Memory rehabilitation for older adults: preserving independent living / Rehabilitación de la memoria para adultos mayores: preservación de la autonomía de vida

Abstract

Episodic memory problems are the hallmark of cognitive ageing in normal elderly people. Learning of new material is worse in pathological cognitive ageing, such as dementia and its preliminary states (mild cognitive impairment). Because episodic learning is crucial to preserve independent living in the elderly, rehabilitation programmes for everyday memory problems are welcomed. The scope of scientific interest has switched from treatment to prevention. We claim that lifestyle interventions are the most direct way to preserve cognition. We summarize evidence for changes in nutrition and exercise. In addition, psychological interventions for elderly people with normal or pathological cognitive ageing are available. Recent meta-analyses found lacking evidence of transfer to everyday life and long-term effects. We critically assess these meta-analyses. We propose theoretically derived experimental interventions relying on spared learning mechanisms. As an example we report visual-imagery training showing positive effects in a randomized control trial, using individual memory diaries on memory improvement.     

An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

The Visual Spatial Learning Test: Differential impairment during the premanifest and manifest stages of Huntington's disease

Visual spatial memory was assessed using the Visual Spatial Learning Test (VSLT) in individuals with mild to moderate Huntington's disease (HD), pre‐manifest gene carriers for HD, and demographically similar controls. The VSLT has been demonstrated to be a valid, normed measure of non‐verbal memory involving minimal motoric responses. The VSLT assesses immediate and delayed memory for designs, positions of the designs, and design/position associations. The HD group was significantly impaired (p < .05) relative to both the control and Pre‐HD groups on immediate and delayed memory for the designs, positions, and design/position associations. Although there were no differences between the Pre‐HD and control groups on immediate or delayed memory for designs or positions, the Pre‐HD group was significantly impaired (p < .05) relative to the control group on immediate and delayed memory for design/position associations. The results offer novel insight into a relatively unexamined memory deficit that may occur in gene carriers for HD prior to phenoconversion. The data indicate that the VSLT may be a useful measure of visuospatial memory during the premanifest and manifest stages of HD.     

The relationship between the Five‐Factor Model personality traits and peptic ulcer disease in a large population‐based adult sample

The current study examined the relationship between the Five‐Factor Model personality traits and physician‐confirmed peptic ulcer disease (PUD) diagnosis in a large population‐based adult sample, controlling for the relevant behavioral and sociodemographic factors. Personality traits were assessed by participants themselves and by knowledgeable informants using the NEO Personality Inventory‐3 (NEO PI‐3). When controlling for age, sex, education, and cigarette smoking, only one of the five NEO PI‐3 domain scales – higher Neuroticism – and two facet scales – lower A1: Trust and higher C1: Competence – made a small, yet significant contribution (p < 0.01) to predicting PUD in logistic regression analyses. In the light of these relatively modest associations, our findings imply that it is certain behavior (such as smoking) and sociodemographic variables (such as age, gender, and education) rather than personality traits that are associated with the diagnosis of PUD at a particular point in time. Further prospective studies with a longitudinal design and multiple assessments would be needed to fully understand if the FFM personality traits serve as risk factors for the development of PUD.     

Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder

IntroductionDelivering psychotherapy by videoconference could considerably extend the accessibility of empirically validated treatments.ObjectiveThe aim of this study was to evaluate the efficacy of a cognitive-behavioural therapy (CBT) for generalized anxiety disorder (GAD), administered via videoconference.MethodFive participants with a primary diagnosis of GAD took part in an experimental multiple baseline case study protocol. The efficacy of the treatment was evaluated using a semi-structured interview, self-report questionnaires, and daily self-monitoring diaries.ResultsThe results demonstrate that overall, participants’ conditions were improved following treatment and they no longer met the diagnostic criteria for GAD in the short-term. Participants’ conditions improved clinically and statistically at each follow-up point, achieving a greater global level of functioning at post-test, as well as at 3-month and 12-month follow-up.ConclusionClinical implications of this new treatment modality and directions for future research are discussed.     

How to improve the appropriation of space and the morale of residents in nursing homes

This study proposes a simple methodology to improve the quality of life of residents in nursing homes. In the experimental condition, an intervention based on the feeling of control, the technique of touching and “you are free to…” was implemented. Assessment of the residents’ appropriation of their personal space and their morale was made one month later. Data showed a significant improvement in both parameters in the experimental condition, whereas values remained stable in the control group, which did not receive the intervention.     

Spirituality and spiritual care – missing concepts from core undergraduate children’s nursing textbooks

Background: Spiritual care is espoused to be fundamental in children’s nursing; however, the extent to which current fundamental children’s nursing textbooks support and advocate spiritual care delivery by children’s nurses and nursing students is unknown. Aim and objectives: To examine whether or not fundamental undergraduate children’s nursing textbooks include spiritual care content. Methods: Five hundred and nineteen books were sampled from the Nursing and Midwifery Core Collection list (UK) using a survey, the Spirituality Textbook Analysis Tool (STAT) to collect data. Analysis and Results: 519 books were included in the study using the STAT and 13 books included content on children’s spirituality. There were a variety of textbooks in the audit of those that made reference to the search terms in the STAT, it was found that content mainly addressed only two areas; religious faiths and the dying child. Recommendations: Children’s nurses require education about children’s spiritual developmental stage and age appropriate spiritual assessment. A lack of detailed information in core children’s nursing textbooks means that this area of nursing practice may be taught as an adjunct to care and not as an element of holistic care which is the gold standard that children’s nurses should strive for.     

Children’s prayers from a Hospital Chapel

Children’s prayers, from prayer books left in the Chapel of a Children’s Hospital between 1998 and 2002, were studied for what the children’s God-talk would reveal about their perceptions of God. Of the 3893 prayers written during this period, 346 were confidently identified as being authored by children. The sample of 346 prayers, which gave rise to 558 expressions of prayer, was explored through a content analysis, used quantitatively to summarise and describe the data, and a thematic analysis, informed by methods from Grounded Theory. The psychological and spiritual significance of the prayers is drawn out, demonstrating the richness and relationality of children’s spirituality. The predominance of prayers written by female writers, suggests that the extent to which relationality is present is related to gender. Questions concerning possible gender-related differences in girls’ and boys’ spirituality are raised and implications for practice are considered.     

循证理念在当代传染病防控领域的应用

循证医学引发医学领域的创新和革命,其理念应用于公共卫生领域形成了循证公共卫生。21世纪多种新发和复发传染病的全球性暴发为循证理念的应用带来挑战。高风险的研究环境、复杂的干预手段、证据稀缺、研究设计困难,以及在高度不确定和紧迫时间下建立程序和生成建议的需求,使循证方法学必须通过拓展和调适以解决传染病问题。六步骤快速风险评估机制、AGREE Ⅱ指南评估工具、全球传染病循证资源数据库,成为满足传染病防治的特殊要求而创新的循证实践工具。