The effect of multisensory semantic congruency on unisensory object recognition in schizophrenia

Multisensory, as opposed to unisensory processing of stimuli, has been found to enhance the performance (e.g., reaction time, accuracy, and discrimination) of healthy individuals across various tasks. However, this enhancement is not as pronounced in patients with schizophrenia (SZ), indicating impaired multisensory integration (MSI) in these individuals. To the best of our knowledge, no study has yet investigated the impact of MSI deficits in the context of working memory, a domain highly reliant on multisensory processing and substantially impaired in schizophrenia. To address this research gap, we employed two adopted versions of the continuous object recognition task to investigate the effect of single-trail multisensory encoding on subsequent object recognition in 21 schizophrenia patients and 21 healthy controls (HC). Participants were tasked with discriminating between initial and repeated presentations. For the initial presentations, half of the stimuli were audiovisual pairings, while the other half were presented unimodal. The task-relevant stimuli were then presented a second time in a unisensory manner (either auditory stimuli in the auditory task or visual stimuli in the visual task). To explore the impact of semantic context on multisensory encoding, half of the audiovisual pairings were selected to be semantically congruent, while the remaining pairs were not semantically related to each other. Consistent with prior studies, our findings demonstrated that the impact of single-trial multisensory presentation during encoding remains discernible during subsequent object recognition. This influence could be distinguished based on the semantic congruity between the auditory and visual stimuli presented during the encoding. This effect was more robust in the auditory task. In the auditory task, when congruent multisensory pairings were encoded, both participant groups demonstrated a multisensory facilitation effect. This effect resulted in improved accuracy and RT performance. Regarding incongruent audiovisual encoding, as expected, HC did not demonstrate an evident multisensory facilitation effect on memory performance. In contrast, SZs exhibited an atypically accelerated reaction time during the subsequent auditory object recognition. Based on the predictive coding model we propose that this observed deviations indicate a reduced semantic modulatory effect and anomalous predictive errors signaling, particularly in the context of conflicting cross-modal sensory inputs in SZ

Young People Who Meaningfully Improve Are More Likely to Mutually Agree to End Treatment

Objective: Symptom improvement is often examined as an indicator of a good outcome of accessing mental health services. However, there is little evidence of whether symptom improvement is associated with other indicators of a good outcome, such as a mutual agreement to end treatment. The aim of this study was to examine whether young people accessing mental health services who meaningfully improved were more likely to mutually agree to end treatment. Methods: Multilevel multinomial regression analysis controlling for age, gender, ethnicity, and referral source was conducted on N = 8,995 episodes of care [Female = 5,469, 61%; meanAge = 13.66 (SD = 2.87) years] using anonymised administrative data from young people's mental health services. Results: Compared to young people with no change in mental health difficulties, those showing positive meaningful changes in mental health difficulties were less likely to have case closure due to non-mutual agreement (Odds Ratio or OR = 0.58, 95% Confidence Interval or CI = 0.50-0.61). Similarly, they were less likely to transfer (OR = 0.61, 95% CI = 0.49-0.74) or end treatment for other reasons (OR = 0.59, 95% CI = 0.50-0.70) than by case closure due to mutual agreement. Conclusion: The findings suggest that young people accessing mental health services whose symptoms meaningfully improve are more likely to mutually agree to end treatment, adding to the evidence that symptom improvement may be appropriate to examine as an indicator of a good outcome of accessing mental health services

Engaging children and young people in digital mental health interventions:Systematic review of modes of delivery, facilitators, and barriers

Background There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible. Objective This review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs. Methods A literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts “child and adolescent mental health,” “digital intervention,” and “engagement.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively. Results This study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP’s engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs. Conclusions The development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs

Patient and Public Involvement in Youth Mental Health Research: Protocol for a Systematic Review of Practices and Impact

Various health settings have advocated for involving patients and members of the public (PPI) in research as a means to increase quality and relevance of the produced knowledge. However, youth PPI has been an understudied area. This protocol paper describes a new project that aims to summarize what is known about PPI with young people in mental health research. In line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Statement guidelines we will identify and appraise suitable articles and extract and synthesize relevant information including at least two reviewers at each stage of the process. Results will be presented in two systematic reviews that will describe (a) how youth PPI has been conducted (Review1) and (b) what impact youth PPI had on the subsequent research and on stakeholders (Review2). To our knowledge, this is the first set of reviews that uses a critical appraisal tool, which is co-developed with children and young people. Findings from this project will provide valuable insights and set out the key steps to adopting adequate PPI methods when involving children and young people in mental health research

SUICIDE AND THE LAST CONTACT WITH A PATIENT WHO DIED BY SUICIDE AS EXPERIENCED BY MEDICAL TEHNICIANS

Samomor v Sloveniji in svetu predstavlja pomemben javno-zdravstveni problem. Večina ljudi, ki so umrli zaradi samomora, je nekaj mesecev ali tednov pred smrtjo obiskalo splošnega zdravnika. Osrednja tema naše naloge je doživljanje samomora pacienta pri medicinskih tehnikih. V raziskavi smo uporabili kvalitativno metodo raziskovanja. Po načelih utemeljene teorije smo analizirali enajst intervjujev z medicinskimi sestrami, ki se spomnijo, da so tekom svoje delovne kariere imele izkušnjo samomora pacienta. Povprečen intervju je trajal 35 minut. Po analizi podatkov smo 121 kod z 1131 navedki in 3 superkodami povezali v dva osrednja koncepta in štiri podkoncepte: Doživljanje samomora pacienta in pojasnjevanje sprožilcev za samomor (s podkonceptoma: Doživljanje samomora pacienta in Delo s samomorilnim pacientom) ter Delo medicinske sestre (s podkonceptoma Delo s pacienti in \u27\u27Jaz kot medicinska sestra\u27\u27). Iz konceptov smo oblikovali Model doživljanja samomora pacienta. Model pojasnjuje vsebine doživljanja samomora pacienta ter mediatorje, ki posredno ali neposredno vplivajo na doživljanje. (Ne)fleksibilnost sistema ter identiteta medicinske sestre dajeta osnovo delu s pacienti. Način dela s pacienti in vzpostavljen odnos med medicinsko sestro in pacientom pa vplivata na doživljanje samomora pacienta. Kadar se medicinske sestre spomnijo zadnjega stika s pacientom, takrat se vsebine doživljanja razširijo (pojavi se več občutij in miselnih odzivov). Od tega, kako si medicinska sestra pojasni izkušnjo samomora pacienta, je odvisno ali bo izkušnja imela vpliv na nadaljnjo obravnavo pacientov. Model doživljanja samomora pacienta pojasnjuje vsebine, ki se pojavljajo ob samomoru pacienta in omogoča razumevanje kompleksne teme.Suicides present a significant public-health issue on a global scale and in Slovenia as well. Most people who have died by suicide visited their general practitioner months or weeks before death. Presenting how nurses deal with suicides of patients is the main topic of this thesis. The study is based on qualitative research principles. Based on the grounded theory method we analyzed eleven in-depth interviews with nurses who remember having dealt with a suicide patient during their career. The average interview lasted approximately 35 minutes. After the analysis of data we merged 121 codes with 1131 quotations and 3 supercodes into two main concepts and four sub-concepts: Experiencing patient suicide and explaining the triggers for it (with sub-concepts Experiencing patient suicide and Dealing with suicidal patients) and The work of nurses (with sub-concepts Work with patients and “Me as a nurse”). From these concepts we created the Experiencing patient suicide model. The model explains the contents of experiencing patient suicide and mediators who directly or indirectly influence the experience process. The system (non) flexibility and identity of the nurse help shape the basis of work with patients. The means of working with patients and established relationship between the nurse and the patient influence the process of experience patient suicide. When nurses recollect the last encounter with a patient the contents of experiencing patient suicide expand (more feelings and mental responses occur). How a nurse reads and explains a patient suicide experience results in whether or not the experience will have an influence on further patient treatment. Experiencing patient suicide model explains the contents which occur with patient suicides and ease the comprehension of a very complex topic

An Example of the Theatre of the Oppressed: KUD Transformator

Kulturno umetniško društvo Transformator (KUD Transformator) je danes v Sloveniji najvidnejša organizacija, ki dela z metodo gledališča zatiranih. Začetki KUD Transformator segajo v leto 2010, ko se je skupina spoznala na 17-dnevnem izobraževanju v okviru Globalna SOFA. Kasneje so postali društvo, jedro kulturnega društva pa še zmeraj predstavljajo prvotni člani in članice. Metodo gledališča zatiranih je v 60. in 70. letih 20. stoletja razvil Augusto Boal, kot odgovor na takratne razmere v Braziliji. Augusto Boal se je pri svojem delu navdihoval po dialoški pedagogiki Paula Freireja. Znotraj gledališča zatiranih je razvil tehnike, ki jih ustvarjalci in gledališke skupine še danes uporabljajo po vsem svetu, med njimi tudi Kulturno umetniško društvo Transformator. KUD Transformator izvaja redne predstave, produkcije, dogodke in delavnice, ki temeljijo na metodi kolektivnega avtorstva in dialogu. Ustvarjalci KUD Transformator težijo k odpiranju tem in problematik, ki so v družbi spregledane in želijo dati glas tistim, ki ga v družbi nimajo. Primeri gledališča zatiranih v svetu in pri nas potrjujejo, da s pomočjo gledališča zatiranih lahko ljudje opozorijo na neenakosti v družbi in prevzamejo aktivno vlogo pri doseganju družbenih sprememb.The cultural and arts society Transformator (KUD Transformator) is the most prominent organisation using the method of the Theatre of the Oppressed in Slovenia today. KUD Transformator traces its history back to 2010 when the founding members met at a 17-day training course as part of the Global SOFA (Global State of Art) project. The group went on to become a cultural society, and its original members still represent a key part of the society as it is today. The method of the Theatre of the Oppressed was developed in the 1960s and 70s by Augusto Boal in response to the situation in Brazil at the time. In his work, Augusto Boal drew inspiration from the dialogic pedagogy of Paul Freire. As part of the Theatre of the Oppressed, Boal developed techniques that artists and theatre groups all over the world, including KUD Transformator, still use to this day. KUD Transformator regularly puts on performances, productions, events, and workshops based on the method of collective authorship and dialogue. The artist members of KUD Transformator strive to address topics and issues that are overlooked in society and wish to give a voice to the voiceless. The examples of the Theatre of the Oppressed in Slovenia and around the world demonstrate that it can be a useful tool for people to be able to speak out against inequalities in society and take an active role in pushing for social change

PARKINSON’S DISEASE DEMENTIA: Clinical correlates of brain SPECT perfusion and treatment

Background: The main clinical feature of dementia in Parkinson\u27s disease is a dysexecutive syndrome. The neuropathology of PD dementia (PDD) is likely multifactorial and affects several neuronal populations. There is evidence that Parkinson’s disease dementia is associated with a cholinergic deficit, supporting the therapeutic role of cholinesterase inhibitors, which are already firstline agents in the treatment of Alzheimer\u27s disease. The paper includes short report on a pilot study with description of cognitive and imaging profiles in patients with mild to moderate stage of Parkinson disease dementia (PDD). Subjects and methods: A random sample of 16 patients with clinical diagnostic criteria for probable PDD was included in the study. Patients were characterized with mild to moderate cognitive decline slightly depressive mood and moderate motor performance. Brain perfusion [99mTc]ECD / SPECT and structural MRI with emphasis on evaluation of the degree of cortical atrophy and the medial temporal atrophy index was performed. All patients had detailed neuropsychological evaluation using a “cognitive process approach”. Neuropsychological data were correlated voxel-wise with normalized brain perfusion images, creating whole-brain correlation maps. Conclusions: Previously reported generalized cognitive impairment in PDD with predominant executive, visouspatial and attentional deficits was confirmed. Performance on specific cognitive measures was correlated with perfusion brain SPECT findings. It could be speculated that different pathological mechanisms underlie widespread significant brain perfusion decrements in temporal, parietal and frontal regions