bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroendocrine Mechanisms of Depression
Authors: Goldstein Jill M. , Holsen L. , Cherkerzian S. , Misra M. , Handra R.J. 
Published: December 2017

Abstract
Studies have demonstrated that major depressive disorder (MDD) is intimately tied to neuroendocrine dysregulation. This arises, in part, from the fact that brain regions that regulate mood also regulate primary neuroendocrine axes and metabolic functions. We and others demonstrated that the origin of MDD-neuroendocrine deficits begins in fetal development, is sex-dependent, emerges just post-puberty, and can be catalyzed by pregnancy (postpartum) and menopause. Here, we critically review clinical and preclinical studies to argue that higher MDD risk in women may arise, in part, from hormone-dependent pathogenic processes initiated during fetal development that drive sex-dependent developmental alterations of HPA circuitry emerging post-puberty with lifelong consequences.
What are Fear and Anxiety? Listening to the Brain
Authors: Ledoux Joseph 
Published: December 2017

Abstract
Imprecise language plagues discussions of “anxiety disorders” and other forms of mental illness. For example, failure to clearly distinguish the constructs “fear” and “anxiety” leads to confused interpretations of findings. Moreover, because both terms are most commonly used to refer to subjective experiences, their use in describing both subjective experiences and behavioral and physiological responses that sometimes, but not always, occur with the experiences, is also problematic. The failure of anxiolytic drug development is due in part to unrealistic expectations generated by imprecise use of the terms fear and anxiety. In order for the science of fear and anxiety to advance, scientists need to pay more attention to their scientific language.
Reward Circuitry and Drug Addiction
Authors: Steele Vaughn R. , Pariyadath Vani , Goldstein Rita Z. , Stein Elliot A. 
Published: December 2017

Abstract
Addiction is a complex neuropsychiatric syndrome related to dysregulation of brain systems including the mesocorticolimbic dopamine reward circuit. Dysregulation of reward circuitry is related to each of the three cyclical stages in the disease model of addiction: maintenance, abstinence, and relapse. Parsing reward circuitry is confounded due to the anatomical complexity of cortico-basal ganglia-thalamocortical loops, forward and backward projections within the circuit, and interactions between neurotransmitter systems. We begin by introducing the neurobiology of the reward system, specifically highlighting nodes of the circuit beyond the basal ganglia, followed by a review of the current literature on reward circuitry dysregulation in addiction. Finally, we discuss biomarkers of addiction identified with neuroimaging that could help guide neuroprediction models and development of targets for effective new interventions, such as noninvasive brain stimulation. The neurocircuitry of reward, especially non-prototypical nodes, may hold essential keys to understanding and treating addiction.
Neuroimaging and Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease
Authors: Gordon Brian A. , Vos Stephanie J.B. , Fagan Anne M. 
Published: December 2017

Abstract
Alzheimer’s disease is characterized by a long asymptomatic (preclinical) phase during which disease-related pathology accumulates in the absence of overt cognitive symptoms. The most prominent neuropathologies are extracellular amyloid plaques and intraneuronal neurofibrillary tangles. Until recently such pathology was observable only at autopsy. Now these, and other novel pathological markers, can be measured in living individuals using cerebrospinal fluid assays, blood tests, and neuroimaging techniques to track disease progression. Understanding changes in these biomarkers is critical for diagnosis, monitoring disease progression, and for the development of disease-modifying therapies. This chapter reviews the current scientific understanding regarding the use of biomarkers to assess Alzheimer’s disease pathology.
Animal models of Alzheimer’s Disease
Authors: Morgan David 
Published: December 2017

Abstract
In the discovery phase of drug development for Alzheimer’s disease it is useful to have animal models in which proof of principle can be obtained. Models of disease symptoms (memory impairment) and models of the disease pathology (lesions, amyloid-depositing models, tau-depositing models) are described and discussed. Moreover, these different types of models can be combined in an attempt to more faithfully replicate the disease condition. Although worms, flies, fish and dogs have been explored, the bulk of the research has focused on rodents, especially mice. Each of these approaches has limitations, but all have contributed to the development of agents designed to prevent or treat Alzheimer’s and other dementias.
Cellular Mechanisms of Dementia
Authors: Gan Li 
Published: December 2017

Abstract
Neurodegenerative dementias, including Alzheimer’s disease (AD), Parkinson’s disease (PD) and Frontotemporal dementia (FTD), pose enormous challenges for our aging society. Genetic and mechanistic studies have revealed common molecular and cellular pathways, including imbalanced proteostasis and aberrant innate immune responses. Key pathogens in AD, PD, and FTD accumulate and spread from one brain region to another, resulting in network dysfunction and cognitive decline. These diseases are multifactorial, caused by interactions among multiple genetic, epigenetic, and environmental factors and pathways. Combination therapies that target multiple pathways may also be needed to stop or delay the dementing conditions in neurodegenerative dementias.
Current Treatments for Alzheimer’s Disease
Authors: Sano Mary , Neugroschil Judith 
Published: December 2017

Abstract
Five medications representing two classes of drugs have been approved by the US Food and Drug Administration for the treatment of Alzheimer’s disease since 1994. There have been no new approved agents since 2003, although hundreds of clinical trials are in progress. This chapter reviews the pharmacology underlying the currently approved treatments, acetylcholinesterase inhibitors and the NMDA receptor antagonist memantine, and the data supporting their efficacy. Other approaches currently in use or being developed are also reviewed, including the use of hormones, agents that modify cardiovascular and metabolic risk, as well as a number of vitamin supplements and nutritional approaches.
Diagnosis and Epidemiology of Pediatric Psychiatric Disorders
Authors: Robinson Elise B. , Neale Benjamin M. , Daly Mark J. 
Published: December 2017

Abstract
Pediatric psychiatric conditions are rising in estimated prevalence, and these disorders place an enormous burden on parents, educators, and the health care system. This rise in prevalence likely contains elements of diagnostic changes, greater awareness of these disorders, and true changes in incidence. It has been estimated that there is nearly a 50% lifetime childhood prevalence of one or more mood, anxiety, or behavioral disorders (excluding eating and substance abuse disorders) and that more than 20% of children meet the definition of severe impairment. This chapter focuses on epidemiology, heritability, and implied genetic architecture in representative pediatric neuropsychiatric conditions. We consider five major diagnostic categories and highlight major diagnosis within each, specifically, intellectual disability, pervasive developmental disorders (autism spectrum disorder [ASD]), hyperactive and inattentive behavior (attention deficit/hyperactivity disorder [ADHD]), obsessive compulsive disorder (OCD) and tic disorders (TD) (which includes Tourette Syndrome [TS] and other chronic tic disorders).
Neurodevelopmental Mechanisms of Pediatric Psychiatric Disorders
Authors: De Rubeis Silvia , Roeder Kathryn , Devlin Bernie 
Published: December 2017

Abstract
The development of the human brain is a complex process that begins during the first weeks of gestation and extends at least through adolescence and early adulthood. This chapter will review the perturbations of the developmental trajectories during prenatal and early postnatal life that can lead to psychiatric disorders of childhood onset. We will provide a general view of the epochs and trajectories of brain development, from embryonic neurulation to postnatal development, with an emphasis on the development of the neocortex. Within each developmental window, we will consider some salient cellular and molecular pathways, and discuss how genetic and environmental insults underlying psychiatric disorders disrupt them.
The Neurobiology of Tic Disorders and Obsessive-Compulsive Disorder
Authors: Pittenger Christopher 
Published: December 2017

Abstract
Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS), along with other tic disorders, involve pathophysiological alterations in the cortico-striatal circuitry. Both are neurodevelopmental conditions, although OCD can also have adult onset. They are frequently comorbid and often run together in families. Recent genetic studies suggest shared risk factors, especially in the case of early-onset OCD. Because of these shared characteristics, they are treated together here. Structural and functional neuroimaging studies are refining our understanding of the abnormalities in corticostriatal connectivity that accompany symptomatology; in the case of TS, these have been accompanied by exciting observations in postmortem tissue that are beginning to connect observed anatomical and network abnormalities to underlying cellular substrates. Finally, recent advances in animal modeling of pathophysiology have allowed testing of specific etiological hypotheses and have established several systems in which more precise mechanistic studies of pathophysiology are now proceeding.
Neurobiology of Eating Disorders
Authors: Hildebrandt Thomas , Heywood Ashley 
Published: December 2017

Abstract
Eating disorders are recognized by a primary disturbance in eating that results in impairing levels of distress. Commonly beginning in adolescence and affecting primarily females, these illnesses have diagnostic criteria that are actively debated but retain core features including disturbances in the maintenance of a healthy weight, episodic binge eating and/or compensatory behaviors, and body image disturbances. This chapter will provide a summary of the primary neurobiological understanding of eating disorders form experiments using animal models as well as the growing literature in humans. Dysregulation in appetite hormones and peptides, adrenal hormones, ovarian hormones, the serotonergic and dopaminergic systems, and several central nervous system neurocircuits all show strong correlation to the development and maintenance of these chronic and frequently relapsing disorders.
Current Treatments for Pediatric Psychiatric Disorders
Authors: Trelles M. Pilar , Siper Paige M. , Grice Dorothy E. 
Published: December 2017

Abstract
Many psychiatric disorders of childhood have a chronic course. As such, they impact multiple developmental epochs and negatively influence developmental trajectories. While early identification and intervention may minimize, or even prevent, symptoms being carried into adulthood, the availability of evidence-based treatments is sparse in children and adolescents compared to adult populations. Establishing effective interventions for psychiatric symptoms presenting in childhood is critical given the chronic course of most psychiatric disorders. This chapter describes psychopharmacological and psychosocial interventions used for the treatment of childhood psychiatric conditions, with an emphasis on empirically supported treatments. Both symptom- and diagnosis-specific approaches are described as well as the use of combined interventions for the following childhood psychiatric conditions: autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, obsessive compulsive disorder (OCD), chronic tic disorders, eating disorders, and conduct problems.
Population ageing in Europe
Authors: Grundy Emily M. , Murphy Michael 
Published: December 2017

Abstract
Population ageing—the process leading to increases in the representation of older people in the total population—was a predominant trend in trend in twentieth-century Europe, which will intensify over the course of the current century. This chapter presents information on the past, current, and likely future size and demographic characteristics of Europe’s older populations over the period 1950–2050 and explains the demographic changes driving population ageing. Information on the availability of close relatives (spouses and children) related to these demographic changes is also provided together with consideration of variations across Europe in the living arrangements and family support of older people. Policy implications, and possible policy responses, to these changes are considered in the final sections.
Ageing in North America: Canada and the United States
Authors: Crimmins Eileen M. , Beltrán-Sánchez Hiram , Brown Lauren , Yon Yongjie 
Published: December 2017

Abstract
Canada and the United States, while similar in many ways, differ somewhat in age structures, life expectancies, policies relevant to an ageing population, and the challenges they face with future ageing. Canada is the older and longest-lived. Both countries have made changes in their healthcare systems to provide access to healthcare across their populations. Socioeconomic differences in the ageing process are an issue in both of these countries. In this chapter, we first outline the demographic conditions relevant to the ageing population in these countries, then examine health issues relevant to the ageing population including a number of dimensions of health and healthcare. We then lay out specific socioeconomic and cultural challenges related to an ageing population in each country and how these are likely to be dealt with in the future.
Population ageing in Sub-Saharan Africa
Authors: Cassim Bilkish , Aboderin Isabella 
Published: December 2017

Abstract
Sub-Saharan Africa (SSA), the youngest and poorest region of the world, is facing an incipient ageing of its population. Its already considerable and rising population of older adults is exposed to a triple burden of disease from persisting communicable and rising non-communicable diseases (NCDs), as well as trauma and injury, while at the same time it lacks access to requisite care. Challenges in addressing this gap include pervasive economic strain and underresourced health systems with competing priorities, as well as insufficient robust data on the patterns of ill health, disability, and care access in older age. Strategies for, and action on adapting SSA’s health and care systems to its ageing populations are urgently needed, and may be forged within the context of a World Health Organization (WHO) decade on healthy ageing 2020–2030.
Health expectancies
Authors: Robine Jean-Marie , Jagger Carol 
Published: December 2017

Abstract
In its first section, this chapter describes the ongoing adult longevity revolution, which is now the main reason for assessing the quality of years lived and to complete the calculation of life expectancy by those of health expectancies. Then, it introduces the main health expectancies used in the United States of America (US) to monitor Healthy People 2020, the national health agenda, in Japan to monitor Health Japan 21, the health promotion plan, and in Europe to monitor the social and health targets of Europe 2020, the current strategy of the European Union. Finally, this chapter summarizes recent trends in health expectancies observed in the US, Japan, and Europe, as well as in other parts of the world, and discusses these observations in relation to the theories on population health which have been proposed since the 1980s.
Economic implications of population ageing
Authors: Mason Andrew , Lee Ronald 
Published: December 2017

Abstract
For decades to come, population ageing will be one of the most important long-term trends affecting the economies of high-income and many developing countries. Government budgets are threatened as growth in revenue declines and growth in spending, particularly on pensions and healthcare, rises. The effects of ageing on the public sector are less important, however, than the effects on economic growth and standards of living. Slow growth in the working-age population is a serious concern, but three other ageing-related changes will have favourable effects. First, people are healthier and can extend their working lives. Second, older societies will be wealthier with ample resources available to fund needed investment. Third, smaller cohorts of workers will have benefitted from higher spending on their health and education. The decline in numbers may be more than offset by the increase in their productivity.
Comprehensive geriatric assessment
Authors: Heckman George , Jónsson Pálmi V. 
Published: December 2017

Abstract
In the context of population ageing, the provision of person-specific care to older persons is complicated by the presence, in a single individual, of multiple chronic conditions, and an increasingly complex, non-institutionally-based, service delivery framework. The most complex seniors benefit from a comprehensive geriatric assessment which, in order to promote greater health system integration and coordination, must be standardized across care delivery sectors. InterRAI instruments provide such functionality, which not only supports more efficient and comprehensive care planning, but leads to multiple useful derivative applications for clinicians, health administrators, and policy makers, such as screeners, risk stratification algorithms, outcome scales, quality indicators, and case-mixed indices. Furthermore, clinical information collected through interRAI instruments provide a rich and robust resource for health research.
Communication
Authors: Allwood Rebecca , Harwood Rowan H. 
Published: December 2017

Abstract
Communication is part of everyday experience, and may be overlooked as a professional skill. However, it is central to healthcare practice. Working with older people can challenge our ability to communicate because of speech, sensory, and cognitive changes related to age or disease, environment, relationships, or social factors. The means our mechanisms of communication must be understood, and problems addressed, in order to enable adequate communication. Multiple sources (such as family members or professional staff) may need to be approached to ascertain full information, and to engage and include important stakeholders in a person’s care. Communication is required in making diagnoses, understanding problems, giving information, including imparting distressing news, delivering care, making decisions, and defusing conflict. Approaching these situations in the right way can improve the experience for patients and their families, maximize satisfaction with the consultation, and improve clinical outcomes.
Optimizing pharmacotherapy for older patients
Authors: O’Mahony Denis 
Published: December 2017

Abstract
The prevalence of complex multimorbidity is increasing steadily in tandem with global population ageing. Complex multimorbidity is in turn intimately associated with polypharmacy, the relationship being one of cause-and-effect. Polypharmacy commonly leads to prescription of inappropriate drugs, resulting in a substantially higher risk of drug-related problems, principally adverse drug–drug and drug–disease interactions. These problems become manifest in the form of common geriatric symptoms such as falls, acute confusion, and incontinence and commonly result in increased healthcare utilization, including hospitalization, with obvious economic consequences. In addition, adverse drug reactions and adverse drug events lead to death in older people.
The challenge of optimization of pharmacotherapy in older people with complex multimorbidity is a major one. There is increasing evidence that avoidance of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) using validated PIM and PPO criteria lists leads to better and safer pharmacotherapy in this high-risk population.
General principles of recovery and rehabilitation
Authors: Wyller Torgeir Bruun , Bautz-Holter Erik 
Published: December 2017

Abstract
Illness tends to affect function in frail elderly patients, and these patients have limited capacity to spontaneous physical recovery. This chapter argues that rehabilitation should be firmly integrated into health services for elderly people and not separated from conventional medical treatment. Further, we argue that these two aspects should be handled simultaneously. Rehabilitation is goal-based, and setting goals in cooperation with patients is a crucial condition for successful rehabilitation, and for its evaluation, clinically as well as scientifically. The World Health Organization International Classification of Functioning, Disability, and Health (ICF) is recommended as a conceptual framework for assessment, goal setting, and evaluation in rehabilitation. Rehabilitation can be considered an iterative rather than a linear process, with regular evaluations and renegotiation of goals playing a crucial role in the efficacy of such a process.
The approach of dying and death, and the mourning process of the survivors
Authors: Martin Jonathan , Nicholson Caroline , George Rob 
Published: December 2017

Abstract
The approach of death often brings the complexity of a person’s life into sharp focus, thereby setting the backdrop for the losses occurring to him or her: the physical limitations inherent to most dying; the social ‘disintegration’ that inevitably accompanies a person’s ultimate leave-taking; and the ‘Why?’ question that often arise.
Like the grief work in which those close to the dying person will usually find themselves engaging, both now and later, for the dying person these accumulating losses are underpinned, consciously or unconsciously, by existential/spiritual questions. Such issues are usually well outside most clinicians’ comfort zone, so how should we approach the multidimensional suffering that may occur during the dying process, and what are the particularities of this period for the older person? This chapter outlines both an approach to care and a practical method for how to support a person, and their loved ones, at this time.
Clinical interventions in home care
Authors: Caplan Gideon 
Published: December 2017

Abstract
Healthcare interventions at home are vital for frail older people who frequently have difficulty accessing services. These clinical interventions include primary and secondary care, acute, subacute, and chronic disease management. Randomized controlled trial and meta-analyses have demonstrated improved health outcomes, such as decreased mortality, reduced hospitalization, and cost-effectiveness from many clinical interventions in home care, but not all. Hospital in the Home provides acute and subacute care at home across a wide range of diagnostic groups, whereas most chronic disease management programmes are disease specific. Improvements in and increased portability of technology has assisted many of these developments, but most home care remains proudly ‘high touch’. Ongoing improvements in technology hold the promise of greater benefits, but completely understanding the role of technological innovation in delivering improved outcomes cost effectively is a work in progress.