Muscular adaptations and insulin‐like growth factor‐1 responses to resistance training are stretch‐mediated

Introduction: Modulation of muscle characteristics was attempted through altering muscle stretch during resistance training. We hypothesized that stretch would enhance muscle responses. Methods: Participants trained for 8 weeks, loading the quadriceps in a shortened (SL, 0–50° knee flexion; n = 10) or lengthened (LL, 40–90°; n = 11) position, followed by 4 weeks of detraining. Controls (CON; n = 10) were untrained. Quadriceps strength, vastus lateralis architecture, anatomical cross‐sectional area (aCSA), and serum insulin‐like growth factor‐1 (IGF‐1) were measured at weeks 0, 8, 10, and 12. Results: Increases in fascicle length (29 ± 4% vs. 14 ± 4%), distal aCSA (53 ± 12% vs. 18 ± 8%), strength (26 ± 6% vs. 7 ± 3%), and IGF‐1 (31 ± 6% vs. 7 ± 6%) were greater in LL compared with SL muscles (P < 0.05). No changes occurred in CON. Detraining decrements in strength and aCSA were greater in SL than LL muscles (P < 0.05). Conclusions: Enhanced muscle in vivo (and somewhat IGF‐1) adaptations to resistance training are concurrent with muscle stretch, which warrants its inclusion within training. Muscle Nerve 49 : 108–119, 2014     

音乐节奏训练对慢性精神分裂症患者疗效和社会功能影响的研究

目的评价音乐节奏训练对精神分裂症患者临床症状的改善及对社会功能恢复的作用。方法将90例慢性精神分裂症患者随机分为研究组及对照组,研究组在原来药物治疗的基础上合并无错化学习模式的音乐节奏训练3个月。对照组在原来药物治疗的基础上合并普通工娱治疗3个月。在治疗前后用阳性和阴性综合征量表（PANSS）、个人和社会功能量表（PSP）评估患者临床症状和社会功能变化。结果研究组PANSS总分、阴性症状、一般精神病理、反应缺乏因子、激活因子及抑郁因子评分均较治疗前下降（P〈0.05）,对照组仅PANSS阴性症状评分较治疗前下降（P〈0.05）;治疗后研究组PANSS总分、阴性症状、反应缺乏因子评分低于对照组（P〈0.05）。研究组治疗后PSP总分较治疗前显著升高（P〈0.05）,治疗后研究组PSP总分高于对照组（P〈0.05）。结论音乐节奏训练对慢性精神分裂症阴性症状及社会功能的改善作用优于普通工娱治疗。     

Self-regulation of brain activity and its effect on cognitive function in patients with multiple sclerosis – First insights from an interventional study using neurofeedback

ObjectiveTo investigate the effects of EEG-based neurofeedback training, in which one can learn to self-regulate one’s own brain activity, on cognitive function in patients with multiple sclerosis (pwMS).MethodsFourteen pwMS performed ten neurofeedback training sessions within 3–4 weeks at home using a tele-rehabilitation system. The aim of the neurofeedback training was to increase voluntarily the sensorimotor rhythm (SMR, 12–15 Hz) in the EEG over central brain areas by receiving visual real-time feedback thereof. Cognitive function was assessed before and after all neurofeedback training sessions using a comprehensive standardized neuropsychological test battery.ResultsHalf of the pwMS (N = 7) showed cognitive improvements in long-term memory and executive functions after neurofeedback training. These patients successfully learned to self-regulate their own brain activity by means of neurofeedback training. The other half of pwMS (N = 7) did neither show any cognitive changes when comparing the pre- and post-assessment nor were they able to modulate their own brain activity in the desired direction during neurofeedback training.ConclusionsData from this interventional study provide first preliminary evidence that successful self-regulation of one’s own brain activity may be associated with cognitive improvements in pwMS.SignificanceThese promising results should stimulate further studies. Neurofeedback might be a promising and alternative tool for future cognitive rehabilitation.     

Mortality and suicide rates in patients discharged from forensic psychiatric wards in Japan

BackgroundJapanese forensic mental health services for patients with psychiatric disorders under the Medical Treatment and Supervision Act was initiated in 2005; however, the prognosis of those patients is not well-known, particularly regarding mortality and suicide. This study aimed to evaluate the all-cause mortality and suicide rate in forensic psychiatric outpatients who had been discharged from forensic psychiatric wards in Japan.MethodsParticipants included 966 patients who had been discharged from forensic psychiatric wards. Data were collected from July 15, 2005 to July 15, 2018 at 29 of the 33 forensic psychiatric wards in Japan. Only the patients who provided written informed consent were included. We and collaborators at each forensic psychiatric ward identified demographic data of participants from the medical records for the inpatient treatment period. The reintegration coordinators, who belonged to the Ministry of Justice, investigated the prognosis of the participants during the outpatient treatment order period. We then connected demographic data and participants’ prognosis for analysis. The crude rates (CRs) and standardized mortality ratios (SMRs) were calculated to analyze all-cause mortality and suicide rates. Univariate analysis was performed to examine the factors associated with all-cause mortality and suicide rates using the Cox proportional hazards ratio model.ResultsThe participants included 3.3 times as many men (n = 739) compared to women (n = 227), and their combined mean age was 47.3 (SD = 12.9). The most common primary psychiatric diagnosis was psychotic disorders (81.3%). The mean follow-up period was 790.2 days (SD = 369.6). The total observation period was 2091.2 person-years. The CR for all-cause death was 812.9 per 100,000 person-years (95% CI [426.5, 1199.4]), while the SMR for all-cause death was 2.2 (95% CI [1.3, 3.5]). The CR for completed suicide was 478.2 per 100,000 person-years (95% CI [181.8, 774.6]). The suicide SMR was 17.9 (95% CI [8.6, 32.9]) overall, 7.7 (95% CI [2.5, 18.0]) for men, and 79.4 (95% CI [25.8, 185.2]) for women. Univariate analysis showed that women had higher completed suicide risk than men (hazard ratio = 3.599, 95% CI [1.041, 12.445]).ConclusionThe all-cause mortality and completed suicide rates were higher in participants than observed in the general population consistent with the results of previous international studies.     

慢性精神分裂症住院患者的程式化技能训练

目的:探讨程式化技能训练对慢性精神分裂症住院患者的康复效果.方法:将 120 例住院患者随机分成训练组和对照组各 60 例,对训练组进行 8 周的程式化训练,然后全部随访 24 周.采用阳性与阴性症状量表(PANSS),自知力与治疗态度问卷(ITAQ)和 Morningside 康复状态量表(MRSS)进行评估.结果:训练组的 PANSS 总分、阴性症状分和一般精神病理分及 ITAQ 分以及 MPSS 各量表分在训练第 20 周末起,都明显优于对照组.结论:程式化技能训练可使慢性精神分裂症住院患者增进多方面的康复效果.     

电刺激疗法治疗脑卒中后吞咽障碍的疗效研究

目的探讨电刺激疗法治疗脑卒中所致吞咽障碍的临床疗效。方法75例脑卒中后吞咽障碍患者分为电刺激组,针灸组及康复训练组各25例,前两组在接受常规药物治疗及康复训练基础上分别加用电刺激治疗和针灸。三组治疗前、治疗第1周及第2周以吞咽障碍程度分级评分评定疗效。结果三组治疗后吞咽障碍程度分级评分均明显高于治疗前（P〈0.01）;电刺激组评分明显高于针灸组和康复训练组（P〈0.01）;电刺激组治疗第1、第2周后有效率明显高于针灸组和康复训练组（P〈0.05）。结论电刺激疗法可明显改善脑卒中所致吞咽障碍,配合针灸,康复训练等综合疗法可加强治疗效果。     

Perceptions of psychiatry residents and non-residents on training needs and care related to patients with intellectual disability and mental health problems: A study from Singapore

Background: People with intellectual disability (ID) have higher risk of mental morbidity and specialised training may be required in their management. We explored the training needs and knowledge as well as perceptions of care of such patients among residents and non-residents working in psychiatry.

Method: The study was conducted as an anonymous survey. Questionnaires were sent to all residents and non-residents at a large psychiatric hospital in Singapore.

Results: Forty-eight out of the 76 questionnaires sent out were returned. All participants responded that postgraduate training was required in the area of ID and mental health and according to the majority, available training was inadequate. Over 90% believed that people with ID were vulnerable to exploitation and they should be under a specialist team.

Conclusion: Efforts should be made to include specialist training in psychiatry of ID in the Singapore psychiatry curriculum to enhance the knowledge and expertise of psychiatrists in this field.     

临床常见的三种女性性功能失调的诊断和治疗

女性性功能失调是指女性在体验性愉悦的能力上具有临床意义的紊乱。本文将简要探讨临床诊疗中常见的三种女性性功能失调,包括女性性高潮障碍、女性性兴趣/唤起障碍及生殖器-盆腔痛/插入障碍的诊断和治疗,为临床工作中相关疾病的识别和诊治提供参考。     

Confessions of a New York rupture researcher: An insider’s guide and critique

Objective: The study of alliance rupture has become quite prevalent since 1990 and especially in the past 10 years where we have seen a noticeable surge in empirical publications on the subject. This honorary paper attempts to provide a critical review of this literature from the perspective of someone who has contributed to it in his collaborative work on a research program designed to investigate ruptures and to develop intervention and training models to resolve them. Method: This paper is organized into three topics or sections: (1) alliance rupture, (2) rupture resolution, and (3) alliance training; and it addresses definitions, findings, questions, and lessons with regard to each topic. Results/Conclusions: It suggests some clinical conceptualizations (concerning agency and communion as well as mutual recognition), training implications (regarding emotion regulation and deliberate practice), and methodological considerations (promoting pluralism and contextualism), along with future directions.