We conceptualize self-concept as a self-organizing dynamical system and investigate implications of this perspective for the dynamic and fixed-point attractor tendencies of self-evaluative thought. Participants who differed in self-concept valence (self-esteem) and coherence (self-certainty, self-stability) engaged in verbal self-reflection for several minutes, then used a computer mouse to track the moment-to-moment self-evaluation expressed in their recorded narrative. Prior to self-reflection, participants recalled positive or negative past actions (positive vs. negative priming), or did not recall past actions (no priming). Priming affected overall self-evaluation (i.e., greatest positivity under positive priming), but only early in the narrative. The effects of self-concept, in contrast, became stronger over time. Self-esteem affected overall self-evaluation, whereas self-certainty and self-stability affected the dynamic properties (e.g., rate of movement between self-evaluative states) and attractor tendencies of self-evaluation. Discussion centers on the interplay between structure and dynamics in the self-system.
Objective To examine the effectiveness of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction. Data Sources PubMed, Scopus, and Google Scholar. Review Methods A systematic review of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify randomized control trials and prospective and retrospective studies published prior to January 31, 2019. Meta-analysis of proportions evaluated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ7) scores, tympanometry, otoscopy findings, and the ability to perform a Valsalva maneuver. Results The systematic review identified 35 studies. Twelve studies met inclusion for meta-analysis (448 patients). Mean ETDQ7 scores decreased by 2.13 from baseline to 6 weeks (95% CI, –3.02 to −1.24; P < .001). From baseline to 6 weeks, 53.0% of patients had improvement in tympanograms ( P < .001). At the long-term point (3-12 months), 50.5% of patients had improved tympanograms from baseline ( P < .001). There was no significant difference in the proportion of improved tympanograms at 6 weeks compared to long term ( P = .535). Normal otoscopy exams at baseline increased by 30.0% at 6 weeks ( P < .001) and 55.4% in the long term ( P < .001). There was a 67.8% increase in proportion of patients able to perform a Valsalva maneuver in the long term compared to baseline ( P < .001). Conclusion Eustachian tube balloon dilation appears to be associated with improvement in subjective and objective treatment outcome metrics. The improvement appears stable at 3 to 12 months after dilation. Patients with eustachian tube dysfunction are likely to benefit from balloon dilation, particularly those with medication-refractory disease.
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