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PubMedDate not supplied

Theory of mind and pragmatic abilities in dementia.

OBJECTIVE: "Theory of Mind" (ToM) is the capacity to attribute mental states to oneself and to others and to interpret behavior in terms of mental states. Deficits in both ToM and pragmatic abilities have been described in patients with neurologic disorders, such as frontal lobe lesions and right hemisphere strokes, but have not been assessed in demented patients. METHODS: This study examined ToM and pragmatic abilities in a consecutive series of 34 patients with probable Alzheimer disease (AD) using a second-order false belief story, 11 short stories assessing understanding of social situations, and a test of pragmatic abilities assessing both indirect requests and-conversational implications. RESULTS: Sixty-five percent of AD patients with mild dementia could not pass a second-order false belief task, whereas no failures were found in a group of 10 age-comparable healthy controls. AD patients who did not pass the second-order false belief task had more severe deficits on tests of verbal anterograde memory, verbal comprehension, abstract thinking, and naming, as compared with AD patients who passed the task. AD patients also showed significantly more severe pragmatic deficits than age-comparable healthy controls, and there was a significant association between ToM and pragmatic deficits. On the other hand, there were no significant associations between ToM or pragmatic deficits, and behavioral problems frequently reported in AD such as depression, delusions, apathy, and irritability. CONCLUSIONS: This initial exploratory investigation demonstrated significant deficits in both ToM and pragmatic abilities in a consecutive series of AD patients with mild dementia.

Aged↗
PubMedDate not supplied

Healing the body, mind and spirit.

Hospitals are, first and foremost, places that function to treat what ails the body. But for those who are not well and their caregivers, hospitals should also offer a source of comfort to the mind and spirit. In response to that need, Sparrow Health System of Lansing has created a special place for their community to go to heal.

Community-Institutional Relations↗
PubMed2001

The mind in REM sleep: reports of emotional experience.

STUDY OBJECTIVES: No consensus has been reached on the characteristics of emotional experience during rapid eye movement sleep (REM). Thus, the relationship between the emotional brain activation and mental activity in REM remains unclear. Our objective is to characterize emotional experience in REM in order to facilitate understanding of brain-mind correlations in this state. DESIGN: We combined instrumental awakenings from REM with the subjects' own ratings of the occurrence and intensity of discrete emotion types for each line in their REM mentation reports. SETTING: The study was performed in the subjects' own homes over three consecutive nights using ambulatory polysomnography. PARTICIPANTS: Nine normal healthy subjects, age 31-60 (mean=43.0). INTERVENTIONS: Awakenings 5-15 minutes into REM periods across the night. MEASUREMENTS AND RESULTS: Emotions were found in 74% of 88 mentation reports, with a balanced proportion of positive and negative emotions. Among the reports scored for emotions, 14% contained one emotion and 86% contained two or more different emotion types. Joy/elation was the most frequent emotion, found in 36% of the reports, followed by surprise (24%), anger (17%), anxiety/fear (11%), and sadness (10%). Anxiety/fear was significantly less intense than joy/elation, anger, and surprise. Except for surprise, no specific emotion type changed from the first to the second half of the night. Negative emotions and surprise but not positive emotions varied significantly across subjects. CONCLUSIONS: The analysis of subject reports of emotions following instrumental awakenings demonstrate a balanced and widespread occurrence of both positive and negative emotions in REM sleep dreams. Emotions in REM are likely to be powerfully modulated by the neurobiological processes which differentiate REM from waking.

Adult↗
PubMedDate not supplied

Mindfulness-based stress reduction and healthcare utilization in the inner city: preliminary findings.

CONTEXT: Research on mindfulness-based stress reduction (MBSR) has focused on measuring symptom reduction in middle-class and working-class populations. The present study examined inner-city patients' healthcare utilization before and after an MBSR intervention. OBJECTIVE: To determine whether completion of an MBSR program resulted in changes in healthcare utilization in an inner-city population. DESIGN: Medical chart review compared the number and diagnoses of health center visits during the year before patients entered the MBSR program with the year following completion of the program. SETTING: The Community Health Center in Meriden, Conn. PATIENTS: The chart review process examined healthcare utilization patterns for 73 patients: 54 who completed the MBSR program in Spanish and 19 who completed the program in English. The focus of this study is a subgroup of 47 patients for whom a complete year of data were available before and after the intervention. INTERVENTION: An 8-week course in MBSR. MAIN OUTCOME MEASURES: The number and diagnoses of patients' health center visits before and after completion of the MBSR program. RESULTS: A significant decrease in the number of chronic care visits was found among the 47 patients for whom complete data were available. The 36 patients who completed the Spanish courses demonstrated a significant decrease in total medical visits and chronic care visits. CONCLUSIONS: The results of this study suggest that MBSR may help contain healthcare costs by decreasing the number of visits made by inner-city patients to their primary care providers after completing the MBSR program.

Adult↗
PubMed2001

Canadian governance of health research involving human subjects: is anybody minding the store?

From an ethical perspective, good governance involves the translation of collective moral intentions into effective and accountable institutional actions. With respect to the use of human subjects in Canadian health research, I contend that there have been many good intentions but very little in the way of appropriate governance arrangements. Hence, the question, "who minds the store?" is especially acute with respect to the protection of vulnerable individuals and groups that are typically recruited as subjects for health research in Canada. Beyond diagnosing failures in governance and their causes, I offer suggestions for significant reforms, including evidence-based ethics assessment, independent oversight, and greater participation of research subjects in governance. I will close with some more general reflections on ethics, law, and governance.

Canada↗
PubMedDate not supplied

Bountiful health care and A Beautiful Mind.

The Nash Equilibrium (put forward by John Nash and celebrated in the film, A Beautiful Mind) mathematically describes multi-player, infinite games. It is a general description of large human transactions, such as health care. Learn how new inputs, new players or new resources can disrupt these transactions.

Delivery of Health Care↗
PubMed2001

[Neuro-infections to be borne in mind].

We presented atypical manifestations in tuberculous meningitis (TbM) and herpes simplex encephalitis (HSE), lymphocytic dominant cerebrospinal fluid pleocytosis in bacterial meningitis, and a hitherto easily overlooked critical illness polyneuropathy (CIP) associated with sepsis. 1) We presented 2 TbM patients with atypical manifestations. One patient was a 25-year-old man who exhibited polymorphonuclear (PMN) dominant pleocytosis in CSF throughout his clinical course. He died the next day after a CSF culture yielded the growth of tuberculous bacilli, before receiving appropriate anti-TBM therapy. This was a rare TbM example of persistent PMN dominant CSF pleocytosis. The other patient was a 39-year-old woman whose CSF pleocytosis changed from lymphocytic dominant to PMN dominant about 1 month after the initiation of antituberculous chemotherapy. This CSF change was followed by multiple cerebral infarcts due to vauculitis caused by TbM. Administration of prednisolone caused marked improvement of the patient's symptomatology. Tuberculomas appeared transiently during anti-TbM therapy, consistent with paradoxical progression of tuberculoma. 2) A few patients with HSE may show atypical CSF findings such as PMN dominant pleocytosis, absence of pleocytosis, and low sugar value. Our national survey of HSE patients showed following percentages of these atypical findings: PMN dominant pleocytosis observed in 10% of the patients in the early stage and at the time of exacerbation, no pleocytosis in 0.9% (1 patient), and low sugar value in 4%. 3) Bacterial meningitis typically causes PMN dominant CSF pleocytosis. However, Listeria meningitis (LM) may cause lymphocytic dominant pleocytosis in 30% of the patients, particularly in elderly ones. We showed one such 69-year-old patient with persistent lymphocytic dominant CSF pleocytosis throughout the clinical course. 4) CIP, septic encephalopathy and critical illness myopathy are 3 major complications associated with sepsis. CIP is a frequent cause of neuromuscular weakness due to axonal dysfunction, which occurs to critically ill patients with sepsis, particularly when multiple organ dysfunctions are present. We showed our CIP patient associated with acute bacterial endocarditis and multiple organ failure. We should bear in mind these atypical manifestations, and frequent and important complications associated with sepsis such as CIP, to provide appropriate management to patients with neuro-infection and sepsis.

Adult↗
PubMed2001

"It's all in your mind": The final common pathway.

The relatively new field of Psychoneuroimmuonology (PNI) seeks to reveal links between many systems of the body once thought to work independently of each other. Through a growing body of research, scientists are revealing that what goes on in our mind impacts not only our mental well being but our state of physical health. Presented here is an overview of the stress response and discussion regarding the effects of stress on physiological processes. Of particular interest is the role stress plays on the ability of the immune system to function properly. Both landmark and current research is cited which supports connections between these systems. Finally, the future of PNI is discussed as well as the role health care providers may take to embrace mind/body philosophies.

Journal Article↗
PubMed2002

Comparative approaches in evolutionary psychology: molecular neuroscience meets the mind.

Evolutionary psychologists often overlook a wealth of information existing between the proximate genotypic level and the ultimate phenotypic level. This commonly ignored level of biological organization is the ongoing activity of neurobiological systems. In this paper, we extend our previous arguments concerning strategic weaknesses of evolutionary psychology by advocating a foundational view that focuses on similarities in brain, behavior, and various basic psychological features across mammalian species. Such an approach offers the potential to link the emerging discipline of evolutionary psychology to its parent scientific disciplines such as biochemistry, physiology, molecular genetics, developmental biology and the neuroscientific analysis of animal behavior. We detail an example of this through our impending work using gene microarray technology to characterize gene expression patterns in rats during aggressive and playful social interactions. Through a focus on functional homologies and the experimental analysis of conserved, subcortical emotional and motivational brain systems, neuroevolutionary psychobiology can reveal ancient features of the human mind that are still shared with other animals. Claims regarding evolved, uniquely human, psychological constructs should be constrained by the rigorous evidentiary standards that are routine in other sciences.

Adaptation, Psychological↗
PubMedDate not supplied

Down's syndrome-associated single minded gene as a novel tumor marker.

The Cancer Genome Anatomy Project (CGAP) database has thousands of Expressed Sequence Tags encompassing both known and novel genes. Bioinformatics of the CGAP database led to the prediction that Single Minded Gene (sim2) could be specific to colon tumors. The sim2 gene is located in a minimum region of the chromosome 21 often implicated in trisomia called Down's Syndrome Critical Region. To date, the sim proteins have not been shown to be involved in cancer. Intrigued by the possible association of a Down's syndrome-related gene to solid tumors, efforts were undertaken to validate the expression specificity. The sim2 isoform (sim2-short-form, sim2-s) expression was seen in carcinomas of colon, pancreas and prostate, but not in corresponding normal tissues. Stage-specific expression of the sim2-s protein was seen in normal matched paraffin sections of the colon tumors. In a matched set of tissues of Benign Prostatic Hyperplasia (BPH) and prostate carcinomas, sim2-s expression was detected in the BPH. The expression specificity of sim2-s in select solid tumors offers both diagnostic and therapeutic potential and warrants additional study.

Adenoma↗
PubMedDate not supplied

The mind's eye: functional MR imaging evaluation of golf motor imagery.

BACKGROUND AND PURPOSE: Mental imagery involves rehearsing or practicing a task in the mind with no physical movement. The technique is commonly used, but the actual physical foundation of imagery has not been evaluated for the fast, complex, automatic motor movement of the golf swing. This study evaluated motor imagery of the golf swing, of golfers of various handicaps, by using functional MR imaging to assess whether areas of brain activation could be defined by this technique and to define any association between activated brain areas and golf skill. METHODS: Six golfers of various handicap levels were evaluated with functional MR imaging during a control condition and during mental imagery of their golf swing. Two control conditions were evaluated--"rest" and "wall"--and were then subtracted from the experimental condition to give the functional activation map. These control conditions were then tested against the golf imagery; the participants were told to mentally rehearse their golf swings from a first person perspective. The percentages of activated pixels in 137 defined regions of interest were calculated. RESULTS: The "rest-versus-golf" paradigm showed activation in motor cortex, parietal cortex, frontal lobe, cerebellum, vermis, and action planning areas (frontal and parietal cortices, supplementary motor area, cerebellum) and areas involved with error detection (cerebellum). Vermis, supplementary motor area, cerebellum, and motor regions generally showed the greatest activation. Little activation was seen in the cingulate gyrus, right temporal lobe, deep gray matter, and brain stem. A correlation existed between increased number of areas of activation and increased handicap. CONCLUSION: This study showed the feasibility of defining areas of brain activation during imagery of a complex, coordinated motor task. Decreased brain activation occurred with increased golf skill level for the supplementary motor area and cerebellum with little activation of basal ganglia.

Adult↗
PubMed1992

Approach to organic psychiatry or the dialogue between brain and mind.

This article describes the evolution of concepts of the relationship between brain and mind. Instead of the earlier dualistic approach to mental and brain disorders, we are nowadays confronted with a new approach where the boundaries between these two "worlds" become more and more blurred.

Biological Psychiatry↗
PubMed2003

Do vaccines cause harm? The need for open-minded analysis based on science and reason.

Public concern about the safety of vaccines began when vaccination began, in the 18th century. Major resistance to vaccinations in the 1980s threatened to shut down vaccine manufacture and immunization programs. The US Congress responded with legislation in 1986-1987 that established a compensation program, communication strategies, and a process of objective, science-based analysis by the Institute of Medicine of whether childhood vaccines cause any of an array of possible adverse events. Since then, research, detection, communication, and education related to vaccine safety have improved but remain less than perfect. All of us who care about children, our own or in the abstract, will serve our children best if we remain vigilant and open-minded in considering issues of vaccine safety, and if we base our conclusions and actions on science, not emotion.

Attitude to Health↗
PubMed2004

Mindfulness meditation training combined with eye movement desensitization and reprocessing in psychotherapy of an elderly patient.

We present our experiences with an elderly patient with depression that was attributed to a surge of physical ailments who also had trauma-derived fear of having to undergo a tracheotomy. He refused pharmacotherapy and was offered intensive training in Mindfulness Meditation (MM) plus Eye Movement Desensitization and Reprocessing (EMDR) therapy during the 2 weeks of hospitalization. This treatment combination had not been used previously. We suggest that EMDR eliminated his fear of surgery, whereas MM relieved his depression and attendant anxiety. However, the two techniques appeared to work synergistically. Following his discharge, he continued to practice MM, which prevented the recurrence of emotional distress, and even helped to reduce its causative physical symptoms. We offer an explanation for the success of our combined treatments and discuss the potential usefulness in specific psychotherapeutic situations. We also propose a place for MM within general geriatric care, and point out the reluctance to consider the therapeutic value of meditation.

Aged↗
PubMed2004

Theory of Mind and social beliefs in adolescents with traumatic brain injury.

Impairments in social performance are common consequences of TBI, yet the neuropsychological basis of these impairments is not well understood. This is particularly true for adolescents, who have the highest incidence of TBI and are at a critical stage of developing social and relationship skills. To address this, adolescents with TBI were compared to their typically developing peers on a social cognition task that included Theory of Mind (ToM) questions. As ToM may be necessary for the development of culture-specific social knowledge, the two groups also were compared in regard to their social beliefs. There were significant differences between injured and uninjured adolescents in social cognition, with group differences increasing as a function of the requirement for ToM. There were few differences in self-reported social knowledge and social beliefs. The implication of this discrepancy for the rehabilitation of adolescents with TBI is discussed.

Adaptation, Psychological↗
PubMed2004

Mind-refreshing acupuncture therapy for facial spasm, trigeminal neuralgia and stubborn facial paralysis.

It has been proved by clinical experiment that needling at Fengchi (GB 20), Wangu (GB 12) and Tianzhu (BL 10) can markedly improve the blood supply to the vertebral basilar artery, increase the cerebral blood flow, and relax the spasm of the vascular smooth muscles. The combined use of Shangxing (GV 23) and Yintang (EX-HN3) can give the effects of resuscitating and tranquilizing the mind, dispelling wind, dredging the channels, and relieving spasm and pain. In short, the above therapy may turn the pathological state into a normal physiological state, and bring a quicker recovery for patients with facial spasm, trigeminal neuralgia and stubborn facial paralysis.

Acupuncture Therapy↗
PubMedDate not supplied

[Analysis of a school timetable, bearing in mind the health status of children].

A type of medical examination of a school timetable is proposed, by bearing in mind the actual educational price established at a specific educational establishment. The ratio of the physiological and emotional stress in pupils during schooling to their learning progress and physical fitness is the price of schooling. The study has revealed no direct relationship between the level of schooling load and the price of education. There are difficulties in learning within the first days of a week and a need for additional efforts to maintain the pupils' working capacity at the end of a week.

Adolescent↗