Massage, Reflexzonenmassage und Akupressur bei Krebspatienten mit Fatigue: systematische Literaturreview

Problembeschreibung: Jährlich erkranken weltweit zehn Millionen Menschen an Krebs und die Zahl wird in Zukunft steigen. In den vergangenen Jahren wurden in der Behandlung von krebserkrankten Patienten unterschiedlich belastende Begleiterscheinungen wie Fatigue beobachtet. Jahrelang wurde Fatigue keine Beachtung geschenkt und durch Pflegende so-wie Ärzte unterbewertet. Bei Fatigue können Pflegende nicht auf bewährte Handlungsmög-lichkeiten wie beispielsweise bei Nausea und Emesis zurückgreifen und sind so in der Be-handlung von Fatigue oftmals ratlos. Die Nursing Intervention Classification (Nic) und die Nursing Outcomes Classifiaction (Noc) verweisen auf verschiedene nichtmedikamentöse Pflegeinterventionen und diese beschreiben unter anderem die Massage in der Pflege von Krebspatienten als geeignete Intervention um Fatigue zu reduzieren. Ziel: Das Ziel der vorliegenden systematischen Literaturübersicht liegt darin, den aktuellen Forschungsstand bezüglich der Wirksamkeit der Massage, der Reflexzonenmassage und der Akupressur auf Fatigue bei Krebspatienten zusammenzufassen. Aus der Problembe-schreibung ergab sich folgende Fragestellung: Wie wird in der wissenschaftlichen Literatur die Wirkung der klassischen Massage, der Reflexzonenmassage und der Akupressur auf Fatigue bei Patienten mit Krebs beschrieben? Mit dieser systematischen Literaturübersicht soll evidenzbasiertes und qualitativ hoch stehendes Wissen zusammengetragen und eine detaillierte, objektive und wissenschaftliche aktuelle Übersicht über die Thematik erstellt und der Pflege zur Verfügung gestellt werden. Methode: Zur Beantwortung der Forschungsfrage wurde eine systematische Literaturüber-sicht erstellt. In den pflegespezifischen Datenbanken Pubmed, Cinahl und Cochrane Library wurde nach relevanter Forschungsliteratur recherchiert. Durch eine systematische Suchstra-tegie sowie definierten Auswahlkriterien wurden acht passende Studien gefunden. Ergebnisse: Die Ergebnisse der acht Studien zeigten eine positive Wirkung der Massage, der Reflexzonenmassage und der Akupressur auf Fatigue bei erwachsenen Krebspatienten. Die Wirkung der Massage wurde in sechs Studien untersucht, davon in vier Studien die klas-sische/schwedische Massagetechnik und in zwei Studien die Massage mit einem körperli-chen Training kombiniert. Die Reflexzonenmassage wurde in Kombination mit Aromathera-pie und Fussbäder untersucht. Die Studie, welche die Wirkung der Akupressur untersuchte, zeigte nicht nur signifikante Verbesserungen von Fatigue, sondern auch der Schmerzen und weiteren krebs- sowie therapiebedingten Symptomen. Schlussfolgerung: Massage und Akupressur sollten in die Berufspraxis integriert werden, da es sich dabei um sichere und einfach anwendbare nichtmedikamentöse Pflegeinterven-tionen handelt. Zukünftige Forschungen sind erforderlich, weil zum vorliegenden For-schungsthema nur sehr wenig Literatur vorhanden ist

Perceptual Correlates of Turkish Word Stress and Their Contribution to Automatic Lexical Access: Evidence from Early ERP Components

Perceptual correlates of Turkish word stress and their contribution to lexical access were studied using the mismatch negativity (MMN) component in event-related potentials (ERPs). The MMN was expected to indicate if segmentally identical Turkish words were distinguished on the sole basis of prosodic features such as fundamental frequency (f0), spectral emphasis (SE), and duration. The salience of these features in lexical access was expected to be reflected in the amplitude of MMN responses. In a multi-deviant oddball paradigm, neural responses to changes in f0, SE, and duration individually, as well as to all three features combined, were recorded for words and pseudowords presented to 14 native speakers of Turkish. The word and pseudoword contrast was used to differentiate language-related effects from acoustic-change effects on the neural responses. First and in line with previous findings, the overall MMN was maximal over frontal and central scalp locations. Second, changes in prosodic features elicited neural responses both in words and pseudowords, confirming the brain's automatic response to any change in auditory input. However, there were processing differences between the prosodic features, most significantly in f0: While f0 manipulation elicited a slightly right-lateralized frontally-maximal MMN in words, it elicited a frontal P3a in pseudowords. Considering that P3a is associated with involuntary allocation of attention to salient changes, the manipulations of f0 in the absence of lexical processing lead to an intentional evaluation of pitch change. f0 is therefore claimed to be lexically specified in Turkish. Rather than combined features, individual prosodic features differentiate language-related effects from acoustic-change effects. The present study confirms that segmentally identical words can be distinguished on the basis of prosodic information alone, and establishes the salience of f0 in lexical access

Breath holds in spontaneous speech

This article provides a first quantitative overview of the timing and volumerelated properties of breath holds in spontaneous conversations. Firstly, we investigate breath holds based on their position within the coinciding respiratory interval amplitude. Secondly, we investigate breath holds based on their timing within the respiratory intervals and in relation to communicative activity following breath holds. We hypothesise that breath holds occur in different regions of the lung capacity range and at different times during the respiratory phase, depending on the conversational and physiological activity following breath holds. The results suggest there is not only considerable variation in both the time and lung capacity scales, but detectable differences are also present in breath holding characteristics involving laughter and speech preparation, while breath holds coinciding with swallowing are difficult to separate from the rest of the data based on temporal and volume information alone. Kokkuvõte. Kätlin Aare, Marcin Włodarczak ja Mattias Heldner: Hinge kinni hoidmine spontaanses kõnes. Artikkel kirjeldab hinge kinni hoidmist spontaansetes vestlustes ajaliste ja kopsumahuga seotud omaduste kaudu. Hinge kinni hoidmist analüüsitakse esmalt selle põhjal, kus see käimasoleva hingamisfaasi kopsumahu ulatuse suhtes asub. Teine fookus on ajalisel faktoril: kus hoitakse hinge kinni käimasoleva hingamisfaasi alguse ja lõpu ning vestlustes sisalduva kõne vm suhtes. Hüpoteeside kohaselt peaks hinge kinni hoidmine ajalisel ja kopsumahuga seotud skaalal toimuma erinevas kohas sõltuvalt sellest, milline kontekst hinge kinni hoidmist vestluses ümbritseb. Tulemused näitavad, et kuigi hinge kinni hoidmine esineb suure varieeruvusega mõlemal skaalal, sisaldab andmestik mustreid, mis eristavad kõneplaneerimisega seotud hinge kinni hoidmist teistest alternatiividest. Tulemustest selgub ka, et neelatustega seotud hinge kinni hoidmist on keeruline muudest eristada vaid aja ja kopsumahuga seotud informatsiooni abil. Märksõnad: hinge kinni hoidmine, kõnehingamine, spontaanne kõne, vestlused kolme osalejag

Backchannel relevance spaces

This contribution introduces backchannel relevance spaces – intervals where it is relevant for a listener in a conversation to produce a backchannel. By annotating and comparing actual visual and vocal backchannels with potential backchannels established using a group of subjects acting as third-party listeners, we show (i) that visual only backchannels represent a substantial proportion of all backchannels; and (ii) that there are more opportunities for backchannels (i.e. potential backchannels or backchannel relevance spaces) than there are actual vocal and visual backchannels. These findings indicate that backchannel relevance spaces enable more accurate acoustic, prosodic, lexical (et cetera) descriptions of backchannel inviting cues than descriptions based on the context of actual vocal backchannels only

Neural correlates of lexical stress: Mismatch negativity reflects fundamental frequency and intensity

Neural correlates of lexical stress were studied using the mismatch negativity (MMN) component in event-related potentials. The MMN responses were expected to reveal the encoding of stress information into long-term memory and the contributions of prosodic features such as fundamental frequency (F0) and intensity toward lexical access. In a passive oddball paradigm, neural responses to changes in F0, intensity, and in both features together were recorded for words and pseudowords. The findings showed significant differences not only between words and pseudowords but also between prosodic features. Early processing of prosodic information in words was indexed by an intensity-related MMN and an F0-related P200. These effects were stable at right-anterior and mid-anterior regions. At a later latency, MMN responses were recorded for both words and pseudowords at the mid-anterior and posterior regions. The P200 effect observed for F0 at the early latency for words developed into an MMN response. Intensity elicited smaller MMN for pseudowords than for words. Moreover, a larger brain area was recruited for the processing of words than for the processing of pseudowords. These findings suggest earlier and higher sensitivity to prosodic changes in words than in pseudowords, reflecting a language-related process. The present study, therefore, not only establishes neural correlates of lexical stress but also confirms the presence of long-term memory traces for prosodic information in the brain

Le rôle de la sémantique dans l’interprétation de aucun

Les syntagmes nominaux déterminés par l'indéfini AUCUN – que l'on peut envisager comme un quantificateur existentiel intégré dans le champ de la négation – reçoivent deux interprétations distinctes, surtout en position de sujet, suivant qu'ils apparaissent dans un énoncé déclaratif ou existentiel.Une lecture non référentielle s'impose en proposition existentielle, où ces SN contribuent à asserter la non existence ou l'absence d'objets (ou de substances ou d'ensembles d'objets) de la catégorie désignées par le nom tête. L'énoncé Dans cette région, il n'y a aucune classe maternelle de plus de quatorze enfants en constitue un exemple caractéristique.Dans des énoncés déclaratifs, comme Aucune maison n'a été épargnée, ce quantificateur négatif opère sur un sous-ensemble fini et spécifique d'objets de la catégorie dénotée par la tête nominale (c'est-à-dire maisons). L'existence de ce sous-ensemble étant présupposée, cette lecture est qualifiée de référentielle.Le problème traité dans cet article est celui d'identifier les facteurs responsables de la sélection de l'une ou de l'autre lecture. En fait, il n'existe pas de critère formel simple permettant de décider si un énoncé donné doit s'analyser comme déclaratif ou existentiel, sauf quand celui-ci fait intervenir une construction impersonnelle comme il y a. L'approche adoptée ici consiste à explorer les possibilités d'une analyse purement sémantique cantonnée dans la phrase. Une éventuelle analyse pragmatique interviendra à un stade ultérieur pour rendre compte des cas demeurés ambigus au niveau phrastique. Un examen des données fournies par un corpus informatisé a donné les résultats suivants :Un SN déterminé par AUCUN et sujet d'un verbe passif accepte seulement la lecture non référentielle, lorsqu'il a un nom tête syncatégorématique marqué [abstrait] et qu'il s'accompagne d'un verbe support. Quant aux SN en AUCUN sujets d'un verbe existentiel, ils manifestent une forte tendance à recevoir une interprétation non référentielle. En revanche, la lecture référentielle s'impose dès que le nom tête du SN sujet est catégorématique et marqué [animé] ou [concret] et que la structure sémantique du verbe est suffisamment riche pour lui assurer une certaine autonomie. En combinant un verbe qui impose peu de contraintes sémantiques à son sujet – ou aucune – à un SN sujet dénotant un référent concret ou animé, on obtiendra souvent une phase ambiguë, dont l'ambiguïté ne sera levée que par une prise en compte de facteurs discursifs ou pragmatiques.This study is concerned with the interpretation of French noun phrases containing an instance of the indefinite determiner AUCUN, which may be seen as existential quantifier in the scope of negation. Such noun phrases give rise to two distinct readings according as they appear in existential or declarative sentences, particularly in the subject position.In existential propositions an NP of the structure AUCUN N is used to asset the non existence of entities, substances, or sets of the category denoted by N relative to a specific location in time and space, as in Dans cette région, il n'y a aucune classe maternelle de plus de quatorze enfants. This reading of AUCUN N is being refused to as non referential.In a declarative sentence like Aucune maison n'a été épargnée, the negative quantifier operates on a finite, specific subset of entities of the category N (i. e. maisons), the existence of which is presupposed. It is asserted that the action, process, or state denoted by the verb does not hold for any of the members of this subset. This reading is claimed to be referential.The question addressed here is that of identifying the factors which determine the interpretation of an actual utterance. In fact, ther exist no simple formal criteria for deciding whether a given utterance containing a noun phrase of this structure should be analysed as declarative rather than existential, except where an explicit use of an impersonal construction such as il y a is involved. This problem must clearly be solved in order for a parser to work out valid inferences from this type of sentences. My approach is exclusively semantic, but an analysis along pragmatic lines may prove necessary in the end to account for certain cases. An analysis of the data obtained from a computer readable corpus yields the following results.A non referential reading is alone available for a subject NP of the type AUCUN N inpassivized sentences, if its head noun features the properties abstract and syncategorematic, and if it takes a verb which typically collocates with this noun (a « support » verb). Furthermore, there is a strong tendency for any subject NP containing AUCUN to be interpreted non referentially when combined with an intransitive existential verb, although a referential reading is shown not to be entirely excluded. On the other hand, the referential reading obtains whenever the nominal head of the subject NP is categorematic and subcategorized animate or concrete and combines with a verb whose semantic structure is sufficiently rich to gurarantee its autonomy. The combination of a verb, which imposes few semantic constraints on its subject – or none – and a subject NP denoting a concrete or animate referent, tends to produce an ambiguous sentence, which may only be disambiguated by taking pragmatic factors into account

Acute ischemic stroke after enjoying Top of Europe.

Sudden onset of disturbed consciousness, neurocognitive deficits, and weakness of the proximal limbs are typical findings of a watershed stroke. Occurrence after an intense emotional experience and electrocardiogram changes are hints toward the rare cause of stroke of a takotsubo cardiomyopathy, even more if the stroke pattern is embolic