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BackgroundKnee osteoarthritis (KOA) is a prevalent condition causing significant pain and functional impairment. Acupuncture has shown promise as an adjunctive therapy, but conventional manual selection of acupoints lacks standardization. The Acugraph system provides a computerized method for identifying acupoints, potentially enhancing treatment precision.ObjectiveThis study aims to compare the effects of computerized Acugraph-guided acupuncture versus manually selected acupuncture as adjuncts to physiotherapy in managing KOA.MethodsA randomized, double-blind controlled trial will be conducted with 50 participants diagnosed with mild to moderate KOA. Participants will be randomly assigned to one of two groups: Group 1 Comp-AcuPhysio (n = 25), receiving Acugraph-guided acupuncture with physiotherapy, or Group 2 Man-AcuPhysio (n = 25), receiving manually selected acupuncture with physiotherapy. Both groups will undergo 12 weekly treatment sessions, each lasting 60 minutes. Outcome measures, including the Knee Injury and Osteoarthritis Outcome Score, active knee flexion range, Timed Up and Go test, Visual Analog Scale for pain, Short Form-36 health survey, and Personal Integrated Energetics score, will be assessed at baseline and immediately post-intervention. An intention-to-treat analysis will be applied. Changes from baseline to 12 weeks will be analyzed using repeated measures analysis of variance for both within-group and between-group comparisons.ResultsThis study will provide a definitive assessment of the effectiveness of computerized Acugraph-guided acupuncture compared to manually selected acupuncture as supplementary treatments alongside KOA physiotherapeutic rehabilitation.ConclusionThis trial will offer insights into how incorporating technology-driven approaches, such as Acugraph, with physiotherapy can enhance the customization and effectiveness of KOA management, leading to improved clinical outcomes. These results could advocate for the integration of technological tools in acupuncture to boost treatment precision and efficacy for KOA.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12624000646549p). more...

Includes 19 articles that address issues related to library skills and Canadian school libraries. Topics include information literacy; inquiry learning; critical thinking and electronic research; collaborative inquiry; information skills and the Big 6 approach to problem solving; student use of online databases; library skills; Internet accuracy; and Web sources. (LRW) more...

Background: Deficient information processing in ADHD theoretically results in sensory overload and may underlie the symptoms of the disorder. Mismatch negativity (MMN) and P3a amplitude reflect an individual's detection and subsequent change in attention to stimulus change in their environment. Our primary aim was to explore MMN and P3a amplitude in adult ADHD patients and to examine the effects of methylphenidate (MPH) on these measures. Methods: Forty initially psychostimulant-naïve, adult ADHD patients without comorbid ASD and 42 matched healthy controls (HC) were assessed with an MMN paradigm at baseline. Both groups were retested after 6 weeks, in which patients were treated with MPH. Results: Neither significant group differences in MMN nor P3a amplitude were found at baseline. Although 6-week MPH treatment significantly reduced symptomatology and improved daily functioning of the patients, it did not significantly affect MMN amplitude; however, it did significantly reduce P3a amplitude compared to the HC. Furthermore, more severe ADHD symptoms were significantly associated with larger MMN amplitudes in the patients, both at baseline and follow-up. Conclusion: We found no evidence for early information processing deficits in patients with ADHD, as measured with MMN and P3a amplitude. Six-week treatment with MPH decreased P3a but not MMN amplitude, although more severe ADHD-symptoms were associated with larger MMN amplitudes in the patients. Given that P3a amplitude represents an important attentional process and that glutamate has been linked to both ADHD and MMN amplitude, future research should investigate augmenting MPH treatment of less responsive adults with ADHD with glutamatergic antagonists. [ABSTRACT FROM AUTHOR] more...

Methylphenidate is a first-line treatment for ADHD; its contribution to sleep problems in adult ADHD is currently unclear. This study investigates (a) subjective sleep disturbances in a group of initially stimulant medication-naïve adults with ADHD and (b) reported changes in sleep problems after 6 weeks of methylphenidate treatment. A prospective, non-randomized, non-blinded, 6-week follow-up study utilising a self-report measure. We found (1) a large difference in reported sleep quality between methylphenidate medication-naïve patients and controls at baseline, (2) a marked improvement in patients after methylphenidate medication, and (3) largest improvement for patients with the poorest reported sleep at baseline. The study indicates that treatment with methylphenidate increases subjective sleep quality for at least some adults with ADHD. [ABSTRACT FROM AUTHOR] more...

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which frequently persists into adulthood. The primary goal of the current study was to (a) investigate attentional functions of stimulant medication-naïve adults with ADHD, and (b) investigate the effects of 6 weeks of methylphenidate treatment on these functions. Methods: The study was a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 stimulant medication-naïve adult patients with ADHD, and 42 age and parental education-matched healthy controls. Assessments included measures of visual attention, based on Bundesen's Theory of Visual Attention (TVA), which yields five precise measures of aspects of visual attention; general psychopathology; ADHD symptoms; dyslexia screening; and estimates of IQ. Results: At baseline, significant differences were found between patients and controls on three attentional parameters: visual short-term memory capacity, threshold of conscious perception, and to a lesser extent visual processing speed. Secondary analyses revealed no significant correlations between TVA parameter estimates and severity of ADHD symptomatology. At follow-up, significant improvements were found specifically for visual processing speed; this improvement had a large effect size, and remained when controlling for re-test effects, IQ, and dyslexia screen performance. There were no significant correlations between changes in visual processing speed and changes in ADHD symptomatology. Conclusions: ADHD in adults may be associated with deficits in three distinct aspects of visual attention. Improvements after 6 weeks of medication are seen specifically in visual processing speed, which could represent an improvement in alertness. Clinical symptoms and visual attentional deficits may represent separate aspects of ADHD in adults. [ABSTRACT FROM AUTHOR] more...

Introduction: The prevalence of dementia in various geriatric psychiatry settings has previously been investigated and been found to lie between 15.2% and 61%. The present study investigated the percentage of patients with "organic brain disorder" [OBD] (dementia, acquired brain injury or other brain disease) in one geriatric psychiatric department in Copenhagen, Denmark., Materials and Methods: The journals of all patients admitted to the geriatric psychiatric department (locked ward, open ward, and day hospital) in 2002 were studied in order to find evidence of (a) psychiatric discharge diagnosis of OBD in 2002 (b) previous diagnosis of OBD (c) the basis of these diagnoses., Results: 130 patients were admitted at least once in 2002. 33.1% had an OBD diagnosis at discharge, whilst a further 18.4% had documented evidence of previously diagnosed OBD and/or assessments supporting the presence of OBD. Effects of gender and age at first admission were found on discharge diagnosis., Conclusion: There is evidence that over half of the patients admitted to the geriatric psychiatry department in this study had an OBD, which is higher than the percentage of patients who were discharged with this diagnosis. The possible consequences of findings and the drawbacks of the study are discussed. more...