822 research outputs found

    Introduction to Psychology

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    Introduction to Psychology is a modified version of Psychology 2e - OpenStax

    Tradition and Innovation in Construction Project Management

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    This book is a reprint of the Special Issue 'Tradition and Innovation in Construction Project Management' that was published in the journal Buildings

    Music and musicality in brain surgery:The effect on delirium and language

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    Delirium is a neuropsychiatric clinical syndrome with overlapping symptoms withthe neurologic primary disease. This is why delirium is such a difficult and underexposedtopic in neurosurgical literature. Delirium is a complication which mightaffect recovery after brain surgery, hence we describe in Chapter 2 a systematicreview which focuses on how delirium is defined in the neurosurgical literature.We included twenty-four studies (5589 patients) and found no validation studiesof screening instruments in neurosurgical papers. Delirium screening instruments,validated in other cohorts, were used in 70% of the studies, consisting of theConfusion Assessment Method (- Intensive Care Unit) (45%), Delirium ObservationScreening Scale (5%), Intensive Care Delirium Screening Checklist (10%), Neelonand Champagne Confusion Scale (5%), and Nursing Delirium Screening Scale (5%).Incidence of post-operative delirium after intracranial surgery was 19%, ranging from12 – 26% caused by variation in clinical features and delirium assessment methods.Our review highlighted the need of future research on delirium in neurosurgery,which should focus on optimizing diagnosis, and assessing prognostic significanceand management.It is unclear what the impact of delirium is on the recovery after brain surgery,as delirium is often a self-limiting and temporary complication. In Chapter 3 wetherefore investigated the impact of delirium, by means of incidence and healthoutcomes, and identified independent risk factors by including 2901 intracranialsurgical procedures. We found that delirium was present in 19.4% with an averageonset (mean/SD) within 2.62/1.22 days and associated with more Intensive CareUnit (ICU) admissions and more discharge towards residential care. These numbersconfirm the impact of delirium with its incidence rates, which were in line with ourprevious systematic review, and significant health-related outcomes. We identifiedseveral independent non-modifiable risk factors such as age, pre-existing memoryproblems, emergency operations, and modifiable risk factors such as low preoperativepotassium and opioid and dexamethasone administration, which shed lighton the pathophysiologic mechanisms of POD in this cohort and could be targetedfor future intervention studies.10As listening to recorded music has been proven to lower delirium-eliciting factors inthe surgical population, such as pain, we were interested in the size of analgesic effectand its underlying mechanism before applying this into our clinical setting. In Chapter4 we describe the results of a two-armed experimental randomized controlled trial inwhich 70 participants received increasing electric stimuli through their non-dominantindex finger. This study was conducted within a unique pain model as participantswere blinded for the outcome. Participants in the music group received a 20-minutemusic intervention and participants in the control group a 20-minute resting period.Although the effect of the music intervention on pain endurance was not statisticallysignificant in our intention-to-treat analysis (p = 0.482, CI -0.85; 1.79), the subgroupanalyses revealed an increase in pain endurance in the music group after correcting fortechnical uncertainties (p = 0.013, CI 0.35; 2.85). This effect on pain endurance couldbe attributed to increased parasympathetic activation, as an increased Heart RateVariability (HRV) was observed in the music vs. the control group (p=0.008;0.032).As our prior chapters increased our knowledge on the significance of delirium on thepost-operative recovery after brain surgery and the possible beneficial effects of music,we decided to design a randomized controlled trial. In Chapter 5 we describe theprotocol and in Chapter 6 we describe the results of this single-centered randomizedcontrolled trial. In this trial we included 189 patients undergoing craniotomy andcompared the effects of music administered before, during and after craniotomy withstandard of clinical care. The primary endpoint delirium was assessed by the deliriumobservation screening scale (DOSS) and confirmed by a psychiatrist accordingto DSM-5 criteria. A variety of secondary outcomes were assessed to substantiatethe effects of music on delirium and its clinical implications. Our results supportthe efficacy of music in preventing delirium after craniotomy, as found with DOSS(OR:0.49, p=0.048) but not after DSM-5 confirmation (OR:0.47, p=0.342). Thispossible beneficial effect is substantiated by the effect of music on pre-operativeautonomic tone, measured with HRV (p=0.021;0.025), and depth of anesthesia(p=&lt;0.001;0.022). Our results fit well within the current literature and support theimplementation of music for the prevention of delirium within the neurosurgicalpopulation. However, delirium screening tools should be validated and the long-termimplications should be evaluated after craniotomy to assess the true impact of musicafter brain surgery.Musicality and language in awake brain surgeryIn the second part of this thesis, the focus swifts towards maintaining musicality andlanguage functions around awake craniotomy. Intra-operative mapping of languagedoes not ensure complete maintenance which mostly deteriorates after tumor resection.Most patients recover to their baseline whereas other remain to suffer from aphasiaaffecting their quality of life. The level of musical training might affect the speed andextend of postoperative language recovery, as increased white matter connectivity inthe corpus callosum is described in musicians compared to non-musicians. Hence,in Chapter 7 we evaluate the effect of musicality on language recovery after awakeglioma surgery in a cohort study of forty-six patients. We divided the patients intothree groups based on the musicality and compared the language scores between thesegroups. With the first study on this topic, we support that musicality protects againstlanguage decline after awake glioma surgery, as a trend towards less deterioration oflanguage was observed within the first three months on the phonological domain (p= 0.04). This seemed plausible as phonology shares a common hierarchical structurebetween language and singing. Moreover, our results support the hypothesis ofmusicality induced contralateral compensation in the (sub-) acute phase through thecorpus callosum as the largest difference of size was found in the anterior corpuscallosum in non- musicians compared to trained musicians (p = 0.02).In Chapter 8 we addressed musicality as a sole brain function and whether it canbe protected during awake craniotomy in a systematic review consisting of tenstudies and fourteen patients. Isolated music disruption, defined as disruption duringmusic tasks with intact language/speech and/or motor functions, was identified intwo patients in the right superior temporal gyrus, one patient in the right and onepatient in the left middle frontal gyrus and one patient in the left medial temporalgyrus. Pre-operative functional MRI confirmed these localizations in three patients.Assessment of post-operative musical function, only conducted in seven patients bymeans of standardized (57%) and non-standardized (43%) tools, report no loss ofmusical function. With these results we concluded that mapping music is feasibleduring awake craniotomy. Moreover, we identified certain brain regions relevant formusic production and detected no decline during follow-up, suggesting an addedvalue of mapping musicality during awake craniotomy. A systematic approach to mapmusicality should be implemented, to improve current knowledge on the added valueof mapping musicality during awake craniotomy.<br/

    Graphonomics and your Brain on Art, Creativity and Innovation : Proceedings of the 19th International Graphonomics Conference (IGS 2019 – Your Brain on Art)

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    [Italiano]: “Grafonomia e cervello su arte, creatività e innovazione”. Un forum internazionale per discutere sui recenti progressi nell'interazione tra arti creative, neuroscienze, ingegneria, comunicazione, tecnologia, industria, istruzione, design, applicazioni forensi e mediche. I contributi hanno esaminato lo stato dell'arte, identificando sfide e opportunità, e hanno delineato le possibili linee di sviluppo di questo settore di ricerca. I temi affrontati includono: strategie integrate per la comprensione dei sistemi neurali, affettivi e cognitivi in ambienti realistici e complessi; individualità e differenziazione dal punto di vista neurale e comportamentale; neuroaesthetics (uso delle neuroscienze per spiegare e comprendere le esperienze estetiche a livello neurologico); creatività e innovazione; neuro-ingegneria e arte ispirata dal cervello, creatività e uso di dispositivi di mobile brain-body imaging (MoBI) indossabili; terapia basata su arte creativa; apprendimento informale; formazione; applicazioni forensi. / [English]: “Graphonomics and your brain on art, creativity and innovation”. A single track, international forum for discussion on recent advances at the intersection of the creative arts, neuroscience, engineering, media, technology, industry, education, design, forensics, and medicine. The contributions reviewed the state of the art, identified challenges and opportunities and created a roadmap for the field of graphonomics and your brain on art. The topics addressed include: integrative strategies for understanding neural, affective and cognitive systems in realistic, complex environments; neural and behavioral individuality and variation; neuroaesthetics (the use of neuroscience to explain and understand the aesthetic experiences at the neurological level); creativity and innovation; neuroengineering and brain-inspired art, creative concepts and wearable mobile brain-body imaging (MoBI) designs; creative art therapy; informal learning; education; forensics

    Behavior quantification as the missing link between fields: Tools for digital psychiatry and their role in the future of neurobiology

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    The great behavioral heterogeneity observed between individuals with the same psychiatric disorder and even within one individual over time complicates both clinical practice and biomedical research. However, modern technologies are an exciting opportunity to improve behavioral characterization. Existing psychiatry methods that are qualitative or unscalable, such as patient surveys or clinical interviews, can now be collected at a greater capacity and analyzed to produce new quantitative measures. Furthermore, recent capabilities for continuous collection of passive sensor streams, such as phone GPS or smartwatch accelerometer, open avenues of novel questioning that were previously entirely unrealistic. Their temporally dense nature enables a cohesive study of real-time neural and behavioral signals. To develop comprehensive neurobiological models of psychiatric disease, it will be critical to first develop strong methods for behavioral quantification. There is huge potential in what can theoretically be captured by current technologies, but this in itself presents a large computational challenge -- one that will necessitate new data processing tools, new machine learning techniques, and ultimately a shift in how interdisciplinary work is conducted. In my thesis, I detail research projects that take different perspectives on digital psychiatry, subsequently tying ideas together with a concluding discussion on the future of the field. I also provide software infrastructure where relevant, with extensive documentation. Major contributions include scientific arguments and proof of concept results for daily free-form audio journals as an underappreciated psychiatry research datatype, as well as novel stability theorems and pilot empirical success for a proposed multi-area recurrent neural network architecture.Comment: PhD thesis cop

    Contributions of Human Prefrontal Cortex to the Recogitation of Thought

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    Human beings have a unique ability to not only verbally articulate past and present experiences, as well as potential future ones, but also evaluate the mental representations of such things. Some evaluations do little good, in that they poorly reflect facts, create needless emotional distress, and contribute to the obstruction of personal goals, whereas some evaluations are the converse: They are grounded in logic, empiricism, and pragmatism and, therefore, are functional rather than dysfunctional. The aim of non-pharmacological mental health interventions is to revise dysfunctional thoughts into more adaptive, healthier ones; however, the neurocognitive mechanisms driving cognitive change have hitherto remained unclear. Therefore, this thesis examines the role of the prefrontal cortex (PFC) in this aspect of human higher cognition using the relatively new method of functional near-infrared spectroscopy (fNIRS). Chapter 1 advances recogitation as the mental ability on which cognitive restructuring largely depends, concluding that, as a cognitive task, it is a form of open-ended human problem-solving that uses metacognitive and reasoning faculties. Because these faculties share similar executive resources, Chapter 2 discusses the systems in the brain involved in controlled information processing, specifically the nature of executive functions and their neural bases. Chapter 3 builds on these ideas to propose an information-processing model of recogitation, which predicts the roles of different subsystems localized within the PFC and elsewhere in the context of emotion regulation. This chapter also highlights several theoretical and empirical challenges to investigating this neurocognitive theory and proposes some solutions, such as to use experimental designs that are more ecologically valid. Chapter 4 focuses on a neuroimaging method that is best suited to investigating questions of spatial localization in ecological experiments, namely functional near-infrared spectroscopy (fNIRS). Chapter 5 then demonstrates a novel approach to investigating the neural bases of interpersonal interactions in clinical settings using fNIRS. Chapter 6 explores physical activity as a ‘bottom-up’ approach to upregulating the PFC, in that it might help clinical populations with executive deficits to regulate their mental health from the ‘top-down’. Chapter 7 addresses some of the methodological issues of investigating clinical interactions and physical activity in more naturalistic settings by assessing an approach to recovering functional events from observed brain data. Chapter 8 draws several conclusions about the role of the PFC in improving psychological as well as physiological well-being, particularly that rostral PFC is inextricably involved in the cognitive effort to modulate dysfunctional thoughts, and proposes some important future directions for ecological research in cognitive neuroscience; for example, psychotherapy is perhaps too physically stagnant, so integrating exercise into treatment environments might boost the effectiveness of intervention strategies

    The Effects of Antipsychotics on Social Cognition

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    Despite the perceived importance of social cognition in determining social functioning outcomes for patients with schizophrenia, it has received limited attention in clinical trials. Furthermore, the impact of antipsychotic medication (which is the primary treatment for schizophrenia) on social cognition has not been thoroughly investigated, and existing studies lack consistent results. A systematic review and research study were conducted to investigate the effects of antipsychotics on social cognition in patients with schizophrenia. The study recruited 73 patients with schizophrenia and 37 healthy volunteers, to take part in a social cognition assessment, as part of a sub-study of a larger-scale randomised controlled trial of antipsychotic reduction/discontinuation vs. maintenance. Narrative results from the systematic review of sedative psychiatric medication effects on social cognition revealed diazepam impairs emotion processing in healthy volunteers. It also showed the extent to which studies of antipsychotics on social cognition have been limited by design. For the analysis in this thesis, cross-sectional results showed impaired social cognition in patients compared to healthy volunteers. Although, antipsychotic dose was not significantly related to any social cognition domain after controlling for confounders. The longitudinal results showed temporary dips in some social cognition domains and social functioning performance at 12- months after being in the antipsychotic reduction/discontinuation group, but improvements at 24 months, although the group x time interaction was only significant for the Theory of Mind domain. Results from these studies should be interpreted with caution due to limitations including unequal group sizes, high attrition, and poor measure reliability. However, the results suggest that relationships between social cognition and antipsychotic reduction may exist, although the associations are complex and require more investigation. Further studies with larger sample sizes over long-term periods are needed, particularly in healthy volunteers, to establish relationships between variables

    Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

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    Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data
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