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PubMed1999

Ethnocultural considerations in group psychotherapy.

The increasingly heterogeneous populations of the industrialized countries necessitate a reappraisal of the sociocultural norms and group-therapeutic approaches that were based primarily on White Judeo-Christian values. This author reviews the literature on the treatment of ethnically different patients and discusses socio-cultural phenomena relevant to group therapy that differ from the mainstream culture. The culturally determined contrasts in perception, attitude, communication, and behavior, which minority members may exhibit in the group, are examined. The specific demands on the therapist working with ethnic group members are highlighted along with the modifications in therapeutic technique. Recommendations for a culturally sensitive and broader training of group therapists are offered.

Adult↗
PubMed2002

Short term aerobic exercise training in young males does not alter sensitivity to a central serotonin agonist.

An increase in the concentration of serotonin in the brain has been shown to cause fatigue during exercise in humans and experimental animals. This type of fatigue is referred to as central fatigue and is likely to be mediated by the concentration of serotonin as well as serotonin receptor sensitivity. Serotonin (5-HT) receptor antagonism in humans and experimental animals has been shown to improve endurance performance. A previous report has shown decreased receptor sensitivity in athletes compared to sedentary controls. It is unclear whether this is due to a training adaptation or if individuals are predisposed to enhanced athletic performance due to their inherent decreased receptor sensitivity. The present study investigated changes in 5-HT receptor sensitivity in response to aerobic exercise. Subjects completed 3 x 30 min of stationary cycling at 70 % of their peak aerobic power (.V(O(2)peak)) for 9 weeks. Serotonin receptor sensitivity was assessed indirectly by measuring the neuroendocrine response following administration of a serotonin agonist (buspirone hydrochloride). The neuroendocrine response following administration of a placebo was also investigated in a blind crossover design. A group of sedentary control subjects was also recruited to control for seasonal variations in central receptor sensitivity. The training caused a significant increase in .V(O(2)peak)) (3.1 +/- 0.16 to 3.6 +/- 0.15 l min(-1), P < 0.05) and endurance capacity (93 +/- 8 to 168 +/- 11 min, P < 0.05), but there was no change (P > 0.05) in the neuroendocrine response in the presence of a serotonin agonist. However, one-quarter of the subjects in the training group demonstrated decreases in receptor sensitivity. These results suggest that despite increases in .V(O(2)peak)) and endurance performance, there was no measurable change in 5-HT receptor sensitivity in the presence of a serotonin agonist. In addition, it is possible that changes in receptor sensitivity may take longer to occur, that the training stimulus used in the present investigation was inadequate and/or that changes occurred in receptor subtypes that were not probed by the agonist used in the present investigation.

Adult↗
PubMed2004

The use of neural networks for predicting the result of endoscopic treatment for vesico-ureteric reflux.

OBJECTIVE: To create an artificial neural network (ANN) to aid in predicting the results of endoscopic treatment for vesico-ureteric reflux (VUR). MATERIALS AND METHODS: During 1999-2001 we used endoscopic treatment in 261 ureteric units with VUR of all grades and causes. An ANN based on multilayer perceptron architecture was created using an 11 x 6 x 1 structure, taking the following as variables: the cause and grade of VUR, the patient's age and sex, the type of implanted substance and its volume, the number of treatments, the affected ureter, the endoscopic findings, and the type of cystography used. In all, 174 cases were used as training samples for the ANN and 87 to validate it. We calculated the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the success rate (%) of the system. RESULTS: In the training group the ANN gave a sensitivity of 86.4%, a specificity of 89.5%, a PPV of 76% and NPV of 94%, with a success rate of 88.6%. In the same training group logistic regression (LR) gave respective values of 68.2%, 58.8%, 39%, 82.7% and 61.4%. In the validation group the respective values for the ANN were 71.4%, 81.6%, 58.8%, 88.6% and 78.9%, and in the same validation group the LR gave 64.4%, 50%, 32.1%, 79.2% and 53.9%. The Wilcoxon test confirmed the independence of both methods (P < 0.001). CONCLUSION: The ANN is an effective tool for assisting the urologist in indicating and applying endoscopic treatments for VUR.

Adolescent↗
PubMed1998

Classical eyeblink conditioning in two strains of mice: conditioned responses, sensitization, and spontaneous eyeblinks.

Conditioned eyeblink responses (CRs), sensitization, and spontaneous eyeblinks were studied in C57BL/6J and BALB/c mice. Both strains of mice acquired CRs during 10 days of classical delay eyeblink conditioning. The BALB/c mice reached a higher asymptotic CR level than the C57BL/6J mice. The CRs were extinguished and recovered in both strains following conditioned stimulus-alone and paired conditioned stimulus-unconditioned stimulus training. During 10 days of explicitly unpaired training, the control groups showed no signs of sensitization and low incidence of spontaneous eyeblinks. When switched to paired training, the unpaired groups exhibited significant conditioned inhibition. These results suggest that strain differences must be considered in experimental design and data interpretation for these basic aspects of associative learning and memory.

Analysis of Variance↗
PubMed1997

Enhancing sensitivity to facial expression of pain.

Clinicians have long appreciated the information communicated by a patient's facial expression. Advances in the measurement of facial movements, using the Facial Action Coding System (FACS) have allowed for identification of a universal expression of pain, which is primarily encoded in four facial movements. While the FACS provides a rigorous assessment of facial expression, the time required to learn the system and to analyze the facial expression by use of slow motion video recording, makes its use impractical in the clinical setting. The purpose of this research was to examine whether exposure to a brief training procedure, based on orienting subjects to the four facial movements, would increase sensitivity to pain communicated by facial expression. Seventy-five occupational and physical therapy student volunteers were randomly assigned to training or control groups. The trained group was exposed to a 30-min training session. Both groups were then asked to rate a videotape of patients undergoing assessment of a painful shoulder and rate the amount of discomfort the patients appeared to be experiencing. Analyses indicated that the trained group was significantly more sensitive to subtle facial movements associated with low levels of pain. Relative to the patients' ratings, there was a tendency for raters to underestimate pain particularly when these were at a high level. The findings lend hope to the feasibility of developing a tool which would be clinically useful though this may be more difficult for observers judging more complex facial expressions associated with high levels of pain.

Adult↗
PubMed2006

Sound facilitates visual learning.

Numerous studies show that practice can result in performance improvements on low-level visual perceptual tasks [1-5]. However, such learning is characteristically difficult and slow, requiring many days of training [6-8]. Here, we show that a multisensory audiovisual training procedure facilitates visual learning and results in significantly faster learning than unisensory visual training. We trained one group of subjects with an audiovisual motion-detection task and a second group with a visual motion-detection task, and compared performance on trials containing only visual signals across ten days of training. Whereas observers in both groups showed improvements of visual sensitivity with training, subjects trained with multisensory stimuli showed significantly more learning both within and across training sessions. These benefits of multisensory training are particularly surprising given that the learning of visual motion stimuli is generally thought to be mediated by low-level visual brain areas [6, 9, 10]. Although crossmodal interactions are ubiquitous in human perceptual processing [11-13], the contribution of crossmodal information to perceptual learning has not been studied previously. Our results show that multisensory interactions can be exploited to yield more efficient learning of sensory information and suggest that multisensory training programs would be most effective for the acquisition of new skills.

Acoustic Stimulation↗
PubMed2003

Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals.

STUDY DESIGN: Pre-post training intervention. OBJECTIVES: To evaluate the effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured (SCI) patients, and to assess the correlation between peak aerobic capacity (VO(2Peak)) and insulin sensitivity. SETTING: Spinal Cord Rehabilitation Unit, Sunnaas Hospital, Nesoddtangen, Norway. METHOD: Six recently injured SCI individuals participated in the arm training intervention and were randomly admitted to a high-intensity (HI; 70-80% heart rate reserve (HRR)) and low-intensity (LI; 40-50% HRR) group. The 1 h interval training consisted of 3 min exercise bouts interspersed with 2 min of rest, three times a week for 8 weeks. In addition, a correlation coefficient was obtained between VO(2Peak) and insulin sensitivity in 11 SCI patients. RESULTS: The 8-week training program resulted in a significant increase in VO(2Peak) and maximal power output (PO(Max)) for the group as a whole (P<0.05). VO(2Peak) increased significantly more and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and triglycerids decreased significantly more in the HI group than in the LI group (P=0.05). Training-induced changes in insulin sensitivity were significantly different between the groups (P=0.05), which was due to a nonsignificant decline in insulin sensitivity in the HI group and a nonsignificant improvement in the LI group. A significant positive correlation was found between VO(2peak) and insulin sensitivity (r=0.68, P=0.02). CONCLUSION: The interval arm training protocol as used in the present study enables recently injured SCI patients to do substantial work at a relatively high intensity. Results indicate that improvements in physical capacity and lipid profile were more pronounced in response to high-intensity training. The significant correlation between maximal oxygen consumption and insulin sensitivity indicates that, as in the able-bodied population, peak aerobic capacity is a predictive value with regard to insulin sensitivity in SCI. Future studies with larger groups assessing the role of exercise intensity on insulin sensitivity in SCI are suggested.

Activities of Daily Living↗
PubMed2005

Prediction of significant fibrosis in HBeAg-positive patients with chronic hepatitis B by a noninvasive model.

A model was constructed consisting of clinical and serum variables to discriminate between hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients with and without significant fibrosis (stages 2-4 vs. stages 0-1). Consecutive treatment-naive CHB patients who underwent liver biopsy were divided into 2 sequential groups: a training group (n = 200) and a validation group (n = 172). Multivariate analysis identified alpha2-macroglobulin, age, gamma glutamyl transpeptidase, and hyaluronic acid as independent predictors of fibrosis. The area under the receiver operating characteristic curve was 0.84 for the training group and 0.77 for the validation group. Using a cutoff score of <3.0, the presence of significant fibrosis (F2 to F4) could be excluded with high accuracy (86.1% negative predictive value [NPV], 70.1% positive predictive value [PPV], and 94.8% sensitivity) in 43 (21.5%) of 200 patients in the training group, and with the same certainty (90.9% NPV, 64.7% PPV, and 98.0% sensitivity) in 22 (12.8%) of 172 patients in the validation group. Similarly, applying a cutoff score of >8.7, the presence of significant fibrosis could be correctly identified with high accuracy (91.1% PPV, 51.6% NPV, and 95.2% specificity) in 41 (20.5%) of 200 patients in the training group, and with the same certainty (84.8% PPV, 52.4% NPV, and 90.4% specificity) in 39 (22.7%) of 172 patients of the validation group. In conclusion, a predictive model with a combination of easily accessible variables identified HBeAg-positive CHB patients with and without significant fibrosis with a high degree of accuracy. Application of this model may decrease the need for liver biopsy in staging of 35.5% CHB.

Adolescent↗
PubMed2005

Alphaxalone and epiallopregnanolone in rats trained to discriminate ethanol.

BACKGROUND: Neurosteroids with a 3 alpha-hydroxy orientation share pharmacological effects with ethanol, increase in brain after ethanol administration, and may mediate ethanol effects. 3beta-hydroxy neurosteroids antagonize in vitro and some, but not all in vivo effects of ethanol and 3 alpha-hydroxy neurosteroids. METHODS: We assessed the discriminative stimulus and rate altering effects of alphaxalone, a 3 alpha-hydroxy neurosteroid, and epiallopregnanolone, a 3beta-hydroxy neurosteroid, in rats trained to discriminate either 0.8 g/kg or 1.2 g/kg ethanol. The ability of epiallopregnanolone to antagonize the discriminative stimulus or rate-altering effects of ethanol or alphaxalone was also assessed. RESULTS: Ethanol had similar discriminative ED50s (0.5 g/kg) in both groups; however rats trained with the lower ethanol dose were more sensitive to rate-decreasing effects of ethanol. Alphaxalone occasioned ethanol-appropriate responding in both training groups, although less effectively in rats trained on the lower ethanol dose (maximum 65% versus 80% ethanol-appropriate responding). No difference in sensitivity to the rate-decreasing effects of alphaxalone was present between groups. Epiallopregnanolone did not reliably occasion ethanol-appropriate responding in either training group, and rats trained on the lower ethanol dose were slightly more sensitive to epiallopregnanolone rate decreasing effects. Epiallopregnanolone did not alter any effects of ethanol or alphaxalone. CONCLUSIONS: Our results agree with previous reports that 3 alpha-hydroxy neurosteroids occasion ethanol-appropriate responding, while 3beta-hydroxy neurosteroids do not; as well as reports showing no antagonism of the discriminative stimulus or rate-suppressant effects of ethanol or 3 alpha-hydroxy neurosteroids by 3beta-hydroxy neurosteroids. Results of the present study demonstrate that ethanol and 3 alpha-hydroxy neurosteroids share discriminative stimulus effects. However, these results are inconsistent with the hypothesis that such neurosteroids mediate the discriminative stimulus of ethanol.

Animals↗
PubMed1990

Effect of training and detraining on in vivo insulin sensitivity.

Insulin sensitivity was determined in rats to clarify the effect of detraining at 1 (trained state), 2, 3, and 7 days (7 rats each) and 14 days (n = 8) after five weeks of voluntary training using euglycemic insulin clamp technique. The relationship between basal insulin and glucose shifted towards a decrease in metabolic insulin needs compared to untrained controls (n = 20). During the insulin clamp study, to maintain comparable plasma glucose and insulin levels in all groups, the glucose infusion rate had to be increased significantly (p less than 0.01) to 9.92 +/- 1.12 mg.kg-1.min-1 compared to control group (6.57 +/- 0.57). This improved sensitivity persisted for 2 days after training but was significantly lowered in the 7-days-after group (p less than 0.01). In summary, this study shows that training effect on insulin sensitivity can be determined after voluntary training in rat. This training effect lasted 2 days after training.

Animals↗
PubMed2004

The joint effects of person and situation factors on stress in spaceflight.

Psychologists can play an important role in spaceflight and exploration. Indeed, their input at four specific stages in spaceflight can help to ensure successful missions. Psychologists have a role to play in: 1) Selection; 2) Training; 3) Real or Simulated Space Missions; and 4) Post-Flight Problems. During selection, psychologists can provide guidelines as to the appropriate coping styles for reacting to mission-related stressors. During training, psychologists can help astronauts to plan for, and cope with, problems (e.g., group conflict). Training in social sensitivity, or in specific coping styles (i.e., to be high in task-oriented coping), would be beneficial so that astronauts are able to deal with unforeseen problems. Task-oriented coping is related to control and efficiency, and reduces stress and anxiety. Emotion-oriented coping relates to anxiety for controllable situations, and task-oriented coping is most efficacious. A primary role for psychologists would be the investigation of what problems could arise from living with others in a limited space and for long periods of times. As such, investigations into group dynamics, physical and psychological stress caused by such an environment, and the lack of normal ways to deal with these problems should all be considered. It is also clear that the impact of spaceflight on an individual does not end with physical re-entry. On the contrary, the astronaut will also have to make a psychological post-flight "re-entry" readjustment to life on Earth. Psychologists have an important role to play during all four stages of the space program, especially in regards to person by situation interactions. That is, space is a novel environment for human beings, and we need to investigate how we can better improve the fit between astronauts and space situational stressors. Not only are person by situation interactions relevant for each of the four stages discussed above, but each of the stages interacts with one another bidirectionally and even multidirectionally.

Adaptation, Psychological↗
PubMed2003

Disassociation of muscle triglyceride content and insulin sensitivity after exercise training in patients with Type 2 diabetes.

AIM/HYPOTHESIS: We determined the effect of exercise training on insulin sensitivity and muscle lipids (triglyceride [TG(m)] and long-chain fatty acyl CoA [LCACoA] concentration) in patients with Type 2 diabetes. METHODS: Seven patients with Type 2 diabetes and six healthy control subjects who were matched for age, BMI, % body fat and VO(2)peak participated in a 3 days per week training program for 8 weeks. Insulin sensitivity was determined pre- and post-training during a 120 min euglycaemic-hyperinsulinaemic clamp and muscle biopsies were obtained before and after each clamp. Oxidative enzyme activities [citrate synthase (CS), beta-hydroxy-acyl-CoA (beta-HAD)] and TG(m) were determined from basal muscle samples pre- and post training, while total LCACoA content was measured in samples obtained before and after insulin-stimulation, pre- and post training. RESULTS: The training-induced increase in VO(2)peak (approximately 20%, p<0.01) was similar in both groups. Compared with control subjects, insulin sensitivity was lower in the diabetic patients before and after training (approximately 60%; p<0.05), but was increased to the same extent in both groups with training (approximately 30%; p<0.01). TG(m) was increased in patients with Type 2 diabetes (170%; p<0.05) before, but was normalized to levels observed in control subjects after training. Basal LCACoA content was similar between groups and was unaltered by training. Insulin-stimulation had no detectable effect on LCACoA content. CS and beta-HAD activity were increased to the same extent in both groups in response to training ( p<0.001). CONCLUSION/INTERPRETATION: We conclude that the enhanced insulin sensitivity observed after short-term exercise training was associated with a marked decrease in TG(m) content in patients with Type 2 diabetes. However, despite the normalization of TG(m )to levels observed in healthy individuals, insulin resistance was not completely reversed in the diabetic patients.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1996

Simulated disability exercises and their impact on attitudes toward persons with disabilities.

Two separate graduate rehabilitation counselling groups from a mid-south university either did or did not take part in a wheelchair sensitivity training pilot study designed to enhance their understanding as to what life might be like for persons who use a wheelchair. Twenty students were individually accompanied on a designated route across campus by a non-disabled graduate researcher. Eighteen other graduate students formed a control group and did not participate. Both groups completed a contextually different 14-item Likert type questionnaire designed to assess their perceptions of persons with physical disabilities based on either the sensitivity exercise or their experience in the rehabilitation programme. Results from this quasi-experimental study suggested that regardless of whether they participated in the sensitivity training, both groups perceived they would become better counsellors. t-Tests revealed significant differences in the two groups' responses to questions pertaining to daily frustrations experienced by persons with physical disabilities and a pre-occupation with how accessible places are. Other differences noted were that persons with physical disabilities must feel different from being stared at and must have a harder time in society. Implications of the utility and misuses of these one-time experiences are explored.

Activities of Daily Living↗
PubMed2005

Effects of Tai Chi and resistance training on cardiovascular risk factors in elderly Chinese subjects: a 12-month longitudinal, randomized, controlled intervention study.

BACKGROUND: Tai Chi is rapidly gaining in popularity, worldwide. This study was performed to assess its impact on cardiovascular risk factors in comparison with resistance training exercises in elderly Chinese subjects. METHODS: A total of 207 healthy elderly participants (65-74 years, 113/207 (55%) men) were randomly assigned to one of three intervention groups: (1) Tai Chi, three times/week for 1 h/session (n = 64); (2) resistance training exercise, three times/week for 1 h/session (n = 65); (3) usual level of physical activity control group (n = 78). Anthropometric measures, dual X-ray densitometry body composition, blood pressure, lipids, glycaemic and insulin sensitivity indices were measured at baseline and 12 months. Repeated-measures analysis of variance (anova) was used to assess the between-group changes using a last-observation-carried-forward intention-to-treat approach. RESULTS: A total of 180 (87.0%) subjects completed the study. No significant changes were identified in the Tai Chi group compared to the resistance training or control group. Of the primary outcomes, only the improvement in the insulin sensitivity index differed, being significantly greater in the resistance training than in the control group [mean difference 0.018 (95% confidence interval ( CI) 0.000-0.037) mmol glucose/min, P = 0.02), and tending to be greater than in the Tai Chi group (mean difference 0.019 (95% CI 0.000-0.038) mmol glucose/min, P < 0.06). CONCLUSION: Tai Chi had no significant effect on any measure compared to the controls, whereas resistance training improved the insulin sensitivity index in this 12-month study.

Aged↗