Older adults have difficulty recalling specific autobiographical events. This over-general memory style is a vulnerability factor for depression. Two groups receiving interventions that have previously been successful at reducing over-general memory in depressed populations were compared to a control group. Participants were healthy older adults aged ≥70 years: memory specificity training (MEST; n = 22), life review (n = 22), and control group (n = 22). There were significant improvements in autobiographical memory specificity in the MEST and life review groups at post-training, relative to the control group, suggesting that over-general memory can be reduced in older adults. Change in social problem solving ability and functional limitations were related to change in autobiographical memory specificity, supporting the suggested role of specific retrieval in generating solutions to social problems and maintaining independence. Qualitative analysis of participants' feedback revealed that life review may be more appropriate for older adults, possibly because it involves integrating specific memories into a positive narrative.
Background: Addressing specific social cognitive difficulties is an important target in early psychosis and may help address poor functional outcomes. However, structured interventions using standard therapy settings including groups suffer from difficulties in recruitment and retention. Aims: To address these issues, we aimed to modify an existing group social cognitive intervention entitled 'Social Cognition and Interaction Training' (SCIT) to be delivered through a virtual world environment (Second Life ©). Methods: A single arm nonrandomized proof-of-concept trial of SCIT-VR was conducted. Five groups of three to five individuals per group were recruited over 6 months. Eight sessions of SCIT-VR therapy were delivered through the virtual world platform Second Life© over a 5-week intervention window. Feasibility was examined using recruitment rates and retention. Acceptability was examined using qualitative methods. Secondary outcomes including social cognitive indices, functioning, and anxiety were measured pre-and postintervention. Results: The SCIT-VR therapy delivered was feasible (36% consent rate and 73.3% intervention completion rate), acceptable (high overall postsession satisfaction scores) and safe (no serious adverse events), and had high levels of participant satisfaction. Users found the environment immersive. Prepost changes were found in emotion recognition scores and levels of anxiety. There were no signs of clinical deterioration on any of the secondary measures.
Autobiographical memory specificity (AMS) reduces with increasing age and is associated with depression, social problem-solving and functional limitations. However, ability to switch between general and specific, as well as between positive and negative retrieval, may be more important for the strategic use of autobiographical information in everyday life. Ability to switch between retrieval modes is likely to rely on aspects of executive function. We propose that age-related deficits in cognitive flexibility impair AMS, but the "positivity effect" protects positively valenced memories from impaired specificity. A training programme to improve the ability to flexibly retrieve different types of memories in depressed adults (MemFlex) was examined in non-depressed older adults to determine effects on AMS, valence and the executive functions underlying cognitive flexibility. Thirty-nine participants aged 70+ (MemFlex, n = 20; control, n = 19) took part. AMS and the inhibition aspect of executive function improved in both groups, suggesting these abilities are amenable to change, although not differentially affected by this type of training. Lower baseline inhibition scores correlated with increased negative, but not positive AMS, suggesting that positive AMS is an automatic process in older adults. Changes in AMS correlated with changes in social problem-solving, emphasising the usefulness of AMs in a social environment.
Professor Ian Macdonald (Nottingham) described the indirect calorimetry techniques used to measure energy expenditure, the assumptions which underlie them and the potential errors which may be incurred.Indirect calorimetry can only be used to estimate energy expenditure accurately if the organism is dependent on aerobic metabolism for the release of energy. If the organism's metabolism is aerobic then energy expenditure can be estimated from measurement of respiratory gas exchange and preferably, also, urinary N loss based on the following relationship: fuel and O2 combine and break down to produce C02, water, protein products and energy.The main complication in using this relationship to estimate energy expenditure is that the amounts of 0 2 , C 0 2 and energy involved are different for the various fuels which can be used. For accuracy, one can determine the actual quantities of different fuels being oxidized or instead use a predictive equation based on the mathematical relationship between 0, consumption, CO, production and the energy equivalents appropriate for the fuels being used. In most situations the fuels being used are carbohydrate, fat and protein; however, if other fuels are also being used (e.g. alcohol) then errors can arise unless the rate of utilization of the other fuel is determined. Different equations were described to calculate energy expenditure from 0, and C 0 2 concentrations (Weir, 1949;Consolazio et al. 1963; Ferrannini, 1988;Simonson & DeFronzo, 1990), but it was emphasized that the latest equations published by Elia & Livesey (1992) use more appropriate values for the energy content and RQ of protein than previous equations and, therefore, are likely to be more accurate. The use of the Haldane (1935) correction which allows for errors involving differences in volumes of inspired and expired air, was strongly recommended.Indirect calorimetry will only provide a valid measure of energy expenditure if the rates of 0, uptake and C 0 2 output which occur through respiratory gas exchange, are equated to the rates of O2 consumption and CO, production occurring in tissue metabolism. Errors may occur with acid-base disturbances or if the pattern of respiration is disturbed by the apparatus used to collect the expired air, e.g. ventilated hood, face mask, mouthpiece Douglas bag (Askanasi et al. 1980).
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