Volume 9, Issue 4

Psychiatric brain research has historically focused on gray matter due, in part, to difficulties inherent in white matter studies. Recent innovations have greatly facilitated white matter research, and abnormalities of myelin, and the oligodendrocytes that elaborate it, have been described in psychotic and mood disorders, including bipolar disorder. The overlap of white matter findings among these disorders is not surprising given their overlap in symptoms, but the degree of apparent overlap could be exaggerated by a high rate of false positive findings among neuroimaging studies that have examined the whole brain rather than particular regions of interest. Future research should focus on the white matter tracts that interconnect the brain regions most consistently implicated in each disorder. Myelin integrity is crucial for efficient and rapid conduction of neuronal impulses. Thus, white matter abnormalities could disrupt the temporal convergence of neural inputs to regions of integration and contribute to dysregulation within the cortico-limbic circuits implicated in bipolar disorder.

The proportion of adults with intellectual disability (ID) who are in need of support with various aspects of personal care is already significant at age 40 years. The aim of this study was to learn about the personal, social, and health characteristics of older people with ID in Israel and to examine their needs and the solutions provided. A cross-sectional and nationwide study collected data about people with ID aged 40 years and older. Formal and informal caregivers were interviewed about medical data and about their own characteristics and needs. The percentage of people with severe and profound ID was 29% and among those living with their families 21%, compared with 3% in hostels and small group homes. Differences in age distribution were found in the various housing settings. A significant correlation was found between the level of intellectual disability and the activities of daily living. As age increased, contact and involvement with family members declined. The use of medical services increased with age in all out-of-home settings. It is possible to compare the differential needs of different age groups, which helps us understand the implications of aging for the populations in the various settings.

Background : Manipulation of joints is associated with a variety of claimed outcomes, but without representative controlled studies. Physiological effects of electroacupuncture and manipulation of the cervical spine depend on the side of the body that treatment is applied to. Both treatments can change the size of the visual blind spot associated with the optic disc of the eye. Methods : We randomly allocated 62 healthy adults to either real or sham manipulative therapy, applied to the upper extremity on the side of an enlarged blind spot. Pre- and post-treatment blind spots were measured. Results : There was a highly statistically significant decrease in blind spot size following manipulation to the upper extremity in the intervention group when compared to the sham group. Left-sided manipulation was shown to result in a significantly greater change in the blind spot size than right-sided manipulation. Conclusions : Manipulation of an upper extremity on one side has a similar effect on the size of the blind spot as manipulation of the cervical spine and acupuncture treatment to the same side. The consequences of manipulation are greater than sham and promote questions to many of the currently held theories relating to change in brain function or visual perception following manipulation. It is recommended that further studies of blind spot phenomena specific to a variety of clinical disorders, treatments, and outcomes be contemplated.

This study examines whether the nervous system can be made more efficient as a cognitive processing instrument and how signal detection theory may be used as an instrument for examining human performance and the effectiveness of clinical treatment. In this paper we will examine how IM affects human cognitive and neuromotor capacities and functioning and how signal detection methods may be used to functionally evaluate treatment efficacy as well as identifying clinical populations and characteristics for rhythmic training is likely to have a positive effect. Rhythm feedback training appears to have a significant effect on clinically observed changes in behavior in attention-deficit/hyperactivity disorder (ADHD) elementary school-age children. Signal detection studies are ongoing to examine the nature of the observed relationships.

Background: This study aims to determine the relationship between parental attitudes and health behaviors of adolescents attending 6th, 7th, and 8th grades in Turkey. Methods : The population of this cross-sectional study includes the 6th, 7th and 8th grades of primary schools located in the city of Manisa (n=63,424). The sample size was calculated as 759 by taking the pattern effect as 2 and considering the standard error as 0.05 at 50% prevalence and 95% confidence interval. In the study, three questionnaires including questions consistent with the goal of the study were used. The questionnaires used included a socio-demographic questionnaire, parental attitudes inventory and the health behavior questionnaire of HBSC (Health Behavior in School-aged Children) survey instrument. Results : It was found that 70.8% of the adolescents participating in the study did not have a regular diet. Furthermore, 19.9% of the adolescents had at least a 60-min physical activity daily. Of the adolescents in the study, 45.1% watched television for 2 or more h/day. A total of 38.3% of the participants in the study had experienced injuries requiring medical attention and treatment over the past year. Furthermore, 61.2% of the participants in the study had been involved in fights during the past year. It was revealed that 2.1% of the adolescents in the study were smokers and 13.1% of the adolescents in the study had tried alcohol. The results of the study revealed a statistically significant difference between parental attitudes of smokers/nonsmokers and those who had been involved in or had not been involved in fights over the past year (p<0.05). Conclusions : In conclusion, it is suggested that training parents on parental attitudes can influence students’ health behaviors in a positive manner.

The Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) aims to provide tailor-made programs to adolescents with greater psychosocial needs. Based on the subjective outcome evaluation data collected from 196 schools, the program implementers were asked to write down five conclusions in the evaluation reports. Results demonstrated that most of the conclusions pertaining to perceptions of the Tier 2 Program, instructors, and perceived effectiveness of the programs were positive in nature. Nevertheless, there were also conclusions that reflected the obstacles encountered and suggestions for improvements. Congruent with the previous evaluation findings, the current study suggests that the Tier 2 Program was well received by the stakeholders, and the evaluation findings generally suggest that the program was beneficial to the development of the program participants.

Information is the main currency in the provision of health and social care. Information plays an even more important role in the rehabilitation process for people who have suffered a major life changing event such as a spinal cord injury or brain injury. For patients/consumers to be able to make decisions about their rehabilitation they require access to information and knowledge, whether it is information about their injury/condition, pain management, returning to work and their community. There is some evidence to suggest that improved health outcomes can be achieved in patients with appropriate knowledge and information about their condition. However, this knowledge should be evidence-based and relevant for the patient. In addition, knowledge must enable patients to assume an important role in their treatment. In this paper, we present a holistic working model of rehabilitation care through the role of information resources. We will report on a number of case stories whose rehabilitation plans were benefited by using the information service. The paper concludes that a holistic rehabilitation model that considers the patient as a whole (the patient along with his/her formal and informal support networks) has a better chance of success.

The purpose of this paper is to document the experiences of program implementers of the Project P.A.T.H.S. in Hong Kong. Thirteen program implementers from three schools were invited to participate in three focus groups to discuss their views on the Tier 1 Program (Secondary Three Level) of the project. All program implementers regarded the program as beneficial to the program participants in different psychosocial domains, particularly interpersonal and personal levels. The program implementers also perceived the program positively and positive metaphors were used to represent the program. Consistent with the previous research findings, the present study provides evidence that support the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. in promoting holistic development in Chinese adolescents in Hong Kong.

There has been an increase in the past several years of the number of people diagnosed with an autism spectrum disorder (ASD). Autism spectrum diagnoses include autism, Asperger’s Disorder, and pervasive developmental disorder not otherwise specified. There are several measures of adaptive functioning that are given to individuals with an ASD, but one that is not often used is the Scales of Independent Behavior-Revised (SIB-R). The 25 participants in this study were clients from a psychology clinic and a private psychology practice; all data obtained were archival. This study examines subscores on the SIB-R and their correlations between Full IQ scores and Verbal IQ scores, to assess the convergent, discriminant, and concurrent validity of the SIB-R with ASD clients and to describe the typical profile seen in this group. Results suggest that the SIB-R could be useful as a source of diagnostically relevant information for individuals with ASDs.

This study explored whether institutional downsizing had an effect on the activity involvement of adults with intellectual disability during deinstitutionalisation in Ontario, Canada. All individuals (n=1012) were assessed with the interRAI Intellectual Disability instrument annually over a 3-year period (2005–2008) in the institutions. Longitudinal data analyses were conducted that controlled for within-subject correlations. Results showed that improvements in activity involvement were made over the course of deinstitutionalisation and that several characteristics were associated with involvement. A significant interaction existed between time and both sex and institution. Implications for jurisdictions in which deinstitutionalisation is planned or under way are discussed.

Background: The aim of this study was to compare the health status data of 4449 adults with intellectual disabilities (ID) aged 40 years and older, from three international sites and identify cross-cultural trends in the prevalence of age-associated organ system morbidities. Study group: Data from samples of older adults with ID in Taiwan, Israel and New York State, United States, collected in three previous studies, were combined for analysis using multivariate logistic regression analyses. Methods: All data were collected using the Rochester Health Status Survey (RHSS), a survey instrument designed to collect data on demographics, morbidity, and health services usage of adults with ID through chart-review by a medical professional. Results: Irrespective of site, the likelihood of the presence of auditory problems, gastrointestinal, cardiovascular, infectious disease, eye, musculoskeletal, and respiratory conditions in people with ID increased with age and the likelihood of the presence of dermatological, endocrine, and psychiatric conditions did not increase with age. Conclusions: Prevalence of organ system diseases with increasing age in people with ID seems to be similar to expected patterns in reference population data for people without ID. The data suggest that it could be useful to increase vigilance, preventive measures, and appropriate screenings for people with ID, similar to efforts that have been incorporated in general practice guidelines. Such efforts may be useful in the delay of onset and/or reduction of the prevalence of some morbidities and secondary disability-related conditions in people with ID. Further studies are needed in these areas.

Attachment theory is a theory of normal development as well as a theory of psychopathology. Attachment theory and research suggests that different types of parental bonding can be important determinants of illness behaviour, depression, pain perception and treatment response in individuals with chronic pain. Different types of parental bonding have been shown to be associated with specific personality characteristics and a variety of psychiatric disorders. We assessed 65 patients with chronic pain who visited the pain management unit of Larissa University Hospital in Greece. All patients completed the Parental Bonding Instrument, the Beck Depression Inventory and the Visual Analogue Scale (VAS) for pain. Results demonstrated that patients who reported an affectionless bond­ing (overprotective and insensitive) with their parents, and especially their mother, reported significantly greater depression and higher VAS scores. Conversely, chronic pain patients with an optimal parental bonding reported lower depression and VAS scores. These findings suggest that parental bonding style could be a useful construct for examining factors affecting psychiatric disorders and pain perception in patients with chronic pain.

Background: In the literature, multidimensional scaling (MDS) analyses have been linked to drinking behavior wherein heavy versus light drinkers’ expectancies map differently on to the MDS space. The present study was a descriptive account of college students’ internal semantic networks of (a) alcohol and (b) marijuana-related stimuli themselves that were semantically related. Methods: Twenty-four (12 for each category) college undergraduates participated in this study. From each alcohol and marijuana category, pairs of words were generated in such a way that each word was paired with every other word. For each category, participants were presented with pairs of words and were asked to give similarity judgments for each pair of words. Participants’ data were entered in the SPSS program and the MDS algorithm was run. Results: Two-dimensional plots, which showed the internal structures of the categories were obtained and showed that more similar words occupied close psychological distance from each other and less similar words occupied longer psychological distance from each other. Conclusions: Assessment techniques such as semantic priming that use words selected from specific regions of the MDS outputs can be used in clinical research to determine alcohol or marijuana dependency or risk.

Background: Disabled people suffering from decubitus ulcers under their ischial tuberosities are usually unsuccessfully treated by continuous bed rest. This can lead to depression, loss of muscle strength, as well as respiratory and venous compromise. The aim of our study was to allow disabled persons suffering from decubitus ulcers under their ischial tuberosities to sit up as long as they wish, every day, while accelerating the healing process. Methods: The alternating pressure relief wheelchair seating system relieves seating pressure completely for 8 s, every 3.5 min at every point in the seat, progressing sequentially from the front of the seat to the rear, and starting again repeatedly from the front and progressing to the rear. This seat was intended as a supplement to the normal medical treatment of decubitus ulcers, with the difference that continuous bed rest was eliminated. Results: Even though their ulcers had persisted for several months (in some cases 4–5 years) before the patients began sitting on the alternating pressure relief wheelchair seating system, they began to heal, and exhibited accelerated healing to complete closure. Conclusions: This seat allows disabled people suffering from decubitus ulcers under their ischial tuberosities to sit up as long as they wish every day while their ulcers heal more rapidly. Because ulcers can heal while sitting on this seat, they are not likely to recur while using this seat. More tests are needed to compare ulcer healing rates with and without this seating system.

Previous studies, using neuroimaging and electrophysiology, have identified the presence of cerebral responses to auditory stimulation in clinically unresponsive persistent vegetative state (PVS) patients. In normal individuals, it has been shown that stimulation with emotional content has a strong influence on autonomic cardiovascular regu­lation tested by heart rate variability (HRV). In this paper, we assessed responses to auditory stimulation with emotion­al content in PVS and minimally conscious (MCS) cases by HRV. We found a pattern of changes induced by auditory stimulation in three of our patients (decreased heart rate, increased HRV, decrease power in the low and increased power in high frequencies) consistent with increased cardiovagal stimulation. Both time and frequency domain changes were more pronounced during affective than during non-affective auditory stimulation, suggesting that PVS patients are able to discriminate between stimuli of different content and are more reactive to emotional than non-emotional stimulation. Our results demonstrate (is a conclusion, should be in present) that auditory stimulation can induce recordable changes in HRV in some PVS cases, providing evidence that these patients retain some preserved cognitive function examined by cardiovascular correlates. The use of HRV to study residual cognitive functions could have practical implications for the management of PVS and MCS.