Opening the closed ward of a nursing home.
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In this paper we describe a brief report on the psychopharmacologic and non-pharmacologic treatment of the main degenerative dementias. We highlight the importance of using cholinesterase inhibitor drugs; moreover we describe the pharmacologic strategies for the related symptoms and the new pharmacologic approaches which include estrogen, non-steroidal-antiinflammatory agents and anti-oxidant agent, like vitamin-E. At least we briefly report the news from the ongoing clinical trials of other pharmacologic agents to improve cognitive functions and to slacken the neurodegenerative processes and the future pharmacological perspectives. In conclusion we briefly describe the non-pharmacological treatment with particular regard to psychoeducational, psychosocial and cognitive strategies that can enhance quality of life on both patients with dementia and their caregivers.
The work represents an introduction article of editors of special issue of the magazine devoted to gene therapy and therapeutics. The main results of clinical gene therapy in the past decade are critically considered in connection with a changes of paradigms of the field. They are: 1) change of the main target of genetic therapy--correction of defects in chromosomes--onto expression and/or output of target genes for gene therapy; 2) transfer from gene transplantation to cell transplantation; 3) tendency for the use of safe/non-viral vectors instead of viral ones.; and 4) conflict of interests in gene therapy. Outlooks in the field are discussed.
Can virtual reality exposure therapy be used to treat people with social phobia? To answer this question it is vital to known if people will respond to virtual humans (avatars) in a virtual social setting in the same way they would to real humans. If someone is extremely anxious with real people, will they also be anxious when faced with simulated people, despite knowing that the avatars are computer generated? In [17] we described a small pilot study that placed 10 people before a virtual audience. The purpose was to assess the extent to which social anxiety, specifically fear of public speaking, was induced by the virtual audience and the extent of influence of degree of immersion (head mounted display or desktop monitor. The current paper describes a follow up study conducted with 40 subjects and the results clearly show that not only is social anxiety induced by the audience, but the degree of anxiety experienced is directly related to the type of virtual audience feedback the speaker receives. In particular, a hostile negative audience scenario was found to generate strong affect in speakers, regardless of whether or not they normally suffered from fear of public speaking.
The focus of this article is on how the technique of Reality Orientation (RO) may impact upon the phenomenon of violence and aggression within an acute psychiatric care environment. Within the text the term violence is used to represent both violence and aggression. Findings relating to how RO is associated with clinical violence in acute psychiatry care came to the fore after the author carried out a research study examining nurses perceptions of RO as practiced within an acute psychiatric and care of the elderly clinical environments. It is clear that RO interacts with the phenomenon of violence in acute psychiatry. It is also clear that psychiatric nurses require a greater understanding of the technique if it is to be implemented with greater efficacy within acute psychiatric care.
There is considerable potential for using virtual reality (VR) in memory rehabilitation which is only just beginning to be realized. PC-based virtual environments are probably better suited for this purpose than more immersive virtual environments because they are relatively inexpensive and portable, and less frightening to patients. Those exploratory studies that have so far been performed indicate that VR involvement would be usefully directed towards improving assessments of memory impairments and in memory remediation using reorganization techniques. In memory assessment, the use of VR could provide more comprehensive, ecologically-valid, and controlled evaluations of prospective, incidental, and spatial memory in a rehabilitation setting than is possible using standardized assessment tests. The additional knowledge gained from these assessments could more effectively direct rehabilitation towards specific impairments of individual patients. In memory remediation, VR training has been found to promote procedural learning in people with memory impairments, and this learning has been found to transfer to improved real-world performance. Future research should investigate ways in which the procedural knowledge gained during VR interaction can be adapted to offset the many disabilities which result from different forms of memory impairment.
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Alzheimer's disease is a neurodegenerative disorder that provokes a progressive loss of memory and of other cognitive functions, with additional symptoms in the behavioural and psychological sphere, loss of autonomy and an important overburdening for the family and the social milieu. Dealing with this disorder and other related dementias requires a multidimensional strategy that is able to face the different needs raised by the patient and his family. Given the lack of a curative pharmacological treatment, psychosocial interventions have emerged over the years that are directed at optimising the function of the patient and supporting the family in caring for him, with very different techniques in each of the spheres of intervention (cognitive, behavioural, environmental, family). In this review, we make a description of the interventions that have been most studied in the field of cognitive stimulation, from the most global approaches (reality orientation therapy, reminiscence therapy, psychostimulation programs) to the most specific ones in the field of memory rehabilitation (training of the explicit memory, technique of delayed remembrance, vagueness, error-free learning, procedure training of the memory and the use of external help), and the results are shown of some studies carried out using these techniques of intervention.
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Interpretation is a product of compromise formation that requires optimal use of the analyst's aggression to be an effective analytic intervention. Aggressive aims useful for the interpretive act are problematic for analysts and have led both to clinical difficulties and to various theoretical reactions against considering interpretation essential for analytic progress. In analysis, diverging aims of analyst and patient are highlighted in connection with the analyst's function as interpreter. The interactions between patient and analyst pertaining to interpretation provide insights into the patient's intrapsychic conflicts that may be less apparent in other material.
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Widespread applications of stem cell-based therapies in the clinic are being reported, yet there is a surprising lack of resolution of the factors that lead to failure of such therapies on a long-term basis. While classical pharmacogenomics aids the prediction of drug responses in an individual based on genetic variation and pharmacological responses, stem cell therapy involves an additional dimension of host-donor cell interactions and adaptability. We propose the development of concise guidelines based on pharmacogenetic and donor/host-related cellular factors studied more extensively in larger data sets, and used in prospective studies to individualize stem cell therapy.
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Cell therapy is the promising therapeutic tool for the next decade. "Regenerative Medicine" based on cell and tissue replacement therapy is proposed as a revolutionary approach to various chronic and incurable conditions. The first key step for successful cell therapy is the establishment of clinical grade human Embryonic Stem Cell (hESC) lines. This article provides a concise summary on conventional and novel methods for hESC line derivation. There is also discussion on progression, future direction and problems in hESC line development. In Thailand, more advance knowledge, skill, and technology are required to develop the first human embryonic stem cell line and step forward to make cell therapy a reality.
This paper will provide an introduction to the use of virtual environments for vestibular re-education. The author illustrates some of the ways in which researchers are using virtual reality to improve therapy for vertigo. Users of virtual reality must make adaptations to avoid mismatches between perception due to virtual reality and that due to vestibular and proprioceptive subsystems. Virtual reality may be an interesting new way of studying vestibular compensation in normal and pathological conditions.