Search

Terminal lucidity is a term used in the medical literature to determine the improvement of mental functioning shortly before death, even among patients with serious and long-term disorders. In 19th century, cases of mind clarity recovery shortly before death, were often recognized by doctors and interpreted as a sign of an impending death. In 20th century, the interest in this phenomenon decreased and then, virtually disappear. In recent years, on the wave of publications concerning near death experiences and related events such as the end of life experiences, papers about the improvement of mental functioning shortly before death, exponentially grew and got a new name, terminal lucidity. In this paper, an overview of the available literature is presented to outline the historical, phenomenological and clinical picture of this phenomenon and its possible implications for medical care and future studies.

The objective of the study was to assess the level of patients' need for information about the planned gynecologic surgery. Material and Methods. The number of 173 patients preparing to undergo planned gynecological procedure were qualified for the study. The participation in the survey was entirely voluntary. Each patient was asked to fulfill the survey conducted using the Amsterdam Preoperative Anxiety and Information Scale- APAIS that enables the estimation of the patient’s need for surgery-related information. Furthermore patients’ clinical and demographic data was collected. Results were analyzed using appropriate statistical tools: the Shapiro-Wilk W-test (for distribution of the studied parameters) and the Mann-Whitney U-test (for comparing two independent groups). P value less than 0.05 was considered statistically significant. Results. It was shown that premenopausal women have a greater need for information about the planned surgery than postmenopausal patients (p0.05). Conclusions. The high level of the need for information about the planned surgery characterizes premenopausal patients and those operated for the first time.

Introduction: In the last decades, researchers' attention has been focused on cognitive dysfunction in schizophrenia. Numerous studies indicate the existence of neurodegenerative deficits in schizophrenia including, but not limited to, motor functions, learning and memory, executive functions, attention, language, spatial skills and general intelligence. Method: A review of available literature on the topic of the past two decades, available in the Pubmed, EBSCO, SCOPUS databases has been made using the keywords: schizophrenia, cognition, early intervention. Results: Cognitive dysfunction is an important feature of the prodromal phase and the first episode of schizophrenia. Researchers have thus proposed to initiate early therapeutic interventions for people with so-called risky mental conditions. The article includes the reference to research on neurocognitive disorders essence in schizophrenia, the definition and review of methods used to identify specific cognitive deficits and issues related to risk of developing psychosis and early therapeutic intervention in high-risk states. Conclusions: Researchers report the importance of detecting cognitive disorders in the early stages of schizophrenia. This broadens the range of therapeutic interventions and enables early intervention in the increased risk of psychosis.

Introduction: Workaholism as a psychological and social phenomenon is the object of only a few empirical studies. Despite the fact that the phenomenon of addiction to work was not specified in the ICD-10 or DSM-5 Classifications, the authors of this paper have decided that it is worth considering its preconditions. Materials and method: Based on the review of the available literature, the topic of work addiction was discussed and the main determinants of workaholism and the so-called workaholic personality were presented. Results: The paper presents the author’s theoretical proposition of workaholism notion which postulates the existence of a form of addiction to work, which has its source in personality and motivation. Conclusions: Undoubtedly, workaholism is addictive, but only obsessive-compulsive components may not be sufficient to determine its nature. Workaholism adopts a three-dimensional structure including behavioral, cognitive and affective aspects. Further research on this issue is needed.

New achievements within structural and functional imaging of central nervous system offer a basis for better understanding of the mechanisms underlying many mental disorders. In everyday clinical practice, we encounter many difficulties in the therapy of eating disorders. They are caused by a complex psychopathological picture, varied grounds of the problems experienced by patients, often poor motivation for active participation in the treatment process, difficulties in communication between patients and therapeutic staff, and various biological conditions of eating disorders. In this paper, the latest reports on new concepts and methods of diagnosis and treatment of anorexia nervosa have been analyzed. The selection of the analyzed publications was based on the criteria taking into account the time of publication, the size of research cohorts, as well as the experience of research teams in the field of nutritional disorders, confirmed by the number of works and their citations. The work aims to spread current information on anorexia nervosa neurobiology that would allow for determining the brain regions involved in the regulation of food intake, and consequently that may be a potential place where neurobiochemical processes responsible for eating disorders occur. In addition, using modern methods of structural imaging, the authors want to show some of the morphometric variations, particularly within white matter, occurring in patients suffering from anorexia nervosa, as well as those evaluated with magnetoencephalography of processes associated with the neuronal processing of information related to food intake. For example as regards anorexia nervosa, it was possible to localize the areas associated with eating disorders and broaden our knowledge about the changes in these areas that cause and accompany the illness. The described in this paper research studies using diffusion MRI fiber tractography showed the presence of changes in the white matter pathways of the brain, especially in the corpus callosum, which indicate a reduced content of myelin. These changes probably reflect malnutrition, and directly represent the effect of lipid deficiency. This leads to a weakening of the structure, and even cell death. In addition, there are more and more reports that show the normal volume of brain cells in patients with long-term remission of anorexia. It was also shown that in patients in remission stage there are functional changes within the amygdala in response to a task not related symptomatologically with anorexia nervosa. The appearing in the scientific literature data stating that in patients with anorexia nervosa there is a reduced density of GFAP + cells of the hippocampus and increased expression of vimentin and nestin, is also worth noting.

There are some significant differences between the health systems in German speaking Europe and Sweden: In Sweden, the number of hospitals is small, caregiving services in the hospital and ambulatory sector are integrated, health professionals with university degrees are granted extended competencies and rights incl. first line consultation and limited prescription. Education is designed to prepare for these functions and responsibilities. It started more than 30 years ago when Linköping implemented the OECD-model of Health Universities. Interprofessional teaching, common learning of the various tracks and training on real patients are constitutive elements of this novel approach. Karolinska University in Stockholm adopted the model in 1998 and gave way to a nationwide reform. A recommendation of the German Science Council regarding training of health professionals, published 2012, drew the attention of educators to this approach. The paper explains the circumstances of the consolidation of this concept. It is important to realize that overarching governance principles and measures deriving from health and education policy are of crucial importance. They evolve from evaluations of needs carried out by the regional health agencies which lead to conditional mandates and financial incentives to the education sector. Moreover, decisions taken by the national board for accreditation and quality assurance take also in account the goals set and the outcomes in education and caregiving. Outside Sweden they would be considered an inappropriate limitation of academic freedom.The paper ends with a reflection of impressions collected during a study trip and shows some lessons to be learnt from the Swedish education and practice.

Contemporary conditions require health professionals both to employ published evidence in their individual practices and as a profession to produce valid evidence of their outcome effectiveness. Heretofore, these two processes of evidence-based practice have often been confounded as one. This theoretical paper separates the two processes into «Evidence-Supported Practice» and «Evidence-Informed Practice.» Each requires a different approach to evidence accumulation and use. Nonetheless, the two processes can and should be interlinked. For external (research) evidence, the research pyramid model values equally the internal and external validity of studies, as both are important for the implementation of external evidence. Furthermore, external evidence must be combined with internal evidence (data generated in the course of interaction with a client) in the decision-making of practitioners. Examples from recent research on occupational therapy practice and literature from several other health professions are cited for illustration. This paper formulates a more comprehensive model for evidence-based practice. From this model follow specific recommendations for practitioners, researchers, and educators in the health professions.

Introduction: Introduction: Both dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) are important dementia syndromes that overlap in their clinical features and clinical course, neuropathological abnormalities, and also therapeutic approach. Nevertheless it is still unclear whether DLB and PDD are two different disorders that require differentiation or are one clinical entity within a spectrum of Lewy body disease. Currently these disorders are mainly distinguished on the basis of the relative timing of the onset of symptoms of dementia and parkinsonism. The present paper presents current concepts on the pathogenesis of both disorders and their possible overlap. Material and methods: Online databases in the field of DLB and PDD were searched for to find potentially eligible articles. Only most recent articles published after the year 2000 were chosen. Results: The clinical features of DLB and PDD are similar and include dementia with hallucinations and cognitive fluctuations, as well as parkinsonian signs. Also cognitive deficits are similar in PDD and in DLB, with predominance of executive dysfunction, visual-spatial deficits and memory impairment. Neuropathological changes in both disorders involve the presence of Lewy bodies and Lewy neurites within brainstem, limbic and neocortex, as well as loss of midbrain dopamine cells, and loss of cholinergic neurons in the nuclei of ventral forebrain. Conclusions: Similarities in clinical manifestation, neuropsychological deficits and neuropathological abnormalities may suggest that both DLB and PDD are two different phenotypes of the same disorder. This review article presents current knowledge on similarities and differences between these two clinical entities and raises the question whether they require differentiation or not.

Introduction: Recently the issue of emotional intelligence has become a widespread theme of discussion. This review paper is made a contribution to this debate. Discovering of effective predictive and protective factors for depression would have far-reaching consequences for society, science and economy. Material and Methods: To investigate this issue, we searched articles available in the Google Scholar and PudMed databases under the following terms: emotional intelligence, depression, emotional intelligence and depression for the years 1999-2019. Accessible literature allowed to show basic information of emotional intelligence, detect a system of relationships between emotional intelligence level and depression, and present recommendations. Results and Discussion: The result of this analysis is a statement that all components of emotional intelligence can be a defense against depression. People with high abilities in regulation their own emotions have large social support, what protect them against depression. The capable managing one’s own and others’ emotions create large and deep interpersonal relationships, what provide more emotional support and tangible assistance during everyday challenges. Stressful life events are among the most powerful predictors of depression, and high level of emotional intelligence enable to cope with them more effectively. Conclusions: The present text will constitute an impulse to explore this theme more. Moreover, there is a recommendation for researchers to create more effective and simplified tests for examining the level of emotional intelligence in case of spreading them much more and use them in a routine psychiatric practice. A confirmation of the title hypothesis can stand a key to struggle with depression.

Introduction: The specific character of Rorschach test responses of parents who had a child with schizophrenia has been reported many times. The analysis presented in this paper is focused on responses commenting on movement seen in the inkblots. According to Zygmunt Piotrowski, these responses reflect the prototypal role – self-concepts and a certain pattern of responding that can be understood as phenomena related to the concept of self. Material and method: I used the Rorschach test to examine 32 couples of parents who had a child suffering from paranoid schizophrenia (as defined in DSM-IV) and 21 couples of parents who had only healthy children. Results: Parents of schizophrenic children gave significantly fewer human movement responses than parents of healthy children, and some features of these responses give them a specific character. The groups of fathers differed from each other to a greater degree than the groups of mothers. The analysis of relationships between movement responses and shading (chiaroscuro) responses, which are regarded as a measure of anxiety, revealed significant associations in the case of some movement qualities. The exception was that movement quality which is referred to as blocked movement and blocked-posture movement in Piotrowski’s interpretive scheme. All movement qualities globally considered were significantly correlated with anxiety, the exceptions being the group of parents of healthy children and the group of all fathers. Discussion: The smaller number of human movement responses found in the group of parents of schizophrenic children may attest to these people’s lower psychological maturity, which is associated with a less distinctly formed prototypal role. Moreover, certain specific features of these responses can be interpreted as a sign of difficulties in expressing this role. The cooccurrence of movement responses with shading responses, which are treated as a sign of anxiety, was not always consistent with expectations; this should be considered a reason to reflect on the psychological meaning of these responses and on the possible return to Rorschach’s original views. Conclusions: The results of the study suggest lower maturity in the case of parents of schizophrenic children, manifesting itself in a less strongly developed prototypal role and certain difficulties in expressing this role. Based on the analysis of the cooccurrence of movement responses and responses commenting on the shading present in the inkblots, it is possible to conclude that there is a need for a new psychological interpretation of these responses.

The article presents a study on delusory changes in perceiving one’s own body in a patient with mental illness. The story of Daniel Paul Schreber is an example of strongly experienced delusions, which, in the described form are contemporarily attributed to schizophrenia. This story, coming from over one hundred years ago, is still vivid, and actualizes the image of mental illness and suffering connected with it in the thoughts of the reader. The author presents these characteristics focusing mainly on the symptoms of dysmorphognosia or dysmorphophobia, which became an important element of delusional constructs. He describes the nature of the experienced symptoms in detail, documenting them with extensive quotations from „Diary of a mental patient” written by such patient. The study of mental illness presented in the paper reveals the meanders of distorted psyche and some changes that are happening in it under the influence of delusions. It is a study undertaking the issue of describing and understanding the symptoms of mental disorders.

The purpose of the paper — to present the theoretical considerations and the results of empirical study concerning on the intentional characteristics of professional consciousness (on the example of social-role attitudes of students). The structure, the dynamics of changes in the social-role attitudes of students during studies at higher educational institution in different forms of studies (full-time and part-time) and the influence of the quality of program content transferred during the education process on the shaping of students' professional awareness were also discussed. The methodology of the research. We used the method of questioning and incomplete sentences in the research. The sample consisted of 94 students of 1 - 5 courses in the following fields: psychology, primary education, mathematics and physics. The study involved 17 part-time students and 77 full-time students. The age of full-time students was from 17 to 22 years old, and the age of part-time students was from 24 to 35 years old. Methods of mathematical statistics are used to evaluate the data. The results of the research. The data of the empirical research of the students' social-role attitudes show that they have content peculiarities as for the specifics of manifestation at different stages of professional training and on different forms of studies at higher educational institution. Social attitudes regarding the role of “student” and the role of “professional” which have three-component structure (cognitive, emotional and behavioural) vary in degree of awareness and completeness, and are ambivalent. This increases their resilience to changes. The discussion. The results of the studies show that the social-role attitudes undergo changes as a result of target influences in the process of professional training of future specialists at higher educational institution. Therefore, the definition of social-role attitudes features will contribute to the development of the effective technologies in the professional training of specialists.

Introduction: Until recently, oxytocin was mainly associated with the pathophysiology of childbirth and sexual functions, but lately this hormone has become the object of interest to psychiatry and psychology due to the significant influence of oxytocin on human behavior in the field of social and emotional functioning. Current scientific research focuses on the participation of oxytocin in the pathogenesis and therapy of mental disorders. Aim: The aim of the paper is to present, on the basis of available literature, the significance of oxytocin for various psychological functions, with particular emphasis on the influence of oxytocin on the course and clinical picture of schizophrenia. Method: Available articles from the Medline / PubMed database were analyzed, which were searched using keywords: oxytocin, schizophrenia, therapeutic use of oxytocin, social cognition, positive symptoms, negative symptoms and time descriptors: 2013-2017. There are included articles published in Polish and English. Results:The research results carried out so far suggest that oxytocin plays a significant role in modulating complex socio-emotional behaviors in schizophrenic patients. The existing research results also indicate a relationship between the dysregulation of the oxytocinergic system and the pathophysiology of schizophrenia. Many of the studies prove that there is a relationship between the level of oxytocin in the patients' blood plasma and the severity of the disease symptoms. Recent genetic studies indicate a possible relationship between polymorphism of oxytocin genesand polymorphism of oxytocin receptor genes and the risk of developing schizophrenia. Conclusions: Contemporary research on the therapeutic potential of oxytocin and its influence on the functioning of schizophrenia patients seem to be very promising and may contribute to increasing the effectiveness of treatment of schizophrenia and possibly other mental disorders, which in turn will improve the quality of life of patients in cognitive, social and emotional functioning.

Summary Individual-tree growth models are the new standard for modeling growth and yield. Their main purpose is to simulate future forest management scenarios but they can also be used to predict wood quality, rockfall protection or habitat quality. Individual tree growth models may consist of different models but core models are diameter increment, height increment, crown ratio (often used as a predictor for increment) and mortality. The model differentiation is based on how these four models include tree age (size), competition and site. Four common growth simulators in Central Europe are BWIN, Moses, Prognaus and Silva. These four models are commonly deployed to simulate 30 years of growth, but a prospective application is the simulation of a whole rotation period (80–150 years). It is therefore crucial to understand the possibilities and limitations of these models by evaluating them. This review paper summarizes the statistical and emergent properties’ evaluation results for these models. Statistical evaluations focus on individual models of a simulator, whereas the evaluation of emergent properties evaluates the entire simulator, by testing if the models conform to known principles of stand growth. Further, the meaning of these evaluation results for the development and improvement of individual-tree growth models is discussed.

The paper describes a patient, who has been consulted and hospitalized multiple times, due to dermatological lesions on his face. We will present his medical history and describe circumstances leading to the final diagnosis of factitious disorder. In the theoretical part we will try to answer the question, whether the extreme severity of the factitious disorders can, at some point, reach the level of delusions.

Rett syndrome is a neurodevelopmental genetic disorder and, because of some behavioral characteristics, individuals affected by the disease are known as silent angels. Girls with Rett syndrome perform stereotyped movements, they have learning difficulties, their reaction time is prolonged, and they seem alienated in the environment. These children require constant pediatric, neurological and orthopedic care. In the treatment of Rett syndrome physical therapy, music therapy, hydrotherapy, hippotherapy, behavioral methods, speech therapy and diet, are also used. In turn, psychological therapy of the syndrome is based on the sensory integration method, using two or more senses simultaneously. In 80% of cases, the syndrome is related to mutations of the MECP2 gene, located on chromosome X. The pathogenesis of Rett syndrome is caused by the occurrence of a non-functional MeCP2 protein, which is a transcription factor of many genes, i.e. Bdnf, mef2c, Sgk1, Uqcrc1. Abnormal expression of these genes reveals a characteristic disease phenotype. Clinical symptoms relate mainly to the nervous, respiratory, skeletal and gastrointestinal systems. Currently causal treatment is not possible. However, researchers are developing methods by which, perhaps in the near future, it will be possible to eliminate the mutations in the MECP2 gene, and this will give a chance to the patient for normal functioning. The paper presents the etiology and pathogenesis of the disease, genetic, clinical, pharmacological aspects and other forms of Rett syndrome treatment.

Despite the increasing offer of antipsychotic drugs, the effectiveness of pharmacotherapy in schizophrenia is still unsatisfactory. Drug resistance, lack of complete remission and the increasing risk of metabolic complications are the reasons why the new forms of therapy in schizophrenia among which unsaturated essential fatty acids omega 3 (EFAs ω-3) affecting the proper functioning of nervous system, are mentioned, are being looked for. Fatty acids represent 50-60% of the dry weight of the brain and diet is one of the factors that influence the value of each of the fat fractions in the neuron membranes. Patients with schizophrenia tend to have irregular nutritional status concerning essential fatty acids ω-3, which might result from metabolic disorders or irregular consumption of fatty acids. Apart from being a review of the literature on this subject, this very paper characterizes essential fatty acids ω-3, their metabolism, the most important sources in the diet and the opinions of experts in the field about the recommended intake. It pays attention to the role of essential fatty acids in both the structure and functioning of the central nervous system is, as well as their role in the pathophysiology of schizophrenia, with particular emphasis on the membrane concept by David Horrobin. The assessment of the errors in consumption and metabolism of essential fatty acids are described as well. The evidence was found both in epidemiological and modeling studies. It supports the participation of EFAs in etiopathogenesis and pathophysiology of schizophrenia. Further research is needed, both observational and interventional, as to the role of essential fatty acids ω-3 in the functioning of the CNS as well as the development and course of schizophrenia.

Background: According to current knowledge, gamma frequency is closely related to the functioning of neural networks underlying the basic activity of the brain and mind. Disorders in mechanisms synchronizing brain activity observed in patients diagnosed with schizophrenia are at the roots of neurocognitive disorders and psychopathological symptoms of the disease. Synchronization mechanisms are also related to the structure and functional effectiveness of the white matter. So far, not many analysis has been conducted concerning changes in the image of high frequency in patients with comorbid schizophrenia and white matter damage. The aim of this research was to present specific features of gamma waves in subjects with different psychiatric diagnoses and condition of brain structure. Methods: Quantitative analysis of an EEG record registered from a patient diagnosed with schizophrenia and comorbid white matter hyperintensities (SCH+WM), a patient with an identical diagnosis but without structural brain changes present in the MRI (SCH-WM) of a healthy control (HC). The range of gamma waves has been obtained by using analogue filters. In order to obtain precise analysis, gamma frequencies have been divided into three bands: 30-50Hz, 50-70Hz, 70-100Hz. Matching Pursuit algorithm has been used for signal analysis enabling assessing the changes in signal energy. Synchronization effectiveness of particular areas of the brain was measured with the aid of coherence value for selected pairs of electrodes. Results: The electrophysiological signals recorded for the SCH+WM patient showed the highest signal energy level identified for all the analyzed bands compared to the results obtained for the same pairs of electrodes of the other subjects. Coherence results revealed hipercompensation for the SCH+WM patient and her level differed substantially compared to the results of the other subjects. Conclusions: The coexistence of schizophrenia with white matter damage can significantly disturb parameters of neural activity with high frequencies. The paper discusses possible explanations for the obtained results.

Summary The heat content of wastewater presents a great but still widely unused potential for energy supply. The thermal energy recovered through heat exchangers and heat pumps can be used for the heating (and cooling) of buildings and even for hot water production. At the moment, at least about 500 installations are operated on a global scale, and most experiences are available in Switzerland. In Austria, some wastewater heat recovery systems are also already under operation, for instance in Amstetten and in Weiz. However, due to the lack of superordinate strategies for planning, implementing, and operating wastewater heat recovery systems on federal and provincial level, the Austrian installations are primarily the result of personal initiatives of local stakeholders. This paper gives a general overview of different policy instruments for initializing and further promoting wastewater heat recovery as well as potential operating models for related heat supply systems and conducts a related comparison with the current Austrian situation. The information gained can serve as an input for the development of an initialization program for wastewater heat recovery on Austrian national level.