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Video Decision Support Tool For Advance Care Planning In Dementia: Randomised Controlled Trial, UK
Video images of advanced dementia can help patients choose the type of care they want in the future, finds a study published on bmj.com today. The images also led to more stable treatment preferences over time.
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N.C. Bill Gives Students 'Vital Access' To Accurate Sex Education Instruction, Editorial States
A bill (S. 221) approved by the North Carolina Legislature that would require a public school sex education curriculum covering abstinence, contraception and sexually transmitted infections "will be the most comprehensive and science-based approach the state has used" for sex education, a Charlotte Observer editorial states, adding that Gov. Bev Perdue (D) "should sign it." The bill would require all public school districts in the state to teach a curriculum that focuses on abstinence but also includes information on preventing pregnancy and STIs. Parents would be able to have their children removed from the comprehensive portions of instruction. According to the editorial, the measure "still gives parents a choice in deciding what kind of sex education their children will receive." The editorial adds, "It also finally provides a curriculum that gives N.C. students vital access to age-appropriate, science-based information critical to their health, safety and well-being," which is "the kind of information that can help them make smart choices in serious situations."Parents are "often the best people for kids to turn to for advice and information" on sex, but "not all children have parents who can provide it, or are even willing to," and "not all children [who] go to their parents adhere to their advice," the editorial states. It continues, "The schools provide another avenue to get this critical advice and information -- and state lawmakers are right to make it available." According to the Observer, North Carolina has the ninth-highest teenage pregnancy rate in the U.S., and about "20,000 teenagers will get pregnant in North Carolina this year." A "comprehensive, science-based education program can help reduce the number of unintended teen pregnancies" and help reduce the spread of STIs, the editorial says. It concludes, "By reaching agreement on this matter, state lawmakers have given the children of this state vital tools to safeguard their health and welfare. ... Perdue should sign this bill and make it law" (Charlotte Observer, 6/26).
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Creative Problem Solving Enhanced By REM Sleep

Research led by a leading expert on the positive benefits of napping at the University of California, San Diego School of Medicine suggests that Rapid Eye Movement (REM) sleep enhances creative problem-solving. The findings may have important implications for how sleep, specifically REM sleep, fosters the formation of associative networks in the brain. The study by Sara Mednick, PhD, assistant professor of psychiatry at UC San Diego and the VA San Diego Healthcare System, and first author Denise Cai, graduate student in the UC San Diego Department of Psychology, shows that REM directly enhances creative processing more than any other sleep or wake state. Their findings were published in the June 8th online edition of the Proceedings of the National Academy of Sciences (PNAS). "We found that - for creative problems that you"ve already been working on - the passage of time is enough to find solutions," said Mednick. "However, for new problems, only REM sleep enhances creativity." Mednick added that it appears REM sleep helps achieve such solutions by stimulating associative networks, allowing the brain to make new and useful associations between unrelated ideas. Importantly, the study showed that these improvements are not due to selective memory enhancements. A critical issue in sleep and cognition is whether improvements in behavioral performance are the result of sleep-specific enhancement or simply reduction of interference - since experiences while awake have been shown to interfere with memory consolidation. The researchers controlled for such interference effects by comparing sleep periods to quiet rest periods without any verbal input. While evidence for the role of sleep in creative problem-solving has been looked at by prior research, underlying mechanisms such as different stages of sleep had not been explored. Using a creativity task called a Remote Associates Test (RAT), study participants were shown multiple groups of three words (for example: cookie, heart, sixteen) and asked to find a fourth word that can be associated to all three words (sweet, in this instance). Participants were tested in the morning, and again in the afternoon, after either a nap with REM sleep, one without REM or a quiet rest period. The researchers manipulated various conditions of prior exposure to elements of the creative problem, and controlled for memory. "Participants grouped by REM sleep, non-REM sleep and quiet rest were indistinguishable on measures of memory," said Cai. "Although the quiet rest and non-REM sleep groups received the same prior exposure to the task, they displayed no improvement on the RAT test. Strikingly, however, the REM sleep group improved by almost 40 percent over their morning performances." The authors hypothesize that the formation of associative networks from previously unassociated information in the brain, leading to creative problem-solving, is facilitated by changes to neurotransmitter systems during REM sleep. Additional contributors to the study include Sarnoff A. Mednick, University of Southern California, Department of Psychology; Elizabeth M. Harrison, UCSD Department of Psychology; and Jennifer Kanady, UCSD Department of Psychiatry and Veterans Affairs San Diego Healthcare System, Research Service. Funding was provided by the National Institutes of Health. Debra Kain University of California - San Diego


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