scholarly journals Super Placebos: A Feasibility Study Combining Contextual Factors to Promote Placebo Effects

2021 ◽  
Vol 12 ◽  
Author(s):  
Jay A. Olson ◽  
Michael Lifshitz ◽  
Amir Raz ◽  
Samuel P. L. Veissière
Keyword(s):  
Pediatric Population ◽  
Contextual Factors ◽  
Skin Lesions ◽  
Future Research ◽  
Placebo Effects ◽  
Ample Evidence ◽  
Hyperactivity Disorder ◽  
Placebo Intervention ◽  
Chronic Skin ◽  
Study Participants

Background: Ample evidence demonstrates that placebo effects are modulated by contextual factors. Few interventions, however, attempt to combine a broad range of these factors. Here, we explore the therapeutic power of placebos by leveraging factors including social proof, positive suggestion, and social learning. This study aimed to test the feasibility of an elaborate “super placebo” intervention to reduce symptoms of various disorders in a pediatric population.Methods: In a single-arm qualitative study, participants entered an inactive MRI scanner which they were told could help their brain heal itself through the power of suggestion. The sample included 11 children (6–13 years old) diagnosed with disorders known to be receptive to placebos and suggestion (Attention Deficit Hyperactivity Disorder, Tourette Syndrome, chronic skin picking, and migraines). The children were given positive suggestions during 2–4 placebo machine sessions over the span of approximately 1 month. We assessed open-ended treatment outcomes via recorded interviews and home visits.Results: The procedure was feasible and no adverse events occurred. Ten of the 11 parents reported improvements in their children after the intervention, ranging from minor transient changes to long-term reductions in subjective and objective symptoms (e.g., migraines and skin lesions).Discussion: These preliminary findings demonstrate the feasibility and promise of combining a broad range of contextual factors in placebo studies. Future research is needed to assess the causal effects of such interventions.

scholarly journals Super placebos: A feasibility study combining contextual factors to promote placebo effects

2020 ◽  
Author(s):  
Jay A. Olson ◽  
Michael Lifshitz ◽  
Amir Raz ◽  
Samuel P. L. Veissière
Keyword(s):  
Pediatric Population ◽  
Contextual Factors ◽  
Skin Lesions ◽  
Future Research ◽  
Placebo Effects ◽  
Ample Evidence ◽  
Hyperactivity Disorder ◽  
Placebo Intervention ◽  
Chronic Skin ◽  
Study Participants

Ample evidence demonstrates that placebo effects are modulated by contextual factors. Few interventions, however, attempt to combine a broad range of these factors. Here, we explore the therapeutic power of placebos by leveraging factors including social proof, positive suggestion, and social learning. This study aimed to test the feasibility of an elaborate "super placebo" intervention to reduce symptoms of various disorders in a pediatric population. In a single-arm qualitative study, participants entered an inactive MRI scanner which they were told could help their brain heal itself through the power of suggestion. The sample included 11 children (6-13 years old) diagnosed with disorders known to be receptive to placebos and suggestion (Attention Deficit Hyperactivity Disorder, Tourette Syndrome, chronic skin picking, and migraines). The children were given positive suggestions before entering the scanner for 2 to 4 sessions over the span of approximately one month. We assessed open-ended treatment outcomes via recorded interviews and home visits. The procedure was feasible and no adverse events occurred. Ten of the eleven parents reported improvements in their children after the intervention, ranging from minor transient changes to long-term reductions in subjective and objective symptoms (e.g., migraines and skin lesions). These preliminary findings demonstrate the feasibility and promise of combining a broad range of contextual factors in placebo studies. Future research is needed to assess the causal effects of such interventions.

scholarly journals Zymbilan®-PSO cream with nano-encapsulated RetileX-A®-PRO mitigates the clinical severity and relieves the symptoms of chronic plaque psoriasis: an interventional clinical study

2021 ◽  
Vol 7 (4) ◽  
pp. 503
Author(s):  
Jan Wadstein
Keyword(s):  
Side Effects ◽  
Skin Irritation ◽  
Skin Lesions ◽  
Clinical Severity ◽  
Inflammatory Disorder ◽  
Self Evaluation ◽  
Increased Risk ◽  
Skin Care Product ◽  
Chronic Skin ◽  
Study Participants

<p><strong>Background:</strong> Skin psoriasis is a serious inflammatory disorder with increased risk of rheumatic, cardiometabolic and psychosocial complications. At present, &gt;50% of patients are dissatisfied with their treatment; thus, novel approaches are in high clinical demand. Retinoids are a major group of anti-psoriatic compounds; nonetheless, dose-dependent topical side effects have limited their effective topical application. RetileX-A<sup>®</sup>-PRO (Pharma Medico, Aarhus, Denmark) is a novel nano-encapsulated retinol ester designed to minimise the risk of skin irritation. The proprietary nano-encapsulation technology used in this compound can protect retinoid molecules from degradation, and thereby prolong and stabilise its release profile. The safety and efficacy of RetileX-A<sup>®</sup>-PRO were evaluated in this study.</p><p><strong>Methods:</strong> 45 patients (58% female, aged 18-80 years) with mild to moderate skin psoriasis were enrolled in a 4-week interventional study. Participants were treated once daily with Zymbilan<sup>®</sup>-PSO cream with RetileX-A<sup>®</sup>-PRO and evaluated both objectively and subjectively at baseline, after 8 hours and at endpoint.</p><p><strong>Results:</strong> Our observations demonstrated that Zymbilan<sup>®</sup>-PSO cream possesses both short-term and long-term anti-psoriatic effects. Shortly after application, objective skin characteristics were improved, and itching reduced in &gt;84% of subjects. At endpoint, 87% of skin lesions improved, 9% did not change and 4% progressed as assessed by a dermatologist. Patients’ self-evaluation yielded similar results: 78% judged Zymbilan<sup>®</sup>-PSO cream as a ‘good’ to ‘very good’ skin care product with suitable cosmetic parameters. No side effects recorded in 95% of participants.</p><p><strong>Conclusions:</strong> In conclusion, Zymbilan<sup>®</sup>-PSO cream is a well-tolerated treatment that can mitigate both clinical severity and subjective symptoms of chronic skin psoriasis.</p>

Speech-Language Pathologists' Comfort Level With Use of Term “Stuttering” During Evaluations

2020 ◽  
Vol 29 (2) ◽  
pp. 841-850 ◽  
Author(s):  
Courtney T. Byrd ◽  
Danielle Werle ◽  
Kenneth O. St. Louis
Keyword(s):  
Communication Disorders ◽  
Academic Experiences ◽  
Comfort Level ◽  
Future Research ◽  
Clinical Experiences ◽  
Speech Language Pathologists ◽  
Comfort Levels ◽  
Parents And Children ◽  
Evaluation Feedback ◽  
Study Participants

Purpose Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term “stuttering,” might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of “stuttering” to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders. Method One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings. Results SLPs were significantly less likely to feel comfortable using the term “stuttering” compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences. Conclusions SLPs were significantly less comfortable relaying the diagnosis “stuttering” to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.

The Influence of Background Auditory Noise on P50 and N100 Suppression Elicited by the Paired-Click Paradigm

2020 ◽  
Vol 34 (3) ◽  
pp. 171-178
Author(s):  
Samantha Major ◽  
Kimberly Carpenter ◽  
Logan Beyer ◽  
Hannah Kwak ◽  
Geraldine Dawson ◽  
...  
Keyword(s):  
Sensory Gating ◽  
Autism Spectrum ◽  
Inhibitory Response ◽  
Future Research ◽  
Typically Developing ◽  
Optimal Outcomes ◽  
Hyperactivity Disorder ◽  
Auditory Sensory Gating ◽  
Auditory Noise ◽  
P50 Suppression

Abstract. Auditory sensory gating is commonly assessed using the Paired-Click Paradigm (PCP), an electroencephalography (EEG) task in which two identical sounds are presented sequentially and the brain’s inhibitory response to the second sound is measured. Many clinical populations demonstrate reduced P50 and/or N100 suppression. Testing sensory gating in children may help to identify individuals at risk for neurodevelopmental disorders earlier, including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which could lead to more optimal outcomes. Minimal research has been done with children because of the difficulty of performing lengthy EEG experiments with young children, requiring them to sit still for long periods of time. We designed a modified, potentially child-friendly version of the PCP and evaluated it in typically developing adults. The PCP was administered twice, once in a traditional silent room (silent movie condition) and once with an audible movie playing (audible movie condition) to minimize boredom and enhance behavioral compliance. We tested whether P50 and N100 suppression were influenced by the presence of the auditory background noise from the movie. N100 suppression was observed in both hemispheres in the silent movie condition and in the left hemisphere only during the audible movie condition, though suppression was attenuated in the audible movie condition. P50 suppression was not observed in either condition. N100 sensory gating was successfully elicited with an audible movie playing during the PCP, supporting the use of the modified task for future research in both children and adults.

Chronic Skin Lesions in Type 2 Diabetic Subjects

2018 ◽  
Vol 18 ◽  
Author(s):  
Eleonora Margherita Chisari ◽  
Borzi Antonio Maria ◽  
Luca Salvatore ◽  
Chisari Giuseppe ◽  
Chisari Clara Grazia
Keyword(s):  
Skin Lesions ◽  
Chronic Skin ◽  
Type 2 Diabetic

Disorders of Development

2010 ◽  
pp. 551-574
Author(s):  
V. Mark Durand
Keyword(s):  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Early Adulthood ◽  
Learning Disorders ◽  
Future Research ◽  
Hyperactivity Disorder ◽  
Asperger Disorder ◽  
Oppositional Defiant ◽  
Assessment And Treatment ◽  
Clinically Significant

Disorders of development include a range of problems first evidenced in childhood. Although most disorders have their origins in childhood, a few fully express themselves before early adulthood. This chapter describes the nature, assessment, and treatment of the more common disorders that are revealed in a clinically significant way during a child’s developing years. The disorders of development affect a range of functioning, from single skills deficits to more pervasive problems that negatively impact a child’s ability to function. Included is coverage of several disorders usually diagnosed first in infancy, childhood, or adolescence, including attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, learning disorders, communication and related disorders, pervasive developmental disorders (including autistic disorder and Asperger disorder), and intellectual disabilities. Recommendations for future research on the potential for advancing knowledge regarding spectrums within some of these disorders, as well as recommendations for treatment, are outlined.

Attention deficit and hyperactivity disorder and nocturnal enuresis co-occurrence in the pediatric population: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ana Cecília de Sena Oliveira ◽  
Bruno da Silva Athanasio ◽  
Flávia Cristina de Carvalho Mrad ◽  
Monica Maria de Almeida Vasconcelos ◽  
Maicon Rodrigues Albuquerque ◽  
...  
Keyword(s):  
Systematic Review ◽  
Attention Deficit ◽  
Nocturnal Enuresis ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Hyperactivity Disorder

373 Historical Use of Substances for Insomnia Impacts Current Beliefs about Hypnotic Medications

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A148-A149
Author(s):  
Jessica Dietch ◽  
Norah Simpson ◽  
Joshua Tutek ◽  
Isabelle Tully ◽  
Elizabeth Rangel ◽  
...  
Keyword(s):  
Prescription Medication ◽  
Stepped Care ◽  
Future Research ◽  
Prescription Medications ◽  
Over The Counter ◽  
Multiple Treatment ◽  
History Of ◽  
Study Participants ◽  
Beliefs About Medications ◽  
The Impact

Abstract Introduction The purpose of the current study was to examine the relationship between current beliefs about hypnotic medications and historical use of prescription hypnotic medications or non-prescription substances for sleep (i.e., over the counter [OTC] medications, alcohol, and cannabis). Methods Participants were 142 middle age and older adults with insomnia (M age = 62.9 [SD = 8.1]; 71.1% female) enrolled in the RCT of the Effectiveness of Stepped-Care Sleep Therapy In General Practice (RESTING) study. Participants reported on history of substances they have tried for insomnia and completed the Beliefs about Medications Questionnaire-Specific with two subscales assessing beliefs about 1) the necessity for hypnotics, and 2) concerns about potential adverse consequences of hypnotics. Participants were grouped based on whether they had used no substances for sleep (No Subs, 11.6%), only prescription medications (Rx Only, 9.5%), only non-prescription substances (NonRx Only, 26.6%), or both prescription and non-prescription substances (Both, 52.3%). Results Sixty-one percent of the sample had used prescription medication for sleep and 79% had used non-prescription substances (74% OTC medication, 23% alcohol, 34% cannabis). The greater number of historical substances endorsed, the stronger the beliefs about necessity of hypnotics, F(1,140)=23.3, p&lt;.001, but not about concerns. Substance groups differed significantly on necessity beliefs, F(3,1)=10.68, p&lt;.001; post-hocs revealed the Both group had stronger beliefs than the No and NonRx Only groups. Substance groups also differed significantly on the concerns subscale, F(3,1)=6.68, p&lt;.001; post-hocs revealed the NonRx Only group had stronger harm beliefs than the other three groups. Conclusion The majority of the sample had used both prescription and non-prescription substances to treat insomnia. Historical use of substances for treating insomnia was associated with current beliefs about hypnotics. Individuals who had used both prescription and non-prescription substances for sleep in the past had stronger beliefs about needing hypnotics to sleep at present, which may reflect a pattern of multiple treatment failures. Individuals who had only tried non-prescription substances for sleep may have specifically sought alternative substances due to concerns about using hypnotics. Future research should seek to understand the impact of treatment history on engagement in and benefit from non-medication-based treatment for insomnia. Support (if any) 1R01AG057500; 2T32MH019938-26A1

Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review

2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong
Keyword(s):  
Rating Scale ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Future Research ◽  
Randomized Controlled ◽  
Comprehensive Search ◽  
High Level ◽  
Numeric Rating

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.

A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder

2021 ◽  
pp. 108705472097855
Author(s):  
Upasana Bondopadhyay ◽  
Unai Diaz-Orueta ◽  
Andrew N. Coogan
Keyword(s):  
Systematic Review ◽  
Circadian Rhythms ◽  
Sleep Disturbances ◽  
Behavioral Outcomes ◽  
Future Research ◽  
Narrative Synthesis ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Form Part

Objective: Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. Methods: Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. Results: 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. Conclusion: Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.

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