Tag Archives: University of California San Diego

University of California San Diego study: Targeted cognitive training benefits patients with severe schizophrenia

8 Dec

Bethany Yeiser wrote in the Psychology Today article, Schizophrenia and Homelessness: Paranoia drove me to sleep outside:

Over the past few years, I have been contacted by several families who have a loved one struggling with schizophrenia. Many of these people with schizophrenia are homeless.
For me, becoming homeless was a direct result of schizophrenia. Because of the illness, I could not work the easiest job or focus enough to take even one class. The illness brought on a paranoia which led me to cut off all my family members and my closest friends.
While homeless, I badly wanted a place to sleep, as I was tired of sleeping outside in a churchyard. Remarkably, I was given plenty of opportunities to leave my homeless life, and I rejected every one of them…. https://www.psychologytoday.com/us/blog/recovery-road/201807/schizophrenia-and-homelessness

SARDAA has information about schizophrenia.

In Quick Facts About Schizophrenia, SARDAA reported:

Quick Facts About Schizophrenia
• Schizophrenia can be found in approximately 1.1% of the world’s population, regardless of racial, ethnic or economic background
• Approximately 3.5 million people in the United States are diagnosed with schizophrenia and it is one of the leading causes of disability.
• Three-quarters of persons with schizophrenia develop the illness between 16 and 25 years of age.
• The disorder is at least partially genetic.
• To be diagnosed as having schizophrenia, one must have associated symptoms for at least six months.
• Studies have indicated that 25% of those having schizophrenia recover completely, 50% are improved over a 10-year period, and 25% do not improve over time.
• Treatment and other economic costs due to schizophrenia are enormous, estimated between $32.5 and $65 billion annually.
• Between one-third and one-half of all homeless adults have schizophrenia.
• 50% of people diagnosed with schizophrenia have received no treatment.
To learn more, we invite you to view a presentation by Linda Whitten Stalters, APRN, BC, FAPA, SARDAA Board of Directors. https://www.slideshare.net/SARDAA https://sardaa.org/resources/about-schizophrenia/

The University of California San Diego reported that cognitive training might aid those suffering from schizophrenia.

Science daily reported in Targeted cognitive training benefits patients with severe schizophrenia:

Schizophrenia is among the most difficult mental illnesses to treat, in part because it is characterized by a wide range of dysfunction, from hallucinations and mood disorders to cognitive impairment, especially verbal and working memory, which can be explained in part by abnormalities in early auditory information processing.
In recent years, targeted cognitive training (TCT) has emerged as a promising therapeutic intervention. TCT uses computerized training, such as sophisticated brain games, to target specific neural pathways, such as memory, learning and auditory-based senses, to beneficially alter the way they process information.
But while TCT has proven effective for mild to moderate forms of schizophrenia under carefully controlled conditions, it remains unclear whether the approach might benefit patients with chronic, refractory schizophrenia treated in non-academic settings, such as those cared for in locked residential rehabilitation centers.
In a study published in the December print issue of Schizophrenia Research, senior author Gregory A. Light, PhD, professor of psychiatry at UC San Diego School of Medicine and director of the Mental Illness, Research, Education and Clinical Center at Veterans Affaris San Diego Healthcare System, and colleagues investigated whether TCT improved auditory and verbal outcomes among the most difficult of schizophrenia patients.
“Chronic, treatment-refractory patients mandated to locked residential care facilities make up just a small subgroup of persons with schizophrenia, but they consume a disproportionately large share of mental health care resources,” said Light. “Finding an effective therapy for them is critical.”
Light’s team studied 46 patients with schizophrenia psychosis recruited from a community-based residential treatment program, each following acute hospitalization. All were deemed “gravely disabled,” unable to care for themselves, and under the guardianship of a private party or government agency. Participants were randomized to either standard treatment-as-usual (TAU) or TAU plus TCT, in which they used laptop computers to perform various learning and memory game exercises, often involving auditory cues.
The researchers found that among participants who completed the roughly three months of TAU-TCT treatment, verbal learning and auditory perception scores improved; and severity of auditory hallucinations lessened. Of note: The benefits were not negatively impacted by age, clinical symptoms, medication or illness duration. “Our results suggest that chronically ill, highly disabled patients can benefit from TCT,” said Light. “That contradicts current assumptions.”
Light cited some caveats. “We’re somewhere between the Wild West and golden age of cognitive training for schizophrenia patients. There is much still to be learned and done,” he said. Patients in this study represented some of the most difficult patients to treat, with therapy regimens that are highly complex. “We need to do a lot more research….” https://www.sciencedaily.com/releases/2018/12/181207112759.htm

Citation:

Targeted cognitive training benefits patients with severe schizophrenia
Study participants improved auditory and verbal outcomes
Date: December 7, 2018
Source: University of California – San Diego
Summary:
Researchers find that patients with severe, refractory schizophrenia benefit from targeted cognitive therapy, improving auditory and verbal outcomes and the way they process information.
Journal Reference:
Michael L. Thomas, Andrew W. Bismark, Yash B. Joshi, Melissa Tarasenko, Emily B.H. Treichler, William C. Hochberger, Wen Zhang, John Nungaray, Joyce Sprock, Lauren Cardoso, Kristine Tiernan, Mouna Attarha, David L. Braff, Sophia Vinogradov, Neal Swerdlow, Gregory A. Light. Targeted cognitive training improves auditory and verbal outcomes among treatment refractory schizophrenia patients mandated to residential care. Schizophrenia Research, 2018; 202: 378 DOI: 10.1016/j.schres.2018.07.025

Here is the press release from University of California San Diego:

PUBLIC RELEASE: 6-DEC-2018
Targeted cognitive training benefits patients with severe schizophrenia
Study participants improved auditory and verbal outcomes
UNIVERSITY OF CALIFORNIA – SAN DIEGO
Schizophrenia is among the most difficult mental illnesses to treat, in part because it is characterized by a wide range of dysfunction, from hallucinations and mood disorders to cognitive impairment, especially verbal and working memory, which can be explained in part by abnormalities in early auditory information processing.
In recent years, targeted cognitive training (TCT) has emerged as a promising therapeutic intervention. TCT uses computerized training, such as sophisticated brain games, to target specific neural pathways, such as memory, learning and auditory-based senses, to beneficially alter the way they process information.
But while TCT has proven effective for mild to moderate forms of schizophrenia under carefully controlled conditions, it remains unclear whether the approach might benefit patients with chronic, refractory schizophrenia treated in non-academic settings, such as those cared for in locked residential rehabilitation centers.
In a study published in the December print issue of Schizophrenia Research, senior author Gregory A. Light, PhD, professor of psychiatry at UC San Diego School of Medicine and director of the Mental Illness, Research, Education and Clinical Center at Veterans Affaris San Diego Healthcare System, and colleagues investigated whether TCT improved auditory and verbal outcomes among the most difficult of schizophrenia patients.
“Chronic, treatment-refractory patients mandated to locked residential care facilities make up just a small subgroup of persons with schizophrenia, but they consume a disproportionately large share of mental health care resources,” said Light. “Finding an effective therapy for them is critical.”
Light’s team studied 46 patients with schizophrenia psychosis recruited from a community-based residential treatment program, each following acute hospitalization. All were deemed “gravely disabled,” unable to care for themselves, and under the guardianship of a private party or government agency. Participants were randomized to either standard treatment-as-usual (TAU) or TAU plus TCT, in which they used laptop computers to perform various learning and memory game exercises, often involving auditory cues.
The researchers found that among participants who completed the roughly three months of TAU-TCT treatment, verbal learning and auditory perception scores improved; and severity of auditory hallucinations lessened. Of note: The benefits were not negatively impacted by age, clinical symptoms, medication or illness duration. “Our results suggest that chronically ill, highly disabled patients can benefit from TCT,” said Light. “That contradicts current assumptions.”
Light cited some caveats. “We’re somewhere between the Wild West and golden age of cognitive training for schizophrenia patients. There is much still to be learned and done,” he said. Patients in this study represented some of the most difficult patients to treat, with therapy regimens that are highly complex. “We need to do a lot more research.”
Light and others are doing so. In a recent paper published in Neuropsychopharmacology, for example, he and colleagues described the underlying mechanism involved in TCT to improve auditory function. And in past work, schizophrenia-and-auditory-cues.aspx Light and others have shown that deficiencies in the neural processing of simple auditory tones can evolve into a cascade of dysfunctional information processing in the brains of patients with schizophrenia.
###
This study was made available online in July 2018 ahead of peer-review and publication this month.
Co-authors include: Michael L. Thomas, Andrew W. Bismark, Yash B. Joshi, Melissa Tarasenko, Emily B.H. Treichler, William C. Hochberger, Joyce Sprock, David L. Braff and Neal Swerdlow, UC San Diego and Veterans Affairs San Diego Healthcare System; Wes Zhang, SDSU-UCSD Joint Doctoral Program in Clinical Psychology; John Nungaray, UC San Diego; Lauren Cardoso, UC San Diego and Alpine Special Treatment Center; Mouna Attarha, Alpine Special Treatment Center; and Sophia Vinogradov, University of Minnesota.
Disclosures: Dr. Greg Light has been a consultant to Astellas, Boehringer-Ingelheim, Dart Neuroscience, Heptares, Lundbeck, Merck, NeuroSig, Neuroverse and Takeda. Dr. Mouna Attarha is a research scientist and stock holder at Posit Science Corporations, which developed the computerized brain training program used in the study.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Science Daily reported in Roots of schizophrenia: Excess of methionine during pregnancy?

An abundance of an amino acid called methionine, which is common in meat, cheese and beans, may provide new clues to the fetal brain development that can manifest in schizophrenia, University of California, Irvine pharmacology researchers report in the journal Molecular Psychiatry.
The findings point to the role methionine overload can play during pregnancy and suggest that targeting the effects of this amino acid may lead to new antipsychotic drugs….
https://www.sciencedaily.com/releases/2017/08/170816100305.htm

Citation:

Roots of schizophrenia: Excess of methionine during pregnancy?
Date: August 16, 2017
Source: University of California – Irvine
Summary:
An abundance of an amino acid called methionine, which is common in meat, cheese and beans, may provide new clues to the fetal brain development that can manifest in schizophrenia, pharmacology researchers report.
Journal Reference:
1. A Alachkar, L Wang, R Yoshimura, A R Hamzeh, Z Wang, N Sanathara, S M Lee, X Xu, G W Abbott, O Civelli. Prenatal one-carbon metabolism dysregulation programs
schizophrenia-like deficits. Molecular Psychiatry, 2017; DOI: 10.1038/mp.2017.164

Here is the press release from UC Irvine:

Public Release: 15-Aug-2017
UCI study uncovers possible roots of schizophrenia
Excess of methionine during pregnancy alters prenatal brain development related to the psychiatric disease
University of California – Irvine
Irvine, Calif., Aug. 15, 2017 – An abundance of an amino acid called methionine, which is common in meat, cheese and beans, may provide new clues to the fetal brain development that can manifest in schizophrenia, University of California, Irvine pharmacology researchers report in the journal Molecular Psychiatry.
The findings point to the role methionine overload can play during pregnancy and suggest that targeting the effects of this amino acid may lead to new antipsychotic drugs.
The UCI study also provides detailed information on the neural developmental mechanisms of the methionine effect, which results in changes in the expression of several genes important to healthy brain growth and, in particular, to one linked to schizophrenia in humans.
Amal Alachkar and colleagues based their approach on studies from the 1960s and 1970s in which schizophrenic patients injected with methionine experienced worsened symptoms. Knowing that schizophrenia is a developmental disorder, the UCI team hypothesized that administering three times the normal daily input of methionine to pregnant mice may produce pups that have also schizophrenia-like deficits, which is what occurred.
The pups of the injected mothers displayed deficits in nine different tests encompassing the three schizophrenia-like symptoms behaviors – “positive” symptoms of overactivity and stereotypy, “negative” symptoms of human interaction deficits, and “cognitive impairments” memory loss.
The research team treated the mice with anti-schizophrenic drugs well used in therapy. A drug that in schizophrenics treats mostly the positive symptoms (haloperidol) did the same in the mice, and a drug that treat preferentially the negative symptoms and the cognitive impairments (clozapine) did the same.
Alachkar, an associate adjunct professor of pharmacology, said that the study is the first to present a mouse model based on methionine-influenced neural development that leads to schizophrenic-like behaviors.
“This mouse model provides much broader detail of biological processes of schizophrenia and thus reflect much better the disorder than in the animal models presently widely used in drug discovery,” said Olivier Civelli, chair and professor of pharmacology and an author on the paper.
“Our study also agrees with the saying, ‘we are what our mothers ate’,” Alachkar added. “Methionine is one of the building blocks of proteins. It is not synthesized by our bodies, and it needs to be ingested. Our study points at the very important role of excess dietary methionine during pregnancy in fetal development, which might have a long-lasting influence on the offspring. This is a very exciting area of research that we hope can be explored in greater depth.”
###
The study received support from the National Institutes of Health (DA024746), the UCI’s Center for Autism Research & Translation, the Eric L and Lila D Nelson Chair of Neuropharmacology, and the Institute of International Education.
Link to study: http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2017164a.html?foxtrotcallback=true
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
Media Contact
Tom Vasich
tmvasich@uci.edu
949-824-6455
@UCIrvine
http://www.uci.edu
University of California – Irvine
Journal
Molecular Psychiatry
Funder
National Institutes of Health
Original Source
http://www.som.uci.edu/news_releases/uc-irvine-study-finds-possible-roots-of-schizophrenia.asp

Related Journal Article
http://dx.doi.org/10.1038/mp.2017

Learn more about prenatal and preconception care.
http://www.nichd.nih.gov/health/topics/preconceptioncare/Pages/default.aspx

http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/prenatal-care.aspx

See, Prenatal care fact sheet http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html

Our goal as a society should be a healthy child in a healthy family who attends a healthy school in a healthy neighborhood. ©

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tags: , , , , , , , , , , ,

University of California, San Diego study: Lying parents tend to raise lying children

20 Mar

Cheating is increasingly a concern in education. Some colleges in an attempt to curb academic dishonesty on campus are beginning to employ methods one has usually associated with Las Vegas casinos. Minnesota State University Mankato has an excellent newsletter article about academic dishonesty. Richard C. Schimming writes in Academic Dishonesty:

A recent survey found that 1/3 of all students admitted to cheating on an examination, 1/2 admitted to cheating on a class assignment, 2/3 admitted to cheating at least once during their college career, and 2/3 have seen classmates cheat on exams or assignments. Paradoxically, 3/4 of those in that survey believe that cheating is not justified under any circumstances. Finally, 1/2 of the students surveyed believe that the faculty of their university do not try to catch cheaters… http://www.mnsu.edu/cetl/teachingresources/articles/academicdishonesty.html

For some students, cheating starts early. By the time some kids reach college they have already established a pattern of cheating. ABC News has a good report, A Cheating Crisis in America’s Schools http://abcnews.go.com/Primetime/story?id=132376&page=1 https://drwilda.wordpress.com/2011/12/21/cheating-in-schools-goes-high-tech/ Apparently, kids are modeling what they learned at home.

Science Daily reported in the article, Lied-to children more likely to cheat, lie:

People lie — we know this. People lie to kids — we know this, too. But what happens next? Do children who’ve been lied to lie more themselves?
Surprisingly, the question had not been asked experimentally until Chelsea Hays, then an undergraduate student in psychology at the University of California, San Diego, approached professor Leslie Carver with it. Now the pair have a paper out in Developmental Science, suggesting that adult dishonesty does make a difference, and not in a good way.
“As far as we know,” said Carver, associate professor of psychology and human development in the UC San Diego Division of Social Sciences. “This is the first experiment confirming what we might have suspected: Lying by an adult affects a child’s honesty.”
The study tested 186 children ages 3 to 7 in a temptation-resistance paradigm. Approximately half of the children were lied to by an experimenter, who said there was “a huge bowl of candy in the next room” but quickly confessed this was just a ruse to get the child to come play a game. The others were simply invited to play, with no mention of candy.
The game asked children to identify character toys they couldn’t see by their sounds. Sounds and toys were pretty easy to pair: a “Tickle me” audio clip for Elmo; “I love cookies” for Cookie Monster; and “There is a rumbly in my tummy” for Winnie the Pooh. One sound was a deliberately tricky exception: Beethoven’s “Fur Elise,” which is not associated with any commercially available character toy.
When the classical music cue was played, the experimenter was called out of the room to, supposedly, take a phone call — leaving the children alone in the room for 90 seconds and tempting them to take a peek at the mysterious toy making that sound. The children were explicitly asked not to peek. On returning, the experimenter also explicitly asked the children to tell the truth. Cameras rolled the whole time.
And? The 5-, 6- and 7-year-olds who had been lied to were both more likely to cheat and then more likely to lie about having done so, too.
About 60 percent of the school-aged children who had not been lied to by the experimenter peeked at the tricky temptation toy — and about 60 percent of the peekers lied about it later. Among those that had been lied to, those figures rose to nearly 80 percent peeking and nearly 90 percent of the peekers lying.
“Why?” remains an open research question, Carver and Hays note in their paper. It could be the 5- to 7-year-old children were simply imitating the behavior modeled by the adult, or it could be they were making judgments about the importance of honesty to this adult. Or, it could be more nuanced: “Perhaps,” they write, “the children did not feel the need to uphold their commitment to tell the truth to someone who they perceived as a liar.”
But it didn’t seem to make any difference to the younger set, the preschoolers, whether they had been deceived by the experimenter earlier. They peeked and lied at about the same rates. That may be because 3- and 4-year-olds don’t have very sophisticated theory-of-mind abilities yet.
The study was not designed to get at the reasons that children are more likely to lie when they have been lied to, but to demonstrate that the phenomenon can occur, Carver said…. http://www.sciencedaily.com/releases/2014/03/140319093802.htm

Citation:

Journal Reference:
1. Chelsea Hays, Leslie J. Carver. Follow the liar: the effects of adult lies on children’s honesty. Developmental Science, 2014; DOI: 10.1111/desc.12171
March 19, 2014
University of California, San Diego
Summary:
A new experiment is the first to show a connection between adult dishonesty and children’s behavior, with kids who have been lied to more likely to cheat and then to lie to cover up the transgression. Research has documented that the majority of parents admit to lying to their children even as they maintain that honesty is an important value. “The actions of parents suggest that they do not believe that the lies they tell their children will impact the child’s own honesty. The current study casts doubt on that belief,” the authors say. The study has implications not only for parenting but also for teaching scenarios and for forensic situations, said Carver: “All sorts of grown-ups may have to re-examine what they say to kids. Even a ‘little white lie’ might have consequences.”

Here is the press release from the University of California, San Diego:

Lied-to Children More Likely to Cheat and Lie
UC San Diego experiment first to show connection between adult dishonesty and children’s behavior
People lie – we know this. People lie to kids – we know this, too. But what happens next? Do children who’ve been lied to lie more themselves?
Surprisingly, the question had not been asked experimentally until Chelsea Hays, then an undergraduate student in psychology at the University of California, San Diego, approached professor Leslie Carver with it. Now the pair have a paper out in Developmental Science, suggesting that adult dishonesty does make a difference, and not in a good way.
“As far as we know,” said Carver, associate professor of psychology and human development in the UC San Diego Division of Social Sciences. “This is the first experiment confirming what we might have suspected: Lying by an adult affects a child’s honesty.”
The study tested 186 children ages 3 to 7 in a temptation-resistance paradigm. Approximately half of the children were lied to by an experimenter, who said there was “a huge bowl of candy in the next room” but quickly confessed this was just a ruse to get the child to come play a game. The others were simply invited to play, with no mention of candy.

Children were asked to identify well-known character toys they couldn’t see by their associated sounds.
The game asked children to identify character toys they couldn’t see by their sounds. Sounds and toys were pretty easy to pair: a “Tickle me” audio clip for Elmo; “I love cookies” for Cookie Monster; and “There is a rumbly in my tummy” for Winnie the Pooh. One sound was a deliberately tricky exception: Beethoven’s “Fur Elise,” which is not associated with any commercially available character toy.
When the classical music cue was played, the experimenter was called out of the room to, supposedly, take a phone call – leaving the children alone in the room for 90 seconds and tempting them to take a peek at the mysterious toy making that sound. The children were explicitly asked not to peek. On returning, the experimenter also explicitly asked the children to tell the truth. Cameras rolled the whole time.
And? The 5-, 6- and 7-year-olds who had been lied to were both more likely to cheat and then more likely to lie about having done so, too.
About 60 percent of the school-aged children who had not been lied to by the experimenter peeked at the tricky temptation toy – and about 60 percent of the peekers lied about it later. Among those that had been lied to, those figures rose to nearly 80 percent peeking and nearly 90 percent of the peekers lying.
“Why?” remains an open research question, Carver and Hays note in their paper. It could be the 5- to 7-year-old children were simply imitating the behavior modeled by the adult, or it could be they were making judgments about the importance of honesty to this adult. Or, it could be more nuanced: “Perhaps,” they write, “the children did not feel the need to uphold their commitment to tell the truth to someone who they perceived as a liar.”

School-aged children, ages 5 to 7, who had been lied to were both more likely to peek and then to lie about having done so. Click on image for larger view.
But it didn’t seem to make any difference to the younger set, the preschoolers, whether they had been deceived by the experimenter earlier. They peeked and lied at about the same rates. That may be because 3- and 4-year-olds don’t have very sophisticated theory-of-mind abilities yet.
The study was not designed to get at the reasons that children are more likely to lie when they have been lied to, but to demonstrate that the phenomenon can occur, Carver said.
What happens when trusted care-givers do the lying also remains an open research question. But Carver and Hays are still urging restraint. Even if it’s expedient for an adult to lie – to get cooperation through deception, for example, or to get children to control their emotions – it’s probably a bad idea in the long run.
Earlier research, Carver and Hays note in the paper, has documented that the majority of parents admit to lying to their children even as they maintain that honesty is an important value.
“The actions of parents,” Carver and Hays write, “suggest that they do not believe that the lies they tell their children will impact the child’s own honesty. The current study casts doubt on that belief.”
The study has implications not only for parenting but also for teaching scenarios and for forensic situations, said Carver: “All sorts of grown-ups may have to re-examine what they say to kids. Even a ‘little white lie’ might have consequences.”
Related Links
Leslie Carver, UC San Diego Psychology and Human Development
Developmental Science
UC San Diego Division of Social Sciences

Indiana University has a concise definition of character education in Creating a Positive Climate: Character Education:

Character education simply does that in a more systematic way. Character education includes two primary components: 1) Education in civic virtue and in the qualities that teach children the forms and rules of citizenship in a just society, and 2) Education in personal adjustment, chiefly in the qualities that enable children to become productive and dependable citizens.4
Character education may include a variety of subcomponents that can be a part of a larger character education program or that can be self-standing.
These can include social skills instruction and curricula, moral development instruction and curricula, values clarification instruction and curricula, caring education and curricula,5 and school values statements. Other programs such as cooperative learning strategies, participatory decision-making for students, and service learning are sometimes also classified as components of character education. Character education itself is often viewed as simply one component of some larger school reform and improvement strategies. For example, the “Basic School” has four components, one of which is a “Commitment to Character.”6According to Likona,7 the moral or character education of elementary students is designed to accomplish three goals:
• To promote development away from self-centered thinking and excessive individualism and toward cooperative relationships and mutual respect;
• To foster the growth of the capacity to think, feel, and act morally; and
• To develop in the classroom and in the school a moral community based on fairness, caring, and participation – such a community being a moral end in itself as well as a support system for the character development of each individual student. http://www.indiana.edu/~safeschl/charactereducation.pdf

See, Character Education Partnership http://www.character.org/key-topics/what-is-character-education/

“I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.”
Thomas Jefferson

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tags: , , , , , , , , , , , , ,