Stimulation of GABAergic neurons of the lateral septum and its effect on movement speed

The lateral septum is associated with the regulation of innate behavior, motivation, and locomotion. Its complex interconnections with cognitive and affective regions such as the hippocampus, hypothalamus, and medial septum have made it an attractive region for studying how motivation regulates behavior in context-specific settings. This GABAergic brain region’s main output is the lateral hypothalamus, which provides downstream signaling of motor commands. Even though stimulation of lateral septum projections to the hypothalamus have shown to decrease running speed in free behaving mice, characterizing movement kinematics due to LS activation has not been studied. GABAergic medium spiny neurons of the lateral septum were selectively activated through the use of optogenetic techniques in transgenic mice. Photostimulation of the lateral septum at theta frequencies caused a non-significant decrease in head and back speed. 3D motion analysis of body movement under photostimulation was quantified, revealing a slow, linear decrease of body speed as photostimulation progressed. These results support the role of lateral septum activation in movement regulation and shed light on the specific manner in which stimulation of the LS gradually decreases movement speed.

Early detection of delirium in older medical inpatients: prodrome, predictors and motor subtyping

Background Delirium is highly prevalent, especially in older patients. It independently leads to adverse outcomes, but remains under-detected, particularly hypoactive forms. Although early identification and intervention is important, delirium prevention is key to improving outcomes. The delirium prodrome concept has been mooted for decades, but remains poorly characterised. Greater understanding of this prodrome would promote prompt identification of delirium-prone patients, and facilitate improved strategies for delirium prevention and management. Methods Medical inpatients of ≥70 years were screened for prevalent delirium using the Revised Delirium Rating Scale (DRS--‐R98). Those without prevalent delirium were assessed daily for delirium development, prodromal features and motor subtype. Survival analysis models identified which prodromal features predicted the emergence of incident delirium in the cohort in the first week of admission. The Delirium Motor Subtype Scale-4 was used to ascertain motor subtype. Results Of 555 patients approached, 191 patients were included in the prospective study. The median age was 80 (IQR 10) and 101 (52.9%) were male. Sixty-one patients developed incident delirium within a week of admission. Several prodromal features predicted delirium emergence in the cohort. Firstly, using a novel Prodromal Checklist based on the existing literature, and controlling for confounders, seven predictive behavioural features were identified in the prodromal period (for example, increasing confusion; and being easily distractible). Additionally, using serial cognitive tests and the DRS-R98 daily, multiple cognitive and other core delirium features were detected in the prodrome (for example inattention; and sleep-wake cycle disturbance). Examining longitudinal motor subtypes in delirium cases, subtypes were found to be predominantly stable over time, the most prevalent being hypoactive subtype (62.3%). Discussion This thesis explored multiple aspects of delirium in older medical inpatients, with particular focus on the characterisation of the delirium prodrome. These findings should help to inform future delirium educational programmes, and detection and prevention strategies.

The relationship between non-suicidal self-injury and suicidality

The overall purpose of this study was to explain the overlap and distinctiveness of non-suicidal self-injury (NSSI) and suicidality from a diathesis-stress perspective. The first part of this study evaluated the third variable theory as an explanation for the high rates of lifetime co-occurrence between NSSI and suicidality. Specifically, it was hypothesized that these forms of self-harm share a common vulnerability profile comprised of five affective, cognitive and behavioural diatheses. The second part of this study tested the hypothesis that NSSI and suicidality become distinguishable on the basis of immediate, proximal stressors, namely psychache and survival and coping beliefs (SCB). Participants (N = 262) were community individuals aged 16-24 years who reported either no history of self-harm (i.e., no history of NSSI, suicidality, or both), a history of NSSI, suicidality or both, or current NSSI-only or current NSSI+suicidality. They were recruited online to complete an online battery of questionnaires. Using a set of discriminant function analyses, it was found that the vulnerability profile was unable to distinguish between the three self-harm groups, but was able to differentiate the no self-harm group from a collated self-harm group. Result patterns were also analyzed for gender differences. It was also found that a current NSSI+suicidality group exhibited significantly higher psychache and lower SCB (for women only) than a current NSSI-only group. These results suggest that NSSI and suicidality may tend to co-occur because they have similar long-term diatheses, but that they may become more distinct with respect to immediate psychological stressors.

The Narrative Value of Dance Communication: "habitus", musicality and emotion

The richness of dance comes from the need to work with an individual body. Still, the body of the dancer belongs to plural context, crossed by artistic and social traditions, which locate the artists in a given field. We claim that role conflict is an essential component of the structure of collective artistic creativity. We address the production of discourse in a British dance company, with data that spawns from the ethnography ‘Dance and Cognition’, directed by David Kirsh at the University of California, together with WayneMcGregor-Random Dance. Our Critical Discourse Analysis is based on multiple interviews to the dancers and choreographer. Our findings show how creativity in dance seems to be empirically observable, and thus embodied and distributed shaped by the dance habitus of the particular social context.

The association between anticholinergic medication burden and health related outcomes in the ‘oldest old’: A systematic review of the literature

Background: Increased exposure to anticholinergic medication is problematic, particularly in those aged 80 years and older.

Objective: The aim of this systematic review was to identify tools used to quantify anticholinergic medication burden and determine the most appropriate tool for use in longitudinal research, conducted in those aged 80 years and older.

Methods: A systematic literature search was conducted across six electronic databases to identify existing tools. Data extraction was conducted independently by two researchers; studies describing the development of each tool were also retrieved and relevant data extracted. An assessment of quality was completed for all studies. Tools were assessed in terms of their measurement of the association between anticholinergic medication burden and a defined set of clinical outcomes, their development and their suitability for use in longitudinal research; the latter was evaluated on the basis of criteria defined as the key attributes of an ideal anticholinergic risk tool.

Results: In total, 807 papers were retrieved, 13 studies were eligible for inclusion and eight tools were identified. Included studies were classed as ‘very good’ or ‘good’ following the quality assessment analysis; one study was unclassified. Anticholinergic medication burden as measured in studies was associated with impaired cognitive and physical function, as well as an increased frequency of falls. The Drug Burden Index (DBI) exhibited most of the key attributes of an ideal anticholinergic risk tool.

Conclusion: This review identified the DBI as the most appropriate tool for use in longitudinal research focused on older people and their exposure to anticholinergic medication burden.

Networking for conservation: social capital and perceptions of organizational success among land trust boards

As an important component in collaborative natural resource management and nonprofit governance, social capital is expected to be related to variations in the performance of land trusts. Land trusts are charitable organizations that work to conserve private land locally, regionally, or nationally. The purpose of this paper is to identify the level of structural and cognitive social capital among local land trusts, and how these two types of social capital relate to the perceived success of land trusts. The analysis integrates data for land trusts operating in the U.S. south-central Appalachian region, which includes western North Carolina, southwest Virginia, and east Tennessee. We use factor analysis to elicit different dimensions of cognitive social capital, including cooperation among board members, shared values, common norms, and communication effectiveness. Measures of structural social capital include the size and diversity of organizational networks of both land trusts and their board members. Finally, a hierarchical linear regression model is employed to estimate how cognitive and structural social capital measures, along with other organizational and individual-level attributes, relate to perceptions of land trust success, defined here as achievement of the land trusts’ mission, conservation, and financial goals. Results show that the diversity of organizational partnerships, cooperation, and shared values among land trust board members are associated with higher levels of perceived success. Organizational capacity, land trust accreditation, volunteerism, and financial support are also important factors influencing perceptions of success among local, nonprofit land trusts.

Older Adult Injury Risk Assessment in the Driving and Occupational Environments

Thesis (Ph.D.)--University of Washington, 2016-08

Exploring Forensic Nursing Ethics and Practice: Roles, Loyalties and Photodocumentation Practices

Thesis (Ph.D.)--University of Washington, 2016-08

Comportamentos de Risco no Tráfego Rodoviário

O presente trabalho descreve um estudo exploratório sobre a temática “Comportamentos de Risco no Tráfego Rodoviário” realizado a condutores da cidade de Bragança. Os principais objetivos direcionam-se para a identificação dos fatores cognitivos que mais influenciam a condução, das atitudes gerais e específicas de maior ou menor risco nos condutores de Bragança, e das crenças normativas e a intenção comportamental face à condução e aos comportamentos de risco. Para obter a informação necessária, foi usado o “Questionário baseado no modelo do Comportamento Planeado para a predição do comportamento de condução”, que foi realizado para a população portuguesa, e que a autora, Doutora Cristina Pimentão, permitiu a adaptação do mesmo ao tema da presente investigação. De uma forma geral, os resultados que se obtiveram evidenciam que o fator cognitivo que mais influencia o processo da condução é a atenção. Quanto às atitudes gerais, os comportamentos apontados que evidenciam maior risco são “A confiança na resposta do carro” e o “Excesso de confiança”, e os comportamentos que revelam menor risco são o cumprimento da regra de paragem completa num sinal de STOP e a discordância de que as pessoas que conduzem de forma agressiva estão mais atentas à condução. Por sua vez, nos resultados das atitudes específicas registam-se atitudes de indiferença, por parte dos inquiridos que responderam “Não concordo nem discordo” nas questões sobre “As campanhas que alertam para os efeitos do álcool são eficazes” e “Se o ensino das escolas de condução fosse adequado não teríamos condutores a conduzir sob a influência do álcool”. Já no que diz respeito às crenças normativas, verificaram-se resultados que apontam para expectativas de menor risco, pois na ótica dos condutores as pessoas que lhe são importantes esperariam deles comportamentos de menor risco. Paralelamente, os resultados sobre as intenções comportamentais traduzem baixas intenções de praticar o comportamento de risco, excetuando no item “É provável que eu venha conduzir um automóvel sob o efeito do álcool”, em que um número considerável de inquiridos respondeu que seria provável e muito provável a intenção de praticar este comportamento de risco. Os resultados são claros relativamente ao consumo de álcool e à sua influência no comportamento dos condutores, sendo necessário e urgente uma intervenção coerente e direcionada para a prevenção da ocorrência deste comportamento.

PICTOAPRENDE: Design and evaluation of a tool that contributes to the personal autonomy of children and youth diagnosed with autism spectrum disorder in Ecuador

This paper presents the development and evaluation of PICTOAPRENDE, which is an interactive software designed to improve oral communication. Additionally, it contributes to the development of children and youth who are diagnosed with autism spectrum disorder (ASD) in Ecuador. To fulfill this purpose initially analyzes the intervention area where the general characteristics of people with ASD and their status in Ecuador is described. Statistical techniques used for this evaluation constitutes the basis of this study. A section that presents the development of research-based cognitive and social parameters of the area of intervention is also shown. Finally, the algorithms to obtain the measurements and experimental results along with the analysis of them are presented.

Social Cognition, Negative Symptoms and Psychosocial Functioning in Schizophrenia.

Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of social cognition dysfunction in schizophrenia patients’ daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocognition. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs—social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.

How does employer support and educational background effect an Ergonomics Practitioner’s awareness of the relationship between ergonomics and psychosocial hazard control?

There is a growning need to address psychological health and safety in the workplace. Ergonomics tends to be widely recognized for its physical applications, such as ¨office¨ and ¨manual materials handling¨ however the other domains of specialization of ergonomics (cognitive and organizational) appear to be less well known. This study evaluates the level of understanding that professionals who practice ergonomics have of the relation between ergonomics and the control of psychosocial hazards in the workplace. A survey was distributed to ergonomics practitioners and asked them about their awareness of the relation between ergonomics and workplace psychosocial hazard control. Ergonomists and human factors specialists demonstrated a greater awareness of this relationship than other allied occupational groups that also practice ergonomics, however they indicated that there may be difficulties in the “real world” applying these areas of knowledge into practice. Participants who demonstrated a high level of awareness of the relation between ergonomics and psychosocial hazard control demonstrated stronger organizational commitment than participants with a low awareness. Ergonomics practitioners who reported having employer support for professional development also demonstrated a higher degree of awareness of the relation between ergonomics and psychosocial hazard control, as did the professionals who had been practicing in the field the longest. This research provides some insight for professional associations for Ergonomists, employers of Ergonomists, and human resource professionals about how ergonomics practitioners perceive the ergonomics field and the profession as well as their employing organization.

THE RELATIVE SIGNIFICANCE OF SYNTACTIC KNOWLEDGE AND VOCABULARY KNOWLEDGE IN SECOND LANGUAGE LISTENING COMPREHENSION

The main purpose of the current study was to examine the role of vocabulary knowledge (VK) and syntactic knowledge (SK) in L2 listening comprehension, as well as their relative significance. Unlike previous studies, the current project employed assessment tasks to measure aural and proceduralized VK and SK. In terms of VK, to avoid under-representing the construct, measures of both breadth (VB) and depth (VD) were included. Additionally, the current study examined the role of VK and SK by accounting for individual differences in two important cognitive factors in L2 listening: metacognitive knowledge (MK) and working memory (WM). Also, to explore the role of VK and SK more fully, the current study accounted for the negative impact of anxiety on WM and L2 listening. The study was carried out in an English as a Foreign Language (EFL) context, and participants were 263 Iranian learners at a wide range of English proficiency from lower-intermediate to advanced. Participants took a battery of ten linguistic, cognitive and affective measures. Then, the collected data were subjected to several preliminary analyses, but structural equation modeling (SEM) was then used as the primary analysis method to answer the study research questions. Results of the preliminary analyses revealed that MK and WM were significant predictors of L2 listening ability; thus, they were kept in the main SEM analyses. The significant role of WM was only observed when the negative effect of anxiety on WM was accounted for. Preliminary analyses also showed that VB and VD were not distinct measures of VK. However, the results also showed that if VB and VD were considered separate, VD was a better predictor of L2 listening success. The main analyses of the current study revealed a significant role for both VK and SK in explaining success in L2 listening comprehension, which differs from findings from previous empirical studies. However, SEM analysis did not reveal a statistically significant difference in terms of the predictive power of the two linguistic factors. Descriptive results of the SEM analysis, along with results from regression analysis, indicated to a more significant role for VK.

FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

Nutraceutics, Frailty and Polypharmacy in the Oldest Old

Malnutrition and nutritional problems are common in older adults. Multiple chronic disease, inflammation, cognitive and functional impairment, geriatric syndromes (including delirium, falls or chronic pain) and drug use (i.e. polypharmacy, adverse drug reactions) may play a role in the onset of malnutrition and nutritional problems.