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PubMed2000

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↗
PubMed2006

Center for Behavioral Neuroscience: a prototype multi-institutional collaborative research center.

The Center for Behavioral Neuroscience was launched in the fall of 1999 with support from the National Science Foundation, the Georgia Research Alliance, and our eight participating institutions (Georgia State University, Emory University, Georgia Institute of Technology, Morehouse School of Medicine, Clark-Atlanta University, Spelman College, Morehouse College, Morris Brown College). The CBN provides the resources to foster innovative research in behavioral neuroscience, with a specific focus on the neurobiology of social behavior. Center faculty working in collaboratories use diverse model systems from invertebrates to humans to investigate fear, aggression, affiliation, and reproductive behaviors. The addition of new research foci in reward and reinforcement, memory and cognition, and sex differences has expanded the potential for collaborations among Center investigators. Technology core laboratories develop the molecular, cellular, systems, behavioral, and imaging tools essential for investigating how the brain influences complex social behavior and, in turn, how social experience influences brain function. In addition to scientific discovery, a major goal of the CBN is to train the next generation of behavioral neuroscientists and to increase the number of women and under-represented minorities in neuroscience. Educational programs are offered for K-12 students to spark an interest in science. Undergraduate and graduate initiatives encourage students to participate in interdisciplinary and inter-institutional programs, while postdoctoral programs provide a bridge between laboratories and allow the interdisciplinary research and educational ventures to flourish. Finally, the CBN is committed to knowledge transfer, partnering with community organizations to bring neuroscience to the public. This multifaceted approach through research, education, and knowledge transfer will have a major impact on how we study interactions between the brain and behavior, as well as how the public views brain function and neuroscience.

Journal Article↗
PubMed2006

Psychological interventions for needle-related procedural pain and distress in children and adolescents.

BACKGROUND: Needle-related procedures are a common source of pain and distress for children. Several psychological (cognitive-behavioral) interventions to help manage or reduce pain and distress are available; however, a previous comprehensive systematic review of the efficacy of these interventions has not been conducted. OBJECTIVES: To assess the efficacy of cognitive-behavioral psychological interventions for needle-related procedural pain and distress in children and adolescents. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 4, 2005), MEDLINE (1966 to 2005), PsycINFO (1887 to 2005), EMBASE (1974 to 2005), the Cumulative Index to Nursing and Allied Health Literature (1982 to 2005), Web of Science (1980 to 2005), and Dissertation-Abstracts International (1980 to 2005). We also searched citation lists and contacted researchers via various electronic list-servers and via email requests. SELECTION CRITERIA: Participants included children and adolescents aged two to 19 years undergoing needle-related procedures. Only randomized controlled trials (RCTs) with at least five participants in each study arm comparing a psychological intervention group with a control or comparison group were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. Included studies were coded for quality using the Oxford Quality Scale devised by Jadad and colleagues. Standardized mean differences with 95% confidence intervals were computed for all analyses using RevMan 4.0 software. MAIN RESULTS: Twenty eight trials with 1951 participants were included. Together, these studies included 1039 participants in treatment conditions and 951 in control conditions. The most commonly studied needle-procedures were immunizations and injections. The largest effect sizes for treatment improvement over control conditions exist for distraction (on self-reported pain, SMD -0.24 (95% CI -0.45 to -0.04), combined cognitive-behavioral interventions--reduced other-reported distress (SMD -0.88, 95% CI -1.65 to -0.12; and behavioral measures of distress (SMD -0.67, 95% CI -0.95 to -0.38) with hypnosis being the most promising--self-reported pain (SMD -1.47, 95% CI -2.67 to -0.27), with promising but limited evidence for the efficacy of numerous other psychological interventions, such as information/preparation, nurse coaching plus distraction, parent positioning plus distraction, and distraction plus suggestion. AUTHORS' CONCLUSIONS: Overall, there is preliminary evidence that a variety of cognitive-behavioral interventions can be used with children and adolescents to successfully manage or reduce pain and distress associated with needle-related procedures. However, many of the included studies received lower quality scores because they failed to describe the randomization procedure and participant withdrawals or drop-outs from the study. Further RCTs need to be conducted, particularly for the many interventions for which we could not locate any trials.

Adolescent↗
PubMed2006

Ethical considerations of neuroscience research: the perspectives on neuroethics in Japan.

Recent technologies and developments in neuroscience have contributed to remarkable scientific discoveries, and have also raised many new philosophical, ethical, legal, and social issues. Research in "neuroethics" has identified various ethical issues, which will be difficult for current biomedical ethics to resolve from both an experimental and a social perspective, such as criminal applications of brain scans, incidental findings during non-clinical brain imaging, and cognitive enhancement. Although American and European neuroscience societies have demonstrated immediate, concrete reactions to these ethical issues, including academic conferences, study programs, and publications, Japanese neuroscientists have so far produced little response. Ethics is tightly linked with one's religion, nationality, culture, and social background, whereas science is tightly linked with the demand, economics, and politics of the society to which individuals belong. Taken together, it is important and necessary for Japanese neuroscientists to consider the ethical problems in Japanese neuroscience. In this paper, we first review the history of neuroethics in the world, and then report the less-developed ethical issues in the Japanese neuroscience community, focusing on neuroimaging and manipulative neuroscience as a first step in discussing how to apply principles in neuroethics to this rapidly progressing field of research.

Bioethical Issues↗
PubMed2002

Medical students' note-taking in a medical biochemistry course: an initial exploration.

Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurate transmission of information, while opponents counter that provided notes inhibit students' cognitive processing or even discourage students from attending lectures. Little if any research has directly addressed medical students' note-taking or the value of providing instructors' notes. The educational literature does suggest that taking lecture notes enhances university students' learning. University students perform best on post-lecture testing if they review a combination of provided notes and their own personal notes, particularly if the provided notes follow a 'skeletal' format that encourages active note-taking.

Biochemistry↗
PubMedDate not supplied

Factors associated with success in searching MEDLINE and applying evidence to answer clinical questions.

OBJECTIVES: This study sought to assess the ability of medical and nurse practitioner students to use MEDLINE to obtain evidence for answering clinical questions and to identify factors associated with the successful answering of questions. METHODS: A convenience sample of medical and nurse practitioner students was recruited. After completing instruments measuring demographic variables, computer and searching attitudes and experience, and cognitive traits, the subjects were given a brief orientation to MEDLINE searching and the techniques of evidence-based medicine. The subjects were then given 5 questions (from a pool of 20) to answer in two sessions using the Ovid MEDLINE system and the Oregon Health & Science University library collection. Each question was answered using three possible responses that reflected the quality of the evidence. All actions capable of being logged by the Ovid system were captured. Statistical analysis was performed using a model based on generalized estimating equations. The relevance-based measures of recall and precision were measured by defining end queries and having relevance judgments made by physicians who were not associated with the study. RESULTS: Forty-five medical and 21 nurse practitioner students provided usable answers to 324 questions. The rate of correctness increased from 32.3 to 51.6 percent for medical students and from 31.7 to 34.7 percent for nurse practitioner students. Ability to answer questions correctly was most strongly associated with correctness of the answer before searching, user experience with MEDLINE features, the evidence-based medicine question type, and the spatial visualization score. The spatial visualization score showed multi-colinearity with student type (medical vs. nurse practitioner). Medical and nurse practitioner students obtained comparable recall and precision, neither of which was associated with correctness of the answer. CONCLUSIONS: Medical and nurse practitioner students in this study were at best moderately successful at answering clinical questions correctly with the assistance of literature searching. The results confirm the importance of evaluating both search ability and the ability to use the resulting information to accomplish a clinical task.

Adult↗
PubMed1999

Evolution of HIV-1 encephalopathy in children.

BACKGROUND: This study has been conducted on a series of HIV-1 infected children, with the aim of illustrating the features of encephalopathy onset, its evolution and its influence on life expectancy. The most useful exams for diagnosis are also outlined. METHODS: The perspective study lasted from January 1989 to June 1997. Forty six symptomatic patients, out of 142 seropositive children, were followed up in the Department of Paediatric and Adolescence Sciences of the University of Turin. The patients, now between 1 yr 2 mth and 13 yr 9 mth old, were born from HIV-1 seropositive mothers; seroreverters have been excluded. Scheduled neuropsychiatric consultations were used, consisting of a neurologic exam and an interview with parents, cognitive evaluations, EEGs, Evoked Potentials and CT scans. The results have been evaluated with log-rank test for the analysis of the survival curves. RESULTS: We found a significantly higher mortality rate in encephalopathic versus non encephalopathic patients; encephalopathic patients, in whom neurologic signs began in the first year of life, have a worse prognosis than the other patients, in whom encephalopathy appeared later. We did not find a statistical correlation between clinical course and immunological deficit. The clinical features of encephalopathy are mainly characterized by pyramidal signs and cognitive deterioration. Clinical sign evolution is linked to the age of encephalopathy onset: plateau pattern encephalopathy, characterized by an early onset, severe motor signs and cognitive delay from the very beginning, shows a greater severity and a shorter survival than progressive encephalopathy, characterized by a slowly progressive evolution of pyramidal signs, to which a cognitive deterioration may be added. CONCLUSIONS: Neuropsychological exams can be helpful in the diagnosis and follow-up of encephalopathy.

AIDS Dementia Complex↗
PubMed2005

Ethology and the biological correlates of mood.

The insights of ethology-the science of animal behavior from a biological and psychological point of view-were incorporated in the 1950s by the British developmental psychiatrist, John Bowlby, into his attachment theory, which argued that a secure affective base in infancy was critical to the normal development of perception, cognition, learning, and emotion, in addition to that of physical parameters. The theory was illustrated by Harlow's pioneering experiments with baby monkeys: those raised with a wire-frame "mother" failed to thrive, compared with the more normal development of those deriving comfort contact from a terry-cloth surrogate. Modern neuroscience techniques have confirmed that the absence of sensory stimulation during periods of maximal synaptic expansion provides the substrate for a subsequent mood disorder. Ethology offers a novel "nature plus nurture" approach to the development of abnormal mood, as well as a target for treatment.

Affect↗
PubMed1990

American conceptions of infant development from 1955 to 1984: what the experts are telling parents.

The efforts of the child development movement to understand development and the factors influencing it have been the basis of 2 interrelated tasks: the scientific study of children, and the dissemination of this knowledge to parents. Content analysis is used to assess the extent to which psychological theories and research about infants have been communicated to parents from 1955 to 1984 in 2 popular publications, the Infant Care manual and Parents magazine. Results indicated that there is not a singular relation between what experts know and what is communicated to parents. Information reflecting scientific advances about the biological components of infant development (perception, cognition, and temperament) have been most accurately communicated to parents, whereas discussions of the mother-infant relationship, child care, feeding, and fathers appeared to be related to the broader cultural context and demographic changes over the past thirty years. This study reveals an interaction between science and culture in our theories of infant development and child rearing.

Child Development↗
PubMed1998

Cybersemiotics: a transdisciplinary framework for information studies.

This paper summarizes recent attempts by this author to create a transdisciplinary, non-Cartesian and non-reductionistic framework for information studies in natural, social, and technological systems. To confront, in a scientific way, the problems of modern information technology where phenomenological man is dealing with socially constructed texts in algorithmically based digital bit-machines we need a theoretical framework spanning from physics over biology and technological design to phenomenological and social production of signification and meaning. I am working with such pragmatic theories as second order cybernetics (coupled with autopolesis theory), Lakoffs biologically oriented cognitive semantics, Peirce's triadic semiotics, and Wittgenstein's pragmatic language game theory. A coherent synthesis of these theories is what the cybersemiotic framework attempts to accomplish.

Cybernetics↗
PubMedDate not supplied

Mind-body medicine: state of the science, implications for practice.

BACKGROUND: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions. METHODS: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials. RESULTS: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies. CONCLUSIONS: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.

Cardiovascular Diseases↗
PubMed1997

Current advances in Alzheimer's disease. A medical model paradigm for psychiatric education.

Psychiatrists have the expertise to play a major leadership role in the diagnosis and treatment of Alzheimer's disease. Psychiatry residents should be trained to recognize both the cognitive and noncognitive symptoms of this disease. Psychiatrists are in an excellent position to keep up with the rapidly expanding pharmacologic armamentarium to treat this devastating illness. Although such potentials are exciting, they undoubtedly will be complicated. Residency directors and departmental chairs should instill enthusiasm toward basic science advances and their clinical implications. Understanding the mechanisms underlying specific central nervous system illnesses should increase the likelihood of discovering the pathophysiology of others. The more psychiatrists and psychiatric residents become interested in these discoveries and the science underlying such progress in Alzheimer's disease, the better they will be able to keep up to date with progress in understanding other psychiatric disorders.

Aged↗
PubMed1994

Science, medicine and phenylketonuria.

Science addresses ignorance; medicine uses facts. The scientific approach to phenylketonuria (PKU) led to the discovery of its causes, both ultimate (allelic heterogeneity at the PAH locus) and proximate (dietary phenylalanine), the proximal phenotype (phenylalanine hydroxylase deficiency), the associated metabolic phenotype and the major distal phenotype (impaired cognitive development and neuropsychological function) for which the pathogenesis is still being investigated. By applying knowledge through newborn screening, early diagnosis and treatment, the brain disease of PKU has been greatly ameliorated. The population approach, which converted incidence into cases, revealed genetic heterogeneity in hyperphenylalaninemia involving four other loci, controlling cofactor (BH4) synthesis and recycling, and non-random geographic distribution of mutant PAH alleles of which more than 170 were known in April 1994. Various mechanisms including founder effect, genetic drift, hypermutability and selection (perhaps) explain the polymorphic aggregate frequency (approximately 0.01) and spectrum of PKU mutations in human populations.

Alleles↗
PubMed1984

Suffering for science: the effects of implicit social demands on response to experimentally induced pain.

In two experiments subjects rated their pain during baseline trials of cold pressor and finger pressure pain. After various instructional treatments, they were posttested with these same stimuli. As in previous studies, we found in both experiments that coping suggestions significantly reduced reported pain. Experiment 1, however, demonstrated that subjects often refrained from using available cognitive coping strategies to reduce pain unless they had been given explicit permission to do so. Experiment 2 replicated this finding and also showed that explicit permission to "do whatever you can to reduce pain" was as effective as a coping suggestion in decreasing reported pain. These findings indicate that subjects' interpretation of what is appropriate responding in the test situation determines how they choose to cope with the painful stimulation. Thus standard experimental procedures for assessing baseline levels of pain implicitly lead subjects to refrain from coping and thereby tend to underestimate their ability to control pain. Moreover, suggestions and other instructional techniques for coping with pain may produce much of their effect not by teaching subjects new coping skills but instead by giving them permission to use already available coping strategies.

Adolescent↗
PubMed2005

Generalised biological function.

A physiological function can be described as a cycle based on a cusp bifurcation set in catastrophe theory. This cycle involves four phases that are successively developed along a functional potential, which is used to perform a given physiological act. The work we present is firstly based on a detailed study of the global function of vision, which covers a vast field extending from the molecular to cerebral scale. We then present other examples of generalised functions by expanding the frame of reference, from the scale of an organ to the scale of a whole organism with predation function, and to the scale of a social group with crisis management. We observed that the criteria remain the same, whether the function is considered on the scale of a cell membrane or a group of individuals organised into a cohort. Moreover, a so-called generalised function can be broken down into simpler sub-functions, each phase of the initial function containing the physiological act of each sub-function. It seems thus that a fractal extension may characterise the four-cusp spiral. This spiral is increasingly large as the types of sub-functions are multiplied. In functions relative to sociological science, such as crisis management, which are not natural but built and designed by humans, close attention must be paid to following the rules of these generalised biological functions.

Animals↗
PubMed1996

Olfactory remediation: current evidence and possible applications.

A number of recent psychological investigations has suggested a significant role for olfactory stimulation in the alteration of cognition, mood and social behaviour. These orthodox investigations have a common, if uneasy, relationship with the holistic practice of so-called aromatherapy. This paper reviews the therapeutic effects of dour on health-related behaviour. It distinguishes two types of research activity, one which is quantitative and science- and medicine-based, the other which is qualitative and anecdote- and experience-based. Both of these endeavours are critically assessed and suggestions are made for improvement in methodology and experimental design.

Aromatherapy↗
PubMed2006

Role of the left inferior frontal gyrus in covert word retrieval: neural correlates of switching during verbal fluency.

Word retrieval ability is commonly assessed with a semantic verbal fluency task, in which subjects must produce a list of exemplars of a category (e.g., animals). The order in which exemplars are produced is not random; rather, subjects tend to produce "clusters" of semantically related items (e.g., cow, pig, sheep) and occasionally "switch" to other clusters (e.g., lion, tiger, bear). Patients with frontal lobe pathology (associated with focal lesions or Parkinson's disease) exhibit reduced output on semantic fluency tasks that has been characterized as a reduction in switching, in contrast to other impaired patient groups who produce normal switches but smaller clusters (e.g., [Troyer, A. K., Moscovitch, M., Winocur, G., Leach, L., & Freedman, M. (1998). Clustering and switching on verbal fluency tests in Alzheimer's and Parkinson's disease. Journal of the International Neuropsychological Society, 4(2), 137-143]). The ability to initiate a switch between two semantic categories may require the selection of weakly activated representations over active (but already reported) representations. Previous studies have shown that increased demands on selection among competing representations are associated with activity in the left inferior frontal gyrus (LIFG) and with deficits in patients with lesions including LIFG [Thompson-Schill, S. L., Jonides, J., Marshuetz, C., Smith, E. E., D'Esposito, M., Kan, I. P., et al. (2002). Effects of frontal lobe damage on interference effects in working memory. Cognitive Affective & Behavioral Neuroscience, 2(2), 109-120; Thompson-Schill, S. L., Swick, D., Farah, M. J., D'Esposito, M., Kan, I. P., & Knight, R. T. (1998). Verb generation in patients with focal frontal lesions: A neuropsychological test of neuroimaging findings. Proceedings of the National Academy of Sciences of the United States of America, 26, 14792-14797]. In the present study, we investigated the neural correlates of switching in the verbal fluency task, and in particular, the role of the LIFG in switching between semantic sub-categories. We observed greater activation in the LIFG during switching compared to free generation (Experiment 1) and self-reported clustering (Experiment 2), which is consistent with the hypothesis that the switching mechanism is subserved by the LIFG due to high semantic selection demands.

Adult↗
PubMed2026

A systematic review of sleep hygiene interventions in physically and operationally demanding occupations.

Workers in physically and operationally demanding (POD) occupations (e.g. military personnel, emergency responders, law enforcement) experience disrupted sleep due to irregular schedules and high-stress work environments. Given the importance of sleep for physical and cognitive performance, interventions to improve sleep in POD occupations are crucial yet remain under-researched. To investigate the effectiveness of sleep hygiene interventions in improving sleep quality and quantity outcomes for POD occupations, a systematic review was conducted across five databases (PubMed, CINAHL, SPORTDiscus, PsycINFO, Web of Science) in September 2024. Eligible studies involved workers in POD occupations where a sleep hygiene intervention was compared against a waitlist or passive control. Ten studies were included, eight randomised controlled trials (RCTs) and two non-randomised controlled trials (NRCTs). Narrative synthesis identified Structured Training Programs (n = 7), Phone Assistance Programs (n = 2), and Single Lecture Interventions (n = 1). Evidence certainty ranged from Very Low to Moderate, converging towards Low quality due to imprecision, risk of bias, and indirectness. Structured Training Programs showed moderate improvements in sleep quality and small-to-moderate effects on sleep duration. Phone Assistance Programs had minimal effects, and Single Lecture Interventions had negligible impact. Higher-quality research is urgently needed to assess sleep hygiene interventions in POD occupations.

Humans↗