Body, Mind & Spirit Articles and Latest News

Related Articles

Speech recognition for the anaesthesia record during crisis scenarios.

Int J Med Inform. 2008 Jul;77(7):448-60

Authors: Alapetite A

INTRODUCTION: This article describes the evaluation of a prototype speech-input interface to an anaesthesia patient record, conducted in a full-scale anaesthesia simulator involving six doctor-nurse anaesthetist teams. OBJECTIVE: The aims of the experiment were, first, to assess the potential advantages and disadvantages of a vocal interface compared to the traditional touch-screen and keyboard interface to an electronic anaesthesia record during crisis situations; second, to assess the usability in a realistic work environment of some speech input strategies (hands-free vocal interface activated by a keyword; combination of command and free text modes); finally, to quantify some of the gains that could be provided by the speech input modality. METHODS: Six anaesthesia teams composed of one doctor and one nurse were each confronted with two crisis scenarios in a full-scale anaesthesia simulator. Each team would fill in the anaesthesia record, in one session using only the traditional touch-screen and keyboard interface while in the other session they could also use the speech input interface. Audio-video recordings of the sessions were subsequently analysed and additional subjective data were gathered from a questionnaire. Analysis of data was made by a method inspired by queuing theory in order to compare the delays associated to the two interfaces and to quantify the workload inherent to the memorization of items to be entered into the anaesthesia record. RESULTS: The experiment showed on the one hand that the traditional touch-screen and keyboard interface imposes a steadily increasing mental workload in terms of items to keep in memory until there is time to update the anaesthesia record, and on the other hand that the speech input interface will allow anaesthetists to enter medications and observations almost simultaneously when they are given or made. The tested speech input strategies were successful, even with the ambient noise. Speaking to the system while working appeared feasible, although improvements in speech recognition rates are needed. CONCLUSION: A vocal interface leads to shorter time between the events to be registered and the actual registration in the electronic anaesthesia record; therefore, this type of interface would likely lead to greater accuracy of items recorded and a reduction of mental workload associated with memorization of events to be registered, especially during time constrained situations. At the same time, current speech recognition technology and speech interfaces require user training and user dedication if a speech interface is to be used successfully.

PMID: 17904900 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

Predictors of dropout from group therapy among patients with bipolar and substance use disorders.

Drug Alcohol Depend. 2008 Apr 1;94(1-3):272-5

Authors: Graff FS, Griffin ML, Weiss RD

OBJECTIVE: Bipolar and substance use disorders frequently co-occur. Integrated treatment for these disorders has been shown to be effective at reducing substance use, but no study has examined attrition from dual diagnosis group therapy. The current study identified baseline demographic and clinical characteristics that predict treatment dropout among patients with co-occurring bipolar and substance use disorders. METHOD: Using binary and multivariate analyses, baseline data were analyzed as part of a randomized controlled trial of integrated group therapy for bipolar and substance use disorders. RESULTS: Cigarette smoking, recent mood episode, and lack of a college education were strong predictors of dropout after controlling for demographic and substance use variables. CONCLUSIONS: Given the strength of smoking as a predictor of dropout as well as the high rate of smoking among this population, a greater focus on the relationship between smoking and bipolar disorder is warranted.

PMID: 18162331 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

Levodopa pharmacotherapy for cocaine dependence: choosing the optimal behavioral therapy platform.

Drug Alcohol Depend. 2008 Apr 1;94(1-3):142-50

Authors: Schmitz JM, Mooney ME, Moeller FG, Stotts AL, Green C, Grabowski J

BACKGROUND: The dopamine precursor levodopa has shown some, albeit relatively weak, promise in treating cocaine dependence. This study sought to identify the most appropriate behavioral therapy platform for levodopa pharmacotherapy by evaluating its effect when administered in combination with behavioral platforms of varying intensities. METHOD: A total of 161 treatment-seeking cocaine dependent subjects received sustained release levodopa/carbidopa (400/100mg bid, Sinemet) or placebo delivered in combination with Clinical Management (ClinMan); ClinMan+cognitive behavioral therapy (CBT); or ClinMan+CBT+voucher-based reinforcement therapy (VBRT) in a 12-week randomized, placebo-controlled, double-blind (for medication condition) trial. Medication compliance was monitored with riboflavin (100mg/capsule) and the Medication Event Monitoring System. Protocol compliance was addressed in weekly, 10-min nurse-delivered ClinMan sessions. Weekly, 1-h CBT sessions focused on coping skills training. VBRT (with escalating reinforcer value) provided cash-valued vouchers contingent on cocaine-negative urine toxicology results. Urine benzoylecgonine assays collected thrice-weekly were analyzed by intention-to-treat criteria using generalized linear mixed models. RESULTS: Levodopa main effects were found on all outcome measures of cocaine use. Contrasts testing the levodopa-placebo difference within each behavioral platform found reliable effects, favoring levodopa, only in the VBRT platform. Levodopa treatment with vouchers produced higher proportions of cocaine-negative urines and longer periods of consecutive abstinence compared to other treatment combinations. CONCLUSION: This is the first study to find a significant treatment effect for levodopa and, in doing so, to demonstrate that the magnitude of this effect is dependent upon conditions of the behavioral therapy platform. The data support use of levodopa with abstinence-based reinforcement therapy as one efficacious combination in cocaine dependence disorder treatment.

PMID: 18164144 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

Effectiveness of brief alcohol interventions for general practice patients with problematic drinking behavior and comorbid anxiety or depressive disorders.

Drug Alcohol Depend. 2008 Apr 1;94(1-3):214-20

Authors: Grothues JM, Bischof G, Reinhardt S, Meyer C, John U, Rumpf HJ

BACKGROUND: Brief interventions (BIs) are effective methods to reduce problematic drinking. It is not known, if the effectiveness of BI differs between patients with or without comorbid depression or anxiety disorders. METHODS: In a randomized controlled BI study with two intervention groups and one control condition, data were collected from 408 general practice (GP) patients with alcohol use disorders, at-risk drinking or binge drinking. 88 participants were diagnosed with comorbid anxiety and/or depressive disorders. The effectiveness of BI was assessed at a 12-month follow-up in relation to the presence and absence of comorbidity. Reduction of drinking in six ordered categories (g/alcohol) between baseline and follow-up served as the outcome variable. RESULTS: BI were significantly related to reduction of drinking in the non-comorbid (-2.64 g/alcohol vs. -8.61 g/alcohol; p=.03) but not in the comorbid subsample (-22.06 g/alcohol vs. -22.09 g/alcohol; p=.76). Compared to non-comorbid participants, a significantly higher reduction of drinking was found for comorbid individuals (-6.55 g/alcohol vs. -22.08 g/alcohol; p=.01). An ordinal regression analysis revealed comorbidity to be a positive predictor for reduction of drinking (estimator=.594; CI=.175-1.013; p<.01). When entering the variables amount of drinking at baseline, intervention and classification of problematic drinking, these became significant predictors, whereas comorbidity showed only a tendency. CONCLUSION: BI did not significantly effect a reduction of drinking in comorbid patients. As BI are known to be less effective for dependent drinkers, a larger proportion of dependents among the comorbid might have limited the effectiveness of BI. Future studies with larger sample sizes of comorbid problem drinkers are necessary to confirm the results.

PMID: 18207336 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

Methodological issues in current antipsychotic drug trials.

Schizophr Bull. 2008 Mar;34(2):275-85

Authors: Leucht S, Heres S, Hamann J, Kane JM

Every year numerous reports on antipsychotic drug trials are being published in neuropsychiatric journals, adding new information to our knowledge in the field. The information however is often hard for the reader to interpret, sometimes contradictory to comparable available studies and leaves more questions open than it actually answers. Although the overall quality of the studies is rather good, there are manifold options for further improvement in the conception, conduct, and reporting of antipsychotic drug trials. In this survey, we address methodological challenges such as the limited generalizability of outcomes due to patient selection and sample size; the vague or even lacking definition of key outcome parameters such as response, remission or relapse, insufficient blinding techniques, the pitfalls of surrogate outcomes and their assessment tools; the varying complex statistical approaches; and the challenge of balancing various ways of reporting outcomes. The authors present practical examples to highlight the current problems and propose a concrete series of suggestions on how to further optimize antipsychotic drug trials in the future.

PMID: 18234700 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

[Borderline personality disorder in dermatology]

Hautarzt. 2008 Apr;59(4):304-7

Authors: Jasch K, Hermes B, Seikowski K, Harth W

Borderline personality disorder is a syndrome of complex psychopathology which is not very common in dermatology. The emotional symptoms are broad and variable, but typically feature emotional instability, intense anger or lack of control of anger, impulsiveness, instabilities in self-perception, problems at work, chronic feelings of emptiness, unstable partnership relations and recurrent suicidal threats. Self-inflicted injuries are common and may lead patients to dermatologists. A 26-year old woman with borderline personality was hospitalized for neurosyphilis. During inpatient treatment she repeatedly cut herself with razor blades. This article highlights the diagnostic criteria and differential approach of the borderline personality disorder in order to facilitate early recognition and therapy.

PMID: 18338145 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

[Psychodermatology]

Hautarzt. 2008 Apr;59(4):287-8

Authors: Gieler U, Harth W

PMID: 18340415 [PubMed - indexed for MEDLINE]

[Read more →]

[Review of symptoms and therapy of paraphylias]

Psychiatr Hung. 2007;22(6):408-17

Authors: Kórász K, Koras R, Simon L

The authors review the historical main milestones in the legislative aspects of sexual deviances, from ancient times through age of enlightenment to present times, including the factors affecting the Hungarian public attitudes towards it. The evolution of nomenclature of sexual orientation disorders is also evaluated thoroughly, detailing the DSM-IV-TR classification and the attempts and difficulties to further develop the present classification system. The authors also review the difficulties of epidemiological studies and sum up the pioneer work of Alfred Kinsey. The etiology of paraphylias is summed up based on biological, psychodynamic and learning theory approaches. Finally, the pharmacological and psychotherapeutic interventions are evaluated considering also comorbidity, outer control and forensic psychiatric aspects.

PMID: 18445868 [PubMed - indexed for MEDLINE]

[Read more →]

[Mirror neurons–novel data on the neurobiology of intersubjectivity]

Psychiatr Hung. 2007;22(6):418-29

Authors: Simon M, Herold R, Fekete S, Tényi T

Social experiences are largely intersubjective in nature, offering an abundance of pre-reflective, simulative knowledge of others’ subjective experiences. In the last decades, special mirror neurons have been found in the premotor area and in the posterior parietal cortex. They directly link perception to action: the perception of actions activates the relevant parts of the observer’s motor system. Emotional expressions evoke resonance states inside the observer in a similar way. Besides underscoring the prereflective and implicit nature of intersubjectivity, this can provide an access to the neuronal basis of empathy and intuition. Moreover, a new integration of psychoanalysis and neuroscience seems to be possible, which shifts the psychoanalytic technique toward non-verbal and non-interpretative methods, and can explain psychoanalytic phenomena, such as introjection, projection, transference, counter-transference, and the very complex enactments.

PMID: 18445869 [PubMed - indexed for MEDLINE]

[Read more →]

Related Articles

[Sexual self-reflection in patients with atopic dermatitis and psoriasis]

Hautarzt. 2008 Apr;59(4):297-303

Authors: Seikowski K, Gelbrich M, Harth W

OBJECTIVE: The aim of this study was to evaluate the differences between the Sexual Self-Reflection in patients with atopic dermatitis and psoriasis from a group of healthy controls. Furthermore the influence of coping with the disease and pruritus on the patients’ sexuality was studied METHODS: Patients with atopic dermatitis (n=38), psoriasis (n=31) and healthy controls (n=33) were tested with various psychological questionnaires. The German questionnaire for partnership attributes (PFB), Marburg questionnaire for coping with skin diseases (MHF) and questionnaire for pruritus and cognition (JKF), and sexual self-concept questionnaire (MSSCQ) served as psychometric measures. RESULTS: Patients with atopic dermatitis showed more fears of sex, with pruritus being the main factor, so that controlling pruritus should also improve sexual experience. Patients with psoriasis and sexual problems showed significantly more social fears and avoidance. CONCLUSION: Appropriate psychosomatic care and educational programs including the therapy of social fears, avoidance and pruritus may also improve sexual life in patients with psoriasis or atopic dermatitis.

PMID: 18340414 [PubMed - indexed for MEDLINE]

[Read more →]