Cultural Competence in Promoting End-of-Life Care for Muslim Patients.

Just a little infographic I put together last term as part of my learning plan. Cultural competence is essential in providing patient centred care.

As healthcare providers we need to be aware of our patient’s backgrounds as it often has a direct influence on promoting well-being in our patients. It can relate to why our patient isn’t eating, thinking at a deeper level maybe the patient or the GI system is not used to the food being served at the bedside. Perhaps as a nurse, it is important to advocate for our patients in obtaining the foods they are accustomed to (ex. rice).

I think sometimes in healthcare we fail to recognize things that are quite important to our patients. Part of what inspired me to create this learning plan was having had the opportunity to sit in the nurse’s lounge on my first shift and overhearing the nurses talk about a particular patient who was at the end of their life. They were not quite sure how to fulfill this patients personal and religious wishes and could not understand why the patient’s family refused to remove him from life sustaining measures, even after multiple family meetings were held.

Having not understood where these issues stemmed from, I decided to do a bit of research into the patient’s faith and quickly discovered that removing the patient off of life-support would be considered suicide under Islamic faith.

While we can’t be expected to know everything as nurses, we should do our due diligence in researching things, particularly in regards to religious backgrounds. Religion is a huge part in many of our patients lives, and being able to incorporate or understand particular aspects is vital in promoting health and well-being.

Anyways, just some food for thought 🙂



The Real Causes Of Depression Have Been Discovered, And They’re Not What You Think.

By: Johann Hari

Across the Western world today, if you are depressed or anxious and you go to your doctor because you just can’t take it any more, you will likely be told a story. It happened to me when I was a teenager in the 1990s. You feel this way, my doctor said, because your brain isn’t working right. It isn’t producing the necessary chemicals. You need to take drugs, and they will fix your broken brain.

I tried this strategy with all my heart for more than a decade. I longed for relief. The drugs would give me a brief boost whenever I jacked up my dose, but then, soon after, the pain would always start to bleed back through. In the end, I was taking the maximum dose for more than a decade. I thought there was something wrong with me because I was taking these drugs but still feeling deep pain.

In the end, my need for answers was so great that I spent three years using my training in the social sciences at Cambridge University to research what really causes depression and anxiety, and how to really solve them. I was startled by many things I learned. The first was that my reaction to the drugs wasn’t freakish ― it was quite normal.

Many leading scientists believe the whole idea that depression is caused by a “chemically imbalanced” brain is wrong.

Depression is often measured by scientists using something called the Hamilton Scale. It runs from 0 (where you are dancing in ecstasy) to 59 (where you are suicidal). Improving your sleep patterns gives you a movement on the Hamilton Scale of around 6 points. Chemical antidepressants give you an improvement, on average, of 1.8 points, according to research by professor Irving Kirsch of Harvard University. It’s a real effect – but it’s modest. Of course, the fact it’s an average means some people get a bigger boost. But for huge numbers of people, like me, it’s not enough to lift us out of depression – so I began to see we need to expand the menu of options for depressed and anxious people. I needed to know how.

But more than that – I was startled to discover that many leading scientists believe the whole idea that depression is caused by a “chemically imbalanced” brain is wrong. I learned that there are in fact nine major causes of depression and anxiety that are unfolding all around us. Two are biological, and seven are out in here in the world, rather than sealed away inside our skulls in the way my doctor told me. The causes are all quite different, and they play out to different degrees in the lives of depressed and anxious people. I was even more startled to discover this isn’t some fringe position – the World Health Organization has been warning for years that we need to start dealing with the deeper causes of depression in this way.

I want to write here about the hardest of those causes for me, personally, to investigate. The nine causes are all different – but this is one that I left, lingering, trying not to look at, for most of my three years of research. I was finally taught about it in San Diego, California, when I met a remarkable scientist named Dr. Vincent Felitti. I have to tell you right at the start though – I found it really painful to investigate this cause. It forced me to reckon with something I had been running from for most of my life. One of the reasons I clung to the theory that my depression was just the result of something going wrong with my brain was, I see now, so I would not have to think about this.


The story of Dr. Felitti’s breakthrough stretches back to the mid-1980s, when it happened almost by accident. At first, it’ll sound like this isn’t a story about depression. But it’s worth following his journey – because it can teach us a lot.

When the patients first came into Felitti’s office, some of them found it hard to fit through the door. They were in the most severe stages of obesity, and they were assigned here, to his clinic, as their last chance. Felitti had been commissioned by the medical provider Kaiser Permanente to figure out how to genuinely solve the company’s exploding obesity costs. Start from scratch, they said. Try anything.

One day, Felitti had a maddening simple idea. He asked: What if these severely overweight people simply stopped eating, and lived off the fat stores they’d built up in their bodies – with monitored nutrition supplements – until they were down to a normal weight? What would happen? Cautiously, they tried it, with a lot of medical supervision – and, startlingly, it worked. The patients were shedding weight, and returning to healthy bodies.

Once the numbers were added up, they seemed unbelievable.

But then something strange happened. In the program, there were some stars ― people who shed incredible amounts of weight, and the medical team ― and all their friends ― expected these people to react with joy, but the people who did best were often thrown into a brutal depression, or panic, or rage. Some of them became suicidal. Without their bulk, they felt unbelievably vulnerable. They often fled the program, gorged on fast food, and put their weight back on very fast.

Felitti was baffled ― until he talked with one 28-year-old woman. In 51 weeks, Felitti had taken her down from 408 pounds to 132 pounds. Then ― quite suddenly, for no reason anyone could see ― she put on 37 pounds in the space of a few weeks. Before long, she was back above 400 pounds. So Felitti asked her gently what had changed when she started to lose weight. It seemed mysterious to both of them. They talked for a long time. There was, she said eventually, one thing. When she was obese, men never hit on her ― but when she got down to a healthy weight, for the first time in a long time, she was propositioned by a man. She fled, and right away began to eat compulsively, and she couldn’t stop.

This was when Felitti thought to ask a question he hadn’t asked before. When did you start to put on weight? She thought about the question. When she was 11 years old, she said. So he asked: Was there anything else that happened in your life when you were 11? Well, she replied ― that was when my grandfather began to rape me.

As Felitti spoke to the 183 people in the program, he found 55 percent had been sexually abused. One woman said she put on weight after she was raped because “overweight is overlooked, and that’s the way I need to be.” It turned out many of these women had been making themselves obese for an unconscious reason: to protect themselves from the attention of men, who they believed would hurt them. Felitti suddenly realized: “What we had perceived as the problem ― major obesity ― was in fact, very frequently, the solution to problems that the rest of us knew nothing about.”

This insight led Felitti to launch a massive program of research, funded by the Centers For Disease Control and Prevention. He wanted to discover how all kinds of childhood trauma affect us as adults. He administered a simple questionnaire to 17,000 ordinary patients in San Diego, who were were coming just for general health care – anything from a headache to a broken leg. It asked if any of 10 bad things had happened to you as a kid, like being neglected, or emotionally abused. Then it asked if you had any of 10 psychological problems, like obesity or depression or addiction. He wanted to see what the matchup was.

Once the numbers were added up, they seemed unbelievable. Childhood trauma caused the risk of adult depression to explode. If you had seven categories of traumatic event as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult, and more than 4,000 percent more likely to be an injecting drug user.


After I had one of my long, probing conversations with Dr. Felitti about this, I walked to the beach in San Diego shaking, and spat into the ocean. He was forcing me to think about a dimension of my depression I did not want to confront. When I was a kid, my mother was ill and my dad was in another country, and in this chaos, I experienced some extreme acts of violence from an adult: I was strangled with an electrical cord, among other acts. I had tried to seal these memories away, to shutter them in my mind. I had refused to contemplate that they were playing out in my adult life.

Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hard-core addiction, or suicide? I have spent a lot of time thinking about this. I have a theory – though I want to stress that this next part is going beyond the scientific evidence discovered by Felitti and the CDC, and I can’t say for sure that it’s true.

If it’s your fault, it’s — at some strange level — under your control.

When you’re a child, you have very little power to change your environment. You can’t move away, or force somebody to stop hurting you. So, you have two choices. You can admit to yourself that you are powerless ― that at any moment, you could be badly hurt, and there’s simply nothing you can do about it. Or you can tell yourself it’s your fault. If you do that, you actually gain some power ― at least in your own mind. If it’s your fault, then there’s something you can do that might make it different. You aren’t a pinball being smacked around a pinball machine. You’re the person controlling the machine. You have your hands on the dangerous levers. In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it’s your fault, it’s ― at some strange level ― under your control.

But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn’t going to think they deserve much as an adult, either. This is no way to live. But it’s a misfiring of the thing that made it possible for you to survive at an earlier point in your life.


But it was what Dr. Felitti discovered next that most helped me. When ordinary patients, responding to his questionnaire, noted that they had experienced childhood trauma, he got their doctors to do something when the patients next came in for care. He got them to say something like, “I see you went through this bad experience as a child. I am sorry this happened to you. Would you like to talk about it?”

Felitti wanted to see if being able to discuss this trauma with a trusted authority figure, and being told it was not your fault, would help to release people’s shame. What happened next was startling. Just being able to discuss the trauma led to a huge fall in future illnesses ― there was a 35-percent reduction in their need for medical care over the following year. For the people who were referred to more extensive help, there was a fall of more than 50 percent. One elderly woman ― who had described being raped as a child ― wrote a letter later, saying: “Thank you for asking … I feared I would die, and no one would ever know what had happened.”

The act of releasing your shame is – in itself – healing. So I went back to people I trusted, and I began to talk about what had happened to me when I was younger. Far from shaming me, far from thinking it showed I was broken, they showed love, and helped me to grieve for what I had gone through.

If you find your work meaningless and you feel you have no control over it, you are far more likely to become depressed.

As I listened back over the tapes of my long conversations with Felitti, it struck me that if he had just told people what my doctor told me – that their brains were broken, this was why they were so distressed, and the only solution was to be drugged – they may never have been able to understand the deeper causes of their problem, and they would never have been released from them.

The more I investigated depression and anxiety, the more I found that, far from being caused by a spontaneously malfunctioning brain, depression and anxiety are mostly being caused by events in our lives. If you find your work meaningless and you feel you have no control over it, you are far more likely to become depressed. If you are lonely and feel that you can’t rely on the people around you to support you, you are far more likely to become depressed. If you think life is all about buying things and climbing up the ladder, you are far more likely to become depressed. If you think your future will be insecure, you are far more likely to become depressed. I started to find a whole blast of scientific evidence that depression and anxiety are not caused in our skulls, but by the way many of us are being made to live. There are real biological factors, like your genes, that can make you significantly more sensitive to these causes, but they are not the primary drivers.

And that led me to the scientific evidence that we have to try to solve our depression and anxiety crises in a very different way (alongside chemical anti-depressants, which should of course remain on the table).

To do that, we need to stop seeing depression and anxiety as an irrational pathology, or a weird misfiring of brain chemicals. They are terribly painful – but they make sense. Your pain is not an irrational spasm. It is a response to what is happening to you. To deal with depression, you need to deal with its underlying causes. On my long journey, I learned about seven different kinds of anti-depressants – ones that are about stripping out the causes, rather than blunting the symptoms. Releasing your shame is only the start.


One day, one of Dr. Felitti’s colleagues, Dr. Robert Anda, told me something I have been thinking about ever since.

When people are behaving in apparently self-destructive ways, “it’s time to stop asking what’s wrong with them,” he said, “and time to start asking what happened to them.”

Testosterone and Its Effects on Aggressive Behaviour in Adolescents

Aggression has been defined as any form of behaviour that is intended to harm another person (Passer, Smith, Atkinson, Mitchell and Muir, 2011). Over the years psychologists and other researchers have been able to study this form of behaviour by analyzing the factors that may contribute to aggression. These factors have been thought to include biological, environmental and psychological levels, which may work individually or all together in contributing to aggressive behaviours. Aggression can take place in various forms including physical aggression where the aggressor exhibits pushing, slapping and shooting other people or verbal aggression, in this form the aggressor may intimidate or engage in taunting and name-calling. The last form of aggression takes place indirectly and involves the aggressor taking part in behaviours such as gossiping, spreading rumors and encouraging others to exclude someone (Facts for teens: aggression, 2002). A wide variety of research has been done on aggressive behaviour in adolescents and it is still an ongoing process into understanding why some children are more predisposed to certain behaviours than others. Research that has been undertaken has discovered that children are more likely to engage in aggressive behaviour if they are exposed to the following risk factors: individual characteristics, home environment, relationships with peers, media violence, social failure, community factors and genetics (Facts for teens: aggression, 2002). Therefore, more research needs to be conducted in order to help understand why some children are more aggressive and to reduce or prevent the behaviour. Studies in the last few decades on aggression have particularly focused on the effects of the androgen hormones; testosterone and cortisol. Much of the research supports the idea that these two hormones do play a role in the expression of aggressive behaviour in young adolescents.

Yi-Zhen Yu and Jun-Xia Shi examined the effects of testosterone and cortisol hormone levels in saliva to examine whether the endocrinal factors contribute to the aggressive behaviour in adolescents.  Their study included the participation of 20 aggressive youth, which was made up of 10 males and 10 females, as well as 20 non- aggressive students. The 40 participants were selected from a population of 1051 students all of whom were between the ages of 11- 16 years of age and from the province of Hubei in China. The groups were then further divided by age, gender, stage of pubertal development and economic status of their families. Once selected Yu and Shi evaluated aggressive behaviours using child behaviour check list (CBCL), along with a parent questionnaire. The use of the CBCL allowed the researchers to adhere to a standardized evaluation technique, consisting of the evaluation of behavioral problems and social competencies based on the reports from people who know the child well. The checklist allowed the researchers to examine a broad range of emotional and behavioral problems and identify two major groups of problem children- those that internalize problems (inhibited behaviour) and those that externalize problems (aggressive behaviour) (Yu & Shi, 2009). Using the questionnaire taken by the child’s guardian along with the rest of the CBCL, Yu and Shi were able to calculate a score for aggression. An aggressive child in this study was defined as having a score that was above or equal to China’s norms. In this case, for male an aggressive student was considered aggressive if their score was above 18, while for females the score had to be 17 or above. Yu and Shi also collected saliva samples from each individual, all at the same point during the day. The collected sample from each participant was examined and tested for the cortisol (CORT), testosterone (T) and growth hormones (GH) using radioimmunoassay, which measures the levels of each hormone. After testing was complete, Yu and Shi were able to compare the results from both groups to determine whether increased levels of the hormones were a contributing factor towards displays of aggressive behaviour.

Richard Tremblay and his colleagues focused on identifying the associations between testosterone level, physical development and a concurrent assessment of antisocial behaviour (Tremblay, Schaal, Boulerice, Arseneault, Soussignan, and Paquette, 1998). The subjects involved were made up of 1161 caucasian males with the mean age sitting at around 6.12 years. All the subjects chosen were from low socioeconomic areas in Montreal. For 57 of the boys who were between the ages of 12 and 13, data on testosterone, physical aggression and social dominance was available to use (Tremblay et. al., 1998).  For behavioral measures, behaviour assessments were obtained from the children’s teachers at the ages of 6,10,11 and 12 years, from peers at 10,11 and 12 and from the boys themselves at 10, 11, 12, and 13 years of age. The teacher’s ratings were obtained using a Social Behaviour Questionnaire (SBQ) and scored on a three level scale consisting of “does not apply”, “applies sometimes” and “frequently applies” (Tremblay et. al., 1998).  Two types of aggression- physical and opposition scores were derived from items such as “blames others”, “disobedient” and “fights”. The range of the scores for physical aggression was from 0-6 and for opposition aggression it was from 0-10. This testing was done at the end of every school year for the ages of 6,10,11 and 12 years of age. For peer ratings, Tremblay and his colleagues used the Pupil Evaluation Inventory that was used at ages 10,11 and 12. The evaluation involved each child in a class to nominate four students who fit the criteria for each item described on the questionnaire. From the questionnaire a score was derived that represented physical aggression. This score was generated from two criterions out of the thirty-five that were “those who start a fight over nothing” and “those that say they can beat everybody” (Tremblay et. al., 1998). For the self-assessments the boys answered a 27-item delinquency questionnaire at the ages of 10, 11, 12 and 13 years of age (Tremblay et. al., 1998).  The questionnaire was made up of a four point rating scale (never, once, twice or often). Questions that were asked included  “steals objects worth more than $10 in school”, “get drunk”, “set a fire”, “carries a weapon” and “takes money from home” (Tremblay et. al., 1998).  The score from the 27 questions were used to obtain a self-reported physical aggression score. Hormonal measures were also obtained for the boys at the ages of 11,12, and 13 years of age. Saliva samples taken at three consistent times (8:30, 10 and 13:00 o’clock) were used to measure testosterone levels. The samples were then subjected to radioimmunoassay testing to obtain the testosterone levels of the boys. The testosterone levels in boys who were 11 years of age did not have a high enough detection limit and therefore their saliva sample was excluded in later statistical analyses.  Physical measures included in the study involved height, wrist, weight and head circumferences for boys between the ages of 12 and 13.

The two studies are similar in the sense that they both focused on whether increased levels of testosterone were found in the more aggressive groups. However, both studies differed in how they were conducted. Yu and Shi focused more on the hormones that are present in aggressive adolescents with the use of testing hormone levels using saliva and the CBCL. The study conducted by Yu and Shi concluded that the cortisol (CORT) and testosterone (T) hormones are associated with adolescent aggressive behaviours. They also stressed that the endocrine factors do play a certain role in the display of aggressive behaviours. However, the study was not able to explain the mechanism, which underlies the occurrence due to external factors such as personality playing a certain role in aggressive behaviours. In the study done by Tremblay and his colleagues, their results concluded that testosterone levels and the individuals body mass were highly correlated with an individual displaying physical aggression. Other differences between the studies focused on different aspects of adolescence, with Tremblay and his colleagues choosing to use only male subjects to test aggression, while Yu and Shi chose to involve both males and females. Overall, Tremblay’s study concluded that boys with the largest body mass tended to be the most physically aggressive. The study also was able to show the link between testosterone and aggression, suggesting that the more testosterone that was present in the boy led to more physical aggression. However, Tremblay and his colleagues stressed that the positive association may be due to other factors, such as social dominance. The boys who had the greater need to dominate would be more likely to express physical aggressive behaviors and often times display them more frequently due to higher levels of testosterone.

Overall, both studies generally agreed that testosterone levels were higher among adolescents with aggressive behaviour. Thus, experiments done on aggression in adolescents may help lead to understanding how to predict aggressive behaviours early on in adolescents. This can therefore help to allow individuals and their families to create an environment where factors that lead to aggression can be lessened since individuals with higher testosterone levels are more at risk to display aggressive behaviours. In conclusion, more research is needed to help continue to support the idea that increased testosterone levels do lead to greater levels of aggression. Although both studies do support the idea that higher testosterone levels and higher body mass lead to more aggressive behaviours, the results are only correlational and more research would be needed to confirm these results.  Research will need to create an understanding of why these individuals have an increased level of testosterone and ways to minimize the factors that can lead to these aggressive behaviours.

– M

Works Cited

Facts for teens: aggression. (n.d.). National Youth Violence Prevention Center. Retrieved March 24, 2012, from

Passer, M. W., Smith, R. E., Atkinson, M. L., Mitchell, J. B., & Muir, D. W. (2011).  Memory.
Psychology: frontiers and applications (Fourth Canadian Edition ed., p.  300). United States
of America: McGraw- Hill Ryerson.

Tremblay, R. E., Schaal, B., Boulerice, B., Arseneault, L., Soussignan, R. G., Paquette, D., et al. (1998). Testosterone, physical aggression, dominance, and physical development in early adolescence. International Journal of Behavioral Development, 22(4), 753-777. Retrieved March 21, 2012, from the Sage Publisher database.

Yu, Y., & Shi, J. (2009). Relationship between levels of testosterone and cortisol in saliva and aggressive behaviours of adolescents. Biomedical and Environmental Sciences, 22, 44-49. Retrieved March 20, 2012, from

Music and its Influence on the Cognitive Abilities of Alzheimer’s Patients

Alzheimer’s is a degenerative disease, in which there is a gradual decrease in memory function, intellectual abilities and a change in personality occurs (APA, n.d.).  In the early stages of the disease, patients often lose the ability to remember and retain new information. In later stages they lose the ability to think, speak and do basic tasks such as brushing ones teeth (APA, n.d.). Alzheimer’s has also become the most common and prevalent form of dementia, in adults over the age of 65 (Passer, Smith, Atkinson, Mitchell and Muir, 2011). Currently there are half a million Canadians with the disease, and it is expected to increase to 1.1 million people by 2035 (Passer et. al., 2011). A wide variety of research is currently being conducted on the disease to find a cure, because of the increasing risk the disease poses on individuals psychological, social and physical well being continues to increase. Recent studies have suggested Alzheimer’s patients having a stronger likelihood to remember new information when it is provided in the context of music. These studies support the idea that the memory of Alzheimer’s patients is affected by music, regardless of familiarity and distortion.

Ashley Vanstone and Lola Cuddy examined the notion of whether the brains of patients with Alzheimer’s are able to preserve memories through music. Using 12 patients with Alzheimer’s ranging from moderate to severe, as well as 12 healthy control participants, Vanstone and Cuddy were able to examine the memory of all 24 participants. Throughout the experiment, participants were exposed to familiar songs, and were asked to identify any distortions in the melodies, and were asked to sing along to the familiar songs. In this study, a Familiarity Decision Test (FDT) was designed containing 10 familiar melodies and 10 novel melodies, participants were asked to determine whether the song was familiar or not. All participants were prompted to sing the melodies of four familiar tunes using the first phrase of the four songs. The rendition of the melody was deemed correct when the rhythm and general melodic contour was deemed recognizable. Thus, the basic goal of the task was to determine whether the participant could produce the tune in an accurate manner during the experiment.  The second category, the novel songs, was created using distorted melodies. This was created through reversal of the sequence of pitches making them unrecognizable. The second method of testing involved the use of a “distorted tunes test”, which required participants to assess and identify incorrect pitches of 26 short familiar melodies (Vanstone and Cuddy, 2009). This portion of the experiment was measured on whether the participant deemed the melody correct or incorrect and whether or not the melody was familiar to create a distorted tunes test recognition score (DTTREC). Another method used in the experiment, involved the use of an Unfamiliar Distorted Tunes Test (UDDT), which Vanstone formed as an analogue to the DDT test (Vanstone and Cuddy, 2009). This method involved using unfamiliar tunes prompting the participant to specify whether or not the melody was distorted. Twenty brief novel melodies were created, 10, which followed Western stylistic norms while the other 10 songs, contained pitch distortions. Through this experiment, the participant was given a starting pitch as a reference point, as well as two trials to give an example of what a distorted novel song sounded like. The entire experiment was presented in the form of the FDT test, the lyrics prompt test, the DDT test and the UDTT test (Vanstone and Cuddy, 2009).

Nicholas Simmons-Stern, Andrew Budson and Brandon Ally focused their study on trying to enhance the memory of Alzheimer’s patients to learn new information. The experimental design included testing their memories using lyrics of children’s songs with repetitive melodies. The study also included the use of lyrics placed on computer screens, as well as using 13 patients with Alzheimer’s and 14 healthy control participants with no familial history for comparison. During the study, participants were tested using two mechanisms: having the lyrics read to them and having the lyrics sung with musical accompaniment. . The stimuli used in the study consisted of using four line excerpts from a group of 80 children’s songs from children’s music databases. All songs selected for the study were subjected to a prescreening test to insure all songs were simple, had repetitive melodies and were unfamiliar to participating patients. However, the four lines from the excerpted song also had to include a “perfect tail rhyme scheme” (Simmons- Stern, Budson and Ally, 2010). The stimuli were further broken down into sung and spoken versions of each song, both of which had the same vocal speeds for the corresponding songs. For more concise examination the songs were broken down into four categories, which consisted of: total words, sung recording length, spoken recording length and expected years of education necessary for text comprehension. Each participant was presented with 40 song excerpts, and the four line lyrics were present on a laptop for the entire session. The session was then further broken down into 20 songs presented with musical accompaniments and the other 20 being spoken version of the songs. Each song used during the sessions was repeated twice in consecutive order. The results of the study were then used to evaluate the differences in memory performance during the sung and spoken conditions when comparing the control group and Alzheimer’s group (Simmons-Stern, et. al., 2010).

The two journals studied the common area of determining what the extent music plays in enhancing memories in patients with Alzheimer’s disease. Vanstone and Cuddy’s experiment saw a range of musical memory across the spectrum of Alzheimer’s the participants. Some participants with the moderate or severe form of the disease showed normal abilities with their musical abilities, others showed partial ability to acknowledge familiar tunes and perform some tasks.   In some cases, the participant did not meet the normal levels despite engaging in the tasks. Overall, the data collected showed that the Alzheimer’s participants performed significantly lower in comparison to the control group. However, when the researchers examined individual cases of the participants, it became evident that there was a high degree of variability in musical memory functioning.  Lastly, the researchers acknowledge that due to the small sample size, the study was not able to determine the degree of preserved musical ability in patients with Alzheimer’s disease. The results only conformed to the notion that this phenomenon is most likely not uncommon in the general population. Both journals used similar approaches in terms of engaging the participant with music and examining the melodies of each song. However, major difference stem in the notion that one study allowed for familiar tunes and analyzing distorted melodies, while the second study focused on unfamiliar melodies. The second study also added another variable, using spoken and musical accompaniment as the two manipulated variables for the experiment in testing the same area of interest in Alzheimer’s patient. Overall, Simmons- Stern and his peers focused on whether music could be used to enhance memory, and the extent to which it plays in recognition of verbal information in both groups of patients. However, unlike the first journal, the Simmons- Stern and his colleagues were able to confirm their hypothesis that patient with Alzheimer’s disease performed better on a task using background music in comparison to spoken lyrics without music (2010).  The findings suggest that music involves more diversified encoding that requires use from many different parts of the brain, such as the cerebellum, hypothalamus, and nucleus accumbens, creating a complex and diversified neural network (Simmons- Stern et. al., 2010).  Therefore “music and sung recordings may create a more robust association at encoding than do stimuli accompanied by only a spoken recording” in patients diagnosed with Alzheimer’s disease (Simmons- Stern et. al., 2010).  Many of the areas associated in encoding and retrieving information from music are also affected at a slower rate in comparison to areas of the brain normally associated with memory, notably “the cortical areas such as the medial prefrontal cortex and orbitofrontal cortex” (Simmons- Stern et. al., 2010).   They also noted that in the healthy control group, no benefit occurred when music was used suggesting that the encoding and retrieval processes for musical and non- musical processes differ in healthy adults in comparison with Alzheimer’s patients. Overall, in comparison to the first journal, Simmons- Stern and his colleagues gave a stronger insight into the role that music has in patients with Alzheimer’s and why this phenomenon may occur.
Thus, experiments with music and Alzheimer’s patients may lead to further studies to examine how memories may be preserved or retrieved and providing a diagnostic progression for the disease. In conclusion, further studies will need to be conducted in order to formulate a more conclusive relationship between music and memory in Alzheimer’s patients. There is not enough data to thoroughly conclude that the memory of Alzheimer’s patients is consistent when music is added into the equation. However based on the data researched from the two journals, there does seem to potentially be a link between the two variables with the second journal being more supportive of music playing a role in the memory of Alzheimer’s patients. In conclusion, the two journals have given insight into how patients with Alzheimer’s disease can potentially be taught novel information using music to present everyday information and in developing more effective therapy treatments.

– M

Works Cited

Alzheimer’s Disease  . (n.d.). American Psychological Association (APA) .  Retrieved November
23, 2011, from

Passer, M. W., Smith, R. E., Atkinson, M. L., Mitchell, J. B., & Muir, D. W. (2011).  Memory.
Psychology: frontiers and applications (Fourth Canadian Edition ed., p.  300). United States
of America: McGraw- Hill Ryerson.

Simmons-Stern, N. R., Budson, A. E., & Ally, B. A. (2010). Music as a memory enhancer in
patients with Alzheimer’s disease. Neuropsychologia, 48(10), 3164-3167 . Retrieved
November  24, 2011,
from DOI:10.1016/j.neuropsychologia.2010.04.033
Vanstone, A. D., & Cuddy, L. L. (2009). Musical memory in Alzheimer disease. Aging,
Neuropsychology, and Cognition
, 17(1), 108-128. Retrieved November 22, 2011, from




Disney Influence on Gender Types and Race

Since its establishment in 1920, the Disney Corporation has since become a household name for wholesome family entertainment. Disney is often associated with promoting pure and innocent fantasies, oftentimes through the use of fairytales. As technology’s role in the lives of children increases, it has become evident that accumulated media experiences, including television and film, have increasing and lasting effects on children’s beliefs and values. Therefore, it is critical to understand how Disney’s ideology of gender types and race, through the use of film, consequently shape children’s values and lead to the formation and reinforcement of stereotypes.

Increasing research on the gender typing messages promoted through Disney films has shown various recurring themes for both male and female characters. Males in Disney films were generally portrayed as: independent, unemotional, brave, physically attractive, and performed non-domestic jobs (England, Descartes & Collier-Meek, 2011). However, females were portrayed as being a victim, physically weak, submissive, sensitive, and valued more for their beauty than intellect (England, Descartes & Collier-Meek, 2011).  In a study conducted by Blaise (2005), female kindergarteners understood that make-up could be used as a powerful tool to determine and express femininity. One young girl chose to wear red lipstick and grow long hair to attract her “prince”, just like she had seen Princess Ariel do in the Disney movie ‘The Little Mermaid’.  It becomes apparent that Disney’ s portrayal of gender roles leads to learned associations of gender typing that can lead to and shape stereotypical views of gendered activities, values, and roles.

Disney films largely impact the images children are exposed to shaping their attitudes towards racial prejudice. Although children can be influenced by a variety of sources, media is often most influential. In an analysis on race and culture in Disney movies, Towbin, Haddock, Zimmerman, Lund and Tanner (2003) noted three recurring themes; negative representation of non-dominant cultures, exaggerated class stereotypes, and characters with shared values are grouped together. Other research on race and culture in Disney films also note that characters of color are generally seen as villainous, therefore leading to racially stereotypic images of marginalized groups. One movie that evidences this includes Aladdin, where the hero, Aladdin, is depicted as having European features, with no accent, as to the villains whom all have Middle Eastern characteristics such as beards, and foreign accents (Anderson & Cavallaro, 2002). In addition, Disney movies have been predominately depicted to relay Western cultural norms, therefore disseminating American cultural messages to children in other cultures, leading to the “Americanization” of cultural norms (Lee, 2010).

Consequently, Disney is able to shape childrens values on gender typing and race by scripting aspects of childhood and society. One example includes the Disney adaptation of Pocahontas, which portrays themes of gender typing and race. As Giroux (1997) points out, Pocahontas was portrayed as a “brown-skinned, Barbie like supermodel with an hourglass figure”, which is an unrealistic representation of a Native American woman, let alone an average female.  As Giroux (1997) points out, many young children fail to recognize the objectification of the female bodies in Disney movies. Additionally, conflicting messages about gender typing included her initial portrayal as a strong woman, only to end with her choosing to remain at home out of a sense of duty to her community rather than for herself (Towbin et al., 2008). Pocahontas was portrayed as being constrained to a certain role, thereby reinforcing stereotypes of gender typing and race.

Although children can be influenced by a variety of sources, media often serves as a powerful learning tool that helps to convey messages about race and gender roles. As Lee (2010) point out, the messages that are conveyed through Disney films have become important socializing agents that help formulate children’s identities. Although, children may not emulate exactly what they see from the films, they may see possibilities in emulating that person. Ultimately, It is imperative that children understand that gender roles are not rigid, and that race and gender do not define roles and values. Parents and educators have the power to counter these unrealistic images by displaying realistic and accurate representations of people and by exposing them to a variety of role models.



Works Cited

Anderson, K. J., & Cavallaro, D. (2002). Parents or pop culture? Children’s heroes and role models. Childhood Education, 78(3), 161-168.

Blaise, M. (2005). A feminist poststructuralist study of children ‚”doing” gender in an urban kindergarten classroom. Early Childhood Research Quarterly, 20(1), 85-108.

England, D., Descartes, L., & Collier-Meek, M. (2011). Gender role portrayal and the Disney princesses. Sex Roles, 64(7-8), 555-567. doi: 10.1007/s11199-011-9930-7

Giroux, H. A. (1997). Are Disney movies good for your kids?. Kinder-Culture: The Corporate Construction of Childhood (pp. 187-195). Boulder, CO: Westview Press.

Lee, L. (2010). Disney in Korea: A socio-cultural context of children’s popular culture. Red Feather Journal: An International Journal of Children’s Visual Culture, 1(2), 41-45. Retrieved from

Li-Vollmer, M., & LaPointe, M. E. (2003). Gender transgression and villainy in animated film. Popular Communication: The International Journal of Media and Culture, 1(2), 89-109.

Towbin, M. A., Haddock, S. A., Zimmerman, T. S., Lund, L. K., & Tanner, L. R. (2004). Images of gender, race, age, and sexual orientation in Disney feature-length animated films. Journal of Feminist Family Therapy, 15(4), 19-44.

Participate in study on recovery from depression

“Bridget Badu-Poku, a Counselling Psychologist Trainee at City University London, is partaking research which aims to explore the experiences of recovery in those who have been given a diagnosis of depression.”

Great opportunity to help researchers explore the meanings one attribute to the experience of recovery following depression. For more information follow the link listed below.