are predictive of histology. The limiting factor in broadly utilizing these techniques is training and the need for reliable detection of these subtleties. This review provides the current evidence and limitations of training in advanced endoscopic imaging, and future directions of learning. A literature search was performed on PubMed and Medline through March 2020 with relevant keywords as advanced endoscopic imaging, training, and learning. References of relevant articles were screened for additional literature. Several didactic and web-based education programs are developed for training in virtual chromoendoscopy, autofluorescence imaging, confocal laser endomicroscopy, and volumetric laser endomicroscopy. Studies and post-hoc analysis on learning curves showed relatively steep learning curves after training, and web-based education seems to be as valuable as in-person didactic training for most techniques. However, consistent performance on expert level after training has not yet been demonstrated. Most advanced endoscopic imaging techniques are learned within a reasonable timeframe. Future efforts to enhance training and implementation of these techniques should focus on developing standardized and broadly incorporated training programs. The future role of artificial intelligence-assistance in advanced endoscopy and training has to be elucidated. Show less
Both, S.; Veen, R.J.B. van; Brom, M.; Weijenborg, P.T.M. 2020
Rationale and objective The aim of this study was to investigate the possible facilitating effect of the partial NMDA receptor agonist D-cycloserine (DCS) on memory consolidation of conditioned... Show moreRationale and objective The aim of this study was to investigate the possible facilitating effect of the partial NMDA receptor agonist D-cycloserine (DCS) on memory consolidation of conditioned sexual responses and to examine the capability of DCS to reduce context-specificity of learning. Methods In a randomized placebo-controlled double-blind trial, 50 healthy females were exposed to a differential conditioning procedure. Two pictures of a male abdomen were used as conditional stimuli (CSs), of which one (the CS+) was followed by the unconditional stimulus (US), a genital vibrotactile stimulus. After the conditioning session on day 1, participants received either 125 mg of DCS or a placebo. The effects of DCS on affect, sexual arousal and US expectancy in response to the CS+ and CS- were examined 24 h after the conditioning procedure. Results A main effect of DCS was found on affect at the first test trials (p = 0.04, eta(2)(p) = 0.09), and a similar non-significant but trend level effect was found for sexual arousal (p = 0.06, eta(2)(p) = 0.07), which appeared to persist over a longer time (p = 0.07, eta(2)(p) = 0.08). Unexpectedly, ratings of positive affect and sexual arousal in response to both the CS+ and the CS- were higher in the DCS condition compared to the control condition, possibly indicating that DCS administration reduced stimulus specificity. Since the results did not show clear evidence for context learning, we were not able to test effects on context-specificity of learning. Conclusion Although largely inconclusive, the results provide tentative support for a facilitating effect of DCS on affect and sexual arousal in response to stimuli that were presented in a sexual conditioning procedure, however, no conclusions can be drawn about effects of DCS on sexual reward learning, since the design and results do not lend themselves to unambiguous interpretation. Show less
Exploring novel environments enhances learning in animals. Due to differing traditions, research into the effects of spatial novelty on learning in humans is scarce. Recent developments of... Show moreExploring novel environments enhances learning in animals. Due to differing traditions, research into the effects of spatial novelty on learning in humans is scarce. Recent developments of affordable and fMRI-compatible virtual reality (VR) and mobile EEG systems can help bridge the gap between the two literatures. One promising study showed that spatial novelty also promotes learning in humans. It still remains largely unknown, however, which aspect of novelty underlies the beneficial effect on memory, as novelty, expectations, and volition are often confounded in animal studies. In humans, these factors can be experimentally manipulated, but such studies are currently lacking. Future studies in humans could combine pharmacological interventions, neuroimaging and VR or use mobile EEG to help elucidate whether the plasticity enhancing mechanisms observed in animals, also exist in humans. When the aspects of exploring a novel environment underlying beneficial memory effects have been identified, effective novelty-exposure interventions could be designed to improve learning and counteract age-related memory decline. Show less
Wijnker, W.; Bakker, A.; Gog, T. van; Drijvers, P. 2018
Teachers are increasingly using video in their lessons, with various aims (eg, to raise students' levels of conceptual knowledge or interest). Videos that can be used for educational purposes are... Show moreTeachers are increasingly using video in their lessons, with various aims (eg, to raise students' levels of conceptual knowledge or interest). Videos that can be used for educational purposes are numerous, ranging from instruction videos to fiction films. Such videos have different characteristics, for example regarding the amount and structure of information, and the audio-visual presentation. However, guidelines on which video characteristics can help to achieve specific teacher aims are lacking. As a first step towards composing such guidelines, we added a film theory perspective to educational research on videos. The study included seven science teachers, 13 videos, and 233 students (aged 13-18 years). We used teacher interviews, video analyses, student questionnaires and a cross-case analysis connecting all the data. Data analysis followed a grounded theory approach, including open and axial coding to structure the data, and the constant comparative method to interconnect them. The results showed that videos that posed questions were associated with an increase in students' interest, and that highly informative videos with authoritative speakers were associated with an increase in students self-reported conceptual knowledge gains. Moreover, teachers often did not have explicit aims for using a particular video, and they selected and used videos in their lessons intuitively. Stimulating teachers to use videos in a more aim oriented way may make video usage more effective. From these findings, we developed a framework to assist teachers in selecting or making videos that match their aims, and a model of possible connections between teacher aims and film types as a first step towards guidelines for teachers using educational videos. Show less
Stronks, H.C.; Walker, J.; Parker, D.J.; Barnes, N. 2017
Tactile vision substitution devices are assistive technologies for the blind that redirect visual information to the tactile sense. They typically include a tactile display that conveys visual... Show moreTactile vision substitution devices are assistive technologies for the blind that redirect visual information to the tactile sense. They typically include a tactile display that conveys visual information to the skin. Two important parameters that determine the maximum information bandwidth of tactile displays are the spatial acuity of the skin, and the ability of the user to discriminate between stimulus intensities. These two parameters were investigated by determining the two-point discrimination (TPD) threshold and the just-noticeable intensity difference (JND) using coin motors on the lower back. Coin motors are eccentric rotating-mass motors that are affordable, energy-efficient, and easy to implement. The lower back was chosen because it is a discreet place to wear assistive technology. It is generally available for use, as it is usually not critically involved in activities of daily living. Rehabilitation with sensory substitution devices often requires training by professional occupational therapists, because the user needs to extract visual information from sparse information presented through an alternative channel such as the skin. In this study they determined whether short, automated training sessions of 5 min each could improve the TPD threshold and JND. It was found that 10 min of computer-assisted training improved the vibrotactile TPD threshold on the lower back by 36%, and that 18 min of training improved the just-noticeable intensity difference (JND) by 44%. It was concluded that short, automated training sessions could provide a fast and inexpensive means to improve people's basic spatial acuity and intensity discrimination skills with coin motors. Show less
Kepinska, O.; Rover, M. de; Caspers, J.; Schiller, N.O. 2017
In response to Voelker et al. (this issue), we argue for a wide array of neural oscillatory mechanisms underlying learning and practice. While the authors propose frontal theta power as the basis... Show moreIn response to Voelker et al. (this issue), we argue for a wide array of neural oscillatory mechanisms underlying learning and practice. While the authors propose frontal theta power as the basis for learning-induced neuro- plasticity, we believe that the temporal dynamics of other frequency bands, together with their synchroni- zation properties can offer a fuller account of the neu- rophysiological changes occurring in the brain during cognitive tasks. Show less
In this research project characteristics of effective instructional development were identified that are appealing to medical teachers and relevant for medical education. Furthermore, we wanted to... Show moreIn this research project characteristics of effective instructional development were identified that are appealing to medical teachers and relevant for medical education. Furthermore, we wanted to know if medical teachers__ learning improved if an instructional development program was adapted in such a way that it included more of these characteristics. In this project we conducted two studies. In the first study, described in Chapters 2 and 3, we focused on selecting characteristics of effective instructional development programs for the medical context. In this study teachers and teacher educators were asked to indicate which of 35 characteristics that had been derived from the literature on effective instructional development (Guskey, 2003; Steinert et al., 2006) were important to them. In the second study, on which we report in Chapters 4 and 5, we used the characteristics collected in the first study as a framework to analyze a successful instructional course called Train the Trainers. This provided insight into its effectiveness and impact. We constructed a new instructional development course, using the information from the framework, and studied the learning processes of the medical teachers who participated in this Plus Course Show less
