Color Stroop and negative priming in schizophrenia: An fMRI study

Disturbances in selective attention represent a core characteristic of schizophrenia, whose neural underpinnings have yet to be fully elucidated. Consequently, we recorded brain activation using functional magnetic resonance imaging (fMRI) while 15 patients with schizophrenia and 15 age-matched controls performed a well-established measure of selective attention—the color Stroop negative priming task. We focused on two aspects of performance: overriding pre-potent responses (Stroop effect) and inhibition of prior negatively primed trials (negative priming effect). Behaviorally, controls demonstrated both significant Stroop and negative priming effects, while schizophrenic subjects only showed the Stroop effect. For the Stroop effect, fMRI indicated significantly greater activation in frontal regions–medial frontal gyrus/anterior cingulate gyrus and middle frontal gyrus for controls–but greater activation in medial parietal regions (posterior cingulate gyrus/precuneus) for patients. Negative priming elicited significant activation in right dorsolateral prefrontal cortex for both groups, but also in left dorsolateral prefrontal cortex for patients. These different patterns of fMRI activation may reflect faulty interaction in schizophrenia within networks of brain regions that are vital to selective attention.     

Visual Feedback and Weight Reduction of a Grip Strength Dynamometer Do Not Increase Reliability in Healthy Children

Study DesignTest–retest reliability study on grip strength in children.IntroductionMeasuring grip strength in children is difficult because of the weight and size of the instrument, brief attention span, and possible lack of task understanding. Therefore, adaptations to the measurement protocols to improve reliability would be very important for research and clinical evaluation.PurposeIn this study, we compared the reliability of a grip strength dynamometer (Lode dynamometer, Lode BV, Groningen, The Netherlands) using three different protocols.MethodsTest–retest reliability of the American Society of Hand Therapists protocol in 104 healthy children (4–12 years) was compared with the reliability in 63 healthy children of a visual feedback protocol and a suspension protocol reducing weight of the instrument.ResultsFor the total group, intraclass correlation coefficients for the dominant and nondominant hands were 0.95–0.97 for all protocols, indicating that all three protocols were reliable.ConclusionNo statistically significant difference was found among the reliability of the different protocols, but the suspension protocol produced small but significantly higher force levels.Level of EvidenceNot applicable.     

Effect of quetiapine vs. placebo on response to two virtual public speaking exposures in individuals with social phobia

ObjectiveClinical practice and open-label studies suggest that quetiapine (an atypical anti-psychotic) might improve symptoms for individuals with social anxiety disorder (SAD). The purpose of this study was to provide a rigorous test of the acute impact of a single dose of quetiapine (25 mg) on SAD symptoms.MethodIndividuals with SAD (N = 20) were exposed to a 4-min virtual reality (VR) public speaking challenge after having received quetiapine or placebo (double-blind) 1 h earlier. A parallel VR challenge occurred 1 week later using a counter-balanced cross-over (within subject) design for the medication-placebo order between the two sessions.ResultThere was no significant drug effect for quetiapine on the primary outcome measures. However, quetiapine was associated with significantly elevated heart rate and sleepiness compared with placebo.ConclusionStudy findings suggest that a single dose of 25 mg quetiapine is not effective in alleviating SAD symptoms in individuals with fears of public speaking.     

Adding Mindfulness Practice to Exercise Therapy for Female Recreational Runners With Patellofemoral Pain: A Randomized Controlled Trial

ContextConsidering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain.ObjectiveTo examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP).DesignRandomized controlled clinical trial.SettingUniversity laboratory.Patients or Other ParticipantsThirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group.Intervention(s)The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention.Main Outcome Measure(s)Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks.ResultsPain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05).ConclusionsMindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners.     

Risk factors for delusion of theft in patients with Alzheimer's disease showing mild Dementia in Japan

The mechanism underlying delusion in Alzheimer's disease patients has not been fully clarified; however, the occurrence of delusion is a critical issue for dementia patients and their caregivers. In Japan, delusion of theft is the most frequent delusion in AD patients. We examined the risk factors for delusion of theft in AD patients showing mild dementia. Fifty-six AD patients were administered HDS-R, MMSE and COGNISTAT, including the ‘speech sample’, to assess their neuropsychological and social cognitive functions. The age, years of education, presence of cohabiting family members and premorbid personality traits were obtained from family members. About 25.0% of AD patients showed delusion of theft (D-group), and 75% did not (non-D-group). About 33.3% of female patients and 5.9% of male patients were included in the D-group (p < 0.05). About 13.6% of patients who were cohabiting with family members and 66.7% of patients who were living alone were included in the D-group (p < 0.05). About 35.1% of patients who had a neurotic personality and 5.3% of patients who did not were included in the D-group (p < 0.05). There were no significant differences in scores on HDS-R, MMSE and COGNISTAT sub-scales, except for ‘speech sample’, between the two groups. In the ‘speech sample’, 38.7% of patients who understood a relationship between two boys and 12.0% of patients who did not were included in the D-group (p < 0.05). These results indicated that delusion of theft in AD patients was related to female gender, absence of cohabiting family members, neurotic personality and retained social cognitive function.     

The use of CAM in a New Zealand-based general practice: a multiple case-study

OBJECTIVE: To explore the factors which underpin the healthcare consumers' decision-making to use CAM in the primary setting. DESIGN: An explorative, multiple case-study of seven convenience-sampled participants where in-depth, semi-structured interviews were employed. RESULTS: The findings showed that participants would continue to utilise CAM, even where CAM had no scientific evidence. The participants believed that CAM should be integrated into mainstream healthcare service delivery. CONCLUSIONS: There are few international studies that have reported on the utilisation and prevalence of CAM within the General Practice (GP) or clinic setting. The reasons why clients select specific CAM therapies, where they are offered in these settings, remain unclear. This study, however, casts further light on this matter.     

Mapping of reproductive health financing: methodological challenges

Low level of funding for reproductive health (RH) is a cause for concern, given that RH service utilization in the vast majority of the developing world is well below the desired level. Though there is an urgent need to track the domestic and international financial resource flows for RH, the instruments through which financial resources are tracked in developing countries are limited. In this paper we examined the methodological and conceptual challenges of monitoring financial resources for RH services at international and national level. At the international level, there are a number of estimates that highlights the need for financial resources for RH programmes but the estimates vary significantly. At the national level, Reproductive Health Accounts (RHA) in the framework of National Health Accounts (NHA) is considered to be the ideal source to track domestic financial flows for RH activities. However, the weak link between data production by the RHA and its application by the stakeholders as well as lack of political will impedes the institutionalization of RHA at the country level.     

Community Health Workers in Schools: A Systematic Review

BackgroundCommunity health workers (CHWs) are trusted community members who provide health education and care. However, no consensus exists regarding whether community health worker-based interventions are effective within the school setting.ObjectiveTo determine outcomes and best practices of school-based community health worker interventions.Data SourcesPubMed, CINAHL, and SCOPUS databases.Study Eligibility CriteriaThis systematic literature review examined articles that described an intervention led by community health workers, targeted children and/or parents, and took place primarily within a Kindergarten-12^th grade school setting. Articles were excluded if they described an intervention outside the United States.ParticipantsCommunity health workers, children, and/or their parentsInterventionsSchool-based community health worker programsResultsOf 1875 articles identified, 13 met inclusion criteria and were included in the final analysis. Of these, 5 described a statistically significant primary outcome. Seven articles provided details regarding community health worker recruitment, training, and roles that would enable reproduction of the intervention.LimitationsThis review focused on interventions in the United States. Bias of individual studies had a wide range of scores (9–21). Heterogeneity of studies also precluded a meta-analysis of primary outcomes.Conclusions and Implications of Key FindingsThe utilization of Community health workers in school-based interventions for children and/or parents is promising. This review identified a lack of detail and uniformity in program presentation, specifically with Community health worker recruitment, training, and roles. A standardized reporting mechanism for Community health worker interventions in schools would better allow for reproducibility and scalability of existing studies.