Experience of spirituality, mental illness and occupation: A life-sustaining phenomenon

Background and Aim:  This article provides an overview of a phenomenological investigation of spirituality with six people who have experienced mental illness. The study aimed to gain a greater understanding of the phenomenon of spirituality and its relationships to occupation and the experience of mental illness.
Methods and Results:  Participants were interviewed and the interviews were audiotaped and transcribed verbatim. Findings emerged through multiple readings and gradually constructed meanings from the data. Spirituality was found to be: unique to each participant, a journey through life, vitally important to participants, manifested as 'spiritual occupations', the foundation of meaningful doing, important socially as well as individually, and was found to support participants in coping with mental illness. This article focuses on the 'meta', integrative theme of spirituality as life sustaining. It concludes with the notion that spirituality is essential to the participants and is a significant aspect of their occupational behaviour.
Conclusion:  It is recommended that occupational therapists give themselves a 'licence' to discuss spirituality in practice and that they commit to learning more about how spirituality is a part of the lives of their clients.     

Phase I trial of a monoclonal antibody specific for alphavbeta3 integrin (MEDI-522) in patients with advanced malignancies, including an assessment of effect on tumor perfusion.

At present, a variety of agents targeting tumor angiogenesis are under clinical investigation as new therapies for patients with cancer. Overexpression of the alpha(v)beta(3) integrin on tumor vasculature has been associated with an aggressive phenotype of several solid tumor types. Murine models have shown that antibodies targeting the alpha(v)beta(3) integrin can affect tumor vasculature and block tumor formation and metastasis. These findings suggest that antibodies directed at alpha(v)beta(3) could be investigated in the treatment of human malignancies. The current phase I dose escalation study evaluated the safety of MEDI-522, a monoclonal antibody specific for the alpha(v)beta(3) integrin, in patients with advanced malignancies. Twenty-five patients with a variety of metastatic solid tumors were treated with MEDI-522 on a weekly basis with doses ranging from 2 to 10 mg/kg/wk. Adverse events were assessed weekly; pharmacokinetic studies were done; and radiographic staging was done every 8 weeks. In addition, dynamic computed tomography imaging was done at baseline and at 8 weeks in patients with suitable target lesions amenable to analysis, to potentially identify the effect of MEDI-522 on tumor perfusion. Treatment was well tolerated, and a maximum tolerated dose was not identified by traditional dose-limiting toxicities. The major adverse events observed were grade 1 and 2 infusion-related reactions (fever, rigors, flushing, injection site reactions, and tachycardia), low-grade constitutional and gastrointestinal symptoms (fatigue, myalgias, and nausea), and asymptomatic hypophosphatemia. Dynamic computed tomography imaging suggested a possible effect on tumor perfusion with an increase in contrast mean transit time from baseline to the 8-week evaluation with increasing doses of MEDI-522. No complete or partial responses were observed. Three patients with metastatic renal cell cancer experienced prolonged stable disease (34 weeks, >1 and >2 years) on treatment. With this weekly schedule of administration, and in the doses studied, MEDI-522 seems to be without significant toxicity, may have effects on tumor perfusion, and may have clinical activity in renal cell cancer. These findings suggest the MEDI-522 could be further investigated as an antiangiogenic agent for the treatment of cancer.     

Memory retrieval processing: neural indices of processes supporting episodic retrieval

Event-related potentials (ERPs) were acquired during separate test phases of a verbal recognition memory exclusion task in order to contribute to current understanding of the functional significance of differences between ERPs elicited by new (unstudied) test words, which are assumed to index processes engaged in pursuit of task-relevant information. Participants were asked to endorse old words from one study task (targets), and to reject new test words as well as those from a second study task (non-targets). The study task designated as the target category varied across test phases. The left-parietal ERP old/new effect - the electrophysiological signature of recollection - was reliable for targets and for non-targets in all test phases, consistent with the view that participants recollected information about both of these classes of test word. The contrast between the ERPs evoked by new test words separated according to target designation revealed no reliable differences. These findings contrast with those in a recent study in which the same tasks were used, but in which the accuracy of task judgments was markedly higher (Dzulkifli, M.A., & Wilding, E. L. (2005). Electrophysiological indices of strategic episodic retrieval processing. Neuropsychologia, 43, 1152-1162). In that study, there were reliable differences between the ERPs evoked by the two classes of new words, but reliable left-parietal ERP old/new effects for targets only. In combination, the findings suggest that differences between ERPs evoked by new test words can reflect processes that are important for controlling what kinds of information will and will not be recollected.     

The influence of criterion shifts on electrophysiological correlates of recognition memory

The claim that event-related potentials (ERPs) index familiarity was assessed by acquiring ERPs during a recognition memory task in which participants were instructed to adopt different decision criteria in separate retrieval phases. In one, the instructions were to respond "old" only when confident that this was the correct response, and to respond "new" otherwise (the conservative condition). In the other, the instructions were to respond new only when confident that this was the correct response (the liberal condition). The rationale for this approach was that the level of familiarity licensing an old response would be higher in the conservative than in the liberal condition, and if ERPs index familiarity, this would be reflected in changes to the putative ERP index. This index comprises relatively more positive-going neural activity for correct judgments to old than to new items, which is evident from 300 to 500 msec poststimulus at mid-frontal scalp locations. In keeping with task instructions, participants made more old responses in the liberal than in the conservative condition. There were reliable mid-frontal ERP old/new effects in both conditions, and the ERPs evoked by correct judgments to words in the conservative condition were relatively more positive-going than those in the liberal condition. This finding is consistent with the view that the mid-frontal ERP old/new effect indexes familiarity, and in combination with other ERP findings, provides strong support for dual-process accounts of recognition memory.