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At least 199 records · Page 11Linked to original sources

Reminiscence therapy for dementia.

BACKGROUND: Reminiscence Therapy (RT) has been defined as vocal or silent recall of events in a person's life, either alone, or with another person or group of people. It typically involves group meetings, at least once a week. in which participants are encouraged to talk about past events, often assisted by aids such as photos, music, objects and videos of the past. There is, often, little consistent application of psychological therapies in dementia services. A number of these 'therapies' were greeted with enthusiasm by health care practitioners in understimulating care environments. They were expected to work miracles and their 'failure' to do this has led to their widespread disuse. A systematic review of the available evidence is important in order to identify the effectiveness of the different therapies. Subsequently, guidelines for their use can be made on a sound evidence base. OBJECTIVES: RT involves groups of elderly people talking of past events, assisted by aids such as videos, pictures and archives, as a means of communicating and reflecting upon their life experiences. The objective of the review is to assess the effects of RT for dementia. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, MEDLINE, PSYCHLIT, EMBASE, OMNI, BIDS, Dissertation Abstracts International, SIGLE and reference lists of relevant articles up to 1998, and we contacted specialists in the field. We also searched relevant internet sites and we handsearched Aging and Mental Health, the Gerontologist, Journal of Gerontology, Current Opinion in Psychiatry, Current Research in Britain: Social Sciences, British Psychological Society conference proceedings and Reminiscence database. SELECTION CRITERIA: Randomised controlled trials and quasi-randomised trials of RT for dementia in elderly people. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: Two trials are included in the review, but only one trial with 15 participants had extractable data. The results were statistically non-significant for both cognition and behaviour. REVIEWER'S CONCLUSIONS: No firm conclusions could be reached regarding the effectiveness of RT for dementia. The review highlighted the urgent need for more systematic research in the area.

Dementia↗

North Star Project: reality orientation in an acute care setting for patients with traumatic brain injuries.

OBJECTIVE: The North Star Project is an acute care rehabilitation approach for patients with moderate and severe traumatic brain injuries. This patient-centered project uses the concepts of Reality Orientation Therapy to develop a unique approach that focuses "environment," "consistency" and "standardization" to promote a total team effort. Patients, treatment staff and members of the patient's family collaborate in a unified bedside protocol that stimulates orientation, encourages patients' appropriate interactions and aims to decrease the length of post-traumatic amnesia. Development of materials, protocols, training and outcome measurement initiatives are described.

Brain Injuries↗

Effects of psychotherapy in schizophrenia: II. Comparative outcome of two forms of treatment.

This study compares the effects of exploratory, insight-oriented (EIO) and reality-adaptive, supportive (RAS) forms of psychotherapy on a sample of 95 schizophrenic patients. Analyses of 2-year outcomes revealed a complex interaction between the type of psychotherapy provided and the domain of psychopathology affected. RAS psychotherapy exerted clear preferential effects in the areas of recidivism and role performance. The EIO psychotherapy exerted preferential, albeit more modest, action in the areas of ego functioning and cognition. Overall, however, the magnitude of the differences was low. The results highlighted the need for more focused studies of subgroups, and of process and contextual influences on outcome.

Adult↗

Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction.

The prevailing opinion in the reperfusion therapy of patients with acute myocardial infarction (AMI) is that the benefit of reperfusion is mostly confined to the first 12 h after the symptom onset. This opinion is based on the results of the prior megatrials of thrombolytic therapy and the experimental studies. Thrombolytic studies have unequivocally proven that the efficacy of thrombolysis to salvage ischaemic myocardium is drastically reduced with the increase in the time-to-treatment interval. A relatively large number of patients present beyond the limit efficacy of thrombolysis and are considered ineligible for this reperfusion modality. Recent experimental and clinical evidence indicates that a large amount of viable myocardium is still present in the area at risk in patients with AMI presenting late after symptom onset and considered ineligible for thrombolysis. In this review, we summarized the existing data demonstrating that this viable myocardium is salvageable given the primary percutaneous coronary intervention (PCI) is used as a reperfusion therapy. By emphasizing this fact, we do not mean to contest the concept of time dependence of myocardial necrosis following coronary occlusion and time dependence of efficacy of interventions performed early (within 2-3 h) after symptom onset or to dissuade the early coronary interventions in patients with AMI. Instead, we strongly recommend the primary PCI in patients with AMI presenting late after onset of myocardial ischaemia.

Angioplasty, Balloon, Coronary↗

Psychotherapies: an overview.

The author schematically describes the three predominating themes in the development of the psychotherapies: dynamic, behavioral, and experiential. These themes represent different conceptualizations of the fundamental nature of man and his ills, therapeutic processes or change agents, the basic nature of the physician-patient relationship, and the primary techniques and methods used. Although there appears to be some unifying thread connecting the four different areas within each theme, a comparable bond does not exist across the three themes. The author questions the potential unification of the psychotherapies and poses specific dimensions for further exploration.

Autogenic Training↗

Xeroderma pigmentosum: from genetics to hopes and realities of cutaneous gene therapy.

Xeroderma pigmentosum (XP) is a rare genodermatosis transmitted as an autosomal and recessive trait. XP patients are highly photosensitive and prone to develop skin tumours in sun-exposed areas. Biochemical and genetic studies have demonstrated that nucleotide excision repair, the most versatile DNA repair mechanism, is deficient in XP cells, leading to ultraviolet-induced hypermutagenesis and a predisposition of XP patients to cancer. Cloning of XP genes responsible for the disease, together with the poor efficacy of classical pharmacological treatments, have motivated approaches towards cutaneous gene therapy of the XP. The author's group have successfully reconstructed XP skin in vitro from XP keratinocytes and fibroblasts. More recently, the possibility to fully revert the phenotype of XP keratinocytes after retrovirus-mediated transfer of the adequate wild-type XP gene in XP keratinocytes was demonstrated. Reconstruction of genetically corrected XP skin in vitro constitutes a new hope toward cutaneous gene therapy of the XP.

DNA↗

Discuss before fabricating: communicating the realities of partial denture therapy. Part I: patient expectations.

During planning for treatment involving cast removable partial dentures (RPDs), it is important to remember that the 2 major reasons why patients seek this treatment are to improve esthetics and to improve mastication. Treatment that is considered unsuccessful may not necessarily represent poor execution of procedures, but rather may not have fulfilled the patient's expectations with regard to these 2 goals. Searches of the Cochrane Collaboration and MEDLINE databases were conducted to identify issues pertaining to patient compliance in wearing cast RPDs. Compliance was better when the patient's chief concern was replacement of anterior teeth. The success of RPDs for replacement of teeth missing from other areas depended on the patient's perception of the value of such replacement. Maximum masticatory efficiency is equivalent for people functioning from second premolar to second premolar and those wearing partial dentures. Many clinicians believe that the prescription of partial dentures which replace teeth missing distally to the second premolars represents overtreatment.

Denture, Partial, Removable↗

Discuss before fabricating: communicating the realities of partial denture therapy. Part II: clinical outcomes.

The premise of this review is that patients' satisfaction (and hence compliance) with partial denture therapy may be better if they are more fully informed about the limitations of the prosthesis they are to receive. Neither the dentist nor the patient should assume that all of their respective expectations will be mutually understood and inherently met. By discussing patient-centred issues and predictable clinical outcomes, both dentist and patient will be better prepared to determine whether a removable prosthesis is appropriate. Searches of the Cochrane Collaboration and MEDLINE databases were conducted to identify issues pertaining to patient compliance in wearing cast removable partial dentures. In addition to the 2 most frequent patient concerns, esthetics and mastication, discussed in the first article of this series, additional aspects of concern to the dentist and the patient when considering a removable partial denture include overeruption, post-insertion care, comfort, longevity of the prosthesis, effect on speech and biologic consequences are discussed here.

Adaptation, Psychological↗