Limits, conditions and possibilities in the use of high level autogenic training in aerospace medicine

Initial results obtained by systematic training using high level autogenic training are presented. The use of this very demanding method for psychotherapy requires that the diagnosis given for the patients ist "neurotic development", that the course of treatment is long, that the basic technique of autogenic training has been mastered, and that the group can be used as a therapeutic factor. Patients who are stable when confronted with conflicts do not react to the demands represented by high level training in the same way as those who exhibit lability in conflict situations. The application of high level autogenic training to improve the psychological performance of subjects with a stable mentality still involves many problems.     

BIOFEEDBACK,AUTOGENIC TRAINING,AND PROGRESSIVE RELAXATION IN THE TREATMENT OF RAYNAUD'S DISEASE: A COMPARATIVE STUDY

Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26° to 17°C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. Results indicated that all patients improved during the first four weeks of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of the training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.     

Varieties of relaxation methods and their unique effects

This paper reviews literature on specific effects of various relaxation methods, and of differences between varieties of two widely-used (and widely modified) methods: progressive relaxation and autogenic training. There is considerable evidence for modality-specific effects. Muscularly-oriented methods have the greatest effects on the musculoskeletal system, autonomically-oriented methods on the autonomic nervous system, etc. Modified methods of Jacobson's progressive relaxation technique have a greater cognitive and less muscular focus than Jacobson's original method, and Norris and Fahrion's autogenic feedback training de-emphasizes hypnotic components of autogenic training compared with Schultz and Luthe's original method. Hypotheses are presented regarding differential effects of these modifications on clinical outcome, on their appeal and usefulness to individuals with various personality profiles, and on possible negative side effects.     

An Evaluation of the Ability to Voluntarily Reduce the Heart Rate after a Month of Yoga Practice

The study aimed at determining whether novices to yoga would be able to reduce their heart rate voluntarily and whether the magnitude of reduction would be more after 30 days of yoga training. Two groups (yoga and control, n = 12 each) were assessed on Day 1 and on Day 30. During the intervening 30 days, the yoga group received training in yoga techniques while the control group carried on with their routine. At each assessment the baseline heart rate was recorded for one minute, this was followed by a six-minute period during which participants were asked to attempt to voluntarily reduce their heart rate, using any strategy. Both the baseline heart rate and the lowest heart rate achieved voluntarily during the six-minute period were significantly lower in the yoga group on Day 30 compared to Day 1 by a group average of 10.7 beats per minute (i.e., bpm) and 6.8 bpm, respectively (p < .05, Wilcoxon paired signed ranks test). In contrast, there was no significant change in either the baseline heart rate or the lowest heart rate achieved voluntarily in the control group on Day 30 compared to Day 1. The results suggest that yoga training can enable practitioners to use their own strategies to reduce the heart rate, which has possible therapeutic applications.     

Effects of imagery training on cognitive performance and use of physiological measures as an assessment tool of mental effort

The effectiveness of motor imagery training on cognitive performance was examined and the physiological mechanisms involved in the contribution of mental practice to motor learning were considered. The subject's mental effort during motor imagery was assessed by using psychophysiological measures and particularly eye blink activity as an 'indirect' measurement of subjects' attention. An electronic flight simulation program (Multiple Attribute Task Battery--MATB) was used to assess performance. Twenty healthy volunteers participated in the study divided in two groups: the control group and the imagery-training group. The subjects of the imagery group were asked for additional imagery training. The subjects of the actual performing group were asked additionally to passively observe the task in order to have equal time of exposure to the task. Performance scores and physiological parameters such as heart rate, respiratory rate, eye blinking activity and muscular activity were recorded during all sessions. The results revealed significantly higher performance level of the imagery-training group than the control group. Heart rate and respiratory rate significantly increased during imagery sessions compared to rest. A slight electromyographic activity was observed during the imagination of movement. Our findings support the notion that mental practice improves motor performance in a task where spatiotemporal or dynamic control of the action is highly required. The effects of mental practice on motor performance could be explained by the existence of a top-down mechanism based on the activation of a central representation of the movements, since the vegetative activation during motor imagery seems to be centrally controlled.     

An evaluation of the ability to voluntarily reduce the heart rate after a month of yoga practice

The study aimed at determining whether novices to yoga would be able to reduce their heart rate voluntarily and whether the magnitude of reduction would be more after 30 days of yoga training. Two groups (yoga and control,n=12 each) were assessed on Day 1 and on Day 30. During the intervening 30 days, the yoga group received training in yoga techniques while the control group carried on with their routine. At each assessment the baseline heart rate was recorded for one minute, this was followed by a six-minute period during which participants were asked to attempt to voluntarily reduce their heart rate, using any strategy. Both the baseline heart rate and the lowest heart rate achieved voluntarily during the six-minute period were significantly lower in the yoga group on Day 30 compared to Day 1 by a group average of 10.7 beats per minute (i.e., bpm) and 6.8 bpm, respectively (p<.05, Wilcoxon paired signed ranks test). In contrast, there was no significant change in either the baseline heart rate or the lowest heart rate achieved voluntarily in the control group on Day 30 compared to Day 1. The results suggest that yoga training can enable practitioners to use their own strategies to reduce the heart rate, which has possible therapeutic applications.     

Long-term consolidation and retention of learning-induced tuning plasticity in the auditory cortex of the guinea pig.

The major goal of this study was to determine whether classical conditioning produces long-term neural consolidation of frequency tuning plasticity in the auditory cortex. Local field potentials (LFPs) were obtained from chronically implanted adult male Hartley guinea pigs that were divided into conditioning (n = 4) and sensitization control (n = 3) groups. Tuning functions were determined in awake subjects for average LFPs (approximately 0.4 to 36.0 kHz, -20 to 80 dB) immediately before training as well as 1 h and 1, 3, 7, and 10 days after training; sensitization subjects did not have a 10-day retention test. Conditioning consisted of a single session of 30 to 45 trials of a 6-s tone (CS, 70 dB) that was not the best frequency (BF, peak of a tuning curve), followed by a brief leg shock (US) at CS offset. Sensitization control animals received the same density of CS and US presentations unpaired. Heart rate recordings showed that the conditioning group developed conditioned bradycardia, whereas the sensitization control group did not. Local field potentials in the conditioning group, but not in the sensitization group, developed tuning plasticity. The ratio of responses to the CS frequency versus the BF were increased 1 h after training, and this increase was retained for the 10-day period of the study. Both tuning plasticity and retention were observed across stimulus levels (10-80 dB). Most noteworthy, tuning plasticity exhibited consolidation (i.e., developed greater CS-specific effects across retention periods), attaining asymptote at 3 days. The findings indicate that LFPs in the auditory cortex have three cardinal features of behavioral memory: associative tuning plasticity, long-term retention, and long-term consolidation. Potential cellular and subcellular mechanisms of LFP tuning plasticity and long-term consolidation are discussed.     

Failure to develop a conditional reflex by stimulation of the cephalad portion of the severed vagosympathetic trunk: Its significance in terms of the central connections of the vagus

Stimulation of the central stump of either vagosympathetic trunk in the dog, the contralateral nerve remaining intact, regularly provoked deep respiratory movements with forceful expiration, followed by a period of apnea, and a fall in blood pressure, systolic and diastolic, of 20–60 mm/Hg. Stimulation of the cephalad portion of the left nerve provoked brief acceleration of heart rate during the period of hyperventilation, followed by bradycardia; when the stimulus was applied to the central stump of the right nerve heart rate remained relatively unchanged. When a 12-second tone as a conditional stimulus (CS) was reinforced during its last six seconds with such stimulation of the vagosympathetic trunk as an unconditional stimulus (US), despite the striking visceromotor responses elicited by the US, no conditional reflex was established even after more than 3,400 trials in 16 dogs (34–781 trials per animal).     

Effects of voluntary activation on neuromuscular endurance analyzed by surface electromyography

The purpose was to examine the relation between voluntary muscle activation and neuromuscular endurance of individual subjects based on the pattern of surface electromyography (EMG). The voluntary muscle activation was estimated from the relation between voluntary force and tetanic force superimposed on the voluntary force (twitch interpolation technique). 14 male subjects (10 regular exercisers and 4 sedentary; 21-29 years old) were divided into a High Voluntary Activation group and a Low Voluntary Activation group. A significant positive correlation of .72 (p<.01) was found between maximum voluntary torque and voluntary activation. A fatigue test was conducted during isometric contractions of 60% and 20% maximum voluntary torque. The endurance time was significantly longer for the Low Voluntary Activation group than the High Voluntary Activation group. The mean power frequency of voluntary EMG obtained from the vastus lateralis muscle decreased consistently whereas the average rectified value increased. The final change of mean power frequency relative to the initial value was significantly greater in the 60% Fatigue task than in the 20% Fatigue task. For the 60% Fatigue task, the final change of mean power frequency and average rectified value relative to the initial value was significantly greater in the Low Voluntary Activation group than in the High Voluntary Activation group. These results suggest that the individual differences in voluntary activation determine the neuromuscular performance usually evaluated as maximum voluntary torque and endurance time and that the voluntary activation may depend on the daily exercise.     

Recidivism of disordered offenders who were conditionally vs. unconditionally released

Postinstitutional arrests and state hospitalizations of 191 patients placed on conditional release (CONREP group) were compared to those of 44 patients released from the same California state hospital with no aftercare due to expiration of commitment terms (MAXOUT group). The two groups were not randomly determined but were comparable in demographic characteristics and rates of preprogram arrest. The CONREP group had a significantly lower community-period arrest rate than did the MAXOUT group (p <.001). Survival rate analyses, using time until arrest and time until revocation as dependent variables, suggested that revocations during the first 240 days of community re-entry reduced the potential arrest rate within the CONREP group. Results were discussed in terms of the “criminalization hypothesis” as well as the crime-preventive possibilities of the conditional release mechanism.     

Infantile handling and the facilitation of discrimination and reversal learning

One group of rats was removed from their home cage and received daily handling from Days 3-21, while the control group of litter mates remained in the cage and did not receive any treatment. On Day 22 all rats were weaned and they were housed in individual cages until they were 60 days old. After two pretraining days, subjects were given daily blocks of one free and three forced trials in the T-maze and were rewarded with food after making the correct response. Following 20 days of training and testing on black-white discrimination, subjects were given 10 days of reversal training with four daily trials. Results indicate that the handled animals showed faster running and a greater number of correct choices than the control rats during both the acquisition and reversal learning phases of the experiment.     

Autogenic training within the therapeutic scope of schizophrenic patients]

The author calls the reader's attention to the rather strange fact that autogenic training, in spite of worldwide recognition and extensive uses of the method in various disciplines of medicine and spheres of live, has not so far been finding wide application in the medical specialty dealing with mental disorders. After discussing some possible causes of this situation and commenting on first signs of a necessary change in attitude toward autogenic training, he reports his own experience in the treatment of schizophrenic patients with this psychotherapeutic method, emphasizing the need for including psychotherapy in a complex concept of the treatment of psychoses.     

纳米炭在分化型甲状腺癌再手术中应用价值的研究

探讨在分化型甲状腺癌（DTC）再手术中应用纳米炭对甲状旁腺保护和引导颈淋巴结清扫的作用与价值。选取2011年2月至2014年2月湖南省人民医院乳腺甲状腺外科116例D T C再手术患者,随机分为观察组（纳米炭组）64例和对照组52例,试验组在术中先向残余甲状腺或癌灶或肿大淋巴结内注射纳米炭0．1ml～0．3ml不等,对照组不使用纳米炭。观察两组辨别甲状旁腺的个数与准确性,以及在颈淋巴结清扫个数的差异。同时观察两组术后常见并发症有无差异。观察组使再手术的D T C患者的甲状旁腺识别率为92．2％,辨别出3个及以上甲状旁腺比率为75％,均明显高于对照组的28．8％、36．5％,两组比较有显著性差异（ P＜0．05）。中央区与侧颈区淋巴结清扫的个数比较,观察组明显多于对照组（P＜0．05）。观察组不增加术后并发症,而且,其一过性的甲状旁腺功能减退的并发症尚有下降趋势（P＜0．05）。纳米炭对DTC再手术中的甲状旁腺的识别率和区域淋巴结的黑染,使甲状旁腺易于识别和保护,有利于更为彻底清扫中央区和侧颈区淋巴结,尚可降低一过性甲状旁腺功能减退的并发症。     

Sustained operations and military performance

A militarily realistic schedule is one that demands several days with only very limited opportunities for sleep, followed by several days without any opportunity for sleep. A trial was carried out to study the effects of total sleep deprivation following partial sleep deprivation. Twelve infantry soldiers, divided into two groups of six, took part in a 6-day trial in which the experimental group was scheduled for 1.5 h of sleep every 24 h for 3 days followed by 3 days in which no sleep was scheduled. The control group was scheduled to have 4 h of sleep every 24 h for 6 days. Following the sleep-deprivation period, unlimited sleep was permitted for both groups in a 40.25-h (1.7-day) rest period. Three of the six subjects in the experimental group completed the 152 h (6.3-day) trial; all six subjects in the control group completed the trial. On the last sleep-deprivation day, cognitive performance was 37% of the baseline value for the experimental group and 94% for the control group.     

The Effectiveness of Driving Game on Trunk Control and Gait Ability in Stroke

Abstract

Patients who require neurological rehabilitation often do not comply with conventional programs because they find the therapy uninteresting. As a result, specialized interactive video games have been designed to be more enjoyable than conventional therapy (CT) tasks. This study aimed to assess the trunk control and gait ability of patients with chronic stroke after participation in driving-based interactive video games (DBIVG). Participants included 24 chronic stroke patients allocated to an experimental group (n?=?13, CT?+?DBIVG) or a control group (n?=?11, CT?+?treadmill walking training). Both groups received CT five days/week; the experimental and control groups participated in DBIVG and treadmill walking training, respectively, three days/week for four weeks. The primary outcome of trunk control was measured by the trunk impairment scale (TISall) and TIS subscales, including static sitting balance (TISssb), dynamic sitting balance (TISdsb), and trunk co-ordination (TISco). Gait ability was measured by the dynamic gait index (DGI), timed walking test (TWT), and time up and go test (TUGT). Both groups demonstrated significant improvements in TISall, TISdsb, and TUGT results. The experimental group showed significantly greater improvement in TISssb, TISco, and DGI than the control group. Our findings indicate that DBIVG can improve trunk control and gait ability in patients with chronic stroke.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

Promotion of creativity (divergent productions) and convergent productions by systematic-relaxation exercises: empirical evidence from five experimental studies with children,young adults,and elderly

Presented are the results of five experimental studies on the effects of systematic-relaxation exercises on divergent as well as convergent performance. Subjects were 40 elementary school children, 120 college students, and 52 elderly. In Experiments 1, 2, 4, and 5, subjects were assigned at random to either an experimental group (participating in a short systematic-relaxation exercise without pre-experience or exercising autogenic training which subjects had learned at least 6 months before) or to a control group (with unspecific relaxation instructions). In Experiment 3, subjects with against without experience of autogenic training were matched for age, gender, years of study, and creativity pretest scores. Before and after systematic against unsystematic relaxation, subjects were tested for divergent performances (word fluency, associational fluency, expressional fluency, and ideational fluency) and convergent performances (short-term memory, concentration, and general intelligence). Results of all experiments consistently show significant improvements of divergent and—to a lesser extent—convergent performances in the experimental groups after systematic-relaxation exercises. These short-term effects of systematic-relaxation exercises are discussed with respect to characteristics and problems of divergent problem solving processes in individuals and groups. © 1997 by John Wiley & Sons, Ltd.     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

Effects of a short-term exercise program on caloric consumption

The present study investigated the effects of a short-term exercise program on caloric intake. Thirty-three women were randomly assigned to either a high-intensity exercise group (80% maximum heart rate), low-intensity exercise group (55% maximum heart rate), or waiting list control group. Exercisers were required to ride ergometer bicycles three times per week for 7 weeks, expending 200 kilocalories of energy per exercise session. All participants recorded food intake during specified weeks before, during, and following the exercise program. Results showed no significant caloric intake differences among the three groups, but a trend toward reduction in food intake with increased exercise intensity was found. Interestingly, comparisons between caloric intake on exercise and nonexercise days revealed that both exercise groups consumed significantly less on exercise days. Additionally, the control group evidenced a larger caloric intake level than did the two exercise groups on exercise days. These results suggest that exercisers do not compensate for energy expenditure by increasing caloric intake and that choosing between low- and high-intensity exercise does not differentially alter caloric intake. Nevertheless, maximization of negative energy balance or weight loss may be best achieved by exercise programs of high frequency and intensity.     

不同机械通气模式下吸痰对ARDS患者肺通气及顺应性的影响

为探讨不同机械通气模式下吸痰对ARDS患者肺通气及顺应性的影响。选择20例ARDS机械通气患者,随机分为A/C组与SIMV组;分别给予开放式吸痰,记录吸痰前后肺通气指标及呼吸系统顺应性指标的变化。结果吸痰后各时间点呼吸频率均显著增加(P0.01);潮气量、分钟通气量在0s显著降低,吸痰后15s、1min显著增加(P0.01);两通气模式比较SIMV组呼吸频率、分钟通气量增加显著(P0.01)。吸痰前后动静态顺应性、动态P-V曲线斜率差异不显著(P0.05),通气模式之间亦无统计学差异。提示开放式吸痰引起呼吸频率显著增加,潮气量及分钟通气量先是下降然后显著增加;SIMV模式呼吸频率、通气量增加较为显著。不同通气模式下吸痰对呼吸系统顺应性影响不显著。