Diabetes and illness image: an analysis of diabetic early-adolescents' self-perception through the Draw-a-person test

To study the self-projective representations expressed by diabetic children, aged between 10 and 15 yr., and to compare these with representations of a control group the Draw-a-person test associated with those for subsequent Draw-a-sick-person were administered to 23 children regularly checked by an Antidiabetic Centre. The diabetic subjects drew an image of "sick person" having projective elements with a regressive value and denoting a refuge in the past, together with depressive signs of retiring into themselves and of less consideration of the self. Also, the diabetic children seemed to be less prone to the cultural stereotype which requires a smiling and happy image of "the healthy person." At the same time there was also a transparent symbolic defense which allowed the diabetics to adapt variously and to move from their anxious state toward psychological recovery.     

Everyday‐like memory for objects in ageing and Alzheimer's disease assessed in a visually complex environment: The role of executive functioning and episodic memory

To investigate everyday memory, more and more studies rely on virtual‐reality applications to bridge the gap between in situ approaches and laboratory settings. In this vein, the present study was designed to assess everyday‐like memory from the virtual reality‐based Human Object Memory for Everyday Scenes (HOMES) test (Sauzéon et al., 2012 , Exp. Psychol., 59, 99) in ageing and in Alzheimer's disease (AD). Two aims motivated this study: the first was to assess multiple processes of episodic memory (EM) functioning embedded within contexts closely related to real life in ageing and AD using the multi‐trial free‐recall paradigm, and the second aim was to evaluate the mediating effects of executive functioning (EF), EM, and subjective memory complaints (SMCs) on age differences in the HOMES measures and in AD. To this end, the HOMES test and neurocognitive tests of EF and EM were administered to 23 younger adults, 23 older adults, and 16 patients with AD. The results were: firstly, compared to young adults, elderly adults presented only free‐recall decline that almost disappeared in recognition condition whereas AD patients exhibited a poor clustering, learning, and recognition performance, and also a high amount of false recognition; secondly, age differences as well as AD related deficits on the HOMES test were mediated by both memory and EF measure while those observed on false memory indices were only mediated by EM measure; thirdly, the HOMES indices are related to SMCs even when episodic or EF measures are controlled. Overall, the results supported the fact that the VR‐based memory test is an appropriate device to capture age‐related differences as well as the AD effect with respect to both in situ and laboratory settings.     

Examining the Unique Characteristics of a Non-Probability Sample of Undocumented Female Sex Workers with Dependent Children: The Case of Haitians in the Dominican Republic

Haitians in the Dominican Republic (DR) are increasingly marginalized due to recent legislation that stripped Haitian-Dominicans of their citizenship and increased Haitian migrants’ deportation risk. Haitian female sex workers (FSWs) are particularly vulnerable, though little is known about them. This study will help public health efforts targeted at sex workers to better reach Haitian FSWs and address their needs by identifying a profile of characteristics unique to this group compared to Dominican FSWs. Data were collected in 2014 among Haitian and Dominican FSWs in Puerto Plata, DR. Surveys assessed respondents’ demographics, health consciousness, depression, and stigma. Adjusted logistic regressions showed that Haitian FSWs were disadvantaged: they had significantly lower rates of education, more children, and less permanent income. Furthermore, Haitian FSWs were more likely to work independently and for fewer hours. Interestingly, Haitian FSWs internalized less stigma than Dominicans. Though we can only speculate, this could be due to migration for sex work, or the lack of formal employment for Haitians. Initiatives to alleviate poverty, create formal jobs, and overturn discriminatory legislation may have the most impact for Haitian FSWs.     

The use of virtual reality for episodic memory assessment: effects of active navigation

Episodic memory was assessed using Virtual Reality (VR). Forty-four (44) subjects visualized a target virtual apartment containing specific objects in each room. Then they visualized a second virtual apartment comprised of specific objects and objects shared by the two apartments. Subjects navigated in the virtual apartments in one of the following two conditions: active and passive. Four main episodic memory components were scored from the VR exposures: (1) learning effect; (2) active forgetting effect; (3) strategies at encoding and at retrieval; and (4) false recognitions (FRs). The effect of navigation mode (active vs. passive) on each memory component was examined. Active subjects had better learning and retrieval (recognition hits) performances compared to passive subjects. A beneficial effect of active navigation was also observed on the source-based FR rates. Active subjects made fewer source-based FRs compared to passive subjects. These overall results for the effect of active navigation are discussed in terms of the distinction between item-specific and relational processing.     

Virtual/real transfer of spatial knowledge: benefit from visual fidelity provided in a virtual environment and impact of active navigation

The purpose of this study was to evaluate the effect the visual fidelity of a virtual environment (VE) (undetailed vs. detailed) has on the transfer of spatial knowledge based on the navigation mode (passive vs. active) for three different spatial recall tasks (wayfinding, sketch mapping, and picture sorting). Sixty-four subjects (32 men and 32 women) participated in the experiment. Spatial learning was evaluated by these three tasks in the context of the Bordeaux district. In the wayfinding task, the results indicated that the detailed VE helped subjects to transfer their spatial knowledge from the VE to the real world, irrespective of the navigation mode. In the sketch-mapping task, the detailed VE increased performances compared to the undetailed VE condition, and allowed subjects to benefit from the active navigation. In the sorting task, performances were better in the detailed VE; however, in the undetailed version of the VE, active learning either did not help the subjects or it even deteriorated their performances. These results are discussed in terms of appropriate perceptive-motor and/or spatial representations for each spatial recall task.     

Age and active navigation effects on episodic memory: A virtual reality study

We investigated the navigation‐related age effects on learning, proactive interference semantic clustering, recognition hits, and false recognitions in a naturalistic situation using a virtual apartment‐based task. We also examined the neuropsychological correlates (executive functioning [EF] and episodic memory) of navigation‐related age effects on memory. Younger and older adults either actively navigated or passively followed the computer‐guided tour of an apartment. The results indicated that active navigation increased recognition hits compared with passive navigation, but it did not influence other memory measures (learning, proactive interference, and semantic clustering) to a similar extent in either age group. Furthermore, active navigation helped to reduce false recognitions in younger adults but increased those made by older adults. This differential effect of active navigation for younger and older adults was accounted for by EF score. Like for the subject‐performed task effects, the effects from the navigation manipulation were well accounted for by item‐specific/relational processing distinction, and they were also consistent with a source monitoring deficit in older adults.     

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly strict regulatory control. Over a thousand randomized trials have been conducted with antidepressants. Statistically significant benefits have been repeatedly demonstrated and the medical literature is flooded with several hundreds of "positive" trials (both pre-approval and post-approval). However, two recent meta-analyses question this picture. The first meta-analysis used data that were submitted to FDA for the approval of 12 antidepressant drugs. While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. "Negative" trials were either left unpublished or were distorted to present "positive" results. The average benefit of these drugs based on the FDA data was of small magnitude, while the published literature suggested larger benefits. A second meta-analysis using also FDA-submitted data examined the relationship between treatment effect and baseline severity of depression. Drug-placebo differences increased with increasing baseline severity and the difference became large enough to be clinically important only in the very small minority of patient populations with severe major depression. In severe major depression, antidepressants did not become more effective, simply placebo lost effectiveness. These data suggest that antidepressants may be less effective than their wide marketing suggests. Short-term benefits are small and long-term balance of benefits and harms is understudied. I discuss how the use of many small randomized trials with clinically non-relevant outcomes, improper interpretation of statistical significance, manipulated study design, biased selection of study populations, short follow-up, and selective and distorted reporting of results has built and nourished a seemingly evidence-based myth on antidepressant effectiveness and how higher evidence standards, with very large long-term trials and careful prospective meta-analyses of individual-level data may reach closer to the truth and clinically useful evidence.     

Exhaled breath analysis in evaluation of psychological stress: A short literature review

Physiological stress is pervasive in today's society. Its detection is normally performed through several unobtrusive methods, driving both caregivers and patients to take measures to reduce the burden of this condition on human health. Among the methods for assessing stress, exhaled breath analysis represents a non‐invasive, real‐time alternative to classic laboratory tests. Therefore, a literature review was performed to assess the presence of altered parameters, related to psychological stress, in exhaled breath. Most studies in our review measured nitric oxide (NO), whose concentration was often correlated, either positively or negatively, with psychological stress, with reasonable scientific support. Other compounds (isoprene, terpene and so on) were rarely studied and with mixed evidence. Further investigations are needed to elucidate the involvement and the pathophysiological role of NO in stress, possibly including a greater number of individuals, as sample size actually represents the main limitation of the work published to date.     

Starting on haemodialysis: A qualitative study to explore the experience and needs of incident patients

Dialysis can be very stressful with the initial months onto treatment being highly critical in terms of both adaptation and mortality. This qualitative study aimed to explore the lived experiences of incident haemodialysis patients in Singapore. Topics related to the end-stage renal disease diagnosis and haemodialysis treatment were raised with 13 incident haemodialysis patients in the form of semi-structured interviews, and interpretative phenomenological analysis was undertaken as the framework for data analysis. Emotional distress, treatment-related concerns and social support emerged as main issues following a critical review of themes. Our study revealed that incident haemodialysis patients have emotional and informational needs, highlighting the importance of intervention programmes in particular to this patient group to promote better psychosocial adjustment to the disease and its treatment.     

The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles,Practices, and Patients,” a level one international meeting,Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute,Thrissur, Kerala,India, October 23–27, 2013

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013.