Neurocognitive deficits and personality traits among euthymic patients with mood disorders in late life.

BACKGROUND: Previous studies revealed that acute depressive episodes are associated with both cognitive deficits and modified personality patterns in late life. Whether or not these psychological changes are present after remission remains a matter of debate. To date, no study provided concomitant assessment of cognition and psychological functions in this particular clinical setting. METHOD: Using a cross-sectional design, 58 remitted outpatients (36 with unipolar early-onset depression (EOD) and 22 with bipolar disorder (BD)) were compared to 62 healthy controls. Assessment included detailed neurocognitive measures and evaluation of the five factor personality dimensions (NEO-Personality Inventory). RESULTS: Group comparisons revealed significant slower processing speed, working and episodic memory performances in BD patients. EOD patients showed cognitive abilities comparable to those of elderly controls. In NEO PI assessment, both BD and EOD patients displayed higher Depressiveness facet scores. In addition, the EOD but not BD group had lower Extraversion factor, and Warmth and Positive Emotion facet scores than controls. CONCLUSIONS: After remission from acute affective symptoms, older BD patients show significant impairment in several cognitive functions while neuropsychological performances remained intact in elderly patients with EOD. Supporting a long-lasting psychological vulnerability, EOD patients are more prone to develop emotion-related personality trait changes than BD patients.

Multicontrast MRI Quantification of Focal Inflammation and Degeneration in Multiple Sclerosis.

INTRODUCTION: Local microstructural pathology in multiple sclerosis patients might influence their clinical performance. This study applied multicontrast MRI to quantify inflammation and neurodegeneration in MS lesions. We explored the impact of MRI-based lesion pathology in cognition and disability. METHODS: 36 relapsing-remitting MS subjects and 18 healthy controls underwent neurological, cognitive, behavioural examinations and 3 T MRI including (i) fluid attenuated inversion recovery, double inversion recovery, and magnetization-prepared gradient echo for lesion count; (ii) T1, T2, and T2(*) relaxometry and magnetisation transfer imaging for lesion tissue characterization. Lesions were classified according to the extent of inflammation/neurodegeneration. A generalized linear model assessed the contribution of lesion groups to clinical performances. RESULTS: Four lesion groups were identified and characterized by (1) absence of significant alterations, (2) prevalent inflammation, (3) concomitant inflammation and microdegeneration, and (4) prevalent tissue loss. Groups 1, 3, 4 correlated with general disability (Adj-R (2) = 0.6; P = 0.0005), executive function (Adj-R (2) = 0.5; P = 0.004), verbal memory (Adj-R (2) = 0.4; P = 0.02), and attention (Adj-R (2) = 0.5; P = 0.002). CONCLUSION: Multicontrast MRI provides a new approach to infer in vivo histopathology of plaques. Our results support evidence that neurodegeneration is the major determinant of patients' disability and cognitive dysfunction.

Progressive multifocal leukoencephalopathy in common variable immunodeficiency: mitigated course under mirtazapine and mefloquine.

Demonstration of survival and outcome of progressive multifocal leukoencephalopathy (PML) in a 56-year-old patient with common variable immunodeficiency, consisting of severe hypogammaglobulinemia and CD4+ T lymphocytopenia, during continuous treatment with mirtazapine (30 mg/day) and mefloquine (250 mg/week) over 23 months. Regular clinical examinations including Rankin scale and Barthel index, nine-hole peg and box and block tests, Berg balance, 10-m walking tests, and Montreal Cognitive Assessment (MoCA) were done. Laboratory diagnostics included complete blood count and JC virus (JCV) concentration in cerebrospinal fluid (CSF). The noncoding control region (NCCR) of JCV, important for neurotropism and neurovirulence, was sequenced. Repetitive MRI investigated the course of brain lesions. JCV was detected in increasing concentrations (peak 2568 copies/ml CSF), and its NCCR was genetically rearranged. Under treatment, the rearrangement changed toward the archetype sequence, and later JCV DNA became undetectable. Total brain lesion volume decreased (8.54 to 3.97 cm(3)) and atrophy increased. Barthel (60 to 100 to 80 points) and Rankin (4 to 2 to 3) scores, gait stability, and box and block (7, 35, 25 pieces) and nine-hole peg (300, 50, 300 s) test performances first improved but subsequently worsened. Cognition and walking speed remained stable. Despite initial rapid deterioration, the patient survived under continuous treatment with mirtazapine and mefloquine even though he belongs to a PML subgroup that is usually fatal within a few months. This course was paralleled by JCV clones with presumably lower replication capability before JCV became undetectable. Neurological deficits were due to PML lesions and progressive brain atrophy.

Nationalist neoliberalism? Minority Nationalism, competitiveness and the urban question

Presentation at: II IAS Annual Research Programme International ConferenceSession: Governing Regions, Lancaster Setember 17-19 2007

Comunicar la ciudad desde el paisaje: hacia una teoría del landscape branding

The need to decode landscape meanings, the society- landscape interaction (intra- and inter-personal communication) and, more recently, the uses of landscape as a territorial sight linked to advertising communication, citymarketing or place branding (mass communication) highlights the study of landscape persuasion, which includes clear emotional, symbolic and, therefore, communicative aspects. The landscape, as a territory image or face, gathers the essence of the implicit message in the space, thus working as a great metaphor for city communication. Regarding the foregoing, specific communication research with intangible landscapes —together with the recent emergence of emotional geographies— suggests a new territorial message theory based on the union of geographical, landscape, emotional and communicational variables. Landscape has historically been studied by geographers, architects, historians or sociologists, among others researchers, but it has not been analysed from communicational viewpoints. In this sense, the proliferation of analyses highlighting the role played by the territory as a communication mediator in the interaction process between society and its spaces (cognition and/or perception) is also remarkable. Current sales of territorial identities lead to increases in the production of territory brands, which have gathered a noticeable relevance within the last years.

Intercultural bridges in teenagers' theatrical events : performing self and constructing cultural identity through a creative drama process

The overriding aim of this drama educational case study is to deepen the understanding of meaning making in a creative intercultural youth theatre process and to examine it in the context of the 10th European Children's TheatreEncounter. The research task is to give a theoretical description of some key features of a creative drama process as the basis for theory about meaning makingin physical theatre. The first task is to illuminate the culture-historical connections of the multilayered practice of the EDERED-association. The second taskis to analyse and interpret theatrical meaning making. The ethnographical research site is regarded as a theatrical event. The analysis of the theatrical eventis divided into four segments: cultural contexts, contextual theatricality, theatrical playing and playing culture. These segments are connected with four research questions: What are the cultural contexts of a creative drama process? How can the organisation of the Encounter, genres, aesthetic codes and perception ofcodes be seen to influence the lived experiences of the participants? What are some of the key phases and characteristics in a creative practice? What kind of cultural learning can be interpreted from the performance texts? The interpretative question concerns identity and community (re)construction. How are the categories, `community´ and `child´ constructed in the Encounter culture? In this drama educational case study the research material (transcribed interviews, coded questionnaire answers, participant drawings, videotaped process text and performance texts) are examined in a multi-method analysis in the meta-theoretical framework of Dewey's naturalistic pragmatism. A three-dimensional research interest through a combination of lived experiences, social contexts and cultural-aesthetical practices compared with drama-educational practices required the methodological project of cultural studies. Furthermore, the critical interpretation of cultural texts is divided into three levels of analyses which are called description, structural analysis and theoretical interpretation. Dialogic validity (truthfulness, self-reflexivity and polyvocality) is combined with contextual validity (sensitivity to social context and awareness of historicity) and with deconstructive validity (awareness of the social discourses). My research suggests that itis possible, by means of physical theatre, to construct symbolic worlds where questions about intercultural identity and multilingual community are examined and where provisional answers are constructed in social interaction.

Dialogue in the crisis of representation : realism and antirealism in the context of the conversation between theologians and quantum physicists in Göttingen 1949-1961

The aim of this study is to analyse the content of the interdisciplinary conversations in Göttingen between 1949 and 1961. The task is to compare models for describing reality presented by quantum physicists and theologians. Descriptions of reality indifferent disciplines are conditioned by the development of the concept of reality in philosophy, physics and theology. Our basic problem is stated in the question: How is it possible for the intramental image to match the external object?Cartesian knowledge presupposes clear and distinct ideas in the mind prior to observation resulting in a true correspondence between the observed object and the cogitative observing subject. The Kantian synthesis between rationalism and empiricism emphasises an extended character of representation. The human mind is not a passive receiver of external information, but is actively construing intramental representations of external reality in the epistemological process. Heidegger's aim was to reach a more primordial mode of understanding reality than what is possible in the Cartesian Subject-Object distinction. In Heidegger's philosophy, ontology as being-in-the-world is prior to knowledge concerning being. Ontology can be grasped only in the totality of being (Dasein), not only as an object of reflection and perception. According to Bohr, quantum mechanics introduces an irreducible loss in representation, which classically understood is a deficiency in knowledge. The conflicting aspects (particle and wave pictures) in our comprehension of physical reality, cannot be completely accommodated into an entire and coherent model of reality. What Bohr rejects is not realism, but the classical Einsteinian version of it. By the use of complementary descriptions, Bohr tries to save a fundamentally realistic position. The fundamental question in Barthian theology is the problem of God as an object of theological discourse. Dialectics is Barth¿s way to express knowledge of God avoiding a speculative theology and a human-centred religious self-consciousness. In Barthian theology, the human capacity for knowledge, independently of revelation, is insufficient to comprehend the being of God. Our knowledge of God is real knowledge in revelation and our words are made to correspond with the divine reality in an analogy of faith. The point of the Bultmannian demythologising programme was to claim the real existence of God beyond our faculties. We cannot simply define God as a human ideal of existence or a focus of values. The theological programme of Bultmann emphasised the notion that we can talk meaningfully of God only insofar as we have existential experience of his intervention. Common to all these twentieth century philosophical, physical and theological positions, is a form of anti-Cartesianism. Consequently, in regard to their epistemology, they can be labelled antirealist. This common insight also made it possible to find a common meeting point between the different disciplines. In this study, the different standpoints from all three areas and the conversations in Göttingen are analysed in the frameworkof realism/antirealism. One of the first tasks in the Göttingen conversations was to analyse the nature of the likeness between the complementary structures inquantum physics introduced by Niels Bohr and the dialectical forms in the Barthian doctrine of God. The reaction against epistemological Cartesianism, metaphysics of substance and deterministic description of reality was the common point of departure for theologians and physicists in the Göttingen discussions. In his complementarity, Bohr anticipated the crossing of traditional epistemic boundaries and the generalisation of epistemological strategies by introducing interpretative procedures across various disciplines.

Mentors, students, and the undergraduate medical course: a virtuous circle

BACKGROUND: Mentoring Programs have been developed in several medical schools, but few studies have investigated the mentors'perspective. PURPOSES: To explore mentors'perceptions regarding their experience. METHODS: Mentors at a medical school were invited to participate in an in-depth interview including questions on satisfaction, difficulties, and perception of changes resulting from the program. RESULTS: Mentors' satisfaction and difficulties are strongly associated with students'involvement in the activity. Mentors believe changes observed in students were more related to life issues; for some mentors, there is no recognition or awareness of the program. However, most of the mentors acknowledged important changes in relation to themselves: as teachers, faculty members, and individuals. CONCLUSION: Attendance is crucial for both the mentoring relationship and strengthening of the program. Students involved in the activity motivate mentors in teaching and curriculum development, thereby creating a virtuous circle and benefiting undergraduate medical education as a whole.

Towards an Integrative Information Society: Studies on Individuality in Speech and Sign

The flow of information within modern information society has increased rapidly over the last decade. The major part of this information flow relies on the individual’s abilities to handle text or speech input. For the majority of us it presents no problems, but there are some individuals who would benefit from other means of conveying information, e.g. signed information flow. During the last decades the new results from various disciplines have all suggested towards the common background and processing for sign and speech and this was one of the key issues that I wanted to investigate further in this thesis. The basis of this thesis is firmly within speech research and that is why I wanted to design analogous test batteries for widely used speech perception tests for signers – to find out whether the results for signers would be the same as in speakers’ perception tests. One of the key findings within biology – and more precisely its effects on speech and communication research – is the mirror neuron system. That finding has enabled us to form new theories about evolution of communication, and it all seems to converge on the hypothesis that all communication has a common core within humans. In this thesis speech and sign are discussed as equal and analogical counterparts of communication and all research methods used in speech are modified for sign. Both speech and sign are thus investigated using similar test batteries. Furthermore, both production and perception of speech and sign are studied separately. An additional framework for studying production is given by gesture research using cry sounds. Results of cry sound research are then compared to results from children acquiring sign language. These results show that individuality manifests itself from very early on in human development. Articulation in adults, both in speech and sign, is studied from two perspectives: normal production and re-learning production when the apparatus has been changed. Normal production is studied both in speech and sign and the effects of changed articulation are studied with regards to speech. Both these studies are done by using carrier sentences. Furthermore, sign production is studied giving the informants possibility for spontaneous speech. The production data from the signing informants is also used as the basis for input in the sign synthesis stimuli used in sign perception test battery. Speech and sign perception were studied using the informants’ answers to questions using forced choice in identification and discrimination tasks. These answers were then compared across language modalities. Three different informant groups participated in the sign perception tests: native signers, sign language interpreters and Finnish adults with no knowledge of any signed language. This gave a chance to investigate which of the characteristics found in the results were due to the language per se and which were due to the changes in modality itself. As the analogous test batteries yielded similar results over different informant groups, some common threads of results could be observed. Starting from very early on in acquiring speech and sign the results were highly individual. However, the results were the same within one individual when the same test was repeated. This individuality of results represented along same patterns across different language modalities and - in some occasions - across language groups. As both modalities yield similar answers to analogous study questions, this has lead us to providing methods for basic input for sign language applications, i.e. signing avatars. This has also given us answers to questions on precision of the animation and intelligibility for the users – what are the parameters that govern intelligibility of synthesised speech or sign and how precise must the animation or synthetic speech be in order for it to be intelligible. The results also give additional support to the well-known fact that intelligibility in fact is not the same as naturalness. In some cases, as shown within the sign perception test battery design, naturalness decreases intelligibility. This also has to be taken into consideration when designing applications. All in all, results from each of the test batteries, be they for signers or speakers, yield strikingly similar patterns, which would indicate yet further support for the common core for all human communication. Thus, we can modify and deepen the phonetic framework models for human communication based on the knowledge obtained from the results of the test batteries within this thesis.

Towards conceptually comprehensive and integrated theory of entrepreneurial opportunity

Insufficient understanding of entrepreneurial opportunities characterizes entrepreneurship research (Companys & McMullen 2006, 302). Subsequently, the purpose of this study was to analyze the concept of entrepreneurial opportunity and to explore and synthetize the integrated theory of entrepreneurial opportunity. A theoretical and concept analytical approach was adapted. Findings of this study was that entrepreneurial opportunity concept was used for variety of different phenomena. No commonly accepted definition existed. Altogether 24 attributes that described the concept were found. The most frequently attached attributes were agent and action, new goods and services, market, value, new means ends or both, and future. Further, the results implied that opportunity could be best understood as a part of a process. Opportunity emerges out of intervened factors. Changes in the environment together with factors related to knowledge, cognition and social ties are the most important drivers of opportunity. Preventing factors that impeded the emergence of opportunity were typically related to cognitive and organizational factors. This study found a tendency towards more integrated theory of entrepreneurial opportunity. The integrated theory acknowledged the usefulness of both discovery and creation theories of opportunity in explaining opportunity. Yet three argument types of integrating two different opportunity theories were identified. These were process category, contextual category and complementing category. Opportunity is at the same time cognitive, social and linguistic construct, although it is shaped by the objective environment. Opportunity requires linguistic endeavors to become explicit. Materialization of opportunity occurs in a social context. Moreover, it is always characterized by some extent of subjectivity, as opportunities cannot appear without the agent and their action. Due to these the concept remains always to some extent ambiguous. Tolerating and harnessing change and investing in human and social capital create the preeminent environment for the entrepreneurial opportunity to be identified.

Influence of intrauterine and extrauterine growth on neurodevelopmental outcome of monozygotic twins

There have been indications that intrauterine and early extrauterine growth can influence childhood mental and motor function. The objective of the present study was to evaluate the influence of intrauterine growth restriction and early extrauterine head growth on the neurodevelopmental outcome of monozygotic twins. Thirty-six monozygous twin pairs were evaluated at the corrected age of 12 to 42 months. Intrauterine growth restriction was quantified using the fetal growth ratio. The effects of birth weight ratio, head circumference at birth and current head circumference on mental and motor outcomes were estimated using mixed-effect linear regression models. Separate estimates of the between (interpair) and within (intrapair) effects of each measure on development were thus obtained. Neurodevelopment was assessed with the Bayley Scales of Infant Development, 2nd edition, by a psychologist blind to the exposure. A standardized neurological examination was performed by a neuropediatrician who was unaware of the exposures under investigation. After adjustment, birth weight ratio and head circumference at birth were not associated with motor or mental outcomes. Current head circumference was associated with mental but not with motor outcomes. Only the intrapair twin effect was significant. An increase of 1 cm in current head circumference of one twin compared with the other was associated with 3.2 points higher in Mental Developmental Index (95%CI = 1.06-5.32; P < 0.03). Thus, no effect of intrauterine growth was found on cognition and only postnatal head growth was associated with cognition. This effect was not shared by the co-twin.

The Brazilian consumer's understanding and perceptions of organic vegetables: a Focus Group approach

Focus Group is a tool which generates, through interview sessions with a small number of participants, preliminary data to be used in subsequent quantitative stages. Many consumer studies use qualitative research with the aim of obtaining information and opinions on a specific product or situation. The objective of the present study was to obtain knowledge on the opinion, understanding and perception of the Brazilian consumer with respect to vegetables, focusing on organic products, using Focus Group Sessions. Four Focus Group Sessions were held with men and women in different environments, following a previously elaborated interview guide. In this study, it was observed that the consumers demonstrated being interested in having a healthy diet, based on fruit, vegetables and natural products. However, only a few declared consuming organic foods. Some participants did not know what the term organic meant, and most of them think that organic products are still very expensive, are not easily available in the supermarkets, do not have a good appearance, mainly in terms of size and packaging, and their certification is not always trustworthy. Almost all participants stated that they read package labels and among the items most observed were best-before date, nutritional information, production system and price. This study has identified important vegetable attributes perceived by the consumer, favouring the planning of a subsequent quantitative research. The results suggest that more information on the benefits of organic agriculture has to be passed on to consumers in order to contribute to a higher consumption of such products.

Exploring Gifted Adults' Perception of Giftedness in their Pursuit of Graduate Education

This qualitative study explores 8 gifted adults' perceptions of their own giftedness and how those perceptions influenced their pursuit of graduate education as revealed by retrospective interviews. This study serves to inform the existing literature surrounding giftedness especially as it relates to gifted individuals across the lifespan and their experiences and perceptions of education at all levels. This study also provides insight into the emotional impact being labeled gifted has on an individual's self-concept and academic identity. The major themes that emerged using the interpretive phenomenological analysis method (Smith & Osborn, 2003) were discussed under five main headings: Evolution of Giftedness, Success and Failure, Expectations, Effort, and Doubt and Proof. An adaptation of the listening guide method (Gilligan, Spencer, Weinberg, & Bertsch, 2003) was used to provide a unique and personal perspective of the phenomenon of giftedness and revealed the feelings behind the themes that emerged in the interpretive phenomenological analysis method. Specifically; this study illuminates the lack of evolution that an individual's understanding and perception of giftedness undergoes across the lifespan, and the impact such a static and school-bound understanding has on gifted adults' self-concept. It also reveals the influence that gifted individuals' innate need to achieve has on their academic aspirations and their perceptions of themselves as gifted. Furthermore, it reveals how important the understanding and internalization of failure can be on the self-concept of gifted individuals, and that this issue needs immediate attention at all levels of education.

Metaphorical Interpretation: Measuring and Facilitating Growth.

Abstract A total of 378 grade 9 students participated in this study to address the problem that although metaphorical literacy and thought are expected and necessary for success in junior and senior high school and beyond, metaphorical concepts and thought are not required to be explicitly taught to these students. The students were from 20 different classes from 4 levels: English language learners (ELL), school to work (SSTW), applied, and academic. All were from 7 secondary schools within a board in southern Ontario. Nine classes made up the control group and 11 classes made up the treatment group. All classes were given 3 pretests and the posttest. The treatment group was given Socratic lessons and direct instruction on metaphorical thought and expressions during 1 semester and in conjunction with their other classroom material. The pretest scores (TOLD, Peabody, preproverbs concrete, and preproverbs abstract) did not reveal any effect of gender, but the academic students had higher scores than the applied students. The SSTW student results are more variable: (a) for the TOLD test, SSTW scores were between those of the academic and applied students; (b) for Peabody scores, SSTW students’ scores are the same as academic and are greater than applied; (c) for preproverbs concrete and preproverbs abstract, the SSTW scores are not different from the applied scores. The postproverbs concrete and postproverbs abstract scores for the treatment groups also showed no effect of gender but revealed that all students who received the treatment did better on their post scores. The positive changes of the treatment group illustrate a measured movement from literal understanding to abstract understanding using direct Socratic instruction and proverbs as a medium.

Autonomic and Electrophysiological Correlates of Cognitive Control in Aging

This thesis tested a model of neurovisceral integration (Thayer & Lane, 2001) wherein parasympathetic autonomic regulation is considered to play a central role in cognitive control. We asked whether respiratory sinus arrhythmia (RSA), a parasympathetic index, and cardiac workload (rate pressure product, RPP) would influence cognition and whether this would change with age. Cognitive control was measured behaviourally and electrophysiologically through the error-related negativity (ERN) and error positivity (Pe). The ERN and Pe are thought to be generated by the anterior cingulate cortex (ACC), a region involved in regulating cognitive and autonomic control and susceptible to age-related change. In Study 1, older and younger adults completed a working memory Go/NoGo task. Although RSA did not relate to performance, higher pre-task RPP was associated with poorer NoGo performance among older adults. Relations between ERN/Pe and accuracy were indirect and more evident in younger adults. Thus, Study 1 supported the link between cognition and autonomic activity, specifically, cardiac workload in older adults. In Study 2, we included younger adults and manipulated a Stroop task to clarify conditions under which associations between RSA and performance will likely emerge. We varied task parameters to allow for proactive versus reactive strategies, and motivation was increased via financial incentive. Pre-task RSA predicted accuracy when response contingencies required maintenance of a specific item in memory. Thus, RSA was most relevant when performance required proactive control, a metabolically costly strategy that would presumably be more reliant on autonomic flexibility. In Study 3, we included older adults and examined RSA and proactive control in an additive factors framework. We maintained the incentive and measured fitness. Higher pre-task RSA among older adults was associated with greater accuracy when proactive control was needed most. Conversely, performance of young women was consistently associated with fitness. Relations between ERN/Pe and accuracy were modest; however, isolating ACC activity via independent component analysis allowed for more associations with accuracy to emerge in younger adults. Thus, performance in both groups appeared to be differentially dependent on RSA and ACC activation. Altogether, these data are consistent with a neurovisceral integration model in the context of cognitive control.