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The Journal of Physiology Jan 2022Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for...
Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for accurate stepping is collected and how its acquisition relates to the step cycle. In cats of both sexes, we showed that a brief (200-400 ms) interruption of visual input can rapidly influence cat's walking along a horizontal ladder. Depending on the phase within the step cycle, a 200 ms period of darkness could be tolerated fully without any changes to the strides or could lead to minor increases of stride duration. The effects of 300-400 ms of visual input denial, which typically prolonged stances and/or swings, also depended on the phase of the darkness onset. The increase of the duration of strides was always shorter than the duration of darkness. We conclude that visual information for planning a swing is collected starting from the middle of the preceding stance until the beginning of the current swing. For a stance (and/or a swing of the other paw), visual information is collected starting from the end of the previous stance and until the middle of the current stance. Acquisition of visual information during these windows is not uniform but depends on the phase of the step cycle. Notably, both the extension of these windows and their non-homogeneity are closely related to the pattern of gaze behaviour in cats, described previously. This new knowledge will help to guide research and understanding of neuronal mechanisms of visuomotor integration and modulation of visual function by strides during locomotion. KEY POINTS: Cats, like humans, rely on vision to navigate in complex environments. In cats walking along a horizontally placed ladder, we show that visual information required for accurate stepping is collected in a non-uniform manner throughout the stride cycle. Brief denial of visual input during a swing prolongs the next stance of that forelimb. Denial of visual input during a stance prolongs this stance, as well as the next swing and stance. Denial during the first half of a stance has a greater effect than during the second half. The phase dependence of the use of vision for accurate stepping and the pattern of affected swings and stances are closely related to the previously described pattern of gaze behaviour in cats. This new knowledge opens new perspectives for research into neuronal mechanisms of visuomotor coordination and visual function during walking and for understanding related disorders.
Topics: Animals; Cats; Darkness; Electromyography; Female; Forelimb; Locomotion; Male; Walking
PubMed: 34761816
DOI: 10.1113/JP282255 -
BMC Geriatrics May 2016There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a meta-review of this literature 1988-2014.
METHOD
A meta-review was carried out of systematic reviews of stress, coping and interventions for people with dementia and their caregivers, using SCOPUS, Google Scholar and CINAHL Plus databases and manual searches.
RESULTS
The meta-review identified 45 systematic reviews, of which 15 were meta-analyses. Thirty one reviews addressed the effects of interventions and 14 addressed the results of correlational studies of factors associated with stress and coping. Of the 31 systematic reviews dealing with intervention studies, 22 focused on caregivers, 6 focused on people with dementia and 3 addressed both groups. Overall, benefits in terms of psychological measures of mental health and depression were generally found for the use of problem focused coping strategies and acceptance and social-emotional support coping strategies. Poor outcomes were associated with wishful thinking, denial, and avoidance coping strategies. The interventions addressed in the systematic reviews were extremely varied and encompassed Psychosocial, Psychoeducational, Technical, Therapy, Support Groups and Multicomponent interventions. Specific outcome measures used in the primary sources covered by the systematic reviews were also extremely varied but could be grouped into three dimensions, viz., a broad dimension of "Psychological Well-Being v. Psychological Morbidity" and two narrower dimensions of "Knowledge and Coping" and of "Institutionalisation Delay".
CONCLUSIONS
This meta-review supports the conclusion that being a caregiver for people with dementia is associated with psychological stress and physical ill-health. Benefits in terms of mental health and depression were generally found for caregiver coping strategies involving problem focus, acceptance and social-emotional support. Negative outcomes for caregivers were associated with wishful thinking, denial and avoidance coping strategies. Psychosocial and Psychoeducational interventions were beneficial for caregivers and for people with dementia. Support groups, Multicomponent interventions and Joint Engagements by both caregivers and people with dementia were generally found to be beneficial. It was notable that virtually all reviews addressed very general coping strategies for stress broadly considered, rather than in terms of specific remedies for specific sources of stress. Investigation of specific stressors and remedies would seem to be a useful area for future research.
Topics: Adaptation, Psychological; Caregivers; Dementia; Depression; Emotions; Humans; Mental Health; Social Support; Stress, Psychological
PubMed: 27193287
DOI: 10.1186/s12877-016-0280-8 -
The American Journal of Hospice &... Mar 2018Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical-psychological-social-spiritual dimension have...
PURPOSE
Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical-psychological-social-spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships between different constituent factors (e.g., fear and pain, spiritual experiences and altered consciousness) are largely unknown. We lack deeper understanding of patients' inner processes to which care should respond. In this study, we hypothesized that fear/pain/denial would happen simultaneously and be associated with a transformation of perception from ego-based (pre-transition) to ego-distant perception/consciousness (post-transition) and that spiritual (transcendental) experiences would primarily occur in periods of calmness and post-transition. Parameters for observing transformation of perception (pre-transition, transition itself, and post-transition) were patients' altered awareness of time/space/body and patients' altered social connectedness.
METHOD
Two interdisciplinary teams observed 80 dying patients with cancer in palliative units at 2 Swiss cantonal hospitals. We applied participant observation based on semistructured observation protocols, supplemented by the list of analgesic and psychotropic medication. Descriptive statistical analysis and Interpretative Phenomenological Analysis (IPA) were combined. International interdisciplinary experts supported the analysis.
RESULTS
Most patients showed at least fear and pain once. Many seemed to have spiritual experiences and to undergo a transformation of perception only partly depending on medication. Line graphs representatively illustrate associations between fear/pain/denial/spiritual experiences and a transformation of perception. No trajectory displayed uninterrupted distress. Many patients seemed to die in peace. Previous near-death or spiritual/mystical experiences may facilitate the dying process.
CONCLUSION
Approaching death seems not only characterized by periods of distress but even more by states beyond fear/pain/denial.
Topics: Adult; Aged; Aged, 80 and over; Attitude to Death; Fear; Female; Humans; Male; Middle Aged; Pain; Palliative Care; Patient Care Team; Spirituality; Switzerland; Terminal Care
PubMed: 28823175
DOI: 10.1177/1049909117725271 -
Proceedings of the National Academy of... Feb 2023In online content moderation, two key values may come into conflict: protecting freedom of expression and preventing harm. Robust rules based in part on how citizens...
In online content moderation, two key values may come into conflict: protecting freedom of expression and preventing harm. Robust rules based in part on how citizens think about these moral dilemmas are necessary to deal with this conflict in a principled way, yet little is known about people's judgments and preferences around content moderation. We examined such moral dilemmas in a conjoint survey experiment where US respondents ( = 2, 564) indicated whether they would remove problematic social media posts on election denial, antivaccination, Holocaust denial, and climate change denial and whether they would take punitive action against the accounts. Respondents were shown key information about the user and their post as well as the consequences of the misinformation. The majority preferred quashing harmful misinformation over protecting free speech. Respondents were more reluctant to suspend accounts than to remove posts and more likely to do either if the harmful consequences of the misinformation were severe or if sharing it was a repeated offense. Features related to the account itself (the person behind the account, their partisanship, and number of followers) had little to no effect on respondents' decisions. Content moderation of harmful misinformation was a partisan issue: Across all four scenarios, Republicans were consistently less willing than Democrats or independents to remove posts or penalize the accounts that posted them. Our results can inform the design of transparent rules for content moderation of harmful misinformation.
Topics: Humans; Speech; Communication; Morals; Emotions; Politics; Social Media
PubMed: 36749721
DOI: 10.1073/pnas.2210666120 -
Rhode Island Medical Journal (2013) Jun 2020To determine the health and socioeconomic consequences of comprehensive abortion denial in Rhode Island.
OBJECTIVES
To determine the health and socioeconomic consequences of comprehensive abortion denial in Rhode Island.
METHODS
Using Turnaway Study findings and RI abortion data from 2013-2016, we project the burden of negative outcomes for women and their families under 100% abortion denial conditions.
RESULTS
Findings suggest negative impacts on the health and socioeconomic well-being of RI women and their families. 982 and 910 women, who would have otherwise received an abortion, will report anxiety and depression, respectively, at one-week post abortion denial, and 1,499 will report receiving Temporary Assistance for Needy Families funding at six months post denial.
CONCLUSIONS
If women who would seek a safe and legal abortion in RI are denied one, clear and undue burden will exist for those who carry to term and raise the child, as well as affecting existing children.
Topics: Abortion Applicants; Abortion, Induced; Abortion, Legal; Adaptation, Psychological; Adolescent; Adult; Anxiety; Depression; Female; Health Impact Assessment; Humans; Poverty; Pregnancy; Rhode Island; State Government; Young Adult
PubMed: 32481788
DOI: No ID Found -
BMC Women's Health Dec 2021Although associated with many successes, oocyte donation can lead to numerous psychological challenges in recipient women. The identification of these challenges during...
BACKGROUND
Although associated with many successes, oocyte donation can lead to numerous psychological challenges in recipient women. The identification of these challenges during the treatment process is crucial to improve recipient mental health. Thus, the aim of this study was to gain an understanding of the experiences of oocyte recipient women.
METHODS
This research was conducted using a qualitative approach and inductive content analysis method. The data collection tool was in-depth interviews. Twenty women with the experience of receiving donated oocyte were selected and entered the study using purposive sampling method and considering the maximum variation.
RESULTS
Three main categories of psychological challenges were extracted from patient interviews, specifically, distressing psychologic symptoms, social stigmatization, and negative coping mechanisms. The category of distressing psychologic symptoms was shaped based on the subcategories of self-esteem destruction, anxiety and stress, depression and spiritual discouragement. The category of social stigmatization included the subcategories of concern about disclosure, judgment of others, and conflict with religious teachings. And the category of negative coping mechanisms was formed based on the subcategories of aggression and denial.
CONCLUSION
The results indicated that the process of treatment with donated oocyte is followed by the experiences of distressing psychologic symptoms, social stigmatization, and negative coping mechanisms in recipient women. As such, paying attention to the socio-cultural factors which affect this process seems necessary to maintain the mental health of these women. Although associated with many successes, oocyte donation can lead to numerous psychological challenges in recipient women. The aim of this study was to gain an understanding of the experiences of oocyte recipient women. This research was conducted using a qualitative approach and inductive content analysis method. The data collection tool was in-depth interviews. Twenty women with the experience of receiving donated oocyte were selected and entered the study using purposive sampling method and considering the maximum variation. Three main categories of psychological challenges were extracted from patient interviews, specifically, distressing psychologic symptoms, social stigmatization, and negative coping mechanisms. The category of distressing psychologic symptoms was shaped based on the subcategories of self-esteem destruction, anxiety and stress, depression and spiritual discouragement. The category of social stigmatization included the subcategories of concern about disclosure, judgment of others, and conflict with religious teachings. And the category of negative coping mechanisms was formed based on the subcategories of aggression and denial. The results indicated that the process of treatment with donated oocyte is followed by experience of distressing psychologic symptoms, social stigmatization, and negative coping mechanisms in recipient women. As such, paying attention to the socio-cultural factors which affect this process seems necessary to maintain the mental health of these women.
Topics: Adaptation, Psychological; Disclosure; Female; Humans; Oocyte Donation; Oocytes; Qualitative Research
PubMed: 34886829
DOI: 10.1186/s12905-021-01562-4 -
The American Journal of Medicine Apr 2021
Topics: Brazil; COVID-19; Communication; Denial, Psychological; Humans; Periodicals as Topic; SARS-CoV-2
PubMed: 33561430
DOI: 10.1016/j.amjmed.2021.01.003 -
Frontiers in Psychology 2022In this paper, we propose to account for the blame addressed to vaccine skeptics and "anti-vax" (VS and AV) by considering their attitude as the result of the...
In this paper, we propose to account for the blame addressed to vaccine skeptics and "anti-vax" (VS and AV) by considering their attitude as the result of the psychological mechanism of denial, understood in a psychodynamic manner. To that effect, we draw on a secondary account of our clinical experience in two hospital units (psychiatry and intensive care unit), and on openly available media material. First, we lay out how VS and AV can be understood as the result from fetishist risk denial, a specific psychological transaction with an object by which VS and AV people feel intimately protected; this object is viewed as so powerful that its protection makes the vaccine appear irrelevant. Second, we show how this mechanism can explain the specific content of the blame frequently addressed to VS and AV, who are reproached with being selfish by vaccinated people and caregivers. We contend that, contrary to common belief, they are thus blamed because they force others (and especially caregivers) to compensate their lack of self-protection and preservation, which derives from their exclusive relation to an almighty object. While such a relation accounts for the unwillingness to consider vaccination, it also explains the harshness of the blame voiced by caregivers, who feel helpless in most situations as they cannot effectively force VS and AV to take care of themselves and others.
PubMed: 35910972
DOI: 10.3389/fpsyg.2022.886368 -
The Western Journal of Medicine May 1990Some symptoms seen in adolescents with the disease of chemical dependence are similar to those seen in adults. Because of their age, lack of personality development,...
Some symptoms seen in adolescents with the disease of chemical dependence are similar to those seen in adults. Because of their age, lack of personality development, dependent family role, immaturity, and acting out of age-related behavioral tendencies, however, symptoms specific to this population occur. These may become exacerbated and telescope--intensify and shorten--the progression of the disease. A plan to solve the problem of adolescent chemical dependence must focus on education, demonstration, cooperation, prevention, intervention, habilitation, treatment, and recovery. The phenomenon of denial in a chemically dependent adolescent yields a more complex delusional system that dictates age-specific intervention approaches. Habilitation is necessary for successful adolescent treatment and recovery because what is needed is an initial process of learning, not relearning or rehabilitation. If specific adolescent issues are addressed through comprehensive, multimodality treatment approaches, then treatment and recovery outcomes for chemically dependent adolescents and their families are substantially improved. Primary care physicians must be alert to the possibility of drug use in their young patients and aware of treatment options.
Topics: Adolescent; Child; Denial, Psychological; Female; Humans; Male; Primary Health Care; Psychology, Adolescent; Substance-Related Disorders
PubMed: 2349798
DOI: No ID Found -
The American Journal of Managed Care Feb 2022The current study investigated mental health utilization review (UR) clinical service authorization requests, denials, and reasons for denial in a statewide Medicaid...
OBJECTIVES
The current study investigated mental health utilization review (UR) clinical service authorization requests, denials, and reasons for denial in a statewide Medicaid managed care organization (MMCO) program.
STUDY DESIGN
Retrospective analysis of utilization review data reported by MMCOs in New York State.
METHODS
Data from the utilization review practices of 15 MMCOs were collected and analyzed for calendar years 2017 and 2018. The data reported are specific to mental health services and include the number of authorization requests, number of clinical denials, and the reasons specified for each denial. Analyses were undertaken to determine the UR denial rates and most common reasons for denials.
RESULTS
A total of 264,901 requests for inpatient mental health service authorizations and 53,687 requests for outpatient mental health service authorizations were made in 2017 and 2018. Of these, 1.5% of inpatient authorization requests and 0.4% of outpatient authorization requests were denied for reasons related to medical necessity. The most common reason for inpatient mental health service denials was that the patient no longer met the standard for the requested level of care.
CONCLUSIONS
Low UR denial rates warrant further examination of the relationship between UR and both quality of care and patient outcomes in mental health care. With the substantial resources spent on UR, findings could point to areas of potential reforms to the system that may minimize these costs and improve care for patients with mental illness.
Topics: Humans; Managed Care Programs; Medicaid; Mental Health Services; Retrospective Studies; United States; Utilization Review
PubMed: 35139293
DOI: 10.37765/ajmc.2022.88824