Iris Publishers-Open access Journal of Biology & Life Sciences | The Discovery of Human Magnetic Tropism

 

Authored by James T Struck*,

Introduction

We all know from our botany classes that plants exhibit tropism. A plant will turn towards the Sun or magnetic fields will affect the growth of a plant. There is some evidence that tropism happens in humans as well with regard to the Magnetic Pole.

Discussion

The Dutch and Norwegians are among the tallest group of homos sapiens [1] Many of the tallest nations are Montenegro, Germany, and countries like Slovenia and Croatia. A possible explanation for that increased height is proximity to the North Magnetic Pole.

“The north magnetic pole, also known as the magnetic north pole, is a point on the surface of Earth’s Northern Hemisphere at which the planet’s magnetic field points vertically downward (in other words, if a magnetic compass needle is allowed to rotate in three dimensions, it will point straight down). There is only one location where this occurs, near (but distinct from) the geographic north pole. The geomagnetic north pole is the northern antipodal pole of an ideal dipole model of the Earth’s magnetic field, which is the most closely fitting model of Earth’s actual magnetic field [2].

The top 5 groups of human nations in Bill Bostock’s list are Netherlands, Latvia, Estonia, Denmark, Czech Republic.” [2].

Conclusion

We conclude there exists possible tropism or growth towards the north magnetic pole among humans. Something else may be increasing growth and height among Europeans, but that topic is open to discussion like better diet and nutrition.

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Iris Publishers-Open access Journal of Complementary & Alternative Medicine | Maxillary Sinusitis of Odontogenic Origin

 

Authored by Vasile Cabac*,

Summary

We present a retrospective study, which was performed on a batch of 177 patients diagnosed with maxillary sinusitis, selected from the total number of patients with OMF disorders during 2017-2018. The patients were examined and treated at the Department of Emergency Medicine of the Institute of Emergency Medicine, Chisinau. The article contains statistical data on odontogenic maxillary sinusitis and the breakdown by age, sex, profession, etiology, addressability, place of life, hospitalization, causal tooth and treatment methods. Results: Out of the total number of 3227 patients with OMF, maxillary sinusitis (5.48%) was established for 177 patients. The majority of the patients 52.54% are from Chisinau. The most affected are the patients aged 31-40 years, constituting 26.56%, the majority being male persons 63.27%. Admission to the medical institution prevailed for 74.01% of the cases by itself, and the medical insurance was presented for 77.97%. Hospitalization of patients ranged from 1-5 days to 55.35%. The frequency of teeth involved in the inflammatory processes of the sinus was 41.78% cases, of which 1st molar prevails with 23.16%, thus being an etiological factor. As a surgical treatment of maxillary sinusitis in the section of oro-maxillofacial surgery, radical cure is used for 58.75% cases.

Keywords:Maxillary sinus; Odontogenic sinusitis; Frequency of odontogenic infection; Surgical treatment

Introduction

Maxillary sinusitis of dental origin is quite common for adults and elderly, being less commonly seen at children and young people. This is explained by the close anatomical relationships that exist between the sinus and the dental system. An important part of the pathology of the maxillary sinus is related to the periapical diseases of the teeth, to the maneuvers of the endodontic treatment, as well as to the traumatization of the floor during and after various surgical manipulations on the teeth of the upper arch [1,2]. According to the data presented by Hîțu D, since 2008, odontogenic sinusitis constitutes 2% of the total number of patients with inflammatory disorders treated in the oro-maxillofacial surgery department [3]. Banuh I. (2010) report from a study conducted in 2008, that out of the total number of patients treated in the oro-maxillo-facial surgery section of CNȘPMU, patients with inflammatory and traumatic processes of the maxillary sinus had constituted 1.83% [4]. In 2018 Ryan E. Little states that 10% of the total number of patients with oro-maxillofacial inflammatory disorders in the United States is odontogenic sinusitis, and a study of 674 patients diagnosed with maxillary sinusitis showed that for 65.7% of cases, the etiological factor was odontogenic [5]. Odontogenic maxillary sinusitis does not have a stable frequency confirming this fact through the mentioned publications. The cause of the variation is based on the multifactorial etiology, the demographic variation as well as the predisposing factors to this pathology: overgrowth, hypoavitaminosis, immunodeficiency etc. [6]. Thus, the multifactorial etiology requires us to establish a method of diagnosis and correct complex treatment and to prevent the possible complications with the unconditional involvement of the specialists in the oro-maxillo-facial area.

The Purpose of the Study

Statistical analysis of patients with odontogenic maxillary sinusitis during the years 2017-2018.

Materials and methods

The study method used was the clinical-statistical, retrospective, based on a mixed analytical and descriptive research, using articles on the topic available in medical information search databases: PubMed, PMC, Hinari, Cyberleninka as well as specialty books, in a total of 135 articles were analyzed, of which 36 were selected. Also, in order to reach the basic goal, a batch of 177 patients diagnosed with maxillary sinusitis were examined. The standard protocol for inclusion in the batch was followed, having as reference the medical records, which included: the etiology of maxillary sinusitis, age, sex, place of life, profession, type of medical insurance, entitlement to the medical institution, how many days the patient was hospitalized, the diagnosis, type of anesthesia and treatment. The statistics: t-Student. The patients were selected from the total number of patients with OMF disorders during the years 2017-2018, which were examined and treated at the Department of Maxillofacial Surgery of the Institute of Emergency Medicine, Chisinau.

Results and Discussions

During 2 years in the Department of Surgery Oro-Maxilo-Facial, 3227 patients were treated, of which 177 patients were maxillary sinusitis, accounting for 5.48% of the total number of patients Table 1. As the number of beds in the ward remained the same, the number of the population and the birth rate decreased, as well as the number of patients decreased from 1748 patients in 2017 to 1479 patients in 2018 with 269 patients constituting 8.33%. According to the represented data, the number of patients with maxillary sinusitis is decreasing from 95 patients in 2017 to 82 patients in 2018, so with 13 patients their number has decreased (Table 1).

Table 1: Number of patients with sinusitis hospitalized during the study period.

to the study conducted by Banuh I, out of the total number of patients treated in the oro-maxillo-facial surgery section within the CNȘPMU, in 2008 patients with inflammatory and traumatic processes of the maxillary sinus constituted 1.83% [3]. Mortuaire G. following a study conducted in 2017 for a period of 6 years states that the number of patients with odontogenic maxillary sinusitis increased by 1.7% from 32% in 2007 to 43% in 2013 [7]. From the analyzed statistical data and the data processed in the study we observe a variability of the percentage of maxillary sinusitis, the exact frequency remains uncertain. As a result of the processing of the data from the group of patients, they were distributed according to the gender, with 112 men representing 63.27% and 65 women, which constituted 36.73%. From the statistical data, men with a higher evident predisposition to sinus pathology are highlighted, the ratio being 26.5% Figure 1. We note the prevalence of men in the research conducted by Hâţu I. for the year 2015, which carried out a study on 93 patients with maxillary sinusitis, it reports that male persons have 55.9% and women 44.1% [8] (Figure 1).

According to Ryan E. Little data for 2018, most female patients suffer from sinusitis with a slight prevalence of 50.3% [5]. Probably the predisposition is due to the different anatomical particularities depending on the gender, namely the size of the maxillary sinuses was smaller in men than in women, and the left sinus is larger than the right one, also another causal factor could be the working conditions, smoking [9,10]. Following the retrospective study for the years 2017-2018, it was found that the largest number of patients belong to the age group 31-40 years, which constitutes 47 patients (26.56%), followed by patients aged 51-60 years in number of 37 people (19.21%). We note that the number of patients with other ages does not vary considerably, with the exception of patients up to 20 years registered with 4 cases of maxillary sinusitis (Table 2).

Table 2: Age analysis.

Burlibașa C. in the specialty literature argues that according to the age distribution of patients with odontogenic sinusitis, an increased frequency was found for the age between 26 and 40 years (53.4%) [6,11]. In the same study, Șcerbatiuc D. argues that the average age of patients with maxillary sinusitis is between 30- 50 years [4,12]. According to the 2017-2018 study, the patients most frequently affected by odontogenic maxillary sinusitis were the patients with the age range 31-40 years, the number being 47 patients Table 2 (Figure 2).

According to the environment of origin Figure 2, in the study group the urban environment prevails with 134 patients (75.70%), followed by the rural environment 43 patients (24.30%). Amărăscu M. also reveals similar data in the study carried out in 2014, namely that the majority of patients with sinus disorders are from urban areas 54.33% and from rural areas 45.67% patients [10] (Table 3).

Table 3: Distribution according to medical insurance.

Analyzing the data from Table 3, according to the medical insurance, we observe that the insured patients make up the majority 77.97%, and those against 22.03%. The study conducted by Cazacu C. and the collaborators for 2015 offers data such that persons with compulsory health insurance are 68.8%, against payment 27.95%, and socially vulnerable persons 3.2% [13]. According to the address for the medical assistance during the years 2017-2018 in the study group we observe patients who addressed themselves to the medical institution 131 (74.01%), followed by those with rectification 29 (16.38%), and transported with the ambulance there were 17 (9.61%) patients (Figure 3).

According to data reported by ЕВ Kucherova, the number of patients who addressed the nurse at the medical institution for 2006-2007 was 70.3%, with rectification 23.5%, and those transported by ambulance 6.2% patients [14]. Similar data were obtained in another study where the address of the patients of the self-employed was 57%, with rectification 35.5%, and the ambulance transport 6.5% patients [15] (Table 4).

Table 4: Distribution according to the days of hospitalization.

Also the data of the study show that the optimal number of patients who addressed and were hospitalized for 1-5 days was 98 (55.37%) cases, for the forms of sinusitis less complicated, and the patients who were treated from 6 to 10 days constituted 64 (36.16%), followed by those who were hospitalized for 11-15 days was 10 (5.65%) The data provided by Epure V. and al., for 2014 report that the major number of distributions according to the days of hospitalization is 5 days (57.3%) [10] (Figure 4).

During the years 2017-2018 we observe the prevalence of workers, which constitutes on average 49.72%, followed by the homeless 33.9%, students 2.26%, retirees 10.17% and invalids 3.95%. Similar data were obtained in the research for 2009. The distribution by social categories was as follows: the workers 47.3%, followed by the homeless 31.2%, the students 2.2%, the retirees 8.6% and the disabled persons with 10, 8% of cases [16]. According to the study we deduce that a major cause of maxillary sinusitis is represented by the tumor affections 8.47% followed by the fungal sinusitis with 5.64% and the post-implant sinusitis with 4.51% of the cases (Table 5).

Table 5: Sinusitis distribution according to the etiological factor.

We also find in the work of Hîțu D, where the tumor factor is the cause of sinusitis for 18.5% cases, having the first place [17]. Puglisi S, following the study carried out for 3 years, found: out of 59 patients with chronic maxillary sinusitis 47 were with sinusitis of nonodontogenic origin, and 12 with sinusitis of odontogenic origin, mentioning that in most cases nonodontogenic sinusitis had polymicrobial origin (75%) [18]. Following an analysis by Oscar A. in 2010, regarding 41 articles including 770 cases from 1986- 2007, the etiology of sinusitis was found to be the iatrogenic cause with a frequency of 55.79% of the cases including: complications of periodontitis 40.38%, odontogenic cyst 6.66%, complications following dental extraction 47.56%, oro-sinus communications 19.72%, extrusion of sinus filling materials 22.27%, apicoectomies for 5.33% in some cases, post-implant sinusitis 4.17%, and sinusitis following the implantation of sinuses for 0.92% of cases [19]. According to the retrospective study over two years, we deduce that the most involved causal tooth is the first upper molar for 23.16% of cases, the second upper molar for 7.90% cases, the first premolar for 3.95% cases, the second premolar for 4.01% cases and the third molar 0.56% cases (Figure 5).

The study carried out by Mighic A on a group of 27 patients diagnosed with odontogenic maxillary sinusitis reports that the most commonly involved causal tooth was the first upper molar in 17 cases (47%), the second molar in 8 cases (22%), the first premolar. in 5 cases (14%), and the third molar in one case (3%) [20]. A study conducted for 2013 on a batch of patients diagnosed with odontogenic maxillary sinusitis reports that from the point of view of the teeth involved in the sinus pathological process, it was noticed that the first molar 1 with an incidence of 55.12%, in the second place there is molar 2 with an incidence of 32.28%, followed by premolars with 25.98 [13] (Figure 6).

According to the study, the most commonly applied method of surgical treatment in odontogenic maxillary sinusitis is the Caldwell- Luc procedure, for 58.75% of cases, followed by COS plastic for 40.67% cases and endoscopic treatment for 15.81%. According to data reported by Ryan E. Little and co-workers in 2018, the treatment method used to treat maxillary sinusitis was endoscopic by 14% of cases [5]. While Guțan A. in the study performed on 70 patients out of which 39 patients with the presence of the oro-antral fistula after dental extractions states that external access is not necessary once the causal factor is removed [21,22]. Hernando J. considers that the sinus mucosa after a chronic inflammatory process of dental cause is no longer treatable and therefore proposes for treatment radical treatment as more effective [23]. Mighic A, after analyzing a batch of 27 patients, established a success rate of 80% starting treatment with the elimination of the causal factor of odontogenic sinusitis, as afterwards the need to apply surgical treatment [20]. Even though the technique of the endoscopic approach compared to the classical one has much more impressive results, especially in order to express the degree of pain and the postoperative edema is approached differently by the specialists [24-36], so based on the information studied and the retrospective study, we affirm that odontogenic maxillary sinusitis has a multifactorial etiology and must be approached according to each case for successful results.

Conclusion

• During 2 years with odontogenic maxillary sinusitis, accounting for 5.48% of the total number.

• The causal tooth was the first upper molar for 23.16% of cases.

• The method of surgical treatment in odontogenic maxillary sinusitis was the Caldwell-Luc procedure for 58.75% of cases.

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Iris Publishers-Open access Journal of Textile Science & Fashion Technology | Enhancing Design Ability Through Experiential Learning in Textile Design Education

 

Authored by Wenliang Xue*,

Abstract

The major of textile design at Donghua University is a double bachelor’s degrees program that was supported by Shanghai Academic Degrees Committee, integrating the discipline of design and textile engineering. This study presented a series of practical courses in four semesters from the sophomore year to senior year, to help undergraduate textile design students enhance their product design skills and abilities through experiential learning. The practical curriculum design, implementation process and learning outcomes are introduced in the paper. Results in the study not only reveal the method to embed experiential learning theory into practical courses, but also indicate the importance of learning-by-doing philosophy in higher-education.

Introduction

Textile education has been developed for more than one century. As early as 1900s, textile schools were founded to cultivate skilled textile engineers for the local industry, and at that time, almost all countries in the world had schools, institutions or universities in textiles [1]. In the past, textile education focused on techniques in the traditional textile and clothing industry. The globalization of textile production and trade has changed the landscape of the worldwide textile industry. Especially in China emerging as the world’s main producer of textiles, the textile industry is transforming and upgrading from traditional manufacturing to high-end production with innovation and original design [2]. At present, Cultivation of interdisciplinary talents becomes more and more important. Donghua University as the most famous Chinese university in textiles located in Shanghai, is the former East-China Textile Institute of Science and Technology and have launched some educational reform programs to promote interdisciplinary.

In 2020, Shanghai Academic Degrees Committee approved an interdisciplinary talent training program for textile design major with double bachelor’s degrees integrated disciplines of Design and Textile Engineering. This textile design major aims to cultivate undergraduate students taking textile technology as a foundation, market as a direction and art design as a feature. It is important for textile design students to acquire practical experiences and product design opportunities. Current courses emphasize theoretical teaching rather than practical, so instruction in the classroom is difficult to support students achieve practical ability. In order to train interdisciplinary undergraduate students with a good understanding of design, market and textile technology, a novel practical curriculum system was developed to implement studentcentered experiential learning from the sophomore to senior year, enhancing students’ design skills and abilities through learning by doing.

Experiential Learning Theory

Engineering education has emphasized dynamic, learnercentered experiences that actively engage students with actual materials to connect theoretical knowledge and practical skills [3]. Design is a complex field that involves both practice and academic discipline [4], and design education has responded to increasing complexity and systemic transformations [5]. One educational approach that integrated design and engineering education is student-centered experiential learning. The practical course context described in this paper was informed by experiential learning theory (ELT). Experiential learning is characterized by the practical experiences and embeddedness in real work tasks [6,7]. There are many forms of experiential learning such as case studies, labs, university-industry cooperation, project-based learning, performance-based learning and others, and the activities in all these forms are significantly different from traditional, teachercentered textbook-style ways [8-10]. One of the most popular contemporary experiential learning theories is proposed by David Kolb, who presents an experiential learning cycle [11-12]. As shown in Figure 1, the cycle is divided into grasping experience and transforming experience, including four stages from concrete experience, reflective observation, abstract conceptualization to active experimentation. This experiential learning cycle has been applied in education of different disciplines. Chen introduced the chemical engineering’s Discovery Laboratory at Imperial College London to implement student-centered project-based learning and the course in the lab module was designed based on the ELT of David Kolb [13]. William O’Brien et.al. presented living labs as an opportunity for experiential learning in building engineering education, and assess the teaching and learning effectiveness [14]. An industry-academia strategy was developed to help undergraduate sport management students enhance employability through practical experiential learning in a specific sporting event [15].

In practical disciplines such as textile engineering, experiential learning could be a useful approach to improve student professional and practical skills, especially when education of textile engineering is integrated with design education, practical experiences are extremely essential to enhance the ability to design textile products and solve real-world tasks in the textile and apparel industry. The study in this paper focuses on practical courses that were designed based on experiential learning from spring term of sophomore year (2nd year) to fall term of senior year (4th year).

Practical Course Design and Implementation

For students majoring in textile design at the College of Textiles, Donghua University, the course module is divided into four parts, including Platform Courses, Major Core Courses, Major Elective Courses and Practical Courses (Figure 2). In addition to courses on textile engineering, Textile Design and Textile Supply Chain are two core courses for textile design major, incorporating the textile product design process from idea generation to product launching, as well as the supply chain process from raw materials to merchandise. Moreover, major elective courses relevant to design and marketing are provided to complement extra fundamental knowledge in design and marketing principles. Students have to complete required credits on those theoretical courses in four semesters from spring term of 2nd year to fall term of 4th year. At the same time, four practical courses are implemented in each semester, and professors in university and experts from industry are invited to give lectures or seminars to students.

Practical course description

The pedagogical design of the four practical courses is based on the Experimental Learning Theory of David Kolb.

• Practical course I (PC I) on Spring term of sophomore year incorporates hand weaving, braiding, hand embroidery, tie-dye, batik and other textile crafts techniques. This course aims at the development of design skills using various materials to form textile products, and experiences of finishing the handmade fabrics help students understand the basic elements of textile structures and their properties.

• Practical course II (PC II) on Fall term of junior year allows the students to implement textile design ideas into physical yarns and fabrics using semi-automatic loom, hand knitting machine and sample spinning machine. Contexts in this course compose of principles and elements in spinning, weaving and knitting, enabling students to experience the product design and development process similar to using industrial facilities.

• Practical course (PC III) on Spring term of Junior year emphasizes entrepreneurship and innovation in textile design. The course incorporates lectures from industry experts for understanding of the new product development process in the industry. According to case studies and experiences obtained from other theoretical and practical courses, the students in groups are asked to provide a proposal, which can present their design ideas with textile technologies, target markets and other strategies for developing the new product.

• Practical course (PC IV) on Fall term of Senior year provides specialty interns in textile companies. Students are organized in groups to complete a 4-weeks internship that a textile design project is offered by the company and needs to be finished by group students.

The four practical courses are gradually implemented in four semesters with different levels of complexity. The students can apply the fundamentals of product design and textile engineering in practical courses and then enhance their textile design skills and abilities through in-depth experience learning from cognition, reflection, conception to active practice.

Gradually implementation process

Figure 3 shows the gradually implementation of four practical courses from the spring term of sophomore year to the fall term of junior year, and students’ design ability is increasing with more practical experiences. There were 60-70 undergraduate students enrolled in one practical course for each semester. The performance of students in every practical course was evaluated in the Experiential Learning Cycle (Figure 1) from concrete experience, reflective observation, abstract conceptualization to active experimentation.

In practical course I, eight professors in the College of Textiles at Donghua University joined in teaching the craft textile design courses in two weeks at the end of sophomore spring term, and each professor was in charge of one or two handcraft techniques. In the first week, professors provided information about different textile handcraft skills, and students could learn methods, principles, tools and cases of each craft skill. The students in this stage obtained concrete experiences and reflective observation. In the second week, after thinking about how to integrate multiple skills and materials in textile design, students were required to complete their own handcraft portfolio and present at the end of the course. This means students engage with abstract conceptualization and active experimentation. The assignments in PC I included a report of fabric analysis and two handcrafts. The report was a summative assessment, which was conducted by professors. The handcrafts portfolio that presented by the designer was conducted by both professors and the students themselves. Moreover, to improve students’ motivation, a textile handcraft competition was held when the course was completed, and top 30 handcrafts were elected and exhibited in Shanghai Textile Museum (Figure 4).

Practical course II was implemented in two weeks at the end of junior fall term, and four professors in the college gave lectures on machine operation, and two industry experts were invited to show some successful commercial fabrics to students. The students went through the experience learning cycle, and created their own designed yarns, woven or knitted fabrics on sample machines. The assessment in PC II was also divided into summative report that indicated how the students completed yarn or fabric samples, and presentation boards that illustrated design theme, inspirations, patterns, structure design and fabric samples. The reports were conducted by professors and the design presentation was evaluated by both students, professors and industrial experts. At the end of the course, those excellent design boards would be exhibited on campus for taking a motivational effect (Figure 5). Practical course III was also implemented in two weeks at the end of junior spring term. Two professors in the college and four industry experts were invited to give lectures on product design and development process. The students could learn and think how textile products were designed and developed in real world. After going through reflection observation and abstract conception in the experiential learning cycle, the students were required to provide a new product proposal and take simulated commercial roadshow, which would be evaluated by industrial experts. This method provides students with exposure in simulated work environment to develop their skills and abilities before graduation (Figure 6).

Previous three practical courses were executed on campus, but the practical course IV that focused on specialty practice was implemented in companies. 5-10 students in one team took a 4-week internship in different companies, which run business on textile manufacturing or textile home/apparel brand. During the internship practical course, each team was required to join in a real project offered by the company and the students were supervised by one professor in the college and one expert/manager in the company. The students could apply knowledge and experiences that they learned from theoretical and practical courses to complete the project. At the end of this course, the students prepared a summary of the project and took a presentation that showed what they did and learned in the internship. A panel of professors with experience in the industry would evaluate students’ learning outcomes (Figure 7).

As David Kolb states that “learning is the best conceived as a process, not in terms of outcomes” [16], the assessment in each practical course has a distributed weightage over the entire learning process instead of just assessing the final report alone. For example, in practical course IV, the participant and intern summary accounts for 40% of the overall mark, whereas the final team report accounts for 40% and evaluation from the company accounts for the remaining 20%.

Learning Outcomes

In practical course I and II, following the experiential learning cycle, students need to have concrete learning and reflective thinking of textile design methodology, and then they had to do a design survey to find inspirations. Finally, different materials and producing methods can be used to implement their design ideas into textile products. More than sixty handcrafted textiles and machine woven or knitted fabrics were created by students. Figure 8 shows two student design works, the left one was a recreation of cyanotype fabrics and hand embroidery that inspirated by marine animals, and the woven fabric on the right broad was inspirated by windows of ancient buildings. The students in these courses were responsible for organizing an exhibition in the activity center of the university to show their work. In addition, top 30 design works that were elected by professors in the university and experts in industry could be exhibited in Shanghai Textile Museum for one year.

In practical III and IV, the students have more chances to communicate and work with experts in the industry, and they can learn about the methods and tools used in the real-world product development process. They also gain employment experiences in team work and internship before leaving the university. Moreover, the students in these courses provided more than 20 proposals in textile product design and development, and five of them were applied and funded by National or Shanghai Innovation and Entrepreneurship Program for College students (Figure 8).

As reflective teaching helps improve the teaching-learning process, a reflection forum was held at the end of fall semester in each year to discuss how the practical courses carried out in the past year and to obtain feedbacks from students and industry experts. The students highlighted that the practical courses provided experiential opportunities to express their design ideas and learn the real-world projects. Industry experts emphasized that experiential learning integrated university and industry was very essential in university training and allowed students to prepare them for future professional activities.

Conclusions

The use of experiential learning theory (ELT) in the practical courses has helped textile design students to implement the knowledge learned both in textile engineering technologies and design courses to create practical product design solution and produce physical sample products. Also, practical courses based on ELT allow the students to understand the product design methodology and the product development process in the textile and apparel industry. The four practical courses established in the College of Textiles at Donghua University have provided gradually training of students from sophomore year to senior year and have achieved positive feedback from both students and industry experts.

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Iris Publishers-Open access Journal of Neurology & Neuroscience | The Neuroscience of Motivational Interviewing

 

Authored by Papaioannou-Spiroulia A*,

Introduction

Psychosocial interventions have found increased success over the last few decades in resolving dysfunctional behaviors addressing malignant cognitions and attitudes, including addictive and compulsive behaviors, anxiety disorders, eating and feeding disorders and patients’ dealing with chronic pain issues [1-3]. Motivational Interviewing (MI) aims to alter dysfunctional attitudes and beliefs with the ultimate goal of changing the clients’ undesired behaviors. Specifically, MI, with verbal interaction as its main tool, focuses on the development and empowerment of the individuals’ motivation to make the desired change [4,5]. In other words, MI is a client-centered directive method for enhancing inner motivation to change negative behavior by exploring and resolving ambivalence [6].

While most of research revolving around this topic focuses on the relationship between cognition and behavioral change in terms of the intervention, the understanding of the neurobiological basis of these changes is equally important. The behavioral changes of such interventions, and specifically MI, attributed to a neurobiological level recently drew the attention of modern studies in a variety of fields. Such evidence can drastically improve our understanding of the given methods. Firstly, by drawing a connection between cognition and behavior changes to specific neural networks and brain regions involved in the process of those changes and hence, help us make related intervention methods more direct and effective [7]. Secondly, the deeper understanding of the neurobiological mechanisms involved in such processes can help us track the progress of the given treatment by adding the biological variable to the behavioral/cognitive one, and provide us a more specific, person-centered and holistic knowledge of the given situation [8]. Finally, this could help in the more accurate categorization of individuals that seek to change their dysfunctional behaviors not only via behavioral characteristics but also via neurobiological underpinnings that are not so easily identified using behaviorbased measures, considering the importance of the individual differences during the interventions. Such evidence can therefore give us critical information ranging from treatment planning to the effectiveness of the treatment methods and approaches used to treat/alter a plethora of dysfunctional behaviors [6,8,9].

The Neurobiological Basis of MI

Even though most research centered around the neurobiological underpinnings and behavioral changes has focused on other intervention methods, such as Cognitive Behavioral Therapy (CBT), there have been a few studies that have specifically focused on ‘change talk’, a key aspect of MI (for review of change talk see, Rollnick et al., 2010 [10]). Change talk reflects a basic side of an individual’s ambivalence about changing. In general, it refers to the individuals’ statements about their ability, need and desire for change [11]. Due to research, it is associated with enhanced motivation for change; and motivation is associated with increased likelihood of actual change (Miller & Rollnick, 2013; Moyers et al., 2005) [4,11].

The handful of studies that have focused on the neurobiological alteration of individuals undergoing MI based therapy have had mixed findings. Specifically, Houck et al. (2013) [12], who investigated specific neural networks underlying change talk, found significant activation in brain regions directly related to the philosophy and approach of MI. These regions are mostly involved in self-perception, attitude change and cognitive dissonance, and include the inferior frontal gyrus, the insula and the superior temporal cortex.

As MI has found increased success in treating substance abuse disorders (Smedslund et al., 2011) [13] and is directly focused on motivation, it is therefore safe to assume that the treatment process of MI is somewhat related to the reward circuits of the brain. By this token, Feldstein et al. (2011) [7] found that individuals that have successfully underwent MI treatment for alcohol abuse showed no activation in regions related to reward processing (e.g., orbitofrontal cortex, nucleus accumbens, insula, caudate, putamen). Despite the identical target group of above-mentioned studies, there were several inconsistencies in their findings mostly centered around the activation of the insula. However, such inconsistencies may be attributed to different methodologies of those studies ranging from the imaging methods used to the stimuli presentation of the cues.

Conclusions

Even though the above representative studies investigating the neurobiological basis of MI have had somewhat inconsistent results, they all seem to agree that there are specific neural networks and brain regions (similar to the ones identified in CBT) which are directly related to the effectiveness of the treatment approach (in our case, at least for substance abuse-related disorders). Those findings indicate the importance of an extensive multidisciplinary investigation of those methods. Based on our clinical experience, we strongly believe that MI conversations meet psychological needs, build socio-emotional skills, enhance neural integration, increase problem-solving skills and resolve ambivalence.

We therefore suggest that an appropriate approach to study the neurocognitive underpinnings of MI, would be an in-depth investigation of the networks involved in the processes underlying it. An important aspect of the human brain is that its functionality is tied to modules (Fox et al., 2005) [14]. Therefore, a modularityoriented approach, focused between and within network activation related to executive functioning, reward and motivation will help us in the identification and understanding of specific activation patterns and the functional organization of the brain related to MI, and possibly in designing more effective intervention methods (Melikopoulos & Papaioannou-Spiroulia, 2019) [6].

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