The Effects of Dance/Movement Therapy on Treatment and Medication Compliance for Individuals Diagnosed with Schizophrenia: A Literature Review

With a high prevalence of non-medication compliance in individuals diagnosed with schizophrenia and a wide range of side effects from administered antipsychotics, it is imperative that the field of dance/movement therapy advocates for the implementation of dance/movement therapy in the treatment for this population. This literature review addressed the gap in dance/movement therapy research on the use of dance/movement therapy to reduce antipsychotic medication side effects and increase medication compliance. The multiple challenges faced by individuals diagnosed with schizophrenia were explored such as, stigmatization, the wide range of possible symptoms, poor insight, and movement dysfunctions. Side effects affecting cognitive, behavioral, and emotional functioning were also clarified. In addition, literature on the therapeutic relationship between dance/movement therapist and patient, body awareness, mind and body connection, physical activity, self-expression, and many other dance/movement therapy techniques were examined, followed by a review of dance/movement therapy literature with individuals diagnosed with schizophrenia. Dance/movement therapy has the potential to increase bodily awareness by providing the individual with insight into their medication side effects and reduce debilitating medication effects on cognitive, behavioral, and emotional functioning. Although limited research includes dance/movement therapy as a complementary form of treatment to increase medication compliance in individual diagnosed with schizophrenia, dance/movement therapy has shown to improve cognitive, behavioral, and emotional functioning in a variety of ways

Why Maintain Light Chain Isotypes? The Influence of Heavy Chain Isotype and Complementary Determining Region Lengths upon Light Chain Isotype in Xenopus laevis

Different immunoglobulin (Ig) heavy chain (H) isotypes have distinct functions, but so far it is unclear if Ig light (L) chains follow the same pattern. It is usually assumed that form follows function; but if this is true, then why have different IgL isotypes with no known functional differences? In this study we investigate IgH and IgL isotype preferential binding and complementary determining region (CDR) lengths to try to address this question using the African clawed frog, Xenopus laevis, as a model. Amphibians exhibit IgH isotype class switch at a single IgH locus and have an additional, more divergent, IgL isotype (σ) plus the two found in mammals (λ and κ). We used quantitative PCR (qPCR) analysis of IgH isotype of B cells sorted by surface IgL isotype expression to find evidence of preferential use of IgL isotype by IgH isotype. We found a relative skewing in the Igκ cells for IgY, in the Igλ cells for IgX, the Igσ cells for IgM, and corroborated published immunoprecipitations showing that IgY and Igσ do not pair with gene expression data of the IgL isotype sorted cells. Our data also suggests that the exaggerated CDR1 of IgHV families III and VII and the long CDR2 of Igσ may cramp IgH CDR3, making the IgHV III/VII-Igσ pairing less common. While these data do not resolve the conundrum of multiple IgL isotype maintenance in vertebrates, they do show that in a tetrapod with several IgH and several IgL isotype options, IgL isotype use is not random

Goals of Care Documentation: Insights from A Pilot Implementation Study

ContextThe Life Sustaining Treatment Decision Initiative is a national effort by the Veterans Health Administration to ensure goals of care documentation occurs among all patients at high risk of life-threatening events. ObjectivesExamine likelihood to receive goals of care documentation and explore associations between documentation and perceived patient care experience at the individual and site level. MethodsRetrospective, quality improvement analysis of initiative pilot data from four geographically diverse Veterans Affairs (VA) sites (Fall 2014-Winter 2016) before national roll-out. Goals of care documentation according to gender, marital status, urban/rural status, race/ethnicity, age, serious health condition, and Care Assessment Needs scores. Association between goals of care documentation and perceived patient care experience analyzed based on Bereaved Family Survey outcomes of overall care, communication, and support. ResultsVeterans were more likely to have goals of care documentation if widowed, urban residents, and of white race. Patients older than 65-years and those with a higher Care Assessment Needs score were twice as likely as a frail patient to have goals of care documented. One pilot site demonstrated a positive association between documentation and perceived support. Pilot site was a statistically significant predictor of the occurrence of goals of care documentation and Bereaved Family Survey scores. ConclusionOlder and seriously ill patients were most likely to have goals of care documented. Association between a documented goals of care conversation and perceived patient care experience were largely unsupported. Site-level largely contributed to understanding the likelihood of documentation and care experience

Cortico-amygdalar connectivity and externalizing/internalizing behavior in children with neurodevelopmental disorders

Background: Externalizing and internalizing behaviors contribute to clinical impairment in children with neurodevelopmental disorders (NDDs). Although associations between externalizing or internalizing behaviors and cortico-amygdalar connectivity have been found in clinical and non-clinical pediatric samples, no previous study has examined whether similar shared associations are present across children with different NDDs. Methods: Multi-modal neuroimaging and behavioral data from the Province of Ontario Neurodevelopmental Disorders (POND) Network were used. POND participants aged 6–18 years with a primary diagnosis of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) or obsessive–compulsive disorder (OCD), as well as typically developing children (TDC) with T1-weighted, resting-state fMRI or diffusion weighted imaging (DWI) and parent-report Child Behavioral Checklist (CBCL) data available, were analyzed (total n = 346). Associations between externalizing or internalizing behavior and cortico-amygdalar structural and functional connectivity indices were examined using linear regressions, controlling for age, gender, and image-modality specific covariates. Behavior-by-diagnosis interaction effects were also examined. Results: No significant linear associations (or diagnosis-by-behavior interaction effects) were found between CBCL-measured externalizing or internalizing behaviors and any of the connectivity indices examined. Post-hoc bootstrapping analyses indicated stability and reliability of these null results. Conclusions: The current study provides evidence towards an absence of a shared linear relationship between internalizing or externalizing behaviors and cortico-amygdalar connectivity properties across a transdiagnostic sample of children with different primary NDD diagnoses and TDC. Different methodological approaches, including incorporation of multi-dimensional behavioral data (e.g., task-based fMRI) or clustering approaches may be needed to clarify complex brain-behavior relationships relevant to externalizing/internalizing behaviors in heterogeneous clinical NDD populations

Problem opioid use and HIV primary care engagement among hospitalized people who use drugs and/or alcohol

Background There is growing public health concern around the potential impact of the opioid crisis on efforts to eradicate HIV. This secondary analysis seeks to determine if those who report opioids as their primary problem drug compared to those who report other drugs and/or alcohol differ in engagement in HIV primary care among a sample of hospitalized people with HIV (PWH) who use drugs and/or alcohol, a traditionally marginalized and difficult to engage population key to ending the HIV epidemic. Setting and participants A total of 801 participants (67% male; 75% Black, non-Hispanic; mean age 44.2) with uncontrolled HIV and reported drug and/or alcohol use were recruited from 11 hospitals around the U.S. in cities with high HIV prevalence from 2012 to 2014 for a multisite clinical trial to improve HIV viral suppression. Methods A generalized linear model compared those who reported opioids as their primary problem drug to those who reported other problem drugs and/or alcohol on their previous engagement in HIV primary care, controlling for age, sex, race, education, income, any previous drug and/or alcohol treatment, length of time since diagnosis, and study site. Results A total of 95 (11.9%) participants reported opioids as their primary problem drug. In adjusted models, those who reported opioids were significantly less likely to have ever engaged in HIV primary care than those who reported no problem drug use (adjusted risk ratio, ARR = 0.84, 95% Confidence Interval, CI 0.73, 0.98), stimulants (ARR = 0.84, 95% CI 0.74, 0.95), and polydrug use but no alcohol (ARR = 0.79, 95% CI 0.68, 0.93). While not statistically significant, the trend in the estimates of the remaining drug and/or alcohol categories (alcohol, cannabis, polydrug use with alcohol, and [but excluding the estimate for] other), point to a similar phenomena—those who identify opioids as their primary problem drug are engaging in HIV primary care less. Conclusions These findings suggest that for hospitalized PWH who use drugs and/or alcohol, tailored and expanded efforts are especially needed to link those who report problem opioid use to HIV primary care. Trial registration This study was funded by National Institutes of Health (NIH) grant: U10-DA01372011 (Project HOPE—Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users; Metsch); which is also a registered clinical trial under the Clinical Trials Network (CTN-0049). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH

Kepler eclipsing binary stars. VII. the catalogue of eclipsing binaries found in the entire Kepler data set

The primary Kepler Mission provided nearly continuous monitoring of ~200,000 objects with unprecedented photometric precision. We present the final catalog of eclipsing binary systems within the 105 deg2 Kepler field of view. This release incorporates the full extent of the data from the primary mission (Q0-Q17 Data Release). As a result, new systems have been added, additional false positives have been removed, ephemerides and principal parameters have been recomputed, classifications have been revised to rely on analytical models, and eclipse timing variations have been computed for each system. We identify several classes of systems including those that exhibit tertiary eclipse events, systems that show clear evidence of additional bodies, heartbeat systems, systems with changing eclipse depths, and systems exhibiting only one eclipse event over the duration of the mission. We have updated the period and galactic latitude distribution diagrams and included a catalog completeness evaluation. The total number of identified eclipsing and ellipsoidal binary systems in the Kepler field of view has increased to 2878, 1.3% of all observed Kepler targets