Approaches to cognitive stimulation in the prevention of dementia

The prevalence of dementia and age-related cognitive impairment is rising due to an aging population worldwide. There is currently no effective pharmacological treatment, but cognitive activity programs could contribute to prevention and risk reduction. However, the results of intervention studies are inconclusive, which may be related to methodological issues. For example, the inconsistent use of umbrella categories to describe cognitive intervention strategies, such as cognitive training or cognitive rehabilitation, has led to confusion regarding their respective contents and efficacies. The interventions studied so far draw on a pool of common basic ingredients. Therefore, rather than focusing on a few high-level categories, it might be beneficial to examine the efficacy of more basic cognitive intervention ingredients, which form the building blocks of complex multi-strand cognitive intervention strategies. Here we suggested a novel format of collating basic cognitive intervention ingredients. Using a representative sample of review articles and treatment studies, we attempted to inventory the most commonly encountered ingredients. Finally, we discuss their suitability for individualized and group-based approaches, as well as the possibility for computerization

Efficacy of a Web-Based, Crowdsourced Peer-To-Peer Cognitive Reappraisal Platform for Depression: Randomized Controlled Trial

Background: Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content. Objective: Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement. Methods: Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, “Panoply” (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 minutes per week for 3 weeks. Both platforms involved posting descriptions of stressful thoughts and situations. Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes). Panoply participants could also practice reappraising stressful situations submitted by other users. Online questionnaires administered at baseline and 3 weeks assessed depression symptoms, reappraisal, and perseverative thinking. Engagement was assessed through self-report measures, session data, and activity levels. Results: The Panoply platform produced significant improvements from pre to post for depression (P=.001), reappraisal (P<.001), and perseverative thinking (P<.001). The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45). The two groups did not diverge significantly at post-test on measures of depression or perseverative thinking, though Panoply users had significantly higher reappraisal scores (P=.02) than expressive writing. We also found significant group by treatment interactions. Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008). Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002). Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95% CI -2.88 to -.20). Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001). Conclusions: Panoply engaged its users and was especially helpful for depressed individuals and for those who might ordinarily underutilize reappraisal techniques. Further investigation is needed to examine the long-term effects of such a platform and whether the benefits generalize to a more diverse population of users.MIT Media Lab Consortiu

Verbal Learning and Transfer of Function in Anxiety

Objective: To evaluate the clinical psychology service provided to South Ayrshire and Arran Trust, to gain an in-depth and accurate analysis of service usage in order to assist future planning and organisation of such a service. Design: Part I involved a casenote review of all patients referred to clinical psychology in year January - December 1997. Part II of the study used a postal questionnaire to survey staff opinions on the service. Setting: Ayr Hospital, South Ayrshire and Arran Trust. Subjects: The casenotes of seventy-eight patients were reviewed for the first part of the study. All potential referrers were surveyed in Part II, including medical consultants & associated specialities, nursing specialists and heads of department of professions allied to medicine. Results: Casenote review revealed the majority of patients are referred for somatoform complaints, although this did not necessarily correspond with the psychologist's diagnosis and formulation following assessment. Questionnaire responses revealed that the majority of referrers were satisfied with the quality of service but dissatisfied with the length of waiting lists and resultant problems in accessing clinical psychology generally. Conclusion: Expansion to the Clinical Psychology service is desirable and this should preferably take the form of dedicated clinical psychology time to specific services, with allocated sessions for indirect work which is currently neglected. The lack of priority attached to such a service, however, means expansion is unlikely to take place in the foreseeable future

Washington University Record, February 28, 2008

https://digitalcommons.wustl.edu/record/2134/thumbnail.jp

2005- 2008 UNLV McNair Journal

Journal articles based on research conducted by undergraduate students in the McNair Scholars Program Table of Contents Biography of Dr. Ronald E. McNair Statements: Dr. Neal J. Smatresk, UNLV President Dr. Juanita P. Fain, Vice President of Student Affairs Dr. William W. Sullivan, Associate Vice President for Retention and Outreach Mr. Keith Rogers, Deputy Executive Director of the Center for Academic Enrichment and Outreach McNair Scholars Institute Staf

Building a flexible CBT model based on structured data for the COPE app

Master's Thesis in InformaticsINF399MAMN-PROGMAMN-IN

Treatment Response in Depression: Predictors and Moderators of Outcome

Major Depressive Disorder (MDD) is a highly prevalent psychological disorder that affects an estimated 20.6% of adults in the United States. Despite significant research efforts, treatment response rates remain unacceptably low. The Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMBARC) study aimed to address this problem through the search for "biosignatures" that include clinical, contextual, and biological measures to identify a more personalized approach to identifying appropriate treatment recommendations. Through three distinct investigations, this dissertation aims to utilize prior research to study “biosignatures" that may be relevant for predicting antidepressant treatment response. Results from this dissertation may inform future personalized approaches to depression care that may reduce the time to receiving adequate treatment.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/147538/1/rcardina_1.pd

Medical, Racist, and Colonial Constructions of Power in Anne Fadiman\u27s The Spirit Catches You and You Fall Down

This essay looks at the values attributed or denied to culture (medical culture, history, Southeast Asian refugees, Asian American cultural citizenship) in the care surrounding a Hmong child diagnosed with spirit loss, according to Hmong interpretation, or epilepsy, as defined by Western medicine. In my reading of Anne Fadiman\u27s The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, medical, colonial, and authorial knowledge often converge in devastating ways, linking the seemingly disparate discourses of war, refugee medicine, and the model minority through colonial representations. I also look at the book\u27s lacuna in its investigation of cultural collisions, finding that its approaches to reporting the medical-cultural conflict from a seemingly neutral position-one balancing the reported views of the epileptic child\u27s parents and the views of her medical practitioners-often reinscribe the Hmong subjects into the very colonial parameters from which the book attempts to extract them

Exploring Perceptions of the Ability of Student Nurses to Achieve Learning Outcomes in Community-Based Psychiatric Mental Health Clinical Settings

The purpose of this qualitative descriptive study was to investigate how traditional undergraduate baccalaureate (BSN) student nurses and their faculty perceive students' ability to achieve learning outcomes in community-based psychiatric mental health (PMH) clinical settings. Studies have shown that 25% of American adults experience a diagnosable PMH problem each year, and that acute care medical-surgical nurses carry an average patient load of five to six persons. Traditionally, PMH clinical experiences occurred on inpatient units located in acute care hospitals or within psychiatric hospital settings. However, many schools are downsizing and even eliminating PMH clinical experiences in favor of those clinical sites providing more technically based skills. The National Council of State Boards of Nursing also has decreased the psychosocial content on state boards to as little as 6% (2010). Additionally, many schools are moving much of the PMH clinical experience to community-based settings. This move to the community mirrors that of present and future employment opportunities for nurses, and statistics provide evidence that all nurses need PMH skills in order to meet the complex needs of their patients. However, there is no evidence as to what students are learning in these more diverse community-based settings. The research questions for the study included: 1) What are student nurses' perceptions of their ability to achieve learning outcomes in community-based PMH clinical settings? 2) What are faculty's perceptions' of the students' ability to achieve learning outcomes in community-based PMH clinical settings? 3) What are student nurses' perceptions of their ability to transfer knowledge gained in their community-based PMH clinical experiences to other healthcare settings? The sample consisted of 42 students and four faculty members from two Midwestern universities, with one faculty member from each school serving as a key informant, assisting the researcher with identification of possible participants and providing additional information useful in understanding the phenomenon. Students were given the option of completing questionnaires online or per paper/pencil. Faculty was encouraged to complete interviews, while given the option of completing an online questionnaire in lieu of the interview. Four self-selecting participants from the student group also participated in an online focus group as a means of member checking, as well as three faculty members participating in individual member checking. Content analysis was completed with responses by students and faculty to the open-ended questionnaire and interview items, as well as their responses during the online focus groups and/or individual member checking. Simple demographics were used to describe the sample. Corroboration of data from campus visits and artifacts was also included and used to provide a richer, thicker description of the phenomenon. The findings from this study showed that student nurses and their faculty perceived that students were able to achieve learning outcomes in the majority of PMH nursing skills through experiences provided in community-based PMH clinical settings. Three student themes emerged from the data: meeting the challenges of developing PMH nursing skills, sharing multiple experiences of feeling competent and empowering all nurses through PMH nursing skills. Three themes also emerged from the faculty data: seizing the day(s), sharing the road to competency, and empowering students in all areas of nursing. Two surprising, yet important findings were that even though most students felt competent with most PMH skills, the few students who did not perceive themselves as achieving the majority of PMH learning outcomes, felt that the experience was worthwhile and valuable. Most students also strongly felt that the PMH experience was important and that it they could and did apply the PMH skills they learned in all nursing practice areas