Evaluating the Effectiveness of a Parent Training Protocol Based on an Acceptance and Commitment Therapy on Happiness and Mental Adjustment among Mothers with Slow Paced Children

Background: The birth of a mentally retarded child can have a profound impact on the entire family; parents face many logistical and emotional difficulties that can impact their happiness and mental adjustment. We aimed to investigate the effectiveness of the parent training protocol based on an acceptance and commitment therapy on happiness and mental adjustment among mothers with slow paced children.Methods: The population of this quasi-experimental included all the mothers with slow-paced children in Tehran, Iran, from 2020. Samples of the study were selected using purposive sampling and randomly divided into an experimental group (Parent training protocol) (n=15), and a control group (n=15). Each of the experimental participants was trained for ten 90-minute sessions, while no therapy was provided to the control group.  The subjects were assessed before and after treatment using the Persian Version of the Mini-MAC and Oxford happiness questionnaire (OHQ). The data was analyzed Using version 18.0.Results: The total sample was 30 mothers with slow-paced children, among whom the highest frequency was for the age group of 37-45 years with the mean age of 43.3. The results showed that the acceptance and commitment therapy had significant effects on happiness (F= 83.4; P=0.04) and mental adjustment (F = 80.9; P=0.06) of the mothers with slow-paced children.Conclusion: Parent training protocol based on an acceptance and commitment therapy increased the happiness of mothers with slow-paced children and improved their mental adjustment

Comparison of the CES-D and PHQ-9 depression scales in people with type 2 diabetes in Tehran, Iran

<p>Abstract</p> <p>Background</p> <p>The quality of life in patients with various chronic disorders, including diabetes has been directly affected by depression. Depression makes patients less likely to manage their self-care regimens. Accurate assessment of depression in diabetic populations is important to the treatment of depression in this group and may improve diabetes management. To our best knowledge, there are few studies that have looked for utilizing questionnaires in screening for depression among patients with diabetes in Iran. Therefore the aim of this study was to assess the efficacy and accuracy of the Center for Epidemiological Studies Depression (CES-D) scale and the Patient Health Questionnaire-9 (PHQ-9), in comparison with clinical interview in people with type 2 diabetes.</p> <p>Methods</p> <p>Outpatients who attended diabetes clinics at IEM were recruited on a consecutive basis between February 2009 and July 2009. Inclusion criteria included patients with type 2 diabetes who could fluently read and speak Persian, had no severe diabetes complications and no history of psychological disorders. The history of psychological disorders was ascertained through patients' medical files, taking history of any medications in this regard. The study design was explained to all patients and informed consent was obtained. Volunteer patients completed the Persian version of the questionnaires (CES-D and PHQ-9) and a psychiatrist interviewed them based on Structured Clinical Interview (SCID) for DSM-IV criteria.</p> <p>Results</p> <p>Of the 185 patients, 43.2% were diagnosed as having Major Depressive Disorder (MDD) based on the clinical interview, 47.6% with PHQ-9 and 61.62% with CES-D. The Area Under the Curve (AUC) for the total score of PHQ-9 was 0.829 ± 0.30. A cut-off score for PHQ-9 of ≥ 13 provided an optimal balance between sensitivity (73.80%) and specificity (76.20%). For CES-D the AUC for the total score was 0.861 ± 0.029. Optimal balance between sensitivity (78.80%) and specificity (77.1%) was provided at cut-off score of ≥ 23.</p> <p>Conclusions</p> <p>It could be concluded that the PHQ-9 and CES-D perform well as screening instruments, but in diagnosing major depressive disorder, a formal diagnostic process following the PHQ-9 and also the CES-D remains essential.</p

Integrating depression care within NCD provision in Bangladesh and Pakistan : a qualitative study

Background Co-morbidity of depression with other non-communicable diseases (NCDs) worsens clinical outcomes for both conditions. Low- and middle-income countries need to strengthen mechanisms for detection and management of co-morbid depression within NCDs. The Behavioural Activation for Comorbid Depression in Non-communicable Disease (BEACON) study explored the acceptability and feasibility of integrating a brief depression intervention (behavioural activation, BA) into NCD services in healthcare facilities in Bangladesh and Pakistan. Methods Face-to-face qualitative interviews were conducted with 43 patients and 18 health workers attending or working in NCD centres in four healthcare facilities in Bangladesh and Pakistan, and with three policy makers in each country. The interviews addressed four research questions (1) how NCD care is delivered, (2) how NCD patients experience distress, (3) how depression care is integrated within NCD provision, and (4) the challenges and opportunities for integrating a brief depression intervention into usual NCD care. The data were analysed using framework analysis, organised by capability, opportunity and motivation factors, cross-synthesised across countries and participant groups. Results Patients and health workers described NCD centres as crowded and time pressured, with waiting times as long as five hours, and consultation times as short as five minutes; resulting in some patient frustration. They did not perceive direct links between their distress and their NCD conditions, instead describing worries about family and finance including affordability of NCD services. Health worker and policy maker accounts suggested these NCD centres lacked preparedness for treating depression in the absence of specific guidelines, standard screening tools, recording systems or training. Barriers and drivers to integrating a brief depression intervention reflected capability, opportunity and motivation factors for all participant groups. While generally valuing the purpose, significant challenges included the busy hospital environment, skill deficits and different conceptions of depression. Conclusions Given current resource constraints and priorities, integrating a brief psychological intervention at these NCD centres appears premature. An opportune first step calls for responding to patients’ expressed concerns on service gaps in provisioning steady and affordable NCD care. Acknowledging differences of conceptions of depression and strengthening psychologically informed NCD care will in turn be required before the introduction of a specific psychological intervention such as BA

Analysis of knee sound signals via least squares modeling

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Predicting Polysomnography Parameters from Anthropometric Features and Breathing Sounds Recorded during Wakefulness

Background: The apnea/hypopnea index (AHI) is the primary outcome of a polysomnography assessment (PSG) for determining obstructive sleep apnea (OSA) severity. However, other OSA severity parameters (i.e., total arousal index, mean oxygen saturation (SpO2%), etc.) are crucial for a full diagnosis of OSA and deciding on a treatment option. PSG assessments and home sleep tests measure these parameters, but there is no screening tool to estimate or predict the OSA severity parameters other than the AHI. In this study, we investigated whether a combination of breathing sounds recorded during wakefulness and anthropometric features could be predictive of PSG parameters. Methods: Anthropometric information and five tracheal breathing sound cycles were recorded during wakefulness from 145 individuals referred to an overnight PSG study. The dataset was divided into training, validation, and blind testing datasets. Spectral and bispectral features of the sounds were evaluated to run correlation and classification analyses with the PSG parameters collected from the PSG sleep reports. Results: Many sound and anthropometric features had significant correlations (up to 0.56) with PSG parameters. Using combinations of sound and anthropometric features in a bilinear model for each PSG parameter resulted in correlation coefficients up to 0.84. Using the evaluated models for classification with a two-class random-forest classifier resulted in a blind testing classification accuracy up to 88.8% for predicting the key PSG parameters such as arousal index. Conclusions: These results add new value to the current OSA screening tools and provide a new promising possibility for predicting PSG parameters using only a few seconds of breathing sounds recorded during wakefulness without conducting an overnight PSG study

Neurocognitive Treatment for a Patient with Alzheimer's Disease Using a Virtual Reality Navigational Environment

In this case study, a man at the onset of Alzheimer's disease (AD) was enrolled in a cognitive treatment program based upon spatial navigation in a virtual reality (VR) environment. We trained him to navigate to targets in a symmetric, landmark-less virtual building. Our research goals were to determine whether an individual with AD could learn to navigate in a simple VR navigation (VRN) environment and whether that training could also bring real-life cognitive benefits. The results show that our participant learned to perfectly navigate to desired targets in the VRN environment over the course of the training program. Furthermore, subjective feedback from his primary caregiver (his wife) indicated that his skill at navigating while driving improved noticeably and that he enjoyed cognitive improvement in his daily life at home. These results suggest that VRN treatments might benefit other people with AD

Design and Application of a Novel Virtual Reality Navigational Technology (VRNChair)

This paper presents a novel virtual reality navigation (VRN) input device, called the VRNChair, offering an intuitive and natural way to interact with virtual reality (VR) environments. Traditionally, VR navigation tests are performed using stationary input devices such as keyboards or joysticks. However, in case of immersive VR environment experiments, such as our recent VRN assessment, the user may feel kinetosis (motion sickness) as a result of the disagreement between vestibular response and the optical flow. In addition, experience in using a joystick or any of the existing computer input devices may cause a bias in the accuracy of participant performance in VR environment experiments. Therefore, we have designed a VR navigational environment that is operated using a wheelchair (VRNChair). The VRNChair translates the movement of a manual wheelchair to feed any VR environment. We evaluated the VRNChair by testing on 34 young individuals in two groups performing the same navigational task with either the VRNChair or a joystick; also one older individual (55 years) performed the same experiment with both a joystick and the VRNChair. The results indicate that the VRNChair does not change the accuracy of the performance; thus removing the plausible bias of having experience using a joystick. More importantly, it significantly reduces the effect of kinetosis. While we developed VRNChair for our spatial cognition study, its application can be in many other studies involving neuroscience, neurorehabilitation, physiotherapy, and/or simply the gaming industry

rTMS as a Treatment of Alzheimer’s Disease with and without Comorbidity of Depression: A Review

With an ever-increasing population of Alzheimer’s disease (AD) patients worldwide, a noninvasive treatment for AD is needed. In this paper, the application of repetitive transcranial magnetic stimulus (rTMS) as a treatment for patients with probable AD is compared to the application of rTMS as a treatment for depression. Comorbidity of depression and dementia is discussed, as well as possible links between the two diseases. The possible confounding antidepressant effects of rTMS on cognitive improvements in AD patients are discussed