Cognitive load of walking in people who are blind: Subjective and objective measures for assessment

BackgroundAlthough walking without vision seems to carry a high cognitive cost, few studies have measured the cognitive load involved in this activity in blind people. The aim of this study was to assess the cognitive load of walking in blind people, using gait analysis, a dual task paradigm and a subjective assessment of cognitive load.MethodsIn a quantitative quasi-experimental design, 25 blind adults walked 40 meters. In one trial, participants walked normally (control condition). In another, they walked while performing an auditory simple reaction time task, and in the third trial they walked, performed the simple reaction time task and avoided obstacles. In addition to the simple reaction time task performance, walking speed was recorded, and participants provided a subjective assessment of cognitive load after each trial. Performance of participants aged less than 60 years were compared with those aged over than 60 years.ResultsWalking significantly reduced performance of the simple reaction time task; carrying out the simple reaction time task while walking significantly reduced walking performance and increased the subjective assessment of cognitive load; and simple reaction time task performance decreased and subjective assessment increased when obstacles were present. Few significant age effects were found.SignificanceWalking without vision involves a cognitive load that increases when the environment becomes complex. Each of the three methods used is relevant when assessing the cognitive load involved in walking in blind people, and could be useful in rehabilitation intervention. The results obtained allowed recommendations to be suggested for the design of technological mobility devices.     

A constructive-critical response to Creative Health: The Arts for Health and Wellbeing (July 2017) by the All–Party Parliamentary Group on Arts,Health and Wellbeing

The recent report from the United Kingdom (UK) All-Party Parliamentary Group on Arts, Health and Wellbeing is receiving widespread publicity across the media. Newspaper articles and social media posts espouse the benefits and importance of employing creative arts within the health domain, citing the report as proof of this. The report is inclusive of the entire range of arts practices, while its recommendations relate in the most part to UK policy and systems. The focus of this article is specific to visual arts practices and art therapy (art-for-health), but may have relevance across arts modalities and approaches (arts and health). This article questions the approach to the evidence taken in the report, and highlights the need for rigour, balance and impartiality in conducting research and presenting evidence. A case is made for the use of formal systematic reviews as appropriate ways to develop the evidence base. Another suggestion is a request for more explicit consideration of the ideological commitments underpinning beliefs about purpose and value within art therapy and the wider arts and health arena.     

Structural Injustices in Our Nonideal World

Madison Powers and Ruth Faden's book Structural Injustice: Power, Advantage, and Human Rights (Oxford University Press, 2019), is an invaluable contribution to help us grasp the contemporary ills of our nonideal world. The authors' general claim is that the concept of structural injustice allows us to identify the causes and social processes leading to the violation of human rights and the production of unfair systems of disadvantage and privilege. Building on Powers and Faden's well-known thesis that social justice is concerned with the achievement of a sufficient level of well-being, the book delves into an in-depth discussion of their conceptual framework, incorporating concrete examples to illustrate their analysis.     

主观疗效评价在恶性肿瘤中医药研究中的应用现状及进展

循证医学模式的引入使得恶性肿瘤中医治疗的有效性有了新的阐述途径,同时也对中医疗效评价体系提出了更高的要求。基于患者的自身感受,医师望闻问切四诊等得到的主观信息是主观疗效评价的重要组成方面,一直以来都是中医疗效评价的重要手段,其由单一的症状是否好转的评价发展至多重症状是否改善、整体生活质量是否提高等的评价方式,主观疗效评价的方式越来越丰富,也越来越规范,文章就目前主观疗效评价在中医药领域的研究现状及进展展开综述。     

耳石复位与药物联合仰卧位摇头法治疗主观性良性阵发性位置性眩晕临床研究

目的:观察耳石复位与药物联合仰卧位摇头法治疗主观性良性阵发性位置性眩晕(S-BPPV)的效果。方法:选取2012年1月至2016年1月期间符合纳入标准的S-BPPV患者186例,采用随机数字表法将患者分为观察组与对照组各93例,对照组采用耳石复位联合药物治疗,观察组在对照组基础上采用仰卧位摇头法治疗。比较两组患者临床疗效、首次治疗成功率、中转手术治疗率、复发率与不良反应发生率的差异。结果:与对照组比较,观察组治疗总有效率、首次治疗成功率明显增高,中转手术治疗率与复发率明显降低,差异具有统计学意义(P0.05);两组中共18例患者经外科手术治疗后症状彻底消失;随访3个月期间,观察组平均复发次数与对照组比较差异具有统计学意义(P0.05);两组患者头晕、恶心呕吐、心律失常、走路不稳与情感障碍等不良反应发生率比较差异无统计学意义(P0.05)。结论:耳石复位与药物联合仰卧位摇头法治疗S-BPPV效果显著,可降低复发率,且未增加不良反应的发生风险。     

Commentary: Climate change worry among adolescents—on the importance of going beyond the constructive–unconstructive dichotomy to explore coping efforts—a commentary on Sciberras and Fernando (2021)

This opinion piece comments on Sciberras and Fernando’s (2021) article in which an 8-year longitudinal study is presented. The authors investigate trajectories of climate change worry through adolescence and associations with measures of depression and engagement with news and politics in late adolescence. Their objective is to explore whether climate change worry is a constructive or unconstructive psychological phenomenon. Their conclusion is that it is mainly an adaptive response but, for some groups, such as young people with pre-existing mental health problems, climate change worry could exacerbate their difficulties. In this commentary, it is argued that since research has found diverse results regarding whether climate worry is adaptive or not, one should perhaps not focus so much on the emotion itself, but rather on how people cope with their worry. Some examples of how young people cope with climate change are presented, and it is argued that taking account of these coping strategies in future longitudinal studies would be beneficial.     

The protective effect of mindfulness and compassion meditation practices on ageing: Hypotheses,models and experimental implementation

Alzheimer's disease (AD) represents a major health and societal issue; there is no treatment to date and the pathophysiological mechanisms underlying this disease are not well understood. Yet, there is hope that AD risk factors and thus the number of AD cases can be significantly reduced by prevention measures based on lifestyle modifications as targeted by non-pharmacological preventive interventions. So far, these interventions have rarely targeted the psycho-affective risk factors related to depression, stress, anxiety, and feeling of loneliness, which are all prevalent in ageing. This paper presents the hypothesis that the regular practice of mindfulness meditation (MM) and loving-kindness and compassion meditation (LKCM) in the ageing population constitutes a lifestyle that is protective against AD. In this model, these practices can promote cognition, mental health, and well-being by strengthening attention control, metacognitive monitoring, emotion regulation and pro-social capacities. Training these capacities could reduce the risk of AD by upregulating beneficial age-related factors such as cognitive reserve, and down-regulating detrimental age-related factors, such as stress, or depression. As an illustration, we present the Medit-Ageing study (public name Silver Santé Study), an on-going European project that assesses the impact and mechanisms of non-pharmacological interventions including meditation, in the ageing population.