What is ‘doll therapy’ for people with dementia? And is it backed by science?
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The way people living with dementia experience the world can change as the disease progresses. Their sense of reality or place in time can become distorted, which can cause agitation and distress.
One of the best ways to support people experiencing changes in perception and behaviour is to manage their environment. This can have profound benefits including reducing the need for sedatives.
One such strategy is the use of dolls as comfort aids.
What is ‘doll therapy’?
More appropriately referred to as “child representation”, lifelike dolls (also known as empathy dolls) can provide comfort for some people with dementia.
Memories from the distant past are often more salient than more recent events in dementia. This means that past experiences of parenthood and caring for young children may feel more “real” to a person with dementia than where they are now.
Hallucinations or delusions may also occur, where a person hears a baby crying or fears they have lost their baby.
Providing a doll can be a tangible way of reducing distress without invalidating the experience of the person with dementia.
Some people believe the doll is real
A recent case involving an aged care nurse mistreating a dementia patient’s therapy doll highlights the importance of appropriate training and support for care workers in this area.
For those who do become attached to a therapeutic doll, they will treat the doll as a real baby needing care and may therefore have a profound emotional response if the doll is mishandled.
It’s important to be guided by the person with dementia and only act as if it’s a real baby if the person themselves believes that is the case.
What does the evidence say about their use?
Evidence shows the use of empathy dolls may help reduce agitation and anxiety and improve overall quality of life in people living with dementia.
Child representation therapy falls under the banner of non-pharmacological approaches to dementia care. More specifically, the attachment to the doll may act as a form of reminiscence therapy, which involves using prompts to reconnect with past experiences.
Interacting with the dolls may also act as a form of sensory stimulation, where the person with dementia may gain comfort from touching and holding the doll. Sensory stimulation may support emotional well-being and aid commnication.
However, not all people living with dementia will respond to an empathy doll.
The introduction of a therapeutic doll needs to be done in conjunction with careful observation and consideration of the person’s background.
Empathy dolls may be inappropriate or less effective for those who have not previously cared for children or who may have experienced past birth trauma or the loss of a child.
Be guided by the person with dementia and how they respond to the doll.
Are there downsides?
The approach has attracted some controversy. It has been suggested that child representation therapy “infantilises” people living with dementia and may increase negative stigma.
Further, the attachment may become so strong that the person with dementia will become upset if someone else picks the doll up. This may create some difficulties in the presence of grandchildren or when cleaning the doll.
The introduction of child representation therapy may also require additional staff training and time. Non-pharmacological interventions such as child representation, however, have been shown to be cost-effective.
Could robots be the future?
The use of more interactive empathy dolls and pet-like robots is also gaining popularity.
While robots have been shown to be feasible and acceptable in dementia care, there remains some contention about their benefits.
While some studies have shown positive outcomes, including reduced agitation, others show no improvement in cognition, behaviour or quality of life among people with dementia.
Advances in artificial intelligence are also being used to help support people living with dementia and inform the community.
Viv and Friends, for example, are AI companions who appear on a screen and can interact with the person with dementia in real time. The AI character Viv has dementia and was co-created with women living with dementia using verbatim scripts of their words, insights and experiences. While Viv can share her experience of living with dementia, she can also be programmed to talk about common interests, such as gardening.
These companions are currently being trialled in some residential aged care facilities and to help educate people on the lived experience of dementia.
How should you respond to your loved one’s empathy doll?
While child representation can be a useful adjunct in dementia care, it requires sensitivity and appropriate consideration of the person’s needs.
People living with dementia may not perceive the social world the same way as a person without dementia. But a person living with dementia is not a child and should never be treated as one.
Ensure all family, friends and care workers are informed about the attachment to the empathy doll to help avoid unintentionally causing distress from inappropriate handling of the doll.
If using an interactive doll, ensure spare batteries are on hand.
Finally, it is important to reassess the attachment over time as the person’s response to the empathy doll may change.
Nikki-Anne Wilson, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Women’s Strength Training Anatomy – by Frédéric Delavier
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Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:
“Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”
In those other books we are left wonder: where’s the underlying information? Where are the explanations that aren’t condescending? Where, dare we ask, is the understanding that a woman might ever lift something heavier than a baby?
Delavier, in contrast, delivers. With 130 pages of detailed anatomical diagrams for all kinds of exercises to genuinely craft your body the way you want it for you. Bigger here, smaller there, functional strength, you decide.
And rest assured: no, you won’t end up looking like Arnold Schwarzenegger unless you not only eat like him, but also have his genes (and possibly his, uh, “supplement” regime).
What you will get though, is a deep understanding of how to tailor your exercise routine to actually deliver the personalized and specific results that you want.
Pick Up Today’s Book on Amazon!
Not looking for a feminine figure? You may like the same author’s book for men:
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Peony Against Inflammation & More
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Yes, this is about the flower, especially white peony (Paeonia lactiflora), and especially the root thereof (Paeoniae radix alba). Yes, the root gets a different botanical name but we promise it is the same plant. You will also read about its active glycoside paeoniflorin, and less commonly, albiflorin (a neuroprotective glycoside present in the root).
It’s one of those herbs that has made its way out of Traditional Chinese Medicine and into labs around the world.
It can be ingested directly as food, or as a powder/capsule, or made into tea.
Anti-inflammatory
Peony suppresses inflammatory pathways, which thus reduces overall inflammation. In particular, this research review found:
❝Pharmacologically, paeoniflorin exhibits powerful anti-inflammatory and immune regulatory effects in some animal models of autoimmune diseases including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE)❞
The reviewers also (albeit working from animal models) suggest it may be beneficial in cases of kidney disease and liver disease, along with other conditions.
Here’s a larger review, which also has studies involving humans (and in vivo studies), that found it to effectively help treat autoimmune conditions including rheumatoid arthritis and psoriasis, amongst others:
❝Modern pharmacological research on TGP is based on the traditional usage of PRA, and its folk medicinal value in the treatment of autoimmune diseases has now been verified. In particular, TGP has been developed into a formulation used clinically for the treatment of autoimmune diseases.
Based on further research on its preparation, quality control, and mechanisms of action, TGP is expected to eventually play a greater role in the treatment of autoimmune diseases. ❞
(TGP = Total Glucosides of Paeony)
Antidepressant / Anxiolytic
It also acts as a natural serotonin reuptake inhibitor (as per many pharmaceutical antidepressants), by reducing the expression of the serotonin transporter protein:
Gut Microbiota-Based Pharmacokinetics and the Antidepressant Mechanism of Paeoniflorin
(remember, most serotonin is produced in the gut)
Here’s how that played out when tested (on rats, though):
Against PMS and/or menopause symptoms
Peony is widely used in Traditional Chinese Medicine to reduce these symptoms in general. However, we couldn’t find a lot of good science for that, although it is very plausible (as the extract contains phytoestrogens and may upregulate estrogen receptors while dialling down testosterone production). Here’s the best we could find for that, and it’s a side-by-side along with licorice root:
❝Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin❞
Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production
(note: that it didn’t affect estradiol levels is reasonable; it contains phytoestrogens after all, not estradiol—and in fact, if you are taking estradiol, you might want to skip this one, as its phytoestrogens could compete with your estradiol for receptors)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Smart Sex – by Dr. Emily Morse
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First, what this isn’t: this isn’t a mere book of sex positions and party tricks, nor is it a book of Cosmo-style “drive your man wild by using hot sauce as lube” advice.
What it offers instead, is a refreshingly mature take on sex, free from the “teehee” titillations and blushes that many books of the genre go for.
Dr. Emily Morse outlines five pillars of sex:
- Embodiment
- Health
- Collaboration
- Self-knowledge
- Self-acceptance
…and talks about each of them in detail, and how we can bring them together. And, of course, how we or our partner(s) could accidentally sabotage ourselves or each other, and the conversations we can (and should!) have, to work past that.
She also, critically, and this is a big source of value in the book, looks at “pleasure thieves”: stress, trauma, and shame. The advice for overcoming these is not “don’t worry; be happy” but rather is actual practical steps one can take.
The style throughout is direct and unpatronizing. Since the advice within pertains to everyone who has and/or wants an active sex life, very little is divided by gender etc.
There is some attention given to anatomy and physiology, complete with clear diagrams. Honestly, most people could benefit from these, because most people’s knowledge of the relevant anatomy stopped with a very basic high school text book diagram that missed a lot out.
Bottom line: this book spends more time on what’s between your ears than what’s between your legs, and yet is very comprehensive in all areas. Everyone has something to gain from this one.
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How to Prepare for Your First Therapy Session
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Everyone (who ever has therapy, anyway) has a first therapy session. So, how to make best use of that, and get things going most effectively? Dr. Tori Olds has advice:
Things to prepare
Questions that you should consider, and prepare answers to beforehand, include:
- Why are you here? Not in any deep philosophical sense, but, what brought you to therapy?
- What would you like to focus on? Chances are, you are paying a hefty hourly rate—so having considered this will allow you to get your money’s worth.
- How will you know when you’ve met your goal? Note that this is really two questions in one, because first you need to identify your goal, and then you need to expand on it. If you woke up tomorrow and all your psychological problems were solved, how would you know? What would be different? What does it look like?
If you have a little time between now and your first session, journaling can help a lot.
Remember also that a first therapy session can also be like a mutual interview, to decide whether it’s a good match. Not every therapist is good at their job, and not every therapist will be good for you specifically. Sometimes, a therapist may be a mismatch through no fault of their own. Considering what those reasons might be can also be a good thing to think about in advance, to help find the best therapist for you in fewer tries!
For most on these ideas, enjoy:
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What are ‘Ozempic babies’? Can the drug really increase your chance of pregnancy?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
We’ve heard a lot about the impacts of Ozempic recently, from rapid weight loss and lowered blood pressure, to persistent vomiting and “Ozempic face”.
Now we’re seeing a rise in stories about “Ozempic babies”, where women who use drugs like Ozempic (semaglutide) report unexpected pregnancies.
But does semaglutide (also sold as Wegovy) improve fertility? And if so, how? Here’s what we know so far.
Remind me, what is Ozempic?
Ozempic and related drugs (glucagon-like peptide-1 receptor agonists or GLP-1-RAs) were developed to help control blood glucose levels in people with type 2 diabetes.
But the reason for Ozempic’s huge popularity worldwide is that it promotes weight loss by slowing stomach emptying and reducing appetite.
Ozempic is prescribed in Australia as a diabetes treatment. It’s not currently approved to treat obesity but some doctors prescribe it “off label” to help people lose weight. Wegovy (a higher dose of semaglutide) is approved for use in Australia to treat obesity but it’s not yet available.
How does obesity affect fertility?
Obesity affects the fine-tuned hormonal balance that regulates the menstrual cycle.
Women with a body mass index (BMI) above 27 are three times more likely than women in the normal weight range to be unable to conceive because they are less likely to ovulate.
The metabolic conditions of type 2 diabetes and polycystic ovary syndrome (PCOS) are both linked to obesity and fertility difficulties.
Women with type 2 diabetes are more likely than other women to have obesity and to experience fertility difficulties and miscarriage.
Similarly, women with PCOS are more likely to have obesity and trouble conceiving than other women because of hormonal imbalances that cause irregular menstrual cycles.
In men, obesity, diabetes and metabolic syndrome (a cluster of conditions that increase the risk of heart disease and stroke) have negative effects on fertility.
Low testosterone levels caused by obesity or type 2 diabetes can affect the quality of sperm.
So how might Ozempic affect fertility?
Weight loss is recommended for people with obesity to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it may also increase the chance of pregnancy in women with obesity.
This is why weight loss and metabolic improvement are the most likely reasons why women who use Ozempic report unexpected pregnancies.
But unexpected pregnancies have also been reported by women who use Ozempic and the contraceptive pill. This has led some experts to suggest that some GLP-1-RAs might affect the absorption of the pill and make it less effective. However, it’s uncertain whether there is a connection between Ozempic and contraceptive failure.
Some women have reported getting pregnant while taking the contraceptive pill and Ozempic. Cottonbro Studio/Pexels In men with type 2 diabetes, obesity and low testosterone, drugs like Ozempic have shown promising results for weight loss and increasing testosterone levels.
Avoid Ozempic if you’re trying to conceive
It’s unclear if semaglutide can be harmful in pregnancy. But data from animal studies suggest it should not be used in pregnancy due to potential risks of fetal abnormalities.
That’s why the Therapeutic Goods Administration recommends women of childbearing potential use contraception when taking semaglutide.
Similarly, PCOS guidelines state health professionals should ensure women with PCOS who use Ozempic have effective contraception.
Guidelines recommended stopping semaglutide at least two months before planning pregnancy.
For women who use Ozempic to manage diabetes, it’s important to seek advice on other options to control blood glucose levels when trying for pregnancy.
What if you get pregnant while taking Ozempic?
For those who conceive while using Ozempic, deciding what to do can be difficult. This decision may be even more complicated considering the unknown potential effects of the drug on the fetus.
While there is little scientific data available, the findings of an observational study of pregnant women with type 2 diabetes who were on diabetes medication, including GLP-1-RAs, are reassuring. This study did not indicate a large increased risk of major congenital malformations in the babies born.
Women considering or currently using semaglutide before, during, or after pregnancy should consult with a health provider about how to best manage their condition.
When pregnancies are planned, women can take steps to improve their baby’s health, such as taking folic acid before conception to reduce the risk of neural tube defects, and stopping smoking and consuming alcohol.
While unexpected pregnancies and “Ozempic babies” may be welcomed, their mothers have not had the opportunity to take these steps and give them the best start in life.
Read the other articles in The Conversation’s Ozempic series here.
Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University and Robert Norman, Emeritus Professor of Reproductive and Periconceptual Medicine, The Robinson Research Institute, University of Adelaide
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Inflammation Spectrum – by Dr. Will Cole
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We’ve previously reviewed Dr. Cole’s other book “Gut Feelings”, and now he’s back, this time to tackle inflammation.
The focus here is on understanding what things trigger inflammation in your body—personally yours, not someone else’s—by something close to the usual elimination process yes, but he offers a way of sliding into it gently instead of simply quitting all the things and gradually adding everything back in.
The next step he takes the reader through is eating not just to avoid triggering inflammation, but to actively combat it. From there, it should be possible for the reader to build an anti-inflammatory cookbook, that’s not only one’s own personal repertoire of cooking, but also specifically tailored to one’s own personal responses to different ingredients.
The style of this book is very pop-science, helpful, walking-the-reader-by-the-hand through the processes involved. Dr. Cole wants to make everything as easy as possible.
Bottom line: if your diet could use an anti-inflammatory revamp, this is a top-tier guidebook for doing just that.
Click here to check out The Inflammation Spectrum, find your food triggers and reset your system!
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