Gambaran Pengaruh Terapi Aktivitas Kelompok Stimulasi Persepsi Perilaku Kekerasan Pada Pasien Resiko Perilaku Kekerasan

The risk of violent behavior is a symptom of schizophrenic patients that can be controlled through perceptual stimulation group activity therapy. It is an effort to train the patient to perceive the stimulus provided or the stimulus that has been experienced. This study aims to investigate the effect of the effect of perceptual stimulation group activity therapy on patients with violent behavior risks based on a literature review.It took three journals from Google scholar and lipi.go.id with group activity therapy, perceptual stimulation, and the risk of violent behavior as the keywords. These are full-text published in 2011-2020. The result of respondents’ characteristics analysis stated 66 people were taken as respondents, 83% are male with the age 21-40 years. Their average value in controlling anger before intervention was 46,873 and 43.5 after the process. It proved to control patients’ anger. Thus, nurses suggested to teach this therapy for overcoming the problem.Keywords: Perceptual stimulation group activity therapy; the risks of violent behavior AbstrakRisiko perilaku kekerasan ialah gejala dari pasien skizofrenia dapat dikontrol melalui terapi aktivitas kelompok stimulasi persepsi. Terapi aktivitas kelompok stimulasi persepsi ialah upaya untuk melatih pasien mempersepsikan stimulus yang disediakan atau stimulus yang pernah dialami. Penelitian ini bertujuan untuk menggambarkan pengaruh terapi aktivitas kelompok stimulasi persepsi pada pasien resiko perilaku kekerasan berdasarkan literature review. Desain karya tulis ilmiah berupa literatur review dengan jumlah tiga artikel yang diambil dari laman jurnal google scholar dan lipi.go.id dengan kata kunci ‘’terapi aktivitas kelompok’’, ‘’stimulasi persepsi’’ dan ‘’resiko perilaku kekerasan’’ berupa artikel fullteks, terbit tahun 2011-2020. Hasil analisa karakteristik responden dari tiga artikel menunjukan jumlah responden 66, sebagian besar (83%) laki-laki dengan umur 21-40 tahun. Nilai rata-rata kemampuan mengontrol kemarahan sebelum intervensi 46,873, setelah intervensi 43,5. Simpulan terapi aktivitas kelompok stimulasi persepsi dapat mengontrol marah pasien resiko perilaku kekerasan. Saran bagi perawat hendaknya mengajarkan terapi aktivitas kelompok stimulasi persepsi untuk mengontrol resiko perilaku kekerasanKata kunci: Terapi aktivitas kelompok stimulasi persepsi; resiko perilaku kekerasan

Predictive Role of Executive Function in the Efficacy of Intermittent Theta Burst Transcranial Magnetic Stimulation Modalities for Treating Methamphetamine Use Disorder—A Randomized Clinical Trial

Background: Repetitive transcranial magnetic stimulation (rTMS) has therapeutic effects on craving in methamphetamine (METH) use disorder (MUD). The chronic abuse of METH causes impairments in executive function, and improving executive function reduces relapse and improves treatment outcomes for drug use disorder. The purpose of this study was to determine whether executive function helped predict patients' responses to rTMS treatment.Methods: This study employed intermittent theta burst stimulation (iTBS) rTMS modalities and observed their therapeutic effects on executive function and craving in MUD patients. MUD patients from an isolated Drug Rehabilitation Institute in China were chosen and randomly allocated to the iTBS group and sham-stimulation group. All participants underwent the Behavior Rating Inventory of Executive Function - Adult Version Scale (BRIEF-A) and Visual Analog Scales (VAS) measurements. Sixty-five healthy adults matched to the general condition of MUD patients were also recruited as healthy controls.Findings: Patients with MUD had significantly worse executive function. iTBS groups had better treatment effects on the MUD group than the sham-stimulation group. Further Spearman rank correlation and stepwise multivariate regression analysis revealed that reduction rates of the total score of the BRIEF-A and subscale scores of the inhibition factor and working memory factor in the iTBS group positively correlated with improvements in craving. ROC curve analysis showed that working memory (AUC = 87.4%; 95% CI = 0.220, 0.631) and GEC (AUC = 0.761%; 95% CI = 0.209, 0.659) had predictive power to iTBS therapeutic efficacy. The cutoff values are 13.393 and 59.804, respectively.Conclusions: The iTBS rTMS had a better therapeutic effect on the executive function of patients with MUD, and the improved executive function had the potential to become a predictor for the efficacy of iTBS modality for MUD treatment.Clinical Trial Registration:ClinicalTrials.gov, identifier: ChiCTR2100046954.

Mindfulness augmentation for anxiety through concurrent use of transcranial direct current stimulation: a randomized double-blind study

Transcranial direct current stimulation (tDCS) have revealed the capability to augment various types of behavioural interventions. We aimed to augment the effects of mindfulness, suggested for reducing anxiety, with concurrent use of tDCS. We conducted a double-blind randomized study with 58 healthy individuals. We introduced treadmill walking for focused meditation and active or sham tDCS on the left dorsolateral prefrontal cortex for 20 min. We evaluated outcomes using State-Trait Anxiety Inventory-State Anxiety (STAI) before the intervention as well as immediately, 60 min, and 1 week after the intervention, and current density from electroencephalograms (EEG) before and after the intervention. The linear mixed-effect models demonstrated that STAI-state anxiety showed a significant interaction effect between 1 week after the intervention and tDCS groups. As for alpha-band EEG activity, the current density in the rostral anterior cingulate cortex (rACC) was significantly reduced in the active compared with the sham stimulation group, and a significant correlation was seen between changes in STAI-trait anxiety and the current density of the rACC in the active stimulation group. Our study provided that despite this being a one-shot and short intervention, the reduction in anxiety lasts for one week, and EEG could potentially help predict its anxiolytic effect.

Brain Activation in Chronic Nonspecific Low Back Pain : A Systematic review and ALE Meta-analysis

Pain, a protective mechanism turns into a pathologic response when it becomes chronic. Recent evidences are pointing towards neuroplastic brain changes as the primary factor for the persisting pain in chronic nonspecific low back pain (cLBP). To summarise the previous fMRI studies, a coordinate-based ALE meta-analysis of resting functional brain imaging studies is carried out to identify the clusters activated in the brain in cLBP. Literature survey: PubMed, Scopus and Sleuth were searched for studies with resting functional whole-brain imaging in cLBP. Till October 2020; 258, 238, and 7 studies were found respectively after search. The activity pattern was documented in without stimulation and with stimulation groups. The risk of bias was assessed by Joanna Briggs Institute critical appraisal checklist for analytical cross-section studies. Total seven (224 cLBP patients, 110 activation foci) and six studies (106 cLBP patients, 66 activation foci) were selected among 277 studies for metanalysis in the without stimulation and with stimulation group respectively. In the without stimulation group 8 statistically significant clusters were found. The clusters are distributed in the prefrontal cortex, primary somatosensory cortex, and primary motor cortex, anterior cingulate cortex, insular cortex, putamen, claustrum, amygdala, and associated white matters in both hemispheres. On the other group, 3 statistically significant clusters were found in the frontal cortex, Parietal cortex, and Insula. In the with stimulation group, significant lateralization was observed and most of the clusters were in the right hemisphere. The white matter involvement was more in the with stimulation group (78.62% Vs 38.21%). The statistically significant clusters found in this study indicate a probable imbalance in GABAergic modulation of brain circuit and dysfunction in descending pain modulation system. This disparity in pain neuro-matrix is the source of spontaneous and persisting pain in cLBP.

Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies

ObjectivesTo examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.DesignMulticohort study with three sets of analyses.SettingUnited Kingdom, Europe, and the United States.ParticipantsThree associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies.Main outcome measuresCognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations.ResultsDuring 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I2=0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β −0.34, P<0.001), carbohydrate sulfotransferase 12 (CHSTC, fully adjusted β −0.33, P<0.001), and peptidyl-glycine α-amidating monooxygenase (AMD, fully adjusted β −0.32, P<0.001). These proteins were associated with increased dementia risk, with the fully adjusted hazard ratio per 1 SD being 1.16 (95% confidence interval 1.05 to 1.28) for SLIT2, 1.13 (1.00 to 1.27) for CHSTC, and 1.04 (0.97 to 1.13) for AMD.ConclusionsThe risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.

The Ultrasonic Electrical Stimulation Treating Recent Pain after Minimally Invasive Intervention with Disc Degenerative Diseases

Objective:To explore the analgesic effect of ultrasonic electrical stimulation for recent pain after minimally invasive interventional therapy for intervertebral disc degenerative diseases (DDD). Methods:From January to August 2019, 130 patients with DDD who were treated by minimally invasive intervention of intervertebral disc, and then were randomly divided into electrical stimulation group and conservative treatment group. After minimally invasive intervention, the electrical stimulation group was treated by ultrasonic electrical stimulation once a day for 7 days. The conservative treatment group was treated with conventional acupuncture and massage once a day for 3 days.The pain degree of before treatment and 3 days, 7 days and 1 month(m) after treatment were evaluated by pain numberical rating scale (NRS), the curative effect of 1 m post-cure was evaluated by NRS weighting method. Results:There was no significant difference of NRS score between the two groups before treatment (P > 0.05). NRS of electrical stimulation group were significant lower than those in conservative treatment group, which was evaluated at several time point for 3 days, 7 days and one month after treatment (P < 0.001). The curative effect of electrical stimulation group on one month after interventional treatment was significantly higher than that of conservative treatment group (P < 0.001). Conclusion:The therapeutic effect of ultrasonic electrical stimulation is better than that of traditional acupuncture and massage for recent pain after minimally invasive interventional therapy with DDD, it is worthy to popularize in clinical treatment. Key words: After interventional therapy with DDD; The recent pain; ultrasonic electrical stimulation

Immediate Effect of Strong Surged Faradic Stimulation vs Self-Stretching in Less Tensed Position on Chronic Upper Trapezius Spasm in Young Females

Faulty postural habits lead to upper trapezius spasm causing pain and affection of neck mobility. The study aimed to compare the immediate effect of Strong Surged Faradic Stimulation and self-stretching in Less Tensed Position in chronic trapezius spasm in young females. 46 female subjects with unilateral chronic trapezius spasm between the age 18-25 years were randomly allocated into Strong Surged Faradic Stimulation group and self-stretching group. Pre and post intervention Numeric Pain Rating Scale and cervical lateral flexion range of motion was measured. Both the interventions were effective in reducing pain (p < 0.0001) and improving range of motion (p <0.0001). When compared for pain, both were equally effective (p = 0.3664) but for range of motion self-stretching in Less Tensed Position was more effective (p < 0.0001). Key words: Trapezius spasm, Strong Surged Faradic Stimulation, Self-Stretching, young females.

Improved Pre-attentive Processing With Occipital rTMS Treatment in Major Depressive Disorder Patients Revealed by MMN

ObjectivesTo investigate the improvement effect of occipital repetitive transcranial magnetic stimulation (rTMS) combined with escitalopram oxalate tablets on pre-attentive processing in patients with first-episode, medication-naive depression.MethodsPatients who were hospitalized between January and December 2019 were selected. They were randomly allocated to real occipital rTMS stimulation group with 27 cases receiving intermittent theta-burst (iTBS) and sham stimulation group with 24 cases over 20 days. The rTMS treatment target is located at the Oz point of the occipital region. Both groups took escitalopram oxalate tablets, and the average daily drug dose was 15.294 ± 5.041 mg. Hamilton Depression Rating Scale (HAMD) was used to assess the symptoms of depression before and after treatment, and mismatch negativity (MMN) was used to assess the improvement of pre-attentive processing before and after treatment.ResultsAfter 20 days of treatment, the total score of HAMD (13.495 ± 3.700) in both groups was significantly lower than that before treatment [21.910 ± 3.841, F(1, 49) = 46, 3.690, p &lt; 0.001]. After treatment, the latency of MMN in the real stimulation group (182.204 ± 31.878 ms) was significantly lower than that in the sham stimulation group (219.896 ± 42.634 ms, p &lt; 0.001), and the amplitude of MMN in the real stimulation group (−7.107 ± 3.374 ms) was significantly higher than that in the sham stimulation group (−2.773 ± 3.7 32 ms, p &lt; 0.001).ConclusionOccipital rTMS treatment can enhance the early therapeutic effect and effectively improve the pre-attentive processing of patients with depression and provide a scientific basis for the new target of rTMS therapy in clinical patients with depression.

Clinical Application of the Vestibular Stimulation Effect on Balance Disorders with Dementia

Background: In a previous study on Alzheimer’s disease (AD), we showed that vestibular dysfunction derived from cerebral disorders contributes to balance disorders. No previous clinical study has attempted to prevent the progression of balance disorders in dementia patients through vestibular stimulation using an air caloric device. Objective: The purpose of this pilot study was to delay the progression of balance disorders by inducing vestibular compensation, specifically by utilizing the effect of vestibular stimulation to activate the cerebrum. Methods: Fifteen individuals were randomized and classified into a stimulation group or a nonstimulation group. Eight AD patients underwent vestibular stimulation every 2 weeks for 6 months in the stimulation group. Seven AD patients participated in the nonstimulation group (the control group). Both groups were subsequently evaluated using a Mini-Mental State Examination (MMSE), stepping test, caloric test, and smooth pursuit eye movement test just before starting the study and 6 months later. Results: For balance parameters, the various tests did not show any significant differences between the two groups. However, in the stepping test, the decline rate tended to be higher in the nonstimulation group than in the stimulation group. The stimulation group’s rate of decline in MMSE scores was lower than that of the nonstimulation group (p=0.015). No adverse events were tracked during the present study. Conclusion: Repeated vestibular stimulation might help patients retain greater balance and higher function. To prove these effects, the future clinical application will require an increased number of cases and longer periods of vestibular stimulation. This study showed that vestibular stimulation by air caloric device is safe and tolerable in patients with AD.

Perceptual Stimulation Group Activity Therapy on Hallucination Patients at the Pemenang Jiwa Sumatra Foundation.

Hallucinations are when a person experiences a change in the pattern and amount of stimulation that is initiated internally or externally in the vicinity with a reduction, exaggeration, distortion, or abnormality in response to each stimulus. Management of schizophrenic patients includes group nursing actions, such as group activity therapy. Group activity therapy is a psychotherapy performed by a group of patients together by way of discussions with each other led or directed by a trained therapist or mental health worker. The number of patients who participated in the perceptual stimulation group activity therapy amounted to 6 people. As a result of this therapy, after receiving perceptual stimulation group activity therapy, patients at the Pemenang Jiwa Sumatra Foundation increased their knowledge, understanding of how to control hallucinations and knowing how to have done it. Increased knowledge shows that patients are able to remember sp 1 - 4 from group therapy activities. It is recommended that patients who experience hallucination problems can be given Group Activity Therapy so that patients are able to perform actions independently and be able to cooperate with other patients.