Body, Mind & Spirit Articles and Latest News

Sexual risk behavior and behavior change among persons newly diagnosed with HIV: the impact of targeted outreach interventions among hard-to-reach populations.

AIDS Patient Care STDS. 2009 Aug;23(8):639-45

Authors: Coleman SM, Rajabiun S, Cabral HJ, Bradford JB, Tobias CR

Abstract
The secondary effect of a national, targeted, outreach initiative in reducing sexual risk behavior among newly diagnosed persons living with HIV/AIDS (PLWHA) was examined in the present study. The findings propose an optimal number of outreach program contacts associated with a change in sexual risk behavior. The primary goal of the initiative was to implement and evaluate strategies to engage and retain underserved populations (PLWHA) in HIV primary medical care. Participants from 10 sites nationwide were enrolled in outreach interventions from 2004 to 2005 that were designed to engage and retain hard-to-reach PLWH in care. The study population in the subanalysis performed was predominantly male, people of color, sexual minorities; mean age of 32, and 31% reported no visits to an HIV health provider since testing positive. The study design was prospective and nonrandomized; 116 newly diagnosed individuals reported on unprotected sex at baseline, 6-, and 12-month interviews. The proportion of individuals reporting unprotected sex postintervention was reduced significantly compared to baseline. Postbaseline, individuals were 80% less likely to report unprotected sex. Additionally, individuals with 1-3 program contacts per month were 80 times less likely to report risky sexual behavior compared to those with 2 or less contacts (adjusted odds ratio [AOR] = 0.20). Substantial risk exists for secondary HIV transmission; this study shows the promise of a supplemental intervention to ensure access to HIV care, retention in care, and risk reduction for positives.

PMID: 19591603 [PubMed - indexed for MEDLINE]

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Development of the hepatitis C self-management program.

Patient Educ Couns. 2011 May;83(2):252-5

Authors: Groessl EJ, Weingart KR, Gifford AL, Asch SM, Ho SB

Abstract
OBJECTIVE: Chronic hepatitis C infection (HCV) is a major health problem that disproportionately affects people with limited resources. Many people with HCV are ineligible or refuse antiviral treatment, but less curative treatment options exist. These options include adhering to follow-up health visits, lifestyle changes, and avoiding hepatotoxins like alcohol. Herein, we describe a recently developed self-management program designed to assist HCV-infected patients with adherence and improve their health-related quality of life (HRQOL).
METHODS: The development of the Hepatitis C Self-Management Program (HCV-SMP) was informed by scientific literature, qualitative interviews with HCV-infected patients, self-management training, and feedback from HCV clinical experts.
RESULTS: The Hepatitis C Self-Management Program (HCV-SMP) is a multi-faceted program that employs cognitive-behavioral principles and is designed to provide HCV-infected people with knowledge and skills for improving their HRQOL. The program consists of six 2-h workshop sessions which are held weekly. The sessions consist of a variety of group activities, including disease-specific information dissemination, action planning, and problem-solving.
CONCLUSION: The intervention teaches skills for adhering to challenging treatment recommendations using a validated theoretical model. A randomized trial will test the efficacy of this novel HCV self-management program for improving HRQOL in a difficult to reach population.

PMID: 20638216 [PubMed - indexed for MEDLINE]

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“Michael’s Game,” a card game for the treatment of psychotic symptoms.

Patient Educ Couns. 2011 May;83(2):210-6

Authors: Khazaal Y, Favrod J, Azoulay S, Finot SC, Bernabotto M, Raffard S, Libbrecht J, Dieben K, Levoyer D, Pomini V

Abstract
OBJECTIVE: “Michael’s Game” is a card game which aims at familiarizing healthcare professionals and patients with cognitive therapy of psychotic symptoms. The present study tests the feasibility and the impact of the intervention in naturalistic settings.
METHODS: 135 patients were recruited in 11 centres. They were assessed pre- and post-tests with the Beck Cognitive Insight Scale (BCIS) and the Peters Delusion Inventory-21 items (PDI-21).
RESULTS: Data about 107 patients were included in the entire analyses. Significant improvements were observed on BCIS subscales as well as a reduction of severity of conviction and preoccupation scores on the PDI-21. The intervention has a moderate effect on the PDI-21 preoccupation and conviction as well as the BCIS subscales. Patients who benefit the most from the program are patients who have a low degree of self-reflectiveness and patients who are concomitantly preoccupied by their symptoms.
CONCLUSION: The present study supports the feasibility and effectiveness of “Michael’s Game” in naturalistic settings.
PRACTICAL IMPLICATIONS: The game seems to be a useful tool for patients with psychotic disorders.

PMID: 20646892 [PubMed - indexed for MEDLINE]

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The neural substrates of mindfulness: an fMRI investigation.

Soc Neurosci. 2011 Jun;6(3):231-42

Authors: Ives-Deliperi VL, Solms M, Meintjes EM

Abstract
“Mindfulness” is a capacity for heightened present-moment awareness that we all possess to a greater or lesser extent. Enhancing this capacity through training has been shown to alleviate stress and promote physical and mental well-being. As a consequence, interest in mindfulness is growing and so is the need to better understand it. This study employed functional magnetic resonance imaging (fMRI) to identify the brain regions involved in state mindfulness and to shed light on its mechanisms of action. Significant signal decreases were observed during mindfulness meditation in midline cortical structures associated with interoception, including bilateral anterior insula, left ventral anterior cingulate cortex, right medial prefrontal cortex, and bilateral precuneus. Significant signal increase was noted in the right posterior cingulate cortex. These findings lend support to the theory that mindfulness achieves its positive outcomes through a process of disidentification.

PMID: 20835972 [PubMed - indexed for MEDLINE]

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Art groups for marginalized women with breast cancer.

Qual Health Res. 2011 May;21(5):652-61

Authors: Collie K, Kante A

Abstract
Professionally led support groups can significantly reduce distress, trauma symptoms, and pain for women with breast cancer. Despite the known benefits, women with breast cancer from marginalized groups tend not to participate in support groups. It is important to address barriers that prevent their participation and to identify types of support groups that appeal to as wide a range of women as possible. For this study, we interviewed women with breast cancer from marginalized groups in the San Francisco Bay Area (United States). We asked them about social, cultural, and psychological barriers that prevent participation in support groups, and about the potential of art groups to overcome these barriers. Our qualitative analysis of the interviews yielded findings that suggest a model for a type of support group that could make the benefits of support groups available to more women with breast cancer.

PMID: 20852014 [PubMed - indexed for MEDLINE]

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Cognitive-behavioral therapy for hand and arm pain.

J Hand Ther. 2011 Apr-Jun;24(2):124-30; quiz 131

Authors: Vranceanu AM, Safren S

Abstract
Cognitive-behavioral therapy (CBT) is a psychological treatment that emphasizes the interrelation among thoughts, behaviors, feelings, and sensations. CBT has been proved effective not only for treatment of psychological illness but also for teaching adaptive coping strategies in the context of chronic illnesses, including chronic pain. The present article provides general information on CBT, specific information on CBT for pain, as well as guidelines and strategies for using CBT for hand and arm pain patients, as part of multidisciplinary care models.

PMID: 21051204 [PubMed - indexed for MEDLINE]

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His or mine? The time course of self-other discrimination in emotion processing.

Soc Neurosci. 2011 Jun;6(3):277-88

Authors: Herbert C, Herbert BM, Ethofer T, Pauli P

Abstract
This electroencephalography (EEG) study investigated at which temporal processing stages self-other discrimination in emotion processing occurs. EEG was recorded in 23 healthy participants during silent reading of unpleasant, pleasant, and neutral pronoun-noun and article–noun expressions that were related to the participants themselves, related to an unknown third person, or had no self-other reference at all. Self- and other-related pronoun–noun pairs elicited larger cortical negativity relative to the processing of article–noun pairs at left posterior electrodes as early as 200 ms after stimulus onset. In the same time windows (from 200 ms to 300 ms and 300 ms to 400 ms) the emotionality of the words enhanced event-related brain potential (ERP) amplitudes at parieto-occipital electrodes. From 350 ms onwards, processing of self-related unpleasant words elicited larger frontal negativity compared to unpleasant words that were related to the other or that had no reference at all. In addition, processing of pleasant words vs. neutral or unpleasant words elicited larger positive amplitudes over parietal electrodes from 450 ms after stimulus onset, in particular when words were self-related. Our findings demonstrate that for verbal emotional stimuli, self–other discrimination first occurs at higher-order, cortical processing stages. This is consistent with the view that categorization of information according to certain stimulus aspects (self–other reference, emotionality) occurs before its meaning is integrated.

PMID: 21104542 [PubMed - indexed for MEDLINE]

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Mirror visual feedback therapy. A practical approach.

J Hand Ther. 2011 Apr-Jun;24(2):170-8; quiz 179

Authors: McCabe C

Abstract
Mirror visual feedback (MVF) was first proposed as a therapy to relieve amputee phantom limb pain in the early 1990s. It is increasingly used to treat a range of other chronic pain conditions. The evidence base to date is limited. Much of the literature consists of pilot projects or case study designs although larger randomized controlled trails are now emerging. However, the described protocols for MVF are inadequate to adapt to clinical practice. In addition, the therapist sees a heterogeneous population whose characteristics may fall outside those of the tight inclusion/exclusion criteria of research studies. This article provides the theoretical background to MVF and a detailed description of applying this therapy in clinical practice.

PMID: 21106347 [PubMed - indexed for MEDLINE]

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Graded motor imagery.

J Hand Ther. 2011 Apr-Jun;24(2):164-8; quiz 169

Authors: Priganc VW, Stralka SW

Abstract
New information regarding cortical changes in patients with chronic pain has prompted a reevaluation of the typical “bottom up” treatment for pain, which focuses on peripheral nociceptive stimuli. More recently, increasing considerations for chronic pain are focused from the “top down” cortical central processing perspective. Graded motor imagery (GMI) is one treatment technique from the “top down” paradigm designed to treat chronic pain. This technique attempts to sequentially normalize central processing to remediate chronic pain. This article briefly summarizes the basic components of GMI, targeting complex regional pain in the upper limb, and describes a case where this method was successfully integrated. The initial research and clinical experience is promising and indicates that patients with chronic pain may benefit from using GMI to “retrain the brain.”

PMID: 21306870 [PubMed - indexed for MEDLINE]

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The role of science and psychology in optimizing care of hand illness.

J Hand Ther. 2011 Apr-Jun;24(2):82-3

Authors: Ring D

PMID: 21306872 [PubMed - indexed for MEDLINE]

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