Proceedings of the 10th international conference on disability, virtual reality and associated technologies (ICDVRAT 2014)

The proceedings of the conferenc

Effectiveness of virtual reality therapy upon anger among alcoholic clients

A Pre Experimental Study to Assess the Effectiveness of Virtual Reality Therapy upon Anger among Alcoholic Clients at Selected De-Addiction Center, Chennai. Objectives of the Study : 1. To assess the level of anger among alcoholic clients before and after Virtual reality therapy. 2. To evaluate the effectiveness of virtual reality therapy by comparing the level of anger among alcoholic clients before and after virtual reality therapy. 3. To determine the level of satisfaction on virtual reality therapy among alcoholic clients. 4. To find out the association between selected demographic variables and the level of anger among alcoholic clients before and after virtual reality therapy. 5. To find out the association between selected clinical variables and the level of anger among alcoholic clients before and after virtual reality therapy. The conceptual framework of the study was based on Hildegard E Peplau which was modified for the present study. Null hypothesis were formulated. The level of significance selected was P<0.05. The research design used in this study was pre - experimental research design. A one group pre-test, post-test design, which is pre experimental in nature, is adopted for conducting the study. An extensive review of literature and guidance by experts formed the foundation to the development of research tools such as Demographic variables proforma, Clinical variables Proforma, Clinical anger scale and Rating Scale on the level of satisfaction about Virtual reality therapy. The content validity was established by submitting the tools to experts and reliability was obtained through test-retest and split half technique and found to be highly reliable. The main study was conducted after the pilot study. The study was carried out upon 30 alcoholic clients, Serene Life Deaddiction center Madhurvoyal, Chennai. The level of anger was assessed before and after virtual reality therapy using Clinical anger scale in the group of alcoholic clients. Virtual reality therapy was administered every day morning 5 – 7 minutes for the period of one week for each alcoholic client. After one week, the level of anger was assessed by using Clinical anger scale among the alcoholic clients. Then the level of satisfaction on virtual reality therapy was also assessed by using satisfactory rating scale. The data obtained were analyzed using Descriptive and Inferential statistics. Major findings of the study : A Significant percentage of the alcoholic clients were aged upto 30 years (46.66%) with mean age of 32.9 years and had a family history of alcohol abuse/ dependence (33.33%), were involved in business (36.66%) and had no children (43.33%), were graduates (33.33%). • All of the alcoholic clients were from urban background and from nuclear family (100%) and majority of them were Hindus (86.66%) with monthly family income of Rs. 5001- 10,000 (60%). More than half of them were married (56.66%). • Majority of the alcoholic clients started consuming alcohol at the age of 16-25 years (63.33%) with mean age of 22.5 years, had a previous history of alcoholics de-addiction treatment (66.66%) and made an effort to quit alcohol (76.66%) and the form of alcohol used was beer (73.33%), psychosocial problems of alcoholic clients was conflicts in relationship (66.66%). • More than half of them had excited feeling at first intake of alcohol (59%) and the precipitating factor of consuming alcohol was family problem (53.33%). • Half of the alcoholic clients had wish to improve oneself in motivation to seek treatment (50%) and had >5 years duration of alcohol dependence (50%). • A significant percentage of the alcoholic clients consumed the amount of alcohol was more than 720 ml in a day (43.33%) and the form of alcohol used was brandy (23.33%), rum (1.33%) and frequency of alcohol consumption (30%). • A significant percentage of the alcoholic clients had moderate level of anger (36.66%) in pretest. However after administration of Virtual reality therapy more than half of them had mild level of anger (56.66%). • The anger score of alcoholic clients were high in pretest (M = 29.16, SD = 7.8) whereas after virtual reality therapy, it was found to be less (M =17.3, SD=4.50). The difference was statistically proven to be highly significant at P<0.001. Thus the null hypothesis Ho1 was rejected. It can be attributed to the effectiveness of virtual reality therapy on reducing anger. • There was no significant association between the level of anger and the selected demographic and clinical variables among alcoholic clients. Hence, the null hypothesis Ho2 and Ho3 was retained. Lack of association in this study may be due to small sample. • The researcher found that all of the alcoholic clients were highly satisfied (100%) regarding the intervention of virtual reality therapy. These findings indicated that the administration of virtual reality therapy is well accepted by all the alcoholic clients. This study demonstrated that virtual reality therapy will help to reduce the level of anger among alcoholic clients. Recommendations : The study can be conducted on a larger sample to generalize the results. • The study can be conducted in the other settings also like psychiatric hospitals and rehabilitation centers. • Longitudinal study can be conducted for long term effects of virtual reality on anger. • A comparative study can be conducted to evaluate the effectiveness of virtual reality therapy and with other psychosocial intervention to reduce the level of anger among alcoholic clients. • The study can be conducted among different groups like adolescents, mentally ill patients, teenagers who abuse other substances, family members of alcoholic clients. • A follow up study can be conducted to assess the effectiveness of the present intervention in reducing the relapse rates of alcoholic clients. • A study can be conducted on quality of life among alcoholic clients

System biology of alcoholism: Understanding of the consequences of the metabolism in brain cells

The addictive drug ethanol represents a serious universal health and social problem. Alcohol abuse and dependency have been increasing in many countries worldwide. Chronic use of alcohol leads to metabolic abnormalities and damage to the brain, which can result in severe cognitive dysfunction and addiction. Areas of the brain such as prefrontal cortex (PFC), the white matter, the hippocampus (HP), the cerebellum and the striatum are particularly vulnerable to the effects of alcohol. The striatum (ST), a region of brain closely associated with addiction mechanisms, is commonly divided into two regions, dorsal (DS) and ventral striatum (VS); the DS comprising caudate nucleus (CN) and putamen (P) while the VS is constituted mainly by nucleus accumbens (NAc). Neuroimaging analysis indicates that microstructural degradation is occurring in alcohol-affected brains and the abnormalities may be correlated with altered locomotor activity, aggressive behavior, changes in reward/aversion-related learning, deficient motor coordination, disturbances in procedural learning and memory. The NAc is strongly implicated in drug addiction but current evidence suggests that DS has also a significant role in this process. One of the aims of the project is to carry out comparative study of the sub-regions of human alcoholic striatum using two omics technologies (proteomics and metabolomics). There were no differences in the levels of dopamine (DA), 3,4-dihydrophenylacetic acid (DOPAC), serotonin (5HT), homovanillic acid (HVA), 5-hydroxyindoleacetic acid (HIAA), histamine, L-glutamate (Glu), -aminobutyric acid (GABA), tyrosine (Tyr) and tryptophan (Tryp) between the DS (CN and P) and VS (NAc) in control brains. Choline (Ch) and acetylcholine (Ach) were higher and, norepinephrine (NE) is lower, in the VS Overall. Alcohol-affected ST had lower levels of neurotransmitters except for Glu (30% higher in the alcoholic ventral striatum). Ratios of DOPAC/DA and HIAA/5HT were higher in alcohol-affected ST indicating an increase in the DA and 5HT turnover. Glutathione was significantly reduced in all three regions of alcohol-affected ST. The pattern of changes of 13 neurometabolites in alcoholic sub-regions relative to their respective control was similar. In order to investigate correlations between the alcohol-related changes in metabolites and and altered protein expressions, the author has selected a single sub-region of ST for a global proteomics study. By analysing CN tissues, 25 unique proteins were found to be differently expressed in alcohol-affected tissue 9 relative to control. From the identified proteins two were dopamine-related proteins and one a GABA-synthesizing enzyme glutamate decarboxylase (GAD) 65. Two proteins that are related to apoptosis and/or neuronal loss (BiD and amyloid-β A4 precursor protein-binding family B member 3) were increased. These results suggest that neurotransmitter metabolism and systems possibly related to neuroprotective mechanisms in both the DS (CN and P) and the VS (NAc) are significantly influenced by long-term heavy alcohol intake associated with alcoholism. Amongst the mechanisms mediating the effects of alcohol oxidative stress may have produce a particularly significant impact and could make a strong contribution to the microstructural damage. It has been known that alcohol can have a particularly damaging effect on the PFC and the HP regions of the fetus/developing/adolescent brain. The change imparted at those stages of development could be irreversible resulting in lasting deficits in a range of personality traits and impacting decision making, memory and learning. The HP is a significant place of neurogenesis and a source of neural stem cell (NSC). These can differentiate into neurons, astrocytes and oligodendrocytes and constitute building blocks of the developing central nervous system. They can also contribute to brain repair at later stages of development and, possibly, even in adulthood. On current evidence, alcohol reduces neurogenesis but little or no tangible information is available on the actual biochemistry and/or the fate of NSC. In the present experiments, the NSC obtained from rat embryos were exposed to various concentrations of ethanol (25 to 100 mM) for up to 96 hours. The cell numbers were found to be reduced in the presence of ethanol but only at the higher concentrations (50 and 100 mM). There were no apparent dramatic changes in the morphology of the cells but the numbers of neuron-like (MAP2-positive) cells were reduced by ethanol in a dose-dependent manner. In proteome analysis of alcoholic cells, a total of 28 proteins were altered in 50 mM ethanol relative to ethanol-free control. Of these proteins some were constituents of cytoskeleton, others were involved in transcription/translation, energy metabolism, signal transduction and oxidative stress. Two of the proteins identified as altered were nucleophosmin (NPM) and dead-end protein homolog 1 (DND1). These were further studied by immunological techniques in cultured neurons and astrocytes. NPM decreased and DND1 increased in both alcohol affected neurons and astrocytes cells

Relationship between lifestyle factors and neurodegeneration in midlife as expressed on arterial spin labelling and structural magnetic resonance imaging

Introduction: Studies have demonstrated a relationship between neurodegeneration and lifestyle factors. Neurodegeneration in midlife (40 – 59 years old) can be assessed using neuroimaging. The aim of the thesis was to evaluate the relationship between lifestyle factors and neurodegeneration in midlife as expressed on arterial spin labelling and structural magnetic resonance imaging. Methods: A systematic review of the relationship between lifestyle and neurodegeneration in midlife as expressed on functional magnetic resonance imaging (fMRI) was undertaken. Additionally, the impact of lifestyle on the arterial spin labelling (ASL) and structural magnetic resonance imaging (sMRI) expression of neurodegeneration in a midlife cohort was analytically assessed. Results: Seven lifestyle factors associated with neurodegeneration in midlife as expressed on fMRI were identified by the systematic review. Using data from the PREVENT Dementia cohort, linear regression analysis demonstrated multiple associations between lifestyle and neurodegeneration in midlife as expressed on ASL and sMRI. Discussion: The findings from this thesis can guide future analysis of PREVENT Dementia cohort data. Furthermore, the findings from this thesis could be shared with the public through the NHS Health Check in England and the Keep Well Programme in Scotland, to help promote lifestyle interventions to optimise brain health in midlife

Psychogeriatric client identification project : phase 1 - final report

The Psychogeriatric Client Identification Project, contracted by the Continuing Care Division and conducted by the Gerontology Research Centre at Simon Fraser University, provides a comprehensive description of the diverse client groups that are typically included under the umbrella term, "psychogeriatric." Traditionally, psychogeriatric clients have been categorized according to medical diagnoses. The current research project adopted a different approach to identifying client needs by using an inclusive definition of the psychogeriatric population and by describing clients in relation to both behavioural characteristics and diagnosis. The focus of the project was on identifying the unique characteristics, behaviours and corresponding needs of client subgroups for the purpose of planning and delivering appropriate services. The specific project objectives were to: 1. describe the characteristics of the various psychogeriatric subgroups, with particular emphasis on behaviours that pose significant care and management challenges within facility and community settings; 2. summarize statistical information on prevalence and projected numbers for British Columbia for the various subgroups; and 3. identify the availability of a model of psychogeriatric care and services that could be applied to policy development and resource planning.Table of Contents: Executive Summary; INTRODUCTION 1: A. Background and Project Objectives; B. Definition of Terms and Behavioural Classification Scheme; C. Report Organization. LITERATURE REVIEW &amp; EPIDEMIOLOGIC/STATISTICAL DATA: A. Introduction; B. PART 1 - Problem Behaviours; Multi-Category Studies: Community; Multi-Category Studies: Institution; Agitated! Aggressive Behaviour; Physical; Verbal; Agitated/Non-Aggressive-Physical; Agitated/Non-Aggressive-Verbal; Ideational; Emotional/Affective Disturbance; Socially Unacceptable Behaviour; Problematic ADLs/Coping Strategies. C. PART 2 - Client Identification by Psychiatric Diagnosis: Prevalence of Psychiatric Disorders: Dementia; Delirium; Mood Disorders; Anxiety Disorders; Schizophrenia and Paranoia; Substance Dependence/Abuse. D. Summary and Conclusions. CONSULTATION PROCESS: A. Research Design/Methods; B. The Sample: Key Informant Survey Participants; Focus Group Participants; C. Data Collection and Analysis. IV RESEARCH FINDINGS: Key Informant Survey: A. Characteristics of Survey Respondents; B. Agency Characteristics; C. Description of Client Characteristics/Behavioural Disturbances and Service Response; D. Most Problematic Client Behaviours; E. Assessment of Facility and Community-Based Resources/Needs; F. Description of Behavioural Disturbance Categories/Groupings; G. Behavioural Disturbance Frequency Ratings; H. Behavioural Disturbance Difficulty Ratings; I. Behaviour Management Difficulty Ratings; J. Specialized Programs/Approaches and Suggested Improvements; K. Utility of Behavioural Classification Scheme; L. Suggested Program Improvements; Focus Group Sessions; M. Summary of Focus Group Results: BC Caregivers\u27 Support Group; Frontline Direct Care Nursing Staff. V CONCLUSIONS AND RECOMMENDATIONS: A. BC Prevalence Estimates by Diagnoses; B. Recommendations Related to Client Subgroups and Resource Needs; C. Recommendations for Future Study. REFERENCES; APPENDICE

Effects of Diversity and Neuropsychological Performance in an NFL Cohort

Objective: The aim of this study was to examine the effect of ethnicity on neuropsychological test performance by comparing scores of white and black former NFL athletes on each subtest of the WMS. Participants and Methods: Data was derived from a de-identified database in South Florida consisting of 63 former NFL white (n=28, 44.4%) and black (n=35, 55.6%) athletes (Mage= 50.38; SD= 11.57). Participants completed the following subtests of the WMS: Logical Memory I and II, Verbal Paired Associates I and II, and Visual Reproduction I and II. Results: A One-Way ANOVA yielded significant effect between ethnicity and performance on several subtests from the WMS-IV. Black athletes had significantly lower scores compared to white athletes on Logical Memory II: F(1,61) = 4.667, p= .035, Verbal Paired Associates I: F(1,61) = 4.536, p = .037, Verbal Paired Associates: II F(1,61) = 4.677, p = .034, and Visual Reproduction I: F(1,61) = 6.562, p = .013. Conclusions: Results suggest significant differences exist between white and black athletes on neuropsychological test performance, necessitating the need for proper normative samples for each ethnic group. It is possible the differences found can be explained by the psychometric properties of the assessment and possibility of a non-representative sample for minorities, or simply individual differences. Previous literature has found white individuals to outperform African-Americans on verbal and non-verbal cognitive tasks after controlling for socioeconomic and other demographic variables (Manly & Jacobs, 2002). This highlights the need for future investigators to identify cultural factors and evaluate how ethnicity specifically plays a role on neuropsychological test performance. Notably, differences between ethnic groups can have significant implications when evaluating a sample of former athletes for cognitive impairment, as these results suggest retired NFL minorities may be more impaired compared to retired NFL white athletes