Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation.

Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview (n = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.

"I Feel Contaminated in My Fake Hand": Obsessive-Compulsive-Disorder like Disgust Sensations Arise from Dummy during Rubber Hand Illusion.

Despite its theoretical and clinical interest, there are no experimental studies exploring obsessive-compulsive disorder (OCD)-like disgust sensations through using somatosensory illusions. Such illusions provide important clues to the nature and limits of multisensory integration and how the brain constructs body image; and may potentially inform novel therapies. One such effect is the rubber hand illusion (RHI) in which tactile sensations are referred to a rubber hand; if the experimenter simultaneously strokes a subject's occluded hand together with a visible fake hand, the subject starts experiencing the touch sensations as arising from the dummy. In this study, we explore whether OCD-like disgust may result from contamination of a dummy hand during the RHI; suggesting a possible integration of somatosensory and limbic inputs in the construction of body image. We predicted that participants would experience sensations of disgust, when placing a disgust stimulus (fake feces, vomit or blood) on the dummy hand after establishing the RHI. We found that 9 out of 11 participants experienced greater disgust during the synchronous condition (real hidden hand and fake hand are stroked in synchrony) compared to the asynchronous control condition (real hidden hand and fake hand are stroked in asynchrony); and on average such disgust was significantly greater during the synchronous condition compared to the asynchronous control condition, Z = 2.7, p = .008. These results argue against a strictly hierarchical modular approach to brain function and suggest that a four-way multisensory interaction occurs between vision, touch, proprioception on the one hand and primal emotions like disgust on the other. These findings may inform novel clinical approaches for OCD; that is, contaminating a dummy during the RHI could possibly be used as part of an in-vivo exposure-intervention for OCD.

Meditation and Yoga can Modulate Brain Mechanisms that affect Behavior and Anxiety-A Modern Scientific Perspective.

Meditation and Yoga techniques are receiving increased attention throughout the world, due to the accumulation of evidence based research that proves the direct and indirect benefits of such practices. Based on studies conducted so far, it has been found that the practice of meditation triggers neurotransmitters that modulate psychological disorders such as anxiety. This paper will review the psychological effects of the practice of meditation, the role of neurotransmitters, and studies using EEG and fMRI.