Visitors to the intensive care unit may be intimidated by the unfamiliar equipment and complex treatment interventions. Virtual reality orientation could be used to acquaint them with the intensive care unit environment. To examine the acceptability and feasibility of virtual reality orientation compared with standard orientation for visitors to an intensive care unit. In this prospective, within-subject experimental design study, visitors underwent a 3-minute virtual reality orientation and completed a survey about the feasibility (feasibility of intervention measure) and acceptability (acceptability of intervention measure) of the virtual reality intensive care unit orientation. No significant difference was found between the mean (SD) total feasibility of intervention measure scores for the standard orientation versus the virtual reality orientation (13.0 [2.57] vs 13.3 [2.19], P = .44). In addition, no significant difference was found between the mean (SD) total acceptability of intervention measure scores for the standard orientation versus the virtual reality orientation (12.0 [3.07] vs 11.9 [4.06], P = .90). Eleven of the 30 participants (37%) experienced dizziness while undergoing the virtual reality orientation, with 9 rating it as mild, 1 as moderate, and 1 as severe. In this pilot study, virtual reality was found to be an acceptable and feasible orientation tool for visitors to the intensive care unit. Future research should explore virtual reality orientations in different hospital areas.

Introduction: Mild cognitive impairment represents a high-risk state for progression to dementia, making neuropsychological interventions a promising therapeutic strategy. Objective: To evaluate the clinical utility of a neuropsychological intervention program on the overall cognitive functioning of older adults with mild cognitive impairment who attended the Center for Research on Longevity, Aging, and Health during 2022. Materials and methods: A pre-post quasi-experimental study with a single intervention group included 26 purposive older adults who participated in 12 sessions of cognitive training and activities of daily living, reality orientation therapy, and reminiscence therapy. Statistical analysis was performed using the Wilcoxon signed-rank test. Results: Although the change in the overall MoCA score was not statistically significant (p = 0.65), a relevant clinical impact was observed: 73% of the patients maintained or improved their cognitive performance. Improvements were identified in specific domains (executive functions, attention, and visuospatial skills), while memory proved to be the most resilient domain. In the functional sphere, 73.1% maintained their independence. A notable finding was that participants with hypertension showed significantly greater improvement in instrumental activities of daily living (p = 0.04). Conclusions: The evaluation of the neuropsychological program suggests that the intervention can contribute to the stabilization of cognitive and functional performance in older adults with mild cognitive impairment. Although no statistically significant changes were observed overall, most participants maintained or improved their performance, representing a preliminary indication of benefit. The heterogeneity in response indicates the need to adapt future interventions according to individual clinical profiles.

Background: Schizophrenia is a chronic mental disorder that significantly affects cognitive function and behavior, frequently characterized by prominent delusions in Paranoid Schizophrenia. Delusional nursing problems are marked by severe distortions of reality perception, which impair patients’ ability to think logically and interact appropriately with their environment. Purpose: To describe and evaluate the implementation of Reality Orientation Therapy (ROT) in addressing delusional nursing problems in a patient with Paranoid Schizophrenia. Method: This research employed an intensive descriptive case study conducted over four days to illustrate and assess the application of Reality Orientation Therapy in Mrs. Y at Liliy 4 Ward, Seorojo Hospital. The primary intervention focused on the consistent, non-confrontational application of ROT through orientation to person, place, and time, integrated with collaborative pharmacological management. Results: The findings demonstrated that Reality Orientation Therapy was substantially effective in correcting cognitive distortions and enhancing reality-based thinking abilities. This improvement was evidenced by significant clinical progress and increased scores in reality-oriented thought content, indicating that the delusional nursing problem experienced by Mrs. Y was successfully resolved. Conclusion: Reality Orientation Therapy can be considered an effective nursing intervention for reducing delusions and improving reality-based thinking in patients with Paranoid Schizophrenia when implemented consistently and collaboratively with pharmacological treatment. Keywords: Delusions; Paranoid Schizophrenia; Reality Orientation Therapy (ROT).

Cognitive deficits such as attentional impairment and executive dysfunction significantly impact daily living activities in older adults with dementia. This study aimed to evaluate the efficacy of Cognitive Stimulation Therapy (CST) compared to Reality Orientation & Reminiscence Therapy (RO&RM) in improving attention, episodic memory, and executive functions in older Chinese adults with mild to moderate dementia. Additionally, it sought to explore the relationship between attention improvements and changes in executive functions. A retrospective observational pre-post study was conducted from September 2018 to July 2021, involving 160 participants aged 65 or above, diagnosed with dementia. Participants were divided into CST (n = 80) and RO&RM (n = 80) groups, receiving six weeks of daily 1-h sessions. Attention and episodic memory were assessed using the Kendrick Cognitive Test for the Elderly (KCTE), and executive functions were evaluated using the Chinese Disability Assessment for Dementia (CDAD). CST significantly improved attention (p = 0.002) and episodic memory (p = 0.010), with attention improvements being more pronounced. RO&RM showed no significant improvement in these areas. Overall, executive functions did not significantly change, but a positive correlation was found between improved attention and reduced decline in executive functions. CST demonstrated notable potential in enhancing attentional capacities and episodic memory in older Chinese adults with dementia. However, its impact on executive functions was inconsistent. Future research should involve larger sample sizes, longer follow-up periods, and explore combining CST with other therapies to maximise therapeutic potential. This study underscores the importance of culturally adapting CST to better fit the needs of the Chinese dementia population.

This study explored whether a failure to down-regulate cognitive-affective activity at night in insomniacs reflect the presence of underlying circadian rhythm abnormalities. 16 sleep maintenance insomniacs (11F; 64.3±7.2y) and 16 good sleepers (11F; 65.4±7.4y) participated in a constant routine protocol involving 24h of wakeful bedrest, which controls for any conditioned response to sleep initiation. Every hour participants completed a cognitive-affective disengagement checklist containing four items assessing the tone and quality of mentations and four items assessing metacognitive activity. Circadian rhythmicity and group differences were tested using cosinor analyses. Except for thought modality (mental activity was auditory vs imagery) and thought structure (mental activity was repetitive vs sequential) in insomniacs, the remaining tone and quality of mentations and all metacognitive measures demonstrated circadian rhythmicity in both insomniacs and good sleepers. However, insomniacs compared to good sleepers demonstrated less 24h variation (smaller amplitude) in reality orientation (mental activity was dream-like vs real-like), volitional control (little vs much control over mental activity) and thought structure; and reflective of continuing cognitive engagement, a greater tendency for sequential mental activity at night (higher mesor). Our findings are consistent with the hyperarousal model of insomnia, with the failure to downregulate prefrontal activity at night leading to greater goal-oriented processing and less cognitive-affective disengagement. Strengthening the circadian rhythmicity of cognitive-affective activity and modifying sequential thinking are potential interventions in the future treatment of insomnia.

A literature search in February 2021, updated in July 2023, using MEDLINE, CENTRAL, PsycINFO, ALOIS, and CINAHL identified 49 studies involving 2,795 participants. We included randomized controlled trials (RCTs) and quasi-RCTs. Intervention components included reminiscence therapy, activities of daily living, physical exercises, cognitive exercises, music and art therapy, reality orientation, and multisensory stimulation. Variations were observed in procedures, materials, delivery modes, and durations, with a low overall risk of bias. Notably, no studies reported barriers to delivery, and only one included patient input. The findings suggest the need for improved intervention design and methodologies, including digital adaptations and individualization of group-based components. Future research should employ established frameworks to describe interventions and prioritize patient and public involvement throughout the research process.

Recovery of cone-mediated vision in Lebercilin associated retinal ciliopathy after gene therapy: One-year results of a phase I/II trial.

Hallucinations are disturbances in sensory perception of an external stimulus object, this sensory disturbance penetrates all five senses. Hallucinations are one of the symptoms of mental disorders, patients experience changes in their sensory perception and experience false sensations of hearing, seeing, tasting, touching or smelling, feeling stimuli that are not actually psychiatric patients experiencing a change in reality orientation. The aim is to determine the characteristics of the patient before carrying out the scheduled activity of reading the Qur'an, implementing the scheduled activity of reading the Qur'an in schizophrenic patients with hallucinations, implementing the implementation stage of the description of the implementation of observing the implementation of Nursing Care with the Implementation of Medication Compliance and Scheduled Activities: Reading Al-Qur'an Against Decreasing Signs and Symptoms of Hallucinations with a percentage of 82 percennt. This scientific paper uses case studies on 2 patients who experience hallucinatory sensory perception disorders. The results of this case study showed that both patients experienced a decrease in signs and symptoms of hallucinations. The conclusion of this case study is that the strategy of medication adherence and activity therapy: reading the Qur'an is effective in reducing hallucinations. Suggestions for families to be able to participate in providing nursing care to patients with hallucinatory sensory perception disorders so that patients feel there is support that can accelerate the healing process of their illness.

ABSTRACTObjectives:In previous studies, intensive rehabilitation for patients with Parkinson’s disease(PD) has been implemented in both outpatient and inpatient settings, with varyingdurations across studies. Among these, most inpatient intensive rehabilitation programsare conducted for 1 month, with few reports evaluating detailed changes inneuropsychological functions. In this study, we investigated the effect of a short-termintensive inpatient rehabilitation program lasting 2 or 3 weeks on motor and non-motorsymptoms, motor ability, and neuropsychological functions in hospitalized patients withPD.Methods:We enrolled 15 patients with PD (7 men, 8 women; mean age, 75.1±6.5 years; Hoehn andYahr stages III/IV, 12/3). The rehabilitation program included physical, occupational,and speech-language therapies and was implemented daily for 2 or 3 weeks. Motor andnon-motor symptoms as well as motor abilities were assessed using the Movement DisordersSociety Unified Parkinson’s Disease Rating Scale, Functional Independence Measure,Parkinson’s Disease Questionnaire-39, and other assessments. Neuropsychologicalfunctions were evaluated using Japanese versions of the Mini-Mental State Examinationand Frontal Assessment Battery and using the CogEvo (computerized cognitive functionevaluation) tool. Scores were compared before and after intervention.Results:This short-term inpatient rehabilitation therapy significantly improved motor andnon-motor symptoms, motor abilities, reality orientation as assessed by CogEvo, and theoverall quality of life.Conclusions:The results of this study suggest that short-term intensive rehabilitation in patientswith PD may achieve favorable outcomes even within a limited timeframe. Furtherdiscussion of the appropriate duration of inpatient rehabilitation for patients with PDis warranted.

Purpose The study explores leadership agility (LA) in Indian organizations. With a scarcity of scholarly literature and research on the subject matter, there remains a conspicuous dearth of primary research investigations that systematically investigate the notion of LA and its potential ramifications on leaders and organizations. Design/methodology/approach The present study employs a grounded theory methodology to explore the concept of LA. This is achieved by administering 11 in-depth interviews with senior executives representing diverse organizational backgrounds in India. Purposive and theoretical sampling was used to select the study participants. The study employs open, axial and selective coding of the interview transcripts using Delve software. Findings The study findings report two distinct factors (internal and external), which are further explained by seven unique dimensions that contribute to the concept of LA. The three inward-focused dimensions are emotional intelligence, strong value orientation and purpose and fulfillment, whereas the four outward-focused dimensions are reality orientation, coach, change champion and stakeholder orientation. Originality/value The current study is the first systematic empirical investigation of LA in the organizational context. This research aims to enhance LA’s global understanding and conceptualization by contributing to the extant literature. Finally, it is anticipated that the outcomes of this study will provide valuable insights for enhancing leadership development strategies and contribute to leaders’ comprehension of effective approaches for managing the frequent and unforeseen obstacles encountered in contemporary business environments.

Neurodegenerative disorders represent a public health problem with an increasing prevalence worldwide, with Alzheimer's disease (AD) being the most commonly diagnosed, accounting for 60-70% of cases in people over 65 years of age. AD causes problems in memory, thinking and behaviour, its symptoms develop slowly and worsen over time. Despite being an incurable disease, there are pharmacological and non-pharmacological treatments that can alleviate the effects of AD. The aim of the present work was to perform a narrative review of the main treatments used for the cognitive deficits of this disease. Among the pharmacological treatments, those indicated according to the stage of the disease are discussed, such as cholinesterase inhibitors, immunotherapy, N-methyl-D-aspartate (NMDA) antagonists, among others. Likewise, non-pharmacological treatments include strategies that have been used for cognitive stimulation and rehabilitation, reality orientation and reminiscence therapy, sensory stimulation techniques, among others. In conclusion, the combination of both treatments proves to be more effective in delaying deterioration in patients with AD, in addition, it is worth mentioning that, within the non-pharmacological treatments, cognitive stimulation is the most used strategy either alone or in combination with others to maintain cognitive and social functions and other activities of daily living, that is, the effectiveness of treatments may depend on the combination of appropriate actions.

Cognitive stimulation enhancing memory and mental function.

Purpose: In the face of dynamic market changes, economic uncertainty, and increasing competition, businesses must demonstrate the ability to adapt and respond swiftly to evolving conditions. Entrepreneurial orientation—encompassing innovation, risk-taking, and the pursuit of new market opportunities—serves as a key factor supporting small and medium-sized enterprises (SMEs) in achieving sustainable success. This study aims to identify how entrepreneurial orientation influences companies' ability to adapt, manage risk, and seize emerging opportunities within a rapidly changing economic environment. The analysis offers valuable insights into strategies that can foster business growth in the context of the new market reality. Design/methodology/approach: The study was conducted on a sample of 53 SMEs using survey questionnaires designed to assess four variables: entrepreneurial orientation, adaptability, resilience to market uncertainty, and the ability to seize new market opportunities. The data were analyzed statistically, including the calculation of means, standard deviations, and examination of relationships between variables. Findings: The results indicate a high level of entrepreneurial orientation (mean = 3.85) among the surveyed firms, reflecting their readiness to innovate, take risks, and explore new opportunities. Adaptability scored an average of 4.05, suggesting that these firms are flexible in responding to changing market conditions. Resilience to market uncertainty had a mean of 3.88, indicating a moderate capacity to manage risk. The ability to seize new market opportunities received the highest average score (4.17), demonstrating strong competitiveness among the participating firms. Originality/value: This study contributes significantly to the understanding of the role entrepreneurial orientation plays in enhancing the adaptability and opportunity exploitation capabilities of SMEs amid dynamic economic shifts. The findings offer valuable guidance for practitioners and policymakers seeking to support SME development in uncertain market conditions and provide practical recommendations for improving strategic management in these firms. Keywords: entrepreneurship, entrepreneurial orientation, dimensions of entrepreneurial orientation. Category of the paper: Research paper.

Humankind has always coexisted with other species: its mimetic features and abilities, which include science and art, as well as the graphical user interface that appears at their intersection, express empathy, understanding, premonition, receptivity and adaptation to the complex dynamics of other species, to being among them. At the same time, the interface is considered exclusively as an “anthropological machine,” i.e. as a technical and symbolic representation of the idea of the “absence” of “nature” in man, creating conditions for rupture and isolation with the original factors of mimesis, stirs the need to compensate nature, hypostasis, fantasmatize, stigmatize, etc. — i.e., to think of the experience of nature in terms of a collision with a monster or catastrophe, and to expect salvation from AI, artificial intelligence. Therefore, in order to adequately think through and evaluate interfaces, it is necessary to return to the most “natural” intelligence — mimesis, autopoiesis, biophilia, live communication — it is necessary to give a word to nature, i.e., to take into account the experience of non-human beings, animals, their behavior, communication, dynamics, everything that was considered in the exclusively functional assessment of interfaces rather, “noises,” “interference”. In fact, in order for the interface to express our characteristics, take into account certain aspects of character and behavior, and give us a sense of attention and care, it is necessary that it interact not so much with “pure consciousness” as with our physicality, responding to existential patterns, “deep time” enclosed in our physicality by evolutionary processes, pre-predictive ways of our presence and orientation in reality. We need not only linguistic, neural network, large, etc. data, but also “live” data — for this purpose, the article examines and analyzes the experiences of interaction with animals in interfaces, the features of biophilic information and animalistic design, the participation of animals in the design of interface shells as living environments.

The research problem was related to the search for appropriate parameters relevant to the tools that support spatial orientation in large-scale building plans. This problem was addressed by selecting the optimal (1) observation perspective (passerby perspective, bird-eye view perspective, top–down view perspective) in a non-immersive virtual reality (VR) and (2) the presentation dimensionality (2D/3D). The perception of the plans was analysed taking into account such independent variables as gender and the individual level of spatial orientation of the study participants, determined based on the Santa Barbara Sense of Direction (SBSOD) and the Mental Rotation tests (MRT). In the research conducted in 2021 on a sample of 103 people, the experimental methodology involved the comparison of preferences of the study participants in terms of geovisualisation before and after getting to know the real tourism space. The results showed the compliance of preferences, i.e. recognition as the optimal plan in 2D dimensionality and the top–down view perspective. No statistically significant differences in spatial orientation due to gender or individual predispositions measured by the SBSOD and the MRT tests were confirmed.

INTRODUCTION: Insecure attachment styles are associated with mental health problems and may influence reality perception. This study investigated the link between attachment styles and reality-testing impairment in individuals with schizophrenia. A cross-sectional survey with 200 participants diagnosed with schizophrenia assessed their attachment styles (Psychosis Attachment Measure) and reality-testing abilities (Bell Reality Testing Inventory). A significant positive correlation emerged between insecure attachment and poorer reality testing (r = .394, p < .001). Avoidant attachment was most prevalent (mean scores: 17.01, SD = 3.71), followed by anxious attachment (16.53, SD = 4.20). Reality-testing impairment manifested across all three domains: uncertainty of perception (7.16, SD = 2.45), reality distortion (3.52, SD = 1.21), and hallucinations/delusions (26.63, SD = 5.83). Interestingly, specific demographics (male, unmarried, 40-50 years old) and those with a duration of illness of less than 5 years had higher mean scores (27.35, SD = 5.61). Insecure attachment styles, notably anxious and avoidant, are dominant among clients with schizophrenia, who also struggle with reality distortion, perceptual uncertainty, and hallucinations/delusions in all three domains. Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured, and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Oriented Psycho-Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality-testing impairment. Fostering Maternal and Child Health (MCH) centers on empathizing secure bonds between mothers (and mothers-to-be) and their children to promote healthy attachment styles as a preventive measure.

Delusions are beliefs held by patients that contradict reality and are entrenched, making them resistant to logical persuasion by others. These beliefs stem from the patient's perception of losing control. A preliminary survey conducted in the maintenance ward of a Mental Hospital revealed cases of schizophrenia with nursing issues related to thought process disorders, particularly delusions of suspicion. The objective of this case study was to assess the efficacy of reality orientation therapy in schizophrenic patients with nursing issues concerning thought process disorders, specifically delusions, within the maintenance ward of a mental hospital. This case study employed a nursing care approach involving assessment, observation, and the implementation of reality orientation therapy over a 6-day period in the maintenance ward of a mental hospital. Following assessment, it was found that the patient expressed suspicion towards family and neighbours, repeatedly stating these beliefs. After implementing strategies targeting delusions I-V, the patient exhibited a return to reality orientation. Through continuous psychiatric therapy, including reality orientation therapy over 6 days, combined with non-pharmacological interventions, delusional behaviours in patients were significantly reduced.

William James’ “stream of thought” is a key component of human cognition. Such thoughts arise in both restricted and unrestricted contexts, either with or without the presence of a secondary task. This study examines the similarities and differences in thoughts produced in these two contexts, which we call restricted and unrestricted mind wandering. Participants performed a mindfulness task representing restricted mind wandering and an unrestricted thought task where they spontaneously explored thoughts, reporting them as they arose. Participants then self-rated their thoughts based on valence, temporal orientation (past/present/future), and reality orientation (imaginary vs. real). Participants’ emotional states were also evaluated using the Emotion Recall Task (ERT) and the PANAS questionnaire. Unrestricted mind wandering generated more thoughts, which were more positive and future-oriented than those in restricted mind wandering. Additionally, participants’ thought valence correlated with their PANAS and ERT scores. Approximately 1 out of 4 thoughts in both restricted and unrestricted mind wandering were imaginary, with increased future orientation linked to more imaginative thought. Despite the statistical differences separating restricted and unrestricted thought, effect sizes were predominantly small, indicating that the thoughts arise during these two types of mind wandering are largely of the same kind.

Severe acquired brain injury (SABI) is a leading cause of death and disability, and it is defined as a brain injury that occurs after birth due to traumatic or non-traumatic causes. Reality orientation therapy (ROT) uses repeated time-place-person orientation and meaningful stimuli to develop a better understanding of the environment and has great potential as an effective strategy to improve cognitive and behavioral functioning. This study aims to investigate the feasibility and potential effects of virtual reality orientation therapy (VR-rot) on optimizing cognitive and behavioral functioning and depressive symptoms post-SABI. Forty patients with SABI were enrolled from October 2022 to December 2023 and divided into two groups: the experimental group (EG, n = 20) received VR_rot, while the control group (CG, n = 20) received standard ROT (S_rot). All patients were evaluated with a psychometric battery, including the Mini-Mental State Examination (MMSE) and the Hamilton Rating Scale for Depression (HRS-D), administered before (T0) and after the end (T1) of rehabilitation. Within-group comparisons indicated a statistically significant change in MMSE scores from T0 to T1 in the EG and CG, with the EG showing a greater improvement than the CG. Regarding HRS-D scores, the EG showed a statistically significant change. VR-ROT could be a valuable tool for improving cognitive-behavioral functioning in SABI patients. The VRRS can help reduce depressive symptoms and improve the reality orientation deficit caused by traumatic brain injury and stroke on brain tissue. This study highlights the benefits of virtual reality.

Alzheimer's disease (AD) is a neurodegenerative condition characterized by cognitive decline and functional impairment. This study compares conventional intervention techniques with emerging artificial intelligence (AI) approaches to AD. Intervention technique refers to a specific method or approach employed to bring about positive change in a particular situation. In the context of AD, such techniques are crucial as they aim to slow down the progression of symptoms, alleviate behavioral challenges, and support patients and their caretakers in managing the complexities of the condition. Conventional intervention techniques, such as cognitive stimulation and reality orientation, have demonstrated benefits in improving cognitive function and emotional well-being. Conventional intervention approaches are widely preferred as they have a proven track record of effectiveness, personalized response, cost-effectiveness, and patient-centered care. Despite these benefits, they are limited by individual variability in response and long-term effectiveness. On the other hand, AI-based approaches such as Computer Vision and Deep Learning (DL) hold the potential to revolutionize Alzheimer's interventions. These technologies offer early detection, personalized care, and remote monitoring capabilities. They can provide tailored interventions, assist decision-making, and enhance caregiver support. Although AI-based interventions face challenges such as data privacy and implementation complexity, their potential to transform Alzheimer's care is significant. This research paper compares conventional and AI-based approaches. It reveals that while traditional techniques are well-established and have proven benefits, AI-based interventions offer novel opportunities for personalized and advanced care. Combining the strengths of both approaches may lead to more comprehensive and effective interventions for individuals with AD. Continued research and collaboration are crucial to harness the full potential of AI in improving Alzheimer's care and enhancing the quality of life for affected individuals and their caregivers.