Psychosomatic education in Turkey

Psychosomatic education during medical study is achieved within psychiatry courses in Turkey. Generally, postgraduate education in psychiatry provides, during the specialization period, also a certain amount of education in psychosomatics. Only the Cerraphasa Medical Faculty at Istanbul University presents a unique form of practice and educational activity in the field of psychosomatics. Here, the Psychoneuroses and Psychosomatics Department within the Psychiatry Clinic (the foundation of which goes back to 1970) provides for medical students a psychosomatic approach and an introduction to psychosomatic concepts within the medical psychology courses and a further theoretical as well as practical knowledge during the psychiatry courses and internships. Postgraduate training in psychosomatics is also unique for Turkey in this department, where psychiatry residents with special interest for psychosomatics spend the major part of their training period in the psychosomatics department and receive theoretical and practical training. Training in psychotherapy is also included in the program. The regular series of seminars and open-lectures organized by this department are directed also to other medical and non-medical staff in various departments and faculties. Consultation-liaison-psychiatry is also part of this training. The department provides under- and postgraduate training (master training) for psychologists. Nurse training (under- and postgraduate) and occupational therapist training are also included in the training program of this Department. The training as well as other therapeutic and research activities of this department are also supported by the Society of Psychosomatics and Psychotherapy.     

Treatment of word retrieval deficits with contextual priming

Background: Repetition priming is often a component of treatments for word‐finding disorders. It can facilitate or interfere with naming success depending on a number of factors. Here we investigate the effectiveness of massed priming coupled with semantic or phonological context as a treatment for naming impairments arising from semantic and phonological deficits. Aims: We aimed to determine whether (1) this procedure, used previously in a short‐term facilitation study, would effectively improve word retrieval in a treatment study, and (2) the pattern of facilitation or interference observed in the facilitation study would carry over to the treatment programme. Methods & Procedures: We used a single subject multiple baseline design. There were two participants: LP with a phonological encoding deficit and AS with both semantic and phonological deficits. Treatment involved identifying and repeating the names of words that were related semantically or phonologically, or unrelated. Pre and post measures of naming were used to assess overall effectiveness of the treatment. Acquisition, maintenance, and generalisation were measured with baseline tests at the start of each session. Correct responses and errors on within‐training naming probes were used to measure sensitivity to priming in a particular context. Outcomes & Results: LP benefited from this procedure regardless of the training context. AS showed interference in the semantic context during training and only modest short‐term gains. These outcomes were predicted by their performance on an earlier facilitation study. Conclusions: Contextual repetition priming has different effects on naming and these differences appear to be related to the context of training (semantic or phonological) and the primary source of an individual's naming impairment (semantic or phonological). This procedure is most effective when semantic processing of words is relatively spared.     

Postgraduate training for young psychiatrists--experience of the Berlin Summer School.

BACKGROUND: Growing professional exchange between Eastern and Western European countries increases the possibilities for international postgraduate training courses and by that satisfying the need for rapid and facilitation of travel and migration in the enlarged European Union increase achieving high standards. The purpose of this study was to evaluate a summer school program that trained young Eastern European psychiatrists and to assess the impact of the program on their professional development and future activities. METHOD: We evaluated the training effect of the first 3 years of the Berlin Summer School with respect to (1) the participants' satisfaction with the topics, quality and originality of the presentations, and (2) long-term effects and implications for their professional career. All participants (N=43) filled out anonymously the evaluation form at the end of each summer school. An evaluation of long-term effects was carried out 2 years later with a questionnaire that was sent via e-mail to all former participants. RESULTS: Participants were most satisfied with practical topics such as "how to prepare a paper", "how to evaluate a paper", or "how to participate in a congress." The appreciation of the presented topics and the appreciation of courses increased in each consecutive summer school. All summer school participants reported that the course had some influence on their future career, and one fifth of the participants felt that their professional development was influenced "a lot". CONCLUSIONS: Although limited to 1 week of intensive training, a summer school program can have a longer lasting positive influence on the professional development of the participants. Participants felt that particularly the training of practical skills improved their research performance. Former participants founded an independent multicentric and multinational research group and supported national courses that were organized similar to the Berlin Summer School.     

Measuring latency distribution of transcallosal fibers using transcranial magnetic stimulation

BackgroundNeuroimaging technology is being developed to enable non-invasive mapping of the latency distribution of cortical projection pathways in white matter, and correlative clinical neurophysiological techniques would be valuable for mutual verification. Interhemispheric interaction through the corpus callosum can be measured with interhemispheric facilitation and inhibition using transcranial magnetic stimulation.ObjectiveTo develop a method for determining the latency distribution of the transcallosal fibers with transcranial magnetic stimulation.MethodsWe measured the precise time courses of interhemispheric facilitation and inhibition with a conditioning-test paired-pulse magnetic stimulation paradigm. The conditioning stimulus was applied to the right primary motor cortex and the test stimulus was applied to the left primary motor cortex. The interstimulus interval was set at 0.1 ms resolution. The proportions of transcallosal fibers with different conduction velocities were calculated by measuring the changes in magnitudes of interhemispheric facilitation and inhibition with interstimulus interval.ResultsBoth interhemispheric facilitation and inhibition increased with increment in interstimulus interval. The magnitude of interhemispheric facilitation was correlated with that of interhemispheric inhibition. The latency distribution of transcallosal fibers measured with interhemispheric facilitation was also correlated with that measured with interhemispheric inhibition.ConclusionsThe data can be interpreted as latency distribution of transcallosal fibers. Interhemispheric interaction measured with transcranial magnetic stimulation is a promising technique to determine the latency distribution of the transcallosal fibers. Similar techniques could be developed for other cortical pathways.     

Importance of role playing in a professional training group]

Role playing constitutes a precious instrument in training responible people for help relations. It permits to by-pass defense mechanisms through induced avoidance in group situation. It makes personal involvment easier, for efforts as well as for representations, and permits to confront reality in the other person. Under the control of the animator, the player has always the right to limit his personal involvment within the boundaries he wishes : this combination of facilitation and involvment framing is especially interesting.     

Acquisition and retention of a mediational strategy for PA learning in EMR children.

The ability of EMR children to acquire and retain a mediational strategy for PA learning was demonstrated by a training procedure which consisted of the sequencing of consecutive lists under varying degrees of mediational facilitation. The components of the training procedure included training interval, overt verbalization, and verbal context combined with imagery instruction. Forty-five EMR children (mean CA = 11.26; mean IQ = 63.33) were randomly assigned to one of three groups: mediation, standard, and control. Analyses of data showed significantly superior performance of the mediation group in acquisition and retention of the mediational strategy. The pedagogical implications of the study were discussed.     

Ethics in Neuroscience Curricula: A Survey of Australia, Canada, Germany, the UK, and the US

This paper analyses ethical training in neuroscience curricula at universities in Australia, Canada, Germany, the United States and the United Kingdom. The main findings are that 52 % of all courses have ethical training available, while in 82 % of those cases, the training is mandatory. In terms of specific contents of the teaching, ethical issues about ‘animal subjects and human participation in research’, ‘scientific misconduct’, and ‘treatment of data’ were the most prominent. A special emphasis during the research was placed on the prevalence of dual-use bioethics. In total, only 3 % of all courses mention it in any of their modules. One of the major findings of the survey was the trend towards ‘mainstreaming’ ethics education particularly in the UK, which is to disperse ethics among the various modules within the education instead of relying on a single ethics module. The paper discusses the utility of this approach for science education as well as describes the overall difficulties that course coordinators face when trying to teach ethics based on the responses to the qualitative part to the survey.     

THE USE OF SMALL PARENT-GROUPS IN AN ADULT TRAINING CENTRE

SUMMARY: 28 parents of adult trainees were involved in three separate courses of about eight weeks in a 150 place adult training centre (ATC). The purpose and content of the courses is described. It was concluded that these courses have practical, and other less-easily observable, long-term advantages for trainees, parents and staff.     

Facilitated communication: A failure to replicate the phenomenon

Twenty-one subjects participated in a study of Biklen's and Crossley's hypothesis that persons with autism show unexpected literacy and improved communication ability through the process of facilitated communication (FC). Repeated measures of literacy were conducted at (a) a baseline test of communicative ability before FC; (b) a pretest with facilitation; and (c) a posttest with facilitation after 20 hours of training. At both the pretest and posttest, the facilitators were screened from hearing or seeing the questions or pictorial stimuli. Although some facilitators reported newfound communicative abilities during training sessions, no client showed unexpected literacy or communicative abilities when tested via the facilitator screening procedure, even after 20 hours of training. Separate analyses indicated that some facilitators influenced the communicative output of their clients.We are grateful for the support and assistance of Martin Hamburg, John Werner, Mike DeFalco, our facilitators, the students who participated in this project, and John Amato. Special thanks to John Pomeroy, consulting psychiatrist, who provided the independent diagnoses on our subjects for the assessment of diagnostic reliability, and to Sarah Robinson for helpful comments in editing an earlier draft. We are also indebted to Canon, USA, for donating three Canon Communicators.     

Therapeutic orientation preferences in trainee clinical psychologists: Personality or training?

Abstract

This study investigated the relative influence of person and training factors on preference for three common therapeutic orientations—cognitive–behavioural therapy (CBT), psychodynamic therapy, and systemic therapy—in 142 U.K. trainee clinical psychologists. Consistent with previous research, preferences for therapeutic orientation were related to personality, philosophical worldview, the theoretical emphasis of training courses, and the orientation of supervisors. Preference for psychodynamic therapy was influenced more by training factors and preference for CBT more by person factors, with the influence of both sets of factors being approximately equal for systemic therapy. Supervision was more influential than the theoretical emphasis of training courses in predicting preferences for psychodynamic and systemic therapies, with the converse pattern found for CBT.     

Guidelines for neuromuscular ultrasound training

Neuromuscular ultrasound has become an essential tool in the diagnostic evaluation of various neuromuscular disorders, and, as such, there is growing interest in neuromuscular ultrasound training. Effective training is critical in mastering this modality. Our aim was to develop consensus-based guidelines for neuromuscular ultrasound training courses. A total of 18 experts participated. Expert opinion was sought through the Delphi method using 4 consecutive electronic surveys. A high degree of consensus was achieved with regard to the general structure of neuromuscular ultrasound training; the categorization of training into basic, intermediate, and advanced levels; the learning objectives; and the curriculum for each level. In this study, a group of neuromuscular ultrasound experts established consensus-based guidelines for neuromuscular ultrasound training. These guidelines can be used in the development of the specialty and the standardization of neuromuscular ultrasound training courses and workshops.     

NMES疗法及单纯吞咽训练对脑卒中后吞咽障碍的疗效观察

目的分析脑卒中后吞咽障碍患者采用神经肌肉电刺激疗法(NMES)联合单纯吞咽训练治疗的疗效。方法选取本科2013年1月至2015年1月的脑卒中后吞咽障碍患者90例,随机分为NMES联合治疗组和常规单纯运动训练组,常规单纯运动训练组予以单纯吞咽功能训练,NMES联合治疗组在常规单纯运动训练组基础上加用NMES疗法。对比两组患者治疗前后的各项吞咽功能评分和临床疗效。结果治疗3个疗程后,NMES联合治疗组和常规单纯运动训练组的洼田饮水试验分级、口面运动功能评分显著低于治疗前,吞咽X线电视透视检查(VFSS)评分、藤岛一郎吞咽疗效评分显著高于治疗前(P0.05);治疗3个疗程后,NMES联合治疗组的洼田饮水试验、口面运动功能评分显著低于对照组,VFSS评分、藤岛一郎吞咽疗效评分显著高于常规单纯运动训练组(P0.05)。治疗3个疗程后,NMES联合治疗组的总有效率为95.55%(43/45)显著高于常规单纯运动训练组77.78%(35/45)(P0.05)。结论对于脑卒中后吞咽障碍患者单纯吞咽训练联合采用NMES疗法,疗效更佳。     

The variability of intracortical inhibition and facilitation

OBJECTIVE: To assess the variability of transcranial magnetic stimulation paired pulse measurements of cortical excitability between subjects, between sessions and within subjects within sessions. METHODS: In experiment 1, intracortical inhibition and facilitation were assessed with a fixed conditioning stimulus intensity (CSI) of 80% of active motor threshold (AMT) whereas in experiment 2, the effect of different CSIs (60-110% of AMT) was investigated. RESULTS: Experiment 1 revealed that subjects differed significantly in the degree of inhibition and facilitation. Between sessions the variability was substantial as predicted by high within session variability. Experiment 2 allowed determination of individual thresholds for inhibition and facilitation. These thresholds were the best predictor of the amount of inhibition or facilitation at a given CSI. Across subjects we observed a high correlation of the threshold for inhibition (expressed in terms of maximum stimulator output) with AMT (r=0.93). Results for facilitation were more variable. CONCLUSIONS: The variability was high if a single CSI was used to compare the percent intracortical inhibition or facilitation between subjects, or between sessions. Much less variable was the threshold for intracortical inhibition/facilitation, which was highly correlated to AMT. We suggest that the ratio of CSI:AMT is a robust and useful additional measure of the integrity of neuronal circuits underlying intracortical inhibition/facilitation.     

My Space,Your Space,Our Space: Exploring the Potential of Collaborative Group Facilitation Between Therapists and Peer Workers in Mental Health Settings

This paper explores the potential of collaborative group facilitation between therapists and peer workers in mental health. A case study of co-practice between a music therapist and a peer worker is used to illustrate how lived experience expertise can enrich and complement therapeutic groups. The paper aims to begin a discussion around collaborative group facilitation within mental health practice and to advocate for continued development of collaborative practice between peer workers and therapists. Experiences of collaboration are explored through the case study provided using a synthesis of the authors’ reflections and dialogue. The importance of role negotiation, role definition, and open communication around changing roles and boundaries are discussed as key considerations for beginning collaborations, as well as the establishment and maintenance of a foundation of trust and support within the working relationship.

     

Immediate and short‐term effects of contextual priming on word retrieval in aphasia

Background: Many therapy techniques for word retrieval disorders use some form of priming to improve access to words. Priming can facilitate or interfere with naming under different circumstances. We examined effects of priming when combined with semantic or phonological context (training words in groups that are semantically or phonologically related) and how these effects interact with the type of naming impairment (semantically or phonologically based). Aims: We addressed three questions (1) Are word retrieval impairments differentially sensitive to priming with semantic or phonological contexts? (2) Would such differences be systematically related to deficits of semantic versus phonological processing? (3) Do effects of priming evolve from immediate interference to short‐term facilitation, as predicted by an interactive activation model of word retrieval? Methods & Procedures: A total of 11 chronic English‐speaking aphasic subjects with varied types of aphasia participated in this experiment. Background measures of semantic and phonological processing ability were administered to determine the nature of each subject's naming impairment. The experiment involved one‐session facilitation treatments for each of three context conditions (semantic, phonological, and unrelated), plus three replications (nine subjects) or one replication (two subjects). Ten pictures in each condition were tested before and after treatment. Five pictures were trained and five served as controls. Participants repeated the name of each picture four times (repetition priming) and then attempted to name each picture individually (naming probe). Repetition priming and naming probes were repeated eight times. We used McNemar tests to compare rates of correct responses before and after priming, and chi square analyses of correct responses and contextual errors on naming probes obtained during the priming sessions. Outcome & results: Our predictions were borne out in the data. Participants varied in their sensitivity to the semantic and phonological contexts. The error data suggest that interference during training is more likely when the context (semantic or phonological) and underlying source of the word processing impairment (semantic or phonological) match. Additionally, we found two sequential effects of contextual priming: immediate interference followed short‐term facilitation. Conclusions: These data have theoretical implications regarding the time course of priming effects, but also have important clinical implications. The present contextual priming procedure is relatively short and could be used as a predictor of performance patterns in a long‐term treatment protocol that uses this approach or other tasks that employ priming.     

GABA-Induced Synaptic Facilitation at Type B to A Photoreceptor Connections in Hermissenda

Gamma-aminobutyric acid (GABA) is a prevalent neurotransmitter in both vertebrate and invertebrate systems. Here we report that, in addition to its usual inhibitory actions, GABA induced synaptic facilitation at type B to A photoreceptor connections of the marine mollusk Hermissenda when applied transiently to the isolated nervous system. Synaptic facilitation also occurred in response to mechanical stimulation of the GABAergic hair cells, which are normally activated by rotational unconditioned stimuli during behavioral training of the intact animal. This synaptic facilitation represents a novel form of GABA-induced neuromodulation which may contribute to learning-dependent suppression of phototaxis in Hermissenda.     

本体感觉神经肌肉促进法对5 km越野后肌疲劳的作用及最佳干预时机*

背景：5 km越野训练后会使人体出现肌疲劳，常导致各种程度的肌肉酸痛和肌无力等，而神经肌肉促进法可改善关节和肌肉柔韧性。 目的：观察感觉神经肌肉促进法对新入学军校学员5 km越野训练后肌疲劳的干预作用及最佳干预时机。 方法：选择新入学的健康军校男学员，均进5 km越野训练。分别在训练前、后针对双下肢、骨盆带肌肉采用本体感觉神经肌肉促进法干预，并设置正常训练组作对照。在训练前，训练后第1，3，5天分别评定其肌疲劳度，并检查相关血液生化指标。 结果与结论：训练后第1，3，5天全部对象肌疲劳度和相关血液生化指标肌红蛋白、谷丙转氨酶、谷草转氨酶、乳酸脱氢酶和肌酸磷酸激酶的平均增幅差异均为训练后神经肌肉促进干预组 < 训练前神经肌肉促进干预组 < 正常训练组(P < 0.05)。结果表明经本体感觉神经肌肉促进法干预可以降低5 km越野训练后相关血生化指标的增高，减轻肌损伤，降低肌疲劳。训练结束后当天行本体感觉神经肌肉促进法干预为最佳时机。     

On occasionally being able to paint

Many of us find that our own work suffers when we practise as art therapists. Yet training courses stress the importance of maintaining our personal artwork alongside therapy practice, and this is widely accepted as a valuable part of a balanced approach to art therapy. Andrea Gilroy has examined this, sometimes difficult, relationship. She outlines her own experiences and reports on her research findings. This article is a reprint of an article originally published in Inscape Spring 1989. It should be noted that at the time the research was being carried out, art therapy training courses ran for only one year full-time or two years part-time.