The Concomitant Relationship Shared by Sleep Disturbances and Type 2 Diabetes: Developing Telemedicine as a Viable Treatment Option

Individually, sleep disturbances and type 2 diabetes pose pervasive challenges to health. In addition, the negative symptomology associated with each condition is exacerbated further when presenting concomitantly. This relationship formulates a destructive loop wherein those with diabetes experience decreased sleep quality, which, in turn, worsens a wide range of health threats experienced by those with diabetes, including obesity and glucose intolerance. Because major lifestyle changes and daily care are needed to effectively manage both diabetes and sleep disturbances, an efficient and timely modality of treatment is essential. Advanced technology incorporating telemedicine and telehealth has the potential to enhance treatment by delivering accepted standard of care, medical monitoring, and education quickly and seamlessly—even in rural locations. This type of intervention has the added potential benefit of fostering patient empowerment

Optimal Management for People with Severe Spasticity

Spasticity is characterized by velocity-dependent increase in tonic stretch reflexes and tendon jerks. Many people affected by spasticity receive late treatment, or no treatment, which greatly reduces the potential to regain full motor control and restore function. There is much to consider before determining treatment for people with spasticity. Treatment of pediatric patients increases the complexity, because of the substantial difference between adult and pediatric spasticity. Proper patient evaluation, utilization of scales and measures, and obtaining patient and caregiver history is vital in determining optimal spasticity treatment. Further, taking into consideration the limitations and desires of individuals serve as a guide to best management. We have grouped contributing factors into the IDAHO Criteria to elucidate a multidisciplinary approach, which considers a person’s complete field of experience. This model is applied to goal setting, and recognizes the importance of a spasticity management team, comprising the treatment subject, his/her family, the environment, and a supportive, well-informed medical staff. The criteria take into account the complexity associated with diagnosing and treating spasticity, with the ultimate goal of improved function

Telemedicine Facilitates CHF Home Health Care for Those with Systolic Dysfunction

An estimated 5 million Americans have congestive heart failure (CHF) and one in five over the age of 40 will develop CHF. There are numerous examples of CHF patients living beyond the years normally expected for people with the disease, usually attributed to taking an active role in disease management. A relatively new alternative for CHF outpatient care is telemedicine and e-health. We investigated the effects of a 6-week in-home telemedicine education and monitoring program for those with systolic dysfunction on the utilization of health care resources. We also measured the effects of the unit 4.5 months after its removal (a total of 6 months post introduction of the unit into the home). Concurrently, we assessed participants' perceptions of the value of having a telemedicine unit. Participants in the telemedicine group reported weighing more times a week with less variability than did the control group. Telemedicine led to a reduction in physician and emergency department visits and those in the experimental group reported the unit facilitating self-care, though this was not significantly different from the control group (possibly due to small sample size). These findings suggest a possibility for improvement in control of CHF when telemedicine is implemented. Our review of the literature also supports the role of telemedicine in facilitating home health care and self-management for CHF patients. There are many challenges still to be addressed before this potential can be reached and further research is needed to identify opportunities in telemedicine

Conscious and Unconscious Retrieval in Picture Recognition: A Framework for Exploring Gender Differences

The authors explored gender differences by examining 2 distinct memory processes involved in recognizing pictures that were scenes captured from videotapes. For Study 1, the authors used a process dissociation procedure (L. J. Anooshian & P. S. Seibert, 1995; L. L. Jacoby, 1991) to obtain separate estimates of the contributions of recollection (conscious retrieval) and sense of familiarity (unconscious retrieval) in recognizing scenes along previously viewed routes of travel. Women obtained higher familiarity scores than did men, whereas no gender difference emerged for conscious recollection. In Study 2, the authors tested both preschool children and adults and found results similar to those in Study 1 for a task with pictures captured from children\u27s cartoons, regardless of age. The results from these studies illustrated the need for greater attention to diverse memory processes when investigating individual differences, including gender differences, in diverse task domains

The Arduous Path Toward Healthcare Reform: Is Unification of Ideals and Realities Possible?

The American healthcare system is in a state of crisis, and through it, the ethical protocols of the medical profession have been called into question. The 50.7 million uninsured Americans,14,24 the rising cost of insurance for individuals and small businesses, hospital inefficiencies and scandals, and the ambiguous relationship shared by the legal and medical professions have made healthcare delivery increasingly difficult for neurosurgeons and other medical professionals to perform their jobs. By scrutinizing the current status of the healthcare system with an understanding of ideals, ethics and the realities of America’s healthcare crisis, adjustments can be made and the integrity of the medical profession can be maintained

Indirect Expression of Preference in Sketch Maps

First graders, fifth graders, university students, and older adults drew sketch maps of familiar environments. Not until after the sketch maps were collected did subjects have any idea that the study had anything to do with expression of preferences. At that time, subjects were asked to identify (recall) objects located in the environment drawn that they liked most, disliked most, and about which they felt neutral These items were compared with other items on the sketch maps to determine whether they were drawn on the same scale, were emphasized, or were absent. A similar pattern of results was found across age groups; most of the subjects did not draw items they disliked on their sketch maps. These results suggested a dissociation between indirect (map drawing) and direct (specific recall) approaches to expressing preferences

Diversity Within Spatial Cognition: Memory Processes Underlying Place Recognition

We conducted three experiments to explore distinct memory processes involved in remembering places in spatial environments. The results of all three experiments demonstrated the viability of the process-dissociation procedure for studying spatial cognition; that procedure yielded separate measures of the role of familiarity (implicit memory) and conscious recollection (explicit memory) in recognizing scenes along a previously viewed route of travel. Those measures were not affected by whether the participants viewed videotapes or also physically walked the route of travel. Increasing the delay between encoding and retrieval led to comparable effects for familiarity and conscious recollection (Experiment 1). In contrast, the adverse consequences of dividing attention during encoding were specific to conscious recollection; familiarity estimates were unaffected (Experiments 2 and 3). Overall, the results reinforced the viability of process dissociation as a vehicle for exploring diverse memory processes underlying place recognition

Effects of Emotional Mood States in Recognizing Places: Disentangling Conscious and Unconscious Retrieval

The effects of emotional mood states on remembering scenes along a route of travel were examined in two experiments. For Experiment 1, 48 participants were exposed to a route of travel following a sad, happy, or neutral mood-induction procedure. Process dissociation (Jacoby, 1991) was used to derive separate estimates of the relative roles of conscious recollection and sense of familiarity (unconscious retrieval) in recognizing scenes. Conscious recollection, but not familiarity, was adversely affected by being in an emotional mood state during exposure. For Experiment 2, 24 participants given neutral mood induction were divided according to self-reports of induced mood. Participants in the sad mood group selected more old frames such as looking sad in a later test of implicit memory (unconscious retrieval) than did those in the happy mood group. These results reinforced that researchers must address diverse memory processes to understand the role of emotional mood states in spatial cognition

Mood and Lexical Access of Positive, Negative, and Neutral Words

Two experiments based upon the Reicher task were conducted to investigate the influence of happy, sad, and neutral moods on the processing of positive, negative, and neutral words. In Experiment 1 participants showed least advantage in determining which of two one-letter-different words, in comparison with nonword controls, had been presented for words that were valenced in congruence with the induced mood. In Experiment 2 mood acted as a prime that produced a detrimental effect of presenting nontarget mood-congruent preview words on participants\u27 performance on the valenced targets. The authors contend that these effects are related to mood’s altering of the baseline activation levels of congruently valenced word nodes in the mental lexicon as well as to mood’s narrowing of the spatial focus of attention