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Exaggerated force production in altered Gz-levels during parabolic flight: the role of computational resources allocation.

Ergonomics. 2010 Feb;53(2):278-85

Authors: Mierau A, Girgenrath M

The purpose of the present experiment was to examine whether the previously observed exaggerated isometric force production in changed-Gz during parabolic flight (Mierau et al. 2008) can be explained by a higher computational demand and, thus, inadequate allocation of the brain’s computational resources to the task. Subjects (n = 12) were tested during the micro-Gz, high-Gz and normal-Gz episodes of parabolic flight. They produced isometric forces of different magnitudes and directions, according to visually prescribed vectors with their right, dominant hand and performed a choice reaction-time task with their left hand. Tasks were performed either separately (single-task) or simultaneously (dual-task). Dual-task interference was present for both tasks, indicating that each task was resources-demanding. However, this interference remained unaffected by the Gz-level. It was concluded that exaggerated force production in changed-Gz is probably not related to inadequate allocation of the brain’s computational resources to the force production task. Statement of Relevance: The present study shows that deficient motor performance in changed-Gz environments (both micro-Gz and high-Gz) is not necessarily related to inadequate computational resources allocation, as was suggested in some previous studies. This finding is of great relevance not only for fundamental research, but also for the training and safety of humans operating in changed-Gz environments, such as astronauts and jet pilots.

PMID: 20099180 [PubMed - indexed for MEDLINE]

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An intervention for delirium superimposed on dementia based on cognitive reserve theory.

Aging Ment Health. 2010 Mar;14(2):232-42

Authors: Kolanowski AM, Fick DM, Clare L, Therrien B, Gill DJ

Delirium superimposed on dementia (DSD) accelerates the trajectory of functional decline and results in prolonged hospitalization, re-hospitalization, premature nursing home placement, and death. In this article we propose a theory-based intervention for DSD that is derived from the literature on cognitive reserve and neuroplasticity. We begin by defining cognitive reserve, the guiding framework for our hypothesis. We review the pathophysiology and neuropsychology of delirium noting the similarities with dementia-these two conditions reflecting acute and chronic reductions in cognitive reserve, respectively. We then review the evidence for activity-dependent plasticity as a possible mechanism for sparing cognitive reserve in dementia and its potential for addressing DSD. Cognitive training (CT) in the form of stimulating activities has been shown to evoke cognitive processing and facilitate plasticity in dementia. Because of the similarities between dementia and delirium, the use of recreational activities as a vehicle for supporting attentional capacity, and delivering cognitive stimulation, may hold promise for the resolution of DSD. Based on integrated evidence from the literature, we hypothesize that engagement in cognitively stimulating recreational activities will help reduce delirium severity and duration in persons with dementia while providing improved quality of life and reduced costs of care.

PMID: 20336555 [PubMed - indexed for MEDLINE]

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Recognizing and managing anxiety disorders in primary health care in Turkey.

BMC Fam Pract. 2010 Apr 28;11(1):30

Authors: Kartal M, Coskun O, Dilbaz N

ABSTRACT: BACKGROUND: Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes. METHODS: A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the postal questionnaire, information on working experience, postgraduate education in psychiatry, the interests of the physicians in psychiatry were obtained. The physicians’ diagnosis and treatment preferences for generalized anxiety disorder (GAD), social phobia (SP), and obsessive compulsive disorder (OCD) were determined through clinical vignettes prepared for data collection. RESULTS: Two hundred and twenty-seven (89.0%) out of 255 GPs included the diagnosis of obsessive compulsive disorder in their differential diagnosis; however, the rates for social phobia and generalized anxiety disorder were 69.4% (n=177) and 22.3% (n=57), respectively. GPs with a post-graduate education on psychiatry diagnosed vignettes more accurately for OCD (p=0.04). For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. The referral rate to a psychiatrist was between 23.1 and 30.6%. The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD. CONCLUSIONS: There is a gap of knowledge in GPs, which leads to poor recognition and management of anxiety disorders in primary care. Effective interventions including post-graduate education and updated guidelines on anxiety disorders should be planned and implemented with their assessments by vignettes.

PMID: 20426828 [PubMed - as supplied by publisher]

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Validation of the German Version of the Brief Assessment of Cognition in Schizophrenia (BACS) - Preliminary Results.

Eur Psychiatry. 2010 Apr 26;

Authors: Sachs G, Winklbaur B, Jagsch R, Keefe RS

The German version of the BACS showed high test-retest reliability. Sensitivity and specificity scores demonstrated good ability to differentiate between patients and controls. The study suggests that the German Version of the BACS is a useful scale to evaluate cognitive functioning.

PMID: 20427153 [PubMed - as supplied by publisher]

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Which is more important for outcome: the physician’s or the patient’s understanding of a health problem? A 2-year follow-up study in primary care.

Gen Hosp Psychiatry. 2010 Jan-Feb;32(1):1-8

Authors: Frostholm L, Ornbøl E, Hansen HS, Olesen F, Weinman J, Fink P

OBJECTIVE: We sought to examine (1) whether the patients’ and the family physicians’ (FPs’) beliefs about the nature of a health problem predict health outcomes and (2) whether the FPs were aware of their patients’ beliefs. METHODS: A 2-year follow-up study of 38 FPs and 1131 patients presenting with well-defined physical disease (n=922) or medically unexplained symptoms (MUS) (n=209) according to the FPs was conducted. Before the consultation, patients categorized their health problem as being either physical or both physical and psychological. After the consultation, the FPs judged their patients’ understanding of the health problem. Outcome measures were (1) patient satisfaction (seven-item Patient Satisfaction Consultation Questionnaire), (2) self-perceived mental and physical health (component summaries of the Medical Outcome Study’s Short Form: SF-36) and (3) health care use extracted from patient registers. MAIN RESULTS: Patients with MUS according to the FPs and patients who believed that the nature of their health problem was both physical and psychological had higher health care use and worse self-rated health than patients in cases where both the FP and the patient had a physical understanding. Patients presenting MUS were more dissatisfied with the consultation than patients with well-defined physical disease. Overall, the FPs’ perceptions of their patients’ understanding were accurate in 82% of the consultations, but when the patients had a both physical and psychological understanding of their health problem, the FPs were right in only 26% of the consultations. CONCLUSIONS: Both FPs’ diagnoses and patients’ beliefs predict important health outcomes such as patient satisfaction, use of health care and self-rated health.

PMID: 20114122 [PubMed - indexed for MEDLINE]

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Protective roles of home and school environments for the health of young Canadians.

J Epidemiol Community Health. 2010 Apr 28;

Authors: Freeman J, King M, Kuntsche E, Pickett W

Background The relationships of home and school environments, health risk behaviours and two sentinel adolescent health outcomes were examined in an aetiological analysis. The analysis focused on determinants of the health of young people and the role of school settings in the optimisation of health. Methods Records were examined from the Canadian sample of the Health Behaviour in School-aged Children (HBSC) Survey. 3402 young people in Ontario, Canada were administered this survey in 2006, of which 1966 were re-administered the survey 1 year later and supplied complete data. Individual items and factor-analytically derived scales were used to examine potential aetiological relationships in a series of structural equation models. Health outcomes examined were serious injury and psychosomatic symptoms. Models developed from cross-sectional data were confirmed longitudinally. Results Adolescents who reported negative home and school environments reported higher levels of substance use, psychosomatic symptoms and serious injuries (the latter identified in longitudinal analysis only). Engagement in health risk behaviour partially mediated the link between these two environments and the sentinel health outcomes. Positive school environments were protective in that they moderated associations between negative home environments and engagement in health risk behaviours. The effects observed in longitudinal analyses were generally consistent with those observed cross-sectionally. Conclusions Negative home environments clearly place adolescents at risk for engagement in health risk behaviours and associated physical health outcomes. Positive school environments can in part moderate these relationships. Optimisation of school social environments therefore remains warranted as a population health strategy.

PMID: 20427549 [PubMed - as supplied by publisher]

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Clinical trial data indicate that supportive interactions with health care providers can benefit patients and may be especially helpful for people who tend to be reclusive (keep to themselves). In a trial funded in part by NCCAM and published in Social Science & Medicine, participants with irritable bowel syndrome (IBS) who received placebo (simulated) acupuncture had some improvement in symptoms, but those who also received support from the acupuncture practitioner experienced even greater improvement.

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Clinical trial data indicate that supportive interactions with health care providers can benefit patients and may be especially helpful for people who tend to be reclusive (keep to themselves). In a trial funded in part by NCCAM and published in Social Science & Medicine, participants with irritable bowel syndrome (IBS) who received placebo (simulated) acupuncture had some improvement in symptoms, but those who also received support from the acupuncture practitioner experienced even greater improvement.

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Witness appearing before the House Subcommittee on Labor-HHS-Education Appropriations (April 28, 2010)

Josephine P. Briggs, M.D., Director
National Center for Complementary and Alternative Medicine

Mr. Chairman and Members of the Committee:

I am pleased to present the President’s Fiscal Year (FY) 2011 Budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2011 budget includes $132,004,000, which is $3,213,000 more than the comparable FY 2010 appropriation of $128,791,000.

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Witness appearing before the House Subcommittee on Labor-HHS-Education Appropriations (April 28, 2010)

Josephine P. Briggs, M.D., Director
National Center for Complementary and Alternative Medicine

Mr. Chairman and Members of the Committee:

I am pleased to present the President’s Fiscal Year (FY) 2011 Budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2011 budget includes $132,004,000, which is $3,213,000 more than the comparable FY 2010 appropriation of $128,791,000.

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