Effects of Ai-Chi Practice on Balance and Left Cerebellar Activation during High Working Memory Load Task in Older People: A Controlled Pilot Trial

Background: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. Methods: A total of 19 people aged 65–86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. Results: The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = −4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). Conclusions: Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities.

Improving services for those who serve: A private practice initiative to improve psychiatric care for first responder and military patients

Objectives Professional isolation and limited opportunities for multidisciplinary collaborations are well-recognised challenges for psychiatrists in private practice. This narrative paper describes the development of a private practice group to assist first responders (FRs) and military patients located in Adelaide, South Australia. The aims included both peer review, and interdisciplinary communication and collaboration. Relevant personnel in the ambulance, police and fire services, military and veterans’ groups, and the compensation system, participated in monthly meetings. Lack of timely access to psychiatric care for FR and military patients was identified as a problem and an expedited referral service was established. Conclusions The Closing the Gap Group was established in 2017. The terminology refers to the gap between treating psychiatrists and the complex organisations that manage the workplace context for FR/military patients. This initiative provides a template for private practice innovations to improve psychiatrists’ skills and knowledge, along with better engagement and understanding between private psychiatrists and relevant community organisations.

Analysis of Endoscopic Evaluation Reliability for Ulcerative Colitis in Histological Remission

The Mayo endoscopic subscore (MES) is a major endoscopic scoring system used to assign a status of mucosal inflammation and disease activity to patients with ulcerative colitis (UC). Using interobserver reliability (IOR), this study clarified the difficulties for endoscopic observers imposed by MES parameters used for the endoscopic evaluation of UC in histological remission. First, 42 endoscopists of four observer groups examined each MES parameter, which were evaluated from endoscopically obtained images of 100 cases as Grade 0 or 1 of the Nancy histological index of histopathological inflammation. Then, IOR was assessed using multiple κ statistics for each finding of MES. The results showed that IOR among all the observers was slight or fair for all the parameters, indicating a low IOR. The experts of the UC practice group had “moderate” or higher IOR for seven of the nine parameters, whereas “slight” or “fair” results were found for all parameters by the trainee group. The IOR for each MES parameter was calculated separately for the observer groups. All the groups showed “slight” or “fair” for “Erythema” and “Decreased vascular pattern”. Large differences between the endoscopists were found in the IOR for the MES parameters in UC in histological remission. Even among UC practice experts, the IOR was low for “Erythema” and “Decreased vascular pattern”.

MASSED TASK REPETITION IS A DOUBLE-EDGED SWORD FOR FLUENCY DEVELOPMENT

To examine the effects of task repetition with different schedules, English-as-a-foreign-language classroom learners performed the same oral narrative task six times under three different schedules. They narrated the same six-frame cartoon story (a) six times consecutively in one class (massed practice), (b) three times at the beginning and at the end of a class (short-spaced practice), and (c) three times as a part of two classes 1 week apart (long-spaced practice). The results yielded by an immediate posttest using a novel cartoon showed that massed practice reduced breakdown fluency (mid-clause and clause-final pauses) the most. However, the participants in the massed-practice group showed degraded speed (slower articulation rate) and repair fluency (more verbatim repetition). The effects of repetition schedule seem limited on a 1-week delayed posttest involving a novel cartoon. Yet, when participants narrated the same practiced cartoon 1 week later, massed practice also resulted in more verbatim repetition.

Incidence and risk factors of post-operative cognitive decline after ablation for atrial fibrillation

Background Catheter ablation is widely used in atrial fibrillation (AF) management. In this study, we are aimed to investigate the incidence of postprocedural cognitive decline in a larger population undergoing AF ablation under local anesthesia, and to evaluate the associated risk factors. Methods This study included 287 patients with normal cognitive functions, with 190 ablated AF patients (study group) and 97 AF patients who are awaiting ablation (practice group). We assessed the neuropsychological function of each patient for twice (study group: 24 h prior to ablation and 48 h post ablation; practice group: on the day of inclusion and 72 h later but before ablation). The reliable change index was used to analyze the neuropsychological testing scores and to identify postoperative cognitive dysfunction (POCD) at 48 h post procedure. Patients in the study group accepting a 6-month follow up were given an extra cognitive assessment. Results Among the ablated AF patients, 13.7% (26/190) had POCD at 48 h after the ablation procedure. Multivariable analysis revealed that, a minimum intraoperative activated clotting time (ACT) < 300 s (OR 3.82, 95% CI 1.48–9.96, P = 0.006) and not taking oral anticoagulants within one month prior to ablation(OR 10.35, 95% CI 3.54–30.27, P < 0.001) were significantly related to POCD at 48 h post-ablation. In 172 patients of the study group accepting a 6-month follow up, there were 23 patients with POCD at 48 h post-ablation and 149 patients without POCD. The global cognitive scores were decreased in 48 h post-operation tests (0 ± 1 vs − 0.15 ± 1.10, P < 0.001) and improved significantly at 6 months post-operation (0 ± 1 vs 0.43 ± 0.92, P < 0.001). In the 23 patients with POCD at 48 h after the procedure, global cognitive performance at 6 months was not significantly different compared with that at baseline (− 0.05 ± 1.25 vs − 0.19 ± 1.33, P = 0.32), while 13 of them had higher scores than baseline level. Conclusions Incident of POCD after ablation procedures is high in the short term. Inadequate periprocedural anticoagulation are possible risk factors. However, most POCD are reversible at 6 months, and a general improvement was observed in cognitive function at 6 months after ablation.

Massed and distributed practice on learning the forehand shot in tennis

Purpose This study aims to determine the effect of the distribution of practice on learning the forehand shot in tennis. Method Twenty-four beginner tennis players participated in the study (13 males and 11 female; 8.63 ± 0.92 years old). The players were separated after groups -massed practice ( N = 12) and distributed practice ( N = 12). Each group practiced the forehand shot for 12 sessions, 4 series per session and 10 trials/series (6 weeks). The accuracy and efficacy were measured through one post-test and one retest, carried out 2 weeks after the last learning session. Results Significant improvements in accuracy between the pre-test and post-test ( p=.004) and between pre-test and re-test ( p=.006) were found in the massed practice group. Significant improvements in accuracy between the pre-test and post-test ( p=.002) and between pre-test and re-test ( p=.001) were found in the distributed practice group. No significant differences were found between groups but there was a favourable trend toward better learning in both, with improved accuracy and efficacy. Conclusion The motor learning through the distribution of practice among children has been noted, with a significant improvement in the skill acquisition of the forehand shot in the two groups. The results are useful because they clear up the doubts about how to plan the teaching of this stroke in tennis, confirming the suitability of carrying out learning programs based on massed and distributed practice.

Sleep and testing both strengthen and distort story recollection

Over time, memories lose episodic detail and become distorted, a process with serious ramifications for topics such as eyewitness identification. What are the processes which contribute to such transformation over time? We investigated the roles of post learning sleep and retrieval practice in memory accuracy, transformation, and distortion, using a naturalistic story recollection task. Undergraduate students listened to a recording of the “War of the Ghosts”, a Native American folktale, and were assigned to either a retrieval practice or listen only study condition, and either a sleep or wake delay group. Sleep and retrieval practice independently resulted in more story elements being recalled accurately, and fewer importations of non-story elements, than the wake, no retrieval practice group. However, sleep and retrieval practice also led to more inferences of non-presented, but story related information. These findings suggest that both sleep and retrieval practice contribute equally to narrative memory stabilization and distortion.

The Increase in VO2 Max and Passing Using Exercise Small-Sided Game 3 vs 3 and 6 vs 6 On Football Players

The purpose of this study was to determine the increase in vo2max and passing skills using small-sided games 3 vs 3 and 6 vs 6 exercises in soccer players. This study uses a quantitative approach, the type of research is experimental research, the sample used is 51 football players in Trenggalek under-14 who were selected randomly, this research was carried out in Trenggalek district, namely the Siwalan field, Sumbergedong field, and Sumberagung field, the instrument in the study This study uses a multistage fitness test and a passing test in football, data analysis uses the Manova test. The results showed that there was a difference between the small-sided games 3 vs 3 exercise group and the 6 vs 6 small-sided games group to increase vo2max with a sig value. 0.031 < 0.05, and there is a difference between the small-sided games 3 vs 3 practice group and the 6 vs 6 small-sided games group to improve passing with a sig value of 0.027 < 0.05. It can be concluded that overall small-side game exercises 3 vs 3 and 6 vs 6 can increase vo2max and passing for football players.

The power of reflective practice: evaluating the impact of a psychoeducation and reflective practice group for surgical nursing staff and health care assistants in a trauma centre

AimsTo offer a psychoeducation and reflective practice group for nursing staff (NS) and health care assistants (HCAs) working on a Trauma and Orthopaedics Ward in Southmead Hospital, Bristol. To explore the staff experience of having a reflective space, and how this impacted on their attitudes and knowledge and confidence in psychiatric presentations.BackgroundReflective practice can raise the quality and consistency of nursing care, but it is not part of everyday culture and practice. Southmead Hospital is a trauma centre and the surgical NS and HCAs care for multiple patients following self-harm or suicide attempts. They report at times not having the mental health knowledge and confidence to appropriately manage patients on the ward and are at high risk of occupational stress and burnout. Our mental health liaison team (MHLT) identified this need and offered to provide a space to address these concerns and evaluate the impact of this intervention.MethodAfter liaising with the ward manager, I developed and provided a fortnightly forty-minute psychoeducation and reflective practice group for NS and HCAs on one Trauma and Orthopaedic ward in Southmead Hospital. Topics were rotated and included suicidal ideation, self-harming behaviour, mind and body link, the stress -vulnerability model and verbal aggression.The staff were asked to complete anonymous paired pre-and post-course questionnaires about their attitudes and confidence regarding mental health difficulties. This questionnaire included both quantitative components (e.g. 1–5 Likert scales) and qualitative components (free text boxes) which were analysed and coded accordingly.ResultQuantitative results showed that staff felt it was important to learn about mental health conditions and have a reflective space. Their confidence and knowledge improved in understanding and managing psychiatric presentations. Qualitative results revealed several common themes – (i) Space; staff valued a protected, structured, safe space, (ii) Relationships: staff valued sharing with colleagues and supporting each other, (iii) Sharing and learning; staff valued a space to think about patient's formulations, discuss common experiences, express their own emotions and learn from each other and (iv) Psychoeducation; the staff welcomed ideas of ways to communicate with patients and specific skills to use on the wards.ConclusionTrauma and Orthopaedic NS and HCAs perceived a range of benefits from participating in a psychoeducation and reflective practice group. Further research is required to evaluate whether reflective practice groups help to reduce staff burnout and can change the ward ethos to improve the patient experience.

Practice Mediates Bidirectional Dual-Task Interference When Performing a Novel Sequential Nonword Repetition Task

Introduction The current study examined the extent to which practice amount mediates dual-task interference patterns associated with concurrent performance of a novel speech task and attention-demanding visuomotor task. Method A Sequential Nonword Repetition Task was used to examine the effect of practice on interference associated with concurrent performance of a Visuomotor Pursuit Task. Twenty-five young adult participants were assigned to either an Extended Practice Group or a Limited Practice Group and performed a novel Sequential Nonword Repetition Task in isolation and while performing a concurrent visuomotor pursuit rotor task. Results Participants in the Limited Practice Group who were afforded a limited amount of practice exhibited dual-task interference (i.e., dual-task performance reductions) for both the speech and visuomotor tasks (i.e., bidirectional dual-task interference). Conversely, participants in the Extended Practice Group who were afforded extended practice exhibited little-to-no observable dual-task interference on the nonword repetition task. Conclusion Data from the current investigation suggest that the amount of initial practice mediates the degree of dual-task interference observed when a novel speech production task is performed with an attention-demanding Visuomotor Pursuit Task. Supplemental Material https://doi.org/10.23641/asha.14608071