Experiences of cognitive stimulation therapy (CST) in Brazil: a qualitative study of people with dementia and their caregivers

OBJECTIVES

There is a lack of investment in psychosocial treatments for people with dementia in Brazil. Cognitive Stimulation Therapy (CST) is a group-based intervention that has shown to have benefits on activities of daily living and mood for people with dementia in Brazil. This study aims to explore the experiences and perceived changes following CST groups.

METHODS

Individual interviews were conducted with the participants of the group (n = 12) and their caregivers (n = 11). Framework analysis was used to inspect the data.

RESULTS

Two main themes have emerged: 'Personal benefits of being part of the group', containing two subthemes: 'Benefits for caregivers' and 'Benefits for person with dementia' and 'Day-to-day changes', containing seven subthemes; 'Memory', Sociability', 'Language', 'Mood', 'Orientation', 'Everyday activities' and 'Behavioural and psychological symptoms'.

CONCLUSION

Results suggest that CST groups led to perceived personal benefits for the people with dementia and caregivers and that there are perceived changes for the participants of the groups.

Enhanced NMR relaxation of fluids confined to porous media: A proposed theory and experimental tests

We propose a theory to account for the NMR relaxation of water protons in situations in which the fluid is confined to porous structures exhibiting a scarce distribution of paramagnetic centers on their surface. Though much of what is stated and assumed concerns the response of water, the model has sufficiently general features to be able to explain proton relaxation of other polar fluids under similar conditions. One of the main results of the paper is to show that the local anisotropy introduced by the dominant dipolar coupling in the relaxation rates of active surface elements induces a measurable dependence on sample orientation in the overall relaxation rates of the saturating fluid provided its confining structure is not statistically isotropic. Measurements of T_{1} proton relaxation on water saturating microcapillary tubes are performed to reveal the effect.

Post-stroke acute elation shortly followed by pathologic jealousy - is there a common anatomic substrate?

Both mania and psychotic symptoms are well known to result from vascular brain injury, but their pathophysiology remains largely unknown.

A 69-year-old man with diabetes and hypertension was seen for sudden behaviour disturbance: euphoric, talkative and uninhibited, he continuously shouted he trusted in Medicine, called the doctor the “King of Medicine”, and repeatedly said “I love doctors, I love nurses, I love Hospitals”. He was overcompliant during neurologic exploration, clearly amused with it. Left sensitive hemi-inattention and left homonymous hemianópsia could also be found. MRI showed an acute right temporo-parieto-insular cortical infarction. The following day he was euthymic and embarrassed for what happened. When visited that afternoon by his wife, she noticed he was strangely suspicious, continuously surveilling all her moves. He progressively worsened, believing she was having affairs with several men. This delusion persisted for the following months, even on risperidone 1 mg/day, culminating in Christmas Eve, when the patient shocked his family saying that his wife was having an affair with one of their sons. At this time, risperidone was discontinued and replaced by quetiapine 200 mg/day, resulting in rapid fading of all symptoms.

Both post-stroke mania and psychotic symptoms have been consistently associated with right hemisphere damage, but, to our knowledge, were not previously reported after the same injury. We believe our patient provides evidence that the same anatomic dysfunction, in this case a temporoparietal infarct, can cause both psychiatric phenomena.