bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuropsychological Predictors of Adaptive Kitchen Behavior in Geriatric Psychiatry Inpatients
Authors: Benedict Ralph H. B. , Goldstein Marion Zucker , Dobraski Melissa , Tannenhaus Judith
Published: March 2014

This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. A mixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both depression and dementia were prevalent among patients. The kitchen skills assessment was abnormal in 69% of patients, compared to none of the normal volunteers. Estimated premorbid IQs, psychiatric diagnosis, and neuropsychological test scores significantly predicted the pass/fail status on the kitchen skills assessment, but there was no effect for age, education, gender, or depression. The discriminant function analysis classified 92% of cases, and the canonical correlation coefficient was .84. Of the neuropsychological tests employed in the study, two tests involving visuospatial processing and attention were retained in the discriminant function analysis. The results are consistent with previous studies that suggest that visuospatial tasks are more predictive of instrumental activities of daily living than are cognitive tasks emphasizing verbal and memory abilities. In addition, we conclude that neuropsychological test data are useful and valid for the purpose of guiding clinical judgments regarding activities of daily living in geriatric psychiatry patients.
Compulsive Behaviors as Presenting Symptoms of Frontotemporal Dementia
Authors: Mendez Mario F. , Perryman Kent M. , Miller Bruce L. , Swartz J. Randolph , Cummings Jeffrey L.
Published: March 2014

Frontotemporal dementia (FTD) is a common neurodegenerative dementia syndrome. Compulsive behaviors frequently occur in FTD and may be presenting symptoms of this disorder. This study evaluated compulsive behaviors as presenting symptoms in 29 patients with FTD compared to 48 patients with Alzheimer's disease (AD) enrolled in the UCLA Alzheimer's Disease Center. The FTD patients met the Lund and Manchester criteria for FTD and had predominant frontal hypoperfusion on single-photon emission computer tomography neuroimaging. The AD patients met National Institute of Neurological and Communicative Disorders-Alzheimer's Disease and Related Disorders criteria for clinically probable AD. Compulsive behaviors occurred in 11 FTD patients (38%) versus 5 AD patients (10%) (χ2 = 6.73, P < .01). This difference persisted after controlling for the younger age of the FTD group. There was a range of compulsive behaviors, with the most frequent being repetitive checking activities. Compulsive behaviors are common presenting symptoms among FTD patients and may result from an inability to inhibit urges to perform compulsive movements from damage to frontal-striatal circuits.
Nocturnal Interactions between Community Elders and Caregivers, as Measured by Cross-correlation of Their Motor Activity
Authors: Pollak Charles P. , Stokes Peter E. , Wagner Daniel R.
Published: March 2014

As the U.S. population ages, families must assume increasing responsibility for the care of elderly members. Disruptive nocturnal behaviors (DNBs) of elders, such as complaining and demanding help, may result in interactions with caregivers that threaten such arrangements. This study aimed to quantify such interactions by cross-correlating motor activity that was simultaneously recorded from the elders and caregivers. Forty-four elder-caregiver pairs reporting DNBs simultaneously kept sleep logs and wore activity recorders for 6 to 8 days. Day and night activity data were analyzed separately, because circadian variations would otherwise have overshadowed the elder-caregiver covariations of interest. An autoregressive model was fitted to each day and night data segment, and the data-model differences were used to calculate a cross-correlation function. Maximum significant values of the cross-correlation functions ( rmax) exceeded .300 in 10 pairs of subjects. The unprocessed motor activity of these pairs looked so similar that rmax was interpreted as a measure of the subjects' interactions. The rmax was significantly larger for nighttime activity, especially in pairs who shared the same bed. It was smaller in pairs whose elders had high depression scores and in those with Parkinson's disease or related disorders. It was not affected by the presence of dementia. Analysis of the lags corresponding to significant values of rmax showed that, in cohabiting pairs, it was mainly the elders who initiated interactions. The findings provide unique, objective evidence that the night is a time of special difficulty for many caregivers of older Americans.
Use of the Cognitive Estimations Test to Discriminate Frontotemporal Dementia from Alzheimer's Disease
Authors: Mendez Mario F. , Doss Robert C. , Cherrier Monique M.
Published: March 2014

This study investigated the cognitive estimations test (CET) in patients with frontotemporal dementia (FTD) and Alzheimer's disease (AD). The CET consists of questions which reflect judgment and reasoning. FTD patients, who have predominant frontotemporal atrophy, may give more extreme estimates on the CET compared to AD patients, who have greater temporoparietal pathology. The CET was administered to 31 FTD and 31 AD patients of comparable dementia severity plus 31 normal elderly controls. Both dementia groups gave significantly more extreme estimates on the CET than did the controls, and, contrary to expectations, AD patients gave more extreme estimates than did FTD patients. Extreme CET scores correlated with poor savings and calculations scores on neuropsychological tests. In conclusion, the CET may be particularly impaired in AD because it reflects impaired memory and numerical ability as well as disturbed judgment and reasoning. The CET may also be helpful in discriminating some patients in moderate stages of AD from those with FTD.
Neurologic Factors Associated with Cognitive Impairment in a Rural Elderly Population in India: The Indo-US Cross-National Dementia Epidemiology Study
Authors: Chandra Vijay , DeKosky Steven T. , Pandav Rajesh , Johnston Janet , Belle Steven H. , Ratcliff Graham , Ganguli Mary
Published: March 2014

Few reports exist of cognitive impairment and associated factors in developing countries. An age-stratified random sample of 388 men and women, 55 years and older, was drawn from a community-based population in the rural area of Ballabgarh in northern India. We classified as “cognitively impaired” those subjects who had scores below the 10th percentile of the population on a general mental status test (the Hindi Mental State Exam, HMSE) and, separately, on a memory test (Delayed Recall of a 10-Item Word List, DRWL). Three hundred seventy-six subjects also underwent a standardized neurologic history and examination. Neurologic factors associated with cognitive impairment, after adjusting for age, gender, and literacy, were history of impaired consciousness and findings of gait disturbance, diminished deep tendon reflexes, and the presence of at least one primitive reflex. We speculate that there may be unique risk factors in developing countries such as nutritional deficiencies leading to focal deficits and cognitive impairment.
Reliability of Routine Clinical Instruments for the Assessment of Alzheimer's Disease Administered by Telephone
Authors: Monteiro Isabel M. , Boksay Istvan , Auer Stefanie R. , Torossian Carol , Sinaiko Elia , Reisberg Barry
Published: March 2014

We investigated the reliability, using a telephone interview procedure, of cognitive, functional, and behavioral scales in an elderly population with normal aging and dementia. Two clinicians performed the assessments: one performed the assessments in a telephone interview format and the other conducted the assessments at the clinic. The telephone interview always preceded the clinic evaluation (2-30 days apart), and both clinicians were blind to any previous evaluations of the patient. The intraclass correlation coefficients between the telephone interview and the ratings obtained by a different clinician on the clinic evaluation varied between 0.92 and 0.98 ( P's ≤ .001) for comprehensive test scores. These results indicate that a telephone interview format, although not a substitute for a face-to-face diagnostic evaluation, is a reliable procedure for obtaining the assessment modalities studied. These findings are particularly important in aged and dementia research populations where personal contact may not always be feasible.
Nosology and Vital Statistics of Dementing Conditions of Elderly People
Authors: Smith David W. E.
Published: March 2014

The nosology of dementing conditions of very old people, as described in the International Classification of Diseases, Ninth Revision (ICD-9) and reported in Vital Statistics of the United States, is examined. Methods included a questionnaire of state officials who oversee death certification that asked chiefly about death certificate entries that denote dementing conditions. Current nosology includes several dementing conditions that are commonly indistinguishable without a postmortem examination. Dementing conditions are grouped with other conditions of unrelated pathogenesis. The words “psychosis” and “dementia” are used interchangeably. The majority of state officials said that some death certificate entries denoting dementing conditions are acceptable as causes of death. The current system of nosology of dementing conditions probably results in the under-reporting of these conditions in vital statistics. The tenth revision of the International Classification of Diseases (ICD-10) classifies dementing conditions similarly to the ninth revision. An alternative system of nosology, based on dementia as a common characteristic, is suggested.
CADASIL Syndrome: A Genetic Form of Vascular Dementia
Authors: Salloway Stephen , Hong Joseph
Published: March 2014

Mental disorders due to cerebral microvascular disease have been known for over 100 years. Recently, an autosomal dominant form of cerebral arteriopathy (CADASIL) has been described in association with a Notch3 family gene on the short arm of chromosome 19. CADASIL causes subcortical lacunar infarction and dementia in over 80% of cases and depression in a large proportion of patients. Clinically, CADASIL may appear to be very similar to hypertensive microvascular disease (Binswanger's disease), a condition that is seen in the elderly. This article reviews the clinical, pathologic, and genetic features of CADASIL. CADASIL is of interest to neurologists and psychiatrists because it is the first syndrome of vascular dementia and depression with an identified gene. How the gene causes the widespread arteriopathy is not yet known. Insights gained from the study of CADASIL should help us better understand its etiology, as well as the options for treatment of the more common forms of microvascular disease seen in the elderly.
The Prion Diseases: Creutzfeldt-Jakob, Gerstmann-Sträussler-Scheinker, and Related Disorders
Authors: Mastrianni James A.
Published: March 2014

The prion diseases are an interesting group of neurodegenerative disorders for a variety of reasons. The most obvious is their property of transmissibility, but beyond that they constitute a fascinating example of the diversity of disease expression possible from a common etiologic factor. Thought of as “strains” in animals and phenotypes in humans, these varied expressions of prion disease are most likely due to subtle conformational changes in the pathogenic form of the prion protein. These strain-like characteristics are best exemplified in the genetic varieties of human prion disease in which specific mutations are associated with specific phenotypic profiles. This review attempts to highlight the clinical and pathologic features of the prion diseases with a particular focus on the genetic determinants that define the various familial forms and that modify sporadic and iatrogenic forms of the disease.
Delirium in Hospitalized Older Patients: Recognition and Risk Factors
Authors: Inouye Sharon K.
Published: March 2014

Delirium, or acute confusional state, represents a common, serious, potentially preventable and increasing problem for older hospitalized patients. This study is intended to improve overall understanding of the problem of delirium and thus to lessen its adverse impact on the older population. The specific aims of this study are (1) to examine the epidemiology of delirium in older patients; (2) to evaluate barriers to recognition; (3) to present the Confusion Assessment Method (CAM) simplified algorithm to improve recognition; (4) to elucidate predisposing and precipitating factors for delirium; and (5) to propose preventive strategies. Delirium occurs in 10-60% of the older hospitalized population and is unrecognized in 32-66% of cases. The CAM algorithm provides a sensitive (94-100%), specific (90-95%), reliable, and easy to use means for identification of delirium. Four predisposing and five precipitating factors were identified and validated to identify patients at high risk for development of delirium. Primary prevention of delirium should address important delirium risk factors and target patients at intermediate to high risk for delirium at admission.
Relationship between Etiology and Phenomenologic Profile in Delirium
Authors: Meagher David J. , O'Hanlon Donal , O'Mahony Edmond , Casey Patricia R. , Trzepacz Paula T.
Published: March 2014

This study describes the symptom profile of 46 patients with delirium seen as consecutive referrals to a consultation-liaison psychiatry service. The relationship between symptoms rated on the Delirium Rating Scale (DRS) and delirium subtypes defined according to three putative etiologic groups are described. The relationship between etiologic groups and motoric subtype of the delirium episode is also described. Drug-related cases had the highest total DRS score and higher scores than the anticholinergic group for perceptual changes, delusions, psychomotor disturbance, and mood lability. Drug-related cases had higher scores than both the anticholinergic and infectious/electrolyte group for changes in sleep-wake cycle and fluctuation of symptoms. Those from the anticholinergic etiologic group were more likely to fit the hypoactive motoric subtype. Although our findings are tentative, etiologic categories may present with different symptom profiles, which may be associated with differing treatment responsiveness and course.
Delirium Phenomenology Illuminates Pathophysiology, Management, and Course
Authors: Meagher David J. , Trzepacz Paula T.
Published: March 2014

The phenomenology of delirium has received little standardized longitudinal study but offers the prospect of valuable insights regarding clinical subtypes, differentiation from other neuropsychiatric disorders, identification of underlying pathophysiologies, management, and course. This review examines current approaches to the investigation of delirium phenomenology and how the findings to date illuminate our understanding of delirium. It concludes with recommendations for future investigations.
Donepezil Improves Symptoms of Delirium in Dementia: Implications for Future Research
Authors: Wengel Steven P. , Roccaforte William H. , Burke William J.
Published: March 2014

Delirium is a common complication of dementia and may produce considerable morbidity. In addition to psychotic symptoms such as hallucinations and delusions, delirium may produce considerable agitation, which may be refractory to conventional medications such as antipsychotics and benzodiazepines. The main approach to delirium is to treat any underlying medical problem that could cause the delirium. However, delirium is not always reversible, and there is no specific treatment for persistent delirium. The authors present a case of delirium complicating a preexisting dementia that resolved rapidly following initiation of the cholinesterase inhibitor donepezil, suggesting that cholinergic dysfunction may have played a role in the etiology of this patient's delirium. Future research needs to be directed at the issue of cholinergic activity in delirium through monitoring of serum anticholinergic activity and its response to procholinergic therapy.
Verbal Fluency Task Affects Gait in Parkinson's Disease with Motor Freezing
Authors: Camicioli Richard , Oken Barry S. , Sexton Gary , Kaye Jeffrey A. , Nutt John G.
Published: March 2014

We examined the effects of a simultaneous verbal fluency task on walking in Parkinson's disease (PD) patients with freezing of gait (PD-F) compared to nonfreezing patients (PD-NF) or control subjects (C). Effects of antiparkinsonian medications on gait in PD-F were examined. PD-F patients exhibited a greater increase in the number of steps to complete the walk with verbal fluency, even when the effect of medication was taken into account (mean increase ± SD): PD-F = 4.2 ± 4.6, n = 10; PD-NF = 0.1 ± 1.6, n = 9; C = 1.5 ± 1.5, n = 19; P = .007. Medications improved walking in PD-F patients by decreasing the number of steps, the time to walk, and freezing. PD-F patients may be more dependent on attention for walking.
Treatment-Resistant Depression in Late Life
Authors: Mulsant Benoit H. , Pollock Bruce G.
Published: March 2014

Depression is the most prevalent functional psychiatric disorder in late life. It is associated with a high risk of mortality from comorbid medical illness and from suicide. Successful antidepressant treatment is one of the most effective ways to reduce disability, prevent morbidity, and improve quality of life in an older depressed patient. Treatment-resistant depression is a common clinical problem, reported to affect up to one-third of older depressed patients. However, published data on this clinically important topic are sparse. Available data and clinical experience indicate that many depressed patients labeled as “treatment resistant” or even “treatment refractory” are so labeled because of variables involving the diagnostic or treatment process, rather than because they suffer from a depression that is truly unresponsive to treatment. Unidentified comorbid medical or psychiatric conditions and misdiagnosis often contribute to treatment resistance. Atypical depressive symptoms, such as somatic and cognitive symptoms, and comorbid medical conditions that can themselves produce depressive symptoms often make it difficult to accurately assess antidepressant response in this age group. This often leads to inadequate pharmacotherapy, another major factor contributing to apparent treatment resistance. In older patients, as in younger patients, the selection of the right antidepressant, the right dose, and the right treatment duration constitute the treatment variables essential in ensuring optimal therapeutic response. Approach to treatment-resistant depression in the elderly involves reconsideration of the diagnosis and use of alternate therapeutic measures in a systematic way, including switching to another agent, combination therapy, and electroconvulsive therapy.
Management of Anxiety in Late Life
Authors: Flint Alastair J.
Published: March 2014

Epidemiologic data are used as a framework to discuss the pharmacologic and cognitive-behavioral management of anxiety disorders in late life. Generalized anxiety disorder (GAD) and phobias account for most cases of anxiety in late life. The high level of comorbidity between GAD and major depression, and the observation that the anxiety usually arises secondarily to the depression, suggests that antidepressant medication should be the primary pharmacologic treatment for many older people with GAD. Most individuals with late-onset agoraphobia do not have a history of panic attacks and the illness often starts after a traumatic event. Exposure therapy is the treatment of choice for agoraphobia without panic. It is uncommon for obsessive-compulsive disorder (OCD) and panic disorder to start for the first time in old age, but these disorders can persist from younger years into late life. Case reports and uncontrolled case series suggest that elderly people with OCD or panic disorder can benefit from pharmacologic and cognitive-behavioral treatments that are known to be effective in younger patients. However, it is not known whether the rate of response among elderly patients is adversely affected by the chronicity of these disorders. The prevalence and incidence of post-traumatic stress disorder in late life are not known. Uncontrolled data support the use of selective serotonin reuptake inhibitors in war veterans with chronic symptoms of post-traumatic stress disorder; other treatments for this condition await evaluation in the elderly.
Behavioral Disturbances of Dementia
Authors: Pollock Bruce G. , Mulsant Benoit H.
Published: March 2014

Behavioral disturbances are common in patients with dementia. Medical intervention is needed if, for example, these behaviors threaten a patient's safety or jeopardize his or her ability to perform activities of daily living. Typical antipsychotic agents are associated with troublesome adverse effects in the elderly (e.g., anticholinergic effects, extrapyramidal symptoms). Atypical antipsychotics have reduced potential to cause these types of side effects but are not free from side effects. Recently, there has been a greater focus on the use of antidepressants to treat behavioral disturbances in dementia. Among these, selective serotonin reuptake inhibitors have been studied more commonly due to their safety profile in the elderly. Citalopram, in particular, has demonstrated efficacy in improving dementia-related behavioral symptoms.
Adaptive trajectory tracking control system design for hypersonic vehicles with parametric uncertainty
Authors: Liu Zhen , Tan Xiangmin , Yuan Ruyi , Fan Guoliang , Yi Jianqiang
Published: March 2014

A new nonlinear adaptive control scheme based on the immersion and invariance theory is presented to achieve robust velocity and altitude tracking for hypersonic vehicles with parametric uncertainty. The longitudinal dynamics of the hypersonic vehicle are first decomposed into velocity, altitude/flight-path angle, and angle of attack/pitch rate subsystems. Then a non-certainty-equivalent controller based on immersion and invariance, consisting of a control module and a parameter estimator, is designed for each subsystem with all the aerodynamic parameters unknown. The main feature of this method lies in the construction of the estimator, which is a sum of a partial estimate generated from the update law and an additional nonlinear term. The new term is capable of assigning appointed stable dynamics to the parameter estimate error. Stability analysis is presented using Lyapunov theory and shows asymptotical convergence of the tracking error to zero. Representative simulations are performed. Rapid and accurate command tracking is demonstrated in these numerical simulations, which illustrate the effectiveness and robustness of the proposed approach.
Online Training for Paraeducators to Support the Communication of Young Children
Authors: Douglas Sarah N. , McNaughton David , Light Janice
Published: March 2014

Paraeducators are frequent sources of support for young children with disabilities in early childhood settings. However, they typically have limited training in providing communication opportunities for children with complex communication needs (CCN). The impact was investigated of providing training in a communication interaction strategy to three paraeducators working with young children with diagnoses of autism and developmental delay. The training included interactive online components as well as opportunities to use and ask questions about the strategy, and reflection on strategy use. After participating in the training activities, the paraeducators were observed to provide a greater number of appropriate communication opportunities during play interactions with the young children. The children with CCN also showed increases in the number of communication acts performed. In addition, paraeducator responses (including comments on child behaviors) increased. Results of social validity and generalization measures are reported. Limitations of the study are also discussed.
Tiltrotor cabin noise control through smart actuators
Authors: Bernardini G , Testa C , Gennaretti M
Published: March 2014

This paper deals with the abatement of the tonal noise inside the fuselage of a mid-range tiltrotor aircraft, as generated by the propulsive system. The problem is basically multidisciplinary, involving interactions among the exterior noise field, elastic fuselage dynamics, interior acoustics and control system. A stiffened fuselage, with piezoelectric patches embedded into the structure, is supposed to be impinged on by the aeroacoustic field generated by propellers and excited by the wing/pylon/proprotor vibratory loads at the wing–fuselage attachment. An optimal linear quadratic regulator cyclic control formulation, coupled with a genetic optimization algorithm, is applied to synthesize the control law driving the smart actuators so as to alleviate cabin noise. The aeroacoustoelastic model considered in the control problem is obtained by combining cabin interior acoustics, fuselage smart shell dynamics and wing/pylon/proprotor aeroelasticity described through modal approaches with the exterior pressure field provided by boundary element method solvers. Numerical results examine the effectiveness and robustness of the proposed active control strategy.
Subchronic Oral Toxicity Study of Decitabine in Combination With Tetrahydrouridine in CD-1 Mice
Authors: Terse Pramod , Engelke Kory , Chan Kenneth , Ling Yonghua , Sharpnack Douglas , Saunthararajah Yogen , Covey Joseph M.
Published: March 2014

Decitabine (5-aza-2′-deoxycytidine; DAC) in combination with tetrahydrouridine (THU) is a potential oral therapy for sickle cell disease and β-thalassemia. A study was conducted in mice to assess safety of this combination therapy using oral gavage of DAC and THU administered 1 hour prior to DAC on 2 consecutive days/week for up to 9 weeks followed by a 28-day recovery to support its clinical trials up to 9-week duration. Tetrahydrouridine, a competitive inhibitor of cytidine deaminase, was used in the combination to improve oral bioavailability of DAC. Doses were 167 mg/kg THU followed by 0, 0.2, 0.4, or 1.0 mg/kg DAC; THU vehicle followed by 1.0 mg/kg DAC; or vehicle alone. End points evaluated were clinical observations, body weights, food consumption, clinical pathology, gross/histopathology, bone marrow micronuclei, and toxicokinetics. There were no treatment-related effects noticed on body weight, food consumption, serum chemistry, or urinalysis parameters. Dose- and gender-dependent changes in plasma DAC levels were observed with a Cmax within 1 hour. At the 1 mg/kg dose tested, THU increased DAC plasma concentration (∼10-fold) as compared to DAC alone. Severe toxicity occurred in females receiving high-dose 1 mg/kg DAC + THU, requiring treatment discontinuation at week 5. Severity and incidence of microscopic findings increased in a dose-dependent fashion; findings included bone marrow hypocellularity (with corresponding hematologic changes and decreases in white blood cells, red blood cells, hemoglobin, hematocrit, reticulocytes, neutrophils, and lymphocytes), thymic/lymphoid depletion, intestinal epithelial apoptosis, and testicular degeneration. Bone marrow micronucleus analysis confirmed bone marrow cytotoxicity, suppression of erythropoiesis, and genotoxicity. Following the recovery period, a complete or trend toward resolution of these effects was observed. In conclusion, the combination therapy resulted in an increased sensitivity to DAC toxicity correlating with DAC plasma levels, and females are more sensitive compared to their male counterparts.
Rapid, high-resolution, whole-brain, susceptibility-based MRI of multiple sclerosis
Authors: Sati P , Thomasson DM , Li N , Pham DL , Biassou NM , Reich DS , Butman JA
Published: March 2014

Background:

Susceptibility-based MRI offers a unique opportunity to study neurological diseases such as multiple sclerosis (MS). In this work, we assessed a three-dimensional segmented echo-planar-imaging (3D-EPI) sequence to rapidly acquire high-resolution T2*-weighted and phase contrast images of the whole brain. We also assessed if these images could depict important features of MS at clinical field strength, and we tested the effect of a gadolinium-based contrast agent (GBCA) on these images.

Materials and methods:

The 3D-EPI acquisition was performed on four healthy volunteers and 15 MS cases on a 3T scanner. The 3D sagittal images of the whole brain were acquired with a voxel size of 0.55 × 0.55 × 0.55 mm3 in less than 4 minutes. For the MS cases, the 3D-EPI acquisition was performed before, during, and after intravenous GBCA injection.

Results:

Both T2*-weighted and phase-contrast images from the 3D-EPI acquisition were sensitive to the presence of lesions, parenchymal veins, and tissue iron. Conspicuity of the veins was enhanced when images were obtained during injection of GBCA.

Conclusions:

We propose this rapid imaging sequence for investigating, in a clinical setting, the spatiotemporal relationship between small parenchymal veins, iron deposition, and lesions in MS patient brains.
Core outcome measures for exercise studies in people with multiple sclerosis: recommendations from a multidisciplinary consensus meeting
Authors: Paul Lorna , Coote Susan , Crosbie Jean , Dixon Diane , Hale Leigh , Holloway Ed , McCrone Paul , Miller Linda , Saxton John , Sincock Caroline , White Lesley
Published: March 2014

Evidence shows that exercise is beneficial for people with multiple sclerosis (MS); however, statistical pooling of data is difficult because of the diversity of outcome measures used. The objective of this review is to report the recommendations of an International Consensus Meeting for a core set of outcome measures for use in exercise studies in MS. From the 100 categories of the International Classification of Function Core Sets for MS, 57 categories were considered as likely/potentially likely to be affected by exercise and were clustered into seven core groups. Outcome measures to address each group were evaluated regarding, for example, psychometric properties. The following are recommended: Modified Fatigue Impact Scale (MFIS) or Fatigue Severity Scale (FSS) for energy and drive, 6-Minute Walk Test (6MWT) for exercise tolerance, Timed Up and Go (TUG) for muscle function and moving around, Multiple Sclerosis Impact Scale (MSIS-29) or Multiple Sclerosis Quality of Life-54 Instrument (MSQoL54) for quality of life and body mass index (BMI) or waist-hip ratio (WHR) for the health risks associated with excess body fat. A cost effectiveness analysis and qualitative evaluation should be included where possible. Using these core measures ensures that future meta-analyses of exercise studies in MS are more robust and thus more effectively inform practice.
Autistic expertise: A critical reflection on the production of knowledge in autism studies
Authors: Milton Damian EM
Published: March 2014

The field of autism studies is a highly disputed territory within which competing contradictory discourses abound. In this field, it is the voices and claims of autistic people regarding their own expertise in knowledge production concerning autism that is most recent in the debate, and traditionally the least attended to. In this article, I utilise the theories of Harry Collins and colleagues in order to reflect upon and conceptualise the various claims to knowledge production and expertise within the field of autism studies, from the perspective of an author who has been diagnosed as being on the autism spectrum. The notion that autistic people lack sociality is problematised, with the suggestion that autistic people are not well described by notions such as the ‘social brain’, or as possessing ‘zero degrees of cognitive empathy’. I then argue, however, that there is a qualitative difference in autistic sociality, and question to what extent such differences are of a biological or cultural nature, and to what extent interactional expertise can be gained by both parties in interactions between autistic and non-autistic people. In conclusion, I argue that autistic people have often become distrustful of researchers and their aims, and are frequently frozen out of the processes of knowledge production. Such a context results in a negative feedback spiral with further damage to the growth of interactional expertise between researchers and autistic people, and a breakdown in trust and communication leading to an increase in tension between stakeholder groups. The involvement of autistic scholars in research and improvements in participatory methods can thus be seen as a requirement, if social research in the field of autism is to claim ethical and epistemological integrity.
Holistic processing of faces as measured by the Thatcher illusion is intact in autism spectrum disorders
Authors: Cleary Laura , Brady Nuala , Fitzgerald Michael , Gallagher Louise
Published: March 2014

Impaired face perception in autism spectrum disorders is thought to reflect a perceptual style characterized by componential rather than configural processing of faces. This study investigated face processing in adolescents with autism spectrum disorders using the Thatcher illusion, a perceptual phenomenon exhibiting ‘inversion effects’ that characterize typical face processing. While previous studies used a limited range of face orientations, we measured perception of normality/grotesqueness of faces at seven orientations ranging from upright to inverted to allow for a detailed comparison of both reaction time and error by orientation profiles. We found that, like their typically developing peers, adolescents with autism spectrum disorders show strong inversion effects whereby reaction times were longer and error rates greater at inverted when compared to upright orientations. Additionally, the adolescents with autism spectrum disorders, like their peers in the typically developing group, show a marked nonlinearity in the error by orientation profile. Error is roughly constant out to 90° and then increases steeply, indicating a sudden shift from configural to local processing that reflects experience with faces in their typical orientations. These findings agree with recent reports that face perception is qualitatively similar in autistic and neurotypical groups.
Trick or treat? Muslim Thangals, psychologisation and pragmatic realism in Northern Kerala, India
Authors: Lang Claudia
Published: March 2014

Thangals are an endogamous community in Kerala, India, of Yemeni heritage who claim direct descent from the Prophet Muhammad’s family. Due to their sacrosanct status, many thangals work as religious healers and thus are part of the informal mental health care system in Northern Kerala. Using the case of one thangal healer as an illustration of the many ritual healers in Kerala who engage the modern discourse of psychology in their practices, I argue that the psychologisation of ritual healing is part of a wider trend: the increasing rationalisation and scientification of traditional medical practices, whereby an increasing number of traditional healers negotiate science, modernity and religion and position their practice within these contested fields. Based on the analysis of this thangal’s healing practice in the local context of Northern Kerala, I further argue that in order to understand “ritual” healing, scholars should emphasise pragmatic realism more than doctrinal purity.
Do psychosocial work conditions predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations
Authors: Clausen Thomas , Burr Hermann , Borg Vilhelm
Published: March 2014

Aims: To investigate whether high psychosocial job demands (quantitative demands and work pace) and low psychosocial job resources (influence at work and quality of leadership) predicted risk of disability pensioning among employees in four occupational groups – employees working with customers, employees working with clients, office workers and manual workers – in line with the propositions of the Job Demands-Resources (JD-R) model. Methods: Survey data from 40,554 individuals were fitted to the DREAM register containing information on payments of disability pension. Using multi-adjusted Cox regression, observations were followed in the DREAM-register to assess risk of disability pensioning. Average follow-up time was 5.9 years (SD=3.0). Results: Low levels of influence at work predicted an increased risk of disability pensioning and medium levels of quantitative demands predicted a decreased risk of disability pensioning in the study population. We found significant interaction effects between job demands and job resources as combinations low quality of leadership and high job demands predicted the highest rate of disability pensioning. Further analyses showed some, but no statistically significant, differences between the four occupational groups in the associations between job demands, job resources and risk of disability pensioning. Conclusions: The study showed that psychosocial job demands and job resources predicted risk of disability pensioning. The direction of some of the observed associations countered the expectations of the JD-R model and the findings of the present study therefore imply that associations between job demands, job resources and adverse labour market outcomes are more complex than conceptualised in the JD-R model.
Psychosocial factors at work and the development of mobility limitations among adults in Denmark
Authors: Hansen Åse Marie , Darsø Lilie , Manty Minna , Nilsson Charlotte , Christensen Ulla , Lund Rikke , Holtermann Andreas , Avlund Kirsten
Published: March 2014

Aim: Psychosocial factors in the working environment have been shown to be associated with mobility limitations, but this has not yet been confirmed in a Danish population. We aimed to examine how psychosocial factors at work are related to developing mobility limitations in Denmark. Methods: This study is based on data from 2952 middle-aged men and women without mobility limitations in 2000. Results: We found increased risk of incident mobility limitations during 6-year follow up among men who often perceived high work pace (OR 5.45, 95% CI 1.21–24.52) vs. never, who only sometimes or/never perceived the work to be meaningful (OR 6.54, 95% CI 1.55–27.55) vs. always, and who sometimes perceived high emotional demands at work (OR 7.85, 95% CI 1.78–34.65) vs. never. Among women, lower risk of incident mobility limitations was observed among those who in 2000 perceived high work pace sometimes (OR 0.46, 95% CI 0.24–0.87) or often (OR 0.43, 95% CI 0.22–0.85) vs. never in 2000. Also, women who always or often experienced high emotional demands had an increased risk. Conclusions: The most important finding was that high work pace was strongly associated with increased risk of mobility limitations among men, but associated with lower risk of mobility limitations among women. This knowledge may be used to better target interventions among men and women in midlife from physical deterioration later in life.
Classical hallucinogens as antidepressants? A review of pharmacodynamics and putative clinical roles
Authors: Baumeister David , Barnes Georgina , Giaroli Giovanni , Tracy Derek
Published: March 2014

Hallucinogens have been part of spiritual practice for millennia, but controversy surrounding their mind-manifesting effects led to their proscription by the mid-20th century, largely without evidence of harm or toxicity and despite nascent data suggesting therapeutic utility in treating depressive illnesses. This review explores their pharmacodynamic actions and the current limited data on their clinic effectiveness. These drugs appear to exert their psychedelic effects through their agonist or partial agonist activity at the serotonergic 5-HT2A receptor, though they also have affinity for other metabotropic serotonin receptors. Hallucinogen binding affects a wide range of intracellular signalling pathways, the precise nature of which remains incompletely understood. They alter the serotonergic tone of brainstem raphe nuclei that project through the brain; they interact with receptors in the prefrontal cortex altering connectivity patterns and intracellular functioning; and they disrupt inhibitory control of sensory input via the thalamus to the cortex. The serotonergic system has long been implicated in anxiety and depressive disorders, and is a major target of most existing antidepressants. Classical hallucinogens alter the functioning of this system, but not in the same way current medications do: whilst there are identified receptors and neurotransmitter pathways through which hallucinogens could therein produce therapeutic effects, the neurobiology of this remains speculative at this time. There is currently an extremely limited but growing literature on hallucinogen safety and clinical application. The drugs appear well tolerated by healthy controls and clinical populations, and the rapid tolerance to repeated administration might reduce the possibility of dependency. Clinical trials reported over the past decade have generally shown positive therapeutic potential, but they are notably few in number. Legislative policy has had a freezing effect on evaluation of these compounds, a better understanding of which might improve our knowledge of the processes involved in consciousness, the neuropathology of depression, and potentially open up new pharmacological therapies.
Introducing the Scientific Consensus on Maintaining Humanity’s Life Support Systems in the 21st Century: Information for Policy Makers
Authors: Barnosky Anthony D , Brown James H , Daily Gretchen C , Dirzo Rodolfo , Ehrlich Anne H , Ehrlich Paul R , Eronen Jussi T , Fortelius Mikael , Hadly Elizabeth A , Leopold Estella B , Mooney Harold A , Myers John Peterson , Naylor Rosamond L , Palumbi Stephen , Stenseth Nils Chr , Wake Marvalee H
Published: March 2014

The Anthropocene is recognized (though not yet formally defined) as the time when human impacts are widespread on Earth. While some of the impacts are essential to supporting large human populations and can be sustainable in the long run, others can irretrievably damage the life support systems upon which the global society has come to depend, or spark rapid changes to which societies cannot adapt fast enough. Among these dangerous trends are increasing climate disruption, extinctions, loss of non-human-dominated ecosystems, pollution, and population overgrowth. Interactions between these five trends exacerbate their potential to trigger harmful global change. Reducing the resultant risks requires effective cooperation between scientists and policy makers to develop strategies that guide for environmental health over the next few decades. To that end, the Scientific Consensus on Maintaining Humanity’s Life Support Systems in the 21st Century was written to make accessible to policy makers and others the basic scientific underpinnings and widespread agreement about both the dangers of and the solutions to climate disruption, extinctions, ecosystem loss, pollution and population overgrowth. When it was released in May 2013, the document included endorsements by 522 global change scientists, including dozens of members of various nations’ most highly recognized scientific bodies, from 41 countries around the world. Since then, endorsements have grown to more than 1300 scientists plus more than 1700 others – business people, NGO representatives, students, and the general public – spanning more than 60 countries. Now also available in Spanish and Chinese, the document has proven useful in helping to stimulate national and international agreements. Further information about the genesis, uses, the signatories, and how to endorse it can be found at http://consensusforaction.stanford.edu/ . Such communication between scientists, policy makers, and the public at large will be essential for effective guidance to address global change as the Anthropocene progresses.
Moving Beyond Description
Authors: Hardin Marie
Published: March 2014

This Twitter Research Forum essay by Communication & Sport Associate Editor Marie Hardin explores the life cycle of scholarship concerning Twitter and other forms of social media in the sporting context. While noting that reliance on descriptive research and content analyses during the relative infancy of Twitter and other social media was sensible in understanding the “message” tendencies of new media forms, the paucity of conceptual and theoretical drive in much of this early research has been notable. Hardin argues that the next logical step in research on social media and sport is to put a much higher priority on studies that theorize new media in communicative terms and place understanding their importance and functioning in a wider sociocultural context. The critique notes the ease of data collection in Twitter research on sport has too often not challenged researchers to go beyond observations about “low-hanging fruit” and to explore understanding of Twitter as a site of discourse around power and identities. Hardin’s essay concludes by noting the need for effects research to really assess whether Twitter is a “game changer” and for communication and sport scholars to bridge social sciences and the humanities in future inquiry.
Much Ado (or Not) About Twitter? Assessing an Emergent Communication and Sport Research Agenda
Authors: Wenner Lawrence A.
Published: March 2014

This Twitter Research Forum essay by Communication & Sport editor Lawrence Wenner introduces a set of invited commentary essays by leading scholars on the theme “Much Ado (or Not) About Twitter? Assessing an Emergent Communication and Sport Research Agenda.” Background is given on the present need for a public forum that takes stock of emerging trends, liabilities, and potentialities about Twitter and sport in communication and sport scholarly inquiry. Key questions about the trajectory and future needs in the Twitter and sport agenda are posed. Authors and topics featured in the Forum are summarized.
Power in the Reverberation
Authors: Billings Andrew
Published: March 2014

This Twitter Research Forum essay by Communication & Sport Associate Editor Andrew Billings explores the problems underlying research efforts reliant on the mass aggregation of tweets within the social media platform. It is argued that Twitter research can often overlook the staying power of sport on television while overestimating the adoption and use of Twitter in the sporting context. Assertions about Twitter’s role in democratizing sport need to be tested carefully as does the dynamic of Twitter’s role in setting the mainstream sport media agenda. A key argument is made that Twitter is worth studying in the realm of sports media not because it is a great representation of the overall public but precisely because it is not at all representative of any generalized population, most certainly including the far-from-monolithic sports fan.