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Inverse association between sense of humor and coronary heart disease.

Prospective studies have suggested that antisocial Type A personality traits may be associated with an increased incidence of coronary heart disease (CHD). However, few data have addressed whether more favorable personality characteristics may be inversely correlated with CHD. Therefore, two standardized questionnaires designed to either assess anger and hostility or to measure the propensity to laugh under a variety of situations encountered in everyday life, were administered to 300 consecutive subjects. Compared to controls, CHD subjects were significantly less likely to experience laughter during daily activities, surprise situations or social interactions (P<0.005). Logistic regression analysis revealed an inverse correlation between humor and CHD, even after adjustment for other covariates, including hypercholesterolemia, hypertension and diabetes mellitus (P=0.03). A significant inverse association was also observed between humor production and antisocial Type A personality traits (P=0.0001). These data extend previous observations linking antisocial Type A personality traits to CHD and raise the possibility that the propensity to laugh may contribute to cardioprotection.

Analysis of Variance↗

Different patterns of dipole source localization in gelastic seizure with or without a sense of mirth.

Dipole source localization corresponding to interictal spikes were estimated using EEG dipole tracing with a realistic three-shell head model in three patients with cryptogenic gelastic epilepsy. The dipole sources in two patients, whose gelastic seizures were accompanied by a subjective feeling of mirth, were estimated in the right or left medio-basal temporal regions. In the other patient, with gelastic seizures without a sense of mirth, the dipole sources were localized in the right frontal region corresponding to the anterior cingulate. The results suggest that the neural activities in hippocampal regions are involved with the generation of gelastic seizures with a sense of mirth and those in the cingulate might be associated with the motor act of laughter.

Action Potentials↗

The essence of humour and its effects and functions: a qualitative study.

Humour is one of the innate abilities that an individual develops whilst growing up and which is affected by his/her experiences in life. The purpose of this study was to describe which categories can be included in the term 'humour' and to describe the effects and functions that humour has on people. The study was exploratory. The data were based on 20 interviews, nine of which were made with women and 11 with men who had no formal connection to health services or nursing. Ages ranged from 17 to 75 years and all the interviewees were from Sweden. The research question was: 'what does humour mean to you?'. The answers given were labelled as: laughter, happiness, unforeseen events/situations, real humour/art form, jokes, plays on words/puns, situation comedy and political satire. The categories were: possibilities/obstacles and weapon/protection. We conclude that the essence of humour can be categorized as possibilities/obstacles and weapon/protection. Humour has effects and functions on individuals. Empathy is a prerequisite for the use of humour in the context of health services and nursing.

Adolescent↗

Humour in nursing care.

Humour is an integral part of everyday life and therefore also a component of the care and treatment of patients in the modern health care system. This paper looks at the role of humour in practical nursing in the light of earlier research literature on the subject. It also describes some preliminary results of our studies on the meaning of humour to professional nurses. We opted to use a qualitative approach in this study because the focus of interest was on an issue that has received only little attention in earlier research. Nurses were presented with a set of unstructured, open-ended questions requiring short, essay-type answers. The data obtained were analysed using the qualitative method of content analysis. In the light of our findings here, humour can be described as a joie de vivre which is manifested in human interaction in the form of fun, jocularity and laughter. Humour is a meaningful factor, both with regard to the patient's well-being and to coping, and also with regard to the interaction of nurse and patient. Humour also allows for more job satisfaction and better motivation. Research should be continued and intensified into the role and use of humour in everyday life and particularly in nursing care.

Adaptation, Psychological↗

Humour between nurse and patient, and among staff: analysis of nurses' diaries.

AIM OF THE STUDY: The aim of this study was to investigate the occurrence of humour both between nurses and patients and among nursing staff. BACKGROUND: Humour has positive effects on both a person's physiology and the psyche. Laughter signifies positive things to people; it may add to feelings of togetherness, closeness and friendliness. The use of humour is an indication of mental well-being and it minimizes the effect of negative factors and protects from difficulties. METHODS: The data consisted of diaries written by nurses (n=16), which were analysed inductively using content analysis. FINDINGS: The main categories of humour between nurse and patient were nurse-based humour, co-operation-orientated humour and patient-orientated humour. Humour among staff consisted of the main category of resource-orientated humour. CONCLUSION: The consequences of humour between nurse and patient enabled them both to cope with various unpleasant procedures. It helped them to manage difficult situations and led to an improvement in the working climate. Humour among staff helped nurses to cope with their work and created a better atmosphere on the ward.

Adaptation, Psychological↗

Cryptogenic gelastic epilepsy of frontal lobe origin: a paediatric case report.

Gelastic (laughing) seizures are an uncommon seizure type which in most cases has an organic cerebral pathology and specifically a hypothalamic hamartoma. The interictal EEG frequently shows focal activity. This report describes a 3 1/2-year-old boy who presented with episodes of unmotivated laughter associated with other epileptic symptomatology before the age of 3 years. Prolonged ambulatory EEG monitoring recorded electroclinical seizures starting in the right frontal area and spreading to the adjacent frontotemporal region. Neurological examination and brain magnetic resonance imaging were normal. Vigabatrin resulted in immediate remission of the seizures and normalization of the EEG.

Anticonvulsants↗

The lifesaving function of humor with the depressed and suicidal elderly.

This article describes situations where laughter or humor occurred during therapy with depressed and suicidal patients. Therapeutic humor is associated with five principles: (1) a positive doctor-patient relationship includes the freedom to be humorous; (2) the humor is life affirming; (3) the humor increases social cohesion; (4) the humor is interactive; (5) the humor reduces stress. The application of these principles is based upon a knowledge of the required interventions and an awareness of when humor is or is not appropriate. The main effects are symptom relief and increased cohesion. Recommendations are made to health practitioners for the optimal use of humor.

Aged↗

Consciousness and body image: lessons from phantom limbs, Capgras syndrome and pain asymbolia.

Words such as 'consciousness' and 'self' actually encompass a number of distinct phenomena that are loosely lumped together. The study of neurological syndromes allows us to explore the neural mechanisms that might underlie different aspects of self, such as body image and emotional responses to sensory stimuli, and perhaps even laughter and humour. Mapping the 'functional logic' of the many different attributes of human nature on to specific neural circuits in the brain offers the best hope of understanding how the activity of neurons gives rise to conscious experience. We consider three neurological syndromes (phantom limbs, Capgras delusion and pain asymbolia) to illustrate this idea.

Body Image↗

Autogenic training to reduce anxiety in nursing students: randomized controlled trial.

AIM: This paper reports a study to determine the effectiveness of autogenic training in reducing anxiety in nursing students. BACKGROUND: Nursing is stressful, and nursing students also have the additional pressures and uncertainties shared with all academic students. Autogenic training is a relaxation technique consisting of six mental exercises and is aimed at relieving tension, anger and stress. Meta-analysis has found large effect sizes for autogenic trainings intervention comparisons, medium effect sizes against control groups, and no effects when compared with other psychological therapies. A controlled trial with 50 nursing students found that the number of certified days off sick was reduced by autogenic training compared with no treatment, and a second trial with only 18 students reported greater improvement in Trait Anxiety, but not State Anxiety, compared with untreated controls. METHODS: A randomized controlled trial with three parallel arms was completed in 1998 with 93 nursing students aged 19-49 years. The setting was a university college in the United Kingdom. The treatment group received eight weekly sessions of autogenic training, the attention control group received eight weekly sessions of laughter therapy, and the time control group received no intervention. The outcome measures were the State-Trait Anxiety Inventory, the Maslach Burnout Inventory, blood pressure and pulse rate completed at baseline, 2 months (end of treatment), and 5, 8, and 11 months from randomization. RESULTS: There was a statistically significantly greater reduction of State (P<0.001) and Trait (P<0.001) Anxiety in the autogenic training group than in both other groups immediately after treatment. There were no differences between the groups for the Maslach Burnout Inventory. The autogenic training group also showed statistically significantly greater reduction immediately after treatment in systolic (P<0.01) and diastolic (P<0.05) blood pressure, and pulse rate (P<0.002), than the other two groups. CONCLUSION. Autogenic training has at least a short-term effect in alleviating stress in nursing students.

Adult↗

Behaviour problems in Angelman syndrome.

Angelman syndrome (AS) is a genetic disorder that is associated with a deletion on chromosome 15, and is characterized by abnormalities or impairments in neurological, motor and intellectual functioning. While behaviour problems have been reported in clients with AS, relatively little is known about their developmental course and outcome. In this study, data on the nature and prevalence of behaviour problems among clients with AS were gathered from two sources: (1) a review of published case reports; and (2) parent responses to a survey of behaviour problems in a small (n = 11) sample of children with AS. Data from both sources showed that behaviour problems were present in males and females of all ages, and included language deficits, excessive laughter, hyperactivity, short attention span, problems with eating and sleeping, aggression, noncompliance, mouthing of objects, tantrums, and repetitive and stereotyped behaviour. Identification and treatment of severe behaviour problems in clients with AS may improve their adaptive functioning.

Adolescent↗

Giggle incontinence (enuresis risoria). A study and an aetiological hypothesis.

Questionnaires answered by 99 student nurses concerning bladder responses to laughter showed that roughly 25% had experienced such reactions at some time in their lives and about 10% could still register such phenomena at the end of their second decade. Giggle incontinence is not a condition confined to an "all or nothing" response of complete micturition. The evidence seems to indicate that the condition is due to some inborn and quite ordinary trigger mechanism exposed by physiological variations in sensitivity or specific control.

Adolescent↗

With onions and tears: a multidimensional analysis of a counter-ritual.

"Family rituals" and "family myths" are useful concepts for understanding some of the behavior of disturbed families and hence for planning therapeutic interventions. A case of a family of a schizophrenic patient is described in which a "counter-ritual" involving onion-peeling to induce tearing was invented. The intervention addressed the family's inappropriate laughter and denial of sadness and seemed to lead to therapeutic gains for the identified patient and the family. This counter-ritual, as an indirect affect-inducing experience, is analyzed from a variety of perspectives and a partial parallel is drawn to an Iranian cultural ritual. A suggestion is made that more light may be shed on the mechanisms and structures of myths and rituals in families by drawing on studies of myths and rituals in ethnography. "Counter-ritual"is offered as a general concept for a type of active family intervention that involves inventing and employing rituals antithetical to pathological ones engaged in by some families.

Adult↗

The Angelman or "happy puppet" syndrome. Clinical and electroencephalographic features and cerebral blood flow.

Two cases of happy puppet or Angelman syndrome are presented. They have the typical clinical features and represent the first Swedish cases. One of the patients is a man of 75 years of age, which shows that this form of severe mental retardation is well compatible with long life. Extended EEG monitoring may identify the typical EEG abnormality when this is difficult to demonstrate in routine EEG records. The typical laughter has no specific correlate in the EEG and thus is probably not an epileptic manifestation. Regional cerebral blood flow studies were normal in the young patient (11 years of age) but in the older patient showed a reduced cerebral circulation, compatible with organic dementia.

Aged↗

Cure og giggle micturition..

Two boys, aged 11 and 13, had involuntary, unstoppable, and complete emptying of the bladder on laughter. In one the wetting occurred only when standing and in company, but in the other occurred regardless of posture or company. One boy had a strong family history of wetting including a grandmother who had giggle micturition as a teenager. The symptoms had been present for between 1 and 2 years. However, unlike cases previously reported, each boy was cured--one within 6 weeks and the other within 6 months. It is not clear how much of the success was due to the general sympathetic and confidence-building measures used, advice about posture, or to the drug propantheline.

Adolescent↗

Gelastic epilepsy.

A case of retinitis pigmentosa with laughing epilepsy is described. Stereotyped repetitive episodes of limb movement, rigidity, and cackling laughter responding to diazepam are recorded. One episode is presented as gelastic status epilepticus and the clinical and EEG features are reported. Features of gelastic epilepsy are discussed and briefly compared with other laughing disorders. A short history of the condition is accompanied by a relevant review of the literature. The possible importance of hypothalamic lesions in laughing epilepsy is discussed and the absence of consistent EEG findings is noted.

Adolescent↗

A self report measure of affective lability.

OBJECTIVES: The development and validation of the Center for Neurologic Study-Lability Scale (CNS-LS), the first self report measure of affective lability in patients with amyotrophic lateral sclerosis (ALS). METHODS: Potential questionnaire items were identified through interviews with patients and families and expert review. Potential items, as well as measures of affect intensity, affective lability in psychopathology, and depression were administered to 99 patients with ALS for item selection and the examination of factor structure and construct validity. Test-retest reliability was examined using an additional sample of 31 patients with ALS, and criterion related validity was examined by comparing CNS-LS scores with physicians' diagnoses of affective lability in a sample of 77 patients with ALS. RESULTS: A seven item questionnaire emerged, composed of two subscales measuring labile laughter (four items) and labile tearfulness (three items). The CNS-LS showed a pattern of associations with affect intensity, affective lability in psychopathology, and depression consistent with a scale measuring affective lability. The CNS-LS also showed good test-retest reliability and internal consistency, and successfully predicted physicians' diagnoses of affective lability. An auxiliary subscale measuring labile frustration, anger, and impatience also emerged. CONCLUSIONS: The CNS-LS is a short, easily administered, and psychometrically sound measure of affective lability for use with patients with ALS. It has potential applications as both a clinical screening device and a research tool. The need for future research into the relation of depression as well as labile frustration, anger, and impatience to the syndrome of affective lability in neurological disorders is discussed.

Affect↗

Gelastic seizures in a young boy: evaluation by magnetic resonance imaging.

OBJECTIVE: To present an interesting case of gelastic seizures in a child who had an underlying brain lesion. CLINICAL PRESENTATION AND INTERVENTION: A 10-year-old boy presented with recurrent episodes of uncontrollable laughter since the age of 6 years. Computed tomography showed a well-defined mass in the region of suprasellar and interpeduncular cisterns. Magnetic resonance imaging revealed a lesion, most likely a hamartoma, arising from the region of tuber cinerium. The lesion was subsequently resected and a marked improvement in the frequency and intensity of seizures was noted. CONCLUSION: This report shows that neuroimaging should be performed on patients with gelastic seizures to exclude any underlying structural lesion of causal significance.

Child↗