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To assess the influence of mild behavioral impairment (MBI) on the cognitive performance of older adults who are cognitively healthy or have mild cognitive impairment (MCI).
Secondary data analysis of a sample (n = 497) of older adults from the Florida Alzheimer’s Disease Research Center who were either cognitively healthy (n = 285) or diagnosed with MCI (n = 212). Over half of the sample (n = 255) met the operationalized diagnostic criteria for MBI. Cognitive domains of executive function, attention, short-term memory, and episodic memory were assessed using a battery of neuropsychological tests.
Older adults with MBI performed worse on tasks of executive function, attention, and episodic memory compared to those without MBI. A significant interaction revealed that persons with MBI and MCI performed worse on tasks of episodic memory compared to individuals with only MCI, but no significant differences were found in performance in cognitively healthy older adults with or without MBI on this cognitive domain. As expected, cognitively healthy older adults performed better than individuals with MCI on every domain of cognition.
The present study found evidence that independent of cognitive status, individuals with MBI performed worse on tests of executive function, attention, and episodic memory than individuals without MBI. Additionally, those with MCI and MBI perform significantly worse on episodic memory tasks than individuals with only MCI. These results provide support for a unique cognitive phenotype associated with MBI and highlight the necessity for assessing both cognitive and behavioral symptoms.
Increasingly, narrative and creative arts approaches are being used to enhance recovery after traumatic brain injury (TBI). Narrative and arts-based approaches congruent with Indigenous storytelling may therefore provide benefit during the transition from hospital to home for some Indigenous TBI patients. This qualitative study explored the use and impact of this approach as part of a larger, longitudinal study of TBI transition with Indigenous Australians.
A combined narrative and arts-based approach was used with one Indigenous Australian artist to describe his transition experiences following TBI. Together with the researchers and filmmaking team, the artist was involved in aspects of the process. The artist contributed two paintings, detailing the story of his life and TBI. Based on the artworks, a film was co-created. Following the viewing of the film, impacts of the narrative and arts-based process were examined through semi-structured interviews with the artist, a service provider and a family member. Multiple sources of data were used in the final thematic analysis including transcripts of the interviews and filming, paintings (including storylines) and researcher notes.
Positive impacts from the process for the artist included positive challenge; healing and identity; understanding TBI and raising awareness.
This approach may enable the individual to take ownership over their transition story and to make sense of their life following TBI at a critical point in their recovery. A combined narrative and arts-based approach has potential as a culturally responsive rehabilitation tool for use with Indigenous Australians during the transition period following TBI.
Mental disorders in children and adolescents have an impact on educational attainment.
To examine the temporal association between attainment in education and subsequent diagnosis of depression or self-harm in the teenage years.
General practitioner, hospital and education records of young people in Wales between 1999 and 2014 were linked and analysed using Cox regression.
Linked records were available for 652 903 young people and of these 33 498 (5.1%) developed depression and 15 946 (2.4%) self-harmed after the age of 12 but before the age of 20. Young people who developed depression over the study period were more likely to have achieved key stage 1 (age 7 years) but not key stage 2 (age 11) (hazard ratio (HR) = 0.79, 95% CI 0.74–0.84) milestones, indicating that they were declining in academic attainment during primary school. Conversely, those who self-harmed were achieving as well as those who did not self-harm in primary school, but showed a severe decline in their attainment during secondary school (HR = 0.72, 95% CI 0.68–0.78).
Long-term declining educational attainment in primary and secondary school was associated with development of depression in the teenage years. Self-harm was associated with declining educational attainment during secondary school only. Incorporating information on academic decline with other known risk factors for depression/self-harm (for example stressful life events, parental mental health problems) may improve risk profiling methods.
We describe the use of a multi-aperture Hartmann mask coupled to a slightly out-of-focus focal plane array imager to monitor atmospheric turbulence (‘seeing’) produced by refractive index fluctuations. The imager (a CCD) is located inside or outside the focal surface of the imaging system so that each sub-aperture of the Hartmann mask produces an image well separated from all of the other images produced by the mask. Since the depth of focus of the sub-apertures is an order of magnitude larger than that of the parent optical system, the individual images are still diffraction-limited. We obtain short (10 to 100 msec) exposures and monitor the position fluctuations of the images. Analysis of the position and intensity fluctuations of the images can be used to determine the atmospheric parameter r0, the wind direction and velocity, and, under some circumstances, the distance of the turbulent layer from the observing site.
We describe a system for rapidly screening hundreds of nanoparticle samples using transmission electron microscopy (TEM). The system uses a liquid handling robot to place up to 96 individual samples onto a single standard TEM grid at separate locations. The grid is then transferred into the TEM and automated software is used to acquire multiscale images of each sample. The images are then analyzed to extract metrics on the size, shape, and morphology of the nanoparticles. The system has been used to characterize plasmonically active nanomaterials.
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:
1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.
2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries and illnesses. Members throughout the health care delivery system, including medical first responders, hospital first receivers, and health care institution support personnel such as janitors, hospital administrators, and security personnel, lack radiation-related training. This lack of knowledge can lead to failure of these groups to respond appropriately after a nuclear detonation or other major radiation incident and limit the effectiveness of the medical response and recovery effort. Efficacy of the response can be improved by getting each group the information it needs to do its job. This paper proposes a sustainable training strategy for spreading curricula throughout the necessary communities. It classifies the members of the health care delivery system into four tiers and identifies tasks for each tier and the radiation-relevant knowledge needed to perform these tasks. By providing education through additional modules to existing training structures, connecting radioactive contamination control to daily professional practices, and augmenting these systems with just-in-time training, the strategy creates a sustainable mechanism for giving members of the health care community improved ability to respond during a radiological or nuclear crisis, reducing fatalities, mitigating injuries, and improving the resiliency of the community.
BlumethalD, BaderJ, ChristensenD, KoernerJ, CuellarJ, HindsS, CrapoJ, GlassmanES, PotterAB, SingletaryL. A Sustainable Training Strategy for Improving Health Care Following a Catastrophic Radiological or Nuclear Incident. Prehosp Disaster Med. 2014;29(1):80-86.
Many older women reduce the amount of cooking and food preparation they do in later life. While cooking may be seen as traditionally associated with women's family roles, little is known about the impact of such reduced engagement with food on their lives. This paper presents the findings from a one-year qualitative study (Changes Around Food Experience, CAFE) of the impact of reduced contact with preparing and cooking meals from scratch for 40 women, aged 65–95 years, living in Norfolk, United Kingdom. Data were collected through semi-structured interviews, focus groups and observations. Women's reasons for reducing food-related activities included changes in health, loss of a partner or a caring role, and new patterns of socialising. Disengagement from cooking and shopping was not found to entail predominantly negative feelings, passive acceptance or searching for forms of support to re-enable more cooking from scratch. Accounts evidenced the dynamic adaptability of older women in actively managing changed relationships with food. In exploring new meal options, older women were not simply disengaging from their environments. CAFE findings linked women's engagement with their environments to how they were using formal services and, even more, to the value they placed on social engagement and being out and about. Through the connections they fostered with friends, family and community, older women actively enabled their continued involvement in their social, public and family spheres. Reduced contact with preparing and cooking meals from scratch, therefore, did not induce or imply passivity or debility in the CAFE cohort. By contrast, it involved their exploring new means of retaining what was important to them about food in the context of their lived situation and social connections with friends, family, the community and public spheres.
SNR 1987A is the expanding remnant from the brightest supernova since the invention of the telescope. The remnant has been monitored extensively in the radio at variety of wavelengths and provides a wealth of data on which to base a simulation. Questions to be answered include estimating the efficiency of particle acceleration at shock fronts, determining the cause of the one-sided radio morphology for SNR 1987A and investigating the gas properties of the pre-supernova environment. We attempt to address these questions using a fully three-dimensional model of SNR 1987A.
Do the logics of entry and coordination that hold in pure single-member district plurality (SMDP) systems and in pure proportional representation (PR) systems hold in the SMDP tier and the PR tier of mixed-member systems? The fact that single-member districts are embedded in multimember districts means the logic of entry and coordination in either may be contaminated by the existence of the other. How can we establish the counterfactual of how many parties we should expect in one tier if the other tier did not exist? We leverage the design of districts in the United Kingdom to address this challenge, observing voting in the same (or very similar) districts but under multiple electoral systems. We find only limited support for the hypothesis that contamination occurs across tiers of mixed-member systems and conclude that there appears to be generally sophisticated decision making about both entry and coordination.1
Public music-making in the eighteenth century was essentially a sociable and an urban activity, with singing to be encountered in the streets, in theatres, concert rooms and churches, as well as in the drawing rooms of the wealthy. At the end of the seventeenth century there was still a recognised division between ‘gentlemen’, who made music for their own pleasure, and masters, ‘who are to earn their support by pleasing not themselves, for it is their day labour, but others’, as Roger North put it. This socio-musical distinction is one of the defining aspects of the period, but by the early years of the nineteenth century the line between gentlemen and players was less distinct; there was an international opera circuit, institutionalised music teaching, and a popular engagement with singing and singers that would have been unrecognisable to the dilettante of a hundred years earlier. The period saw some of the most important developments in the history of singing; the castrati came into their own and continued to represent the acme of vocalism even as great women soloists established themselves as serious competitors. It was the age of the first star tenor soloists – not the power performers that we now associate with the voice, but lyrical singers, often taught by castrati, who exploited their head register to take them to great heights. Twentieth-century music history identified two distinct eighteenth-century periods – the Baroque and the Classical – but in practice the developments in composition meant very little to singers, whose freely creative contribution to the art of performance was probably greater than at any time before or since. There is some evidence that the Renaissance ideal of separate performance styles for church, chamber and theatre continued on into the eighteenth century, but the differences between them were increasingly of scale rather than substance (and the aristocratic ‘chamber’ increasingly gave way to the bourgeois drawing room).
Seventeenth-century singers lived and worked in a continuing present, and the historical baggage they carried with them probably extended only to re-used music from a generation or two earlier and memories of more recent legendary local performances. The works that music historians see as significant landmarks such as Euridice, Orfeo and the other early favole in musica would have been just larger-scale realisations of the kinds of theatrical creations that were part of an Italian singer’s normal working life. The reimagining of polyphony as solo song had been part of the singer’s skill set for perhaps a hundred years before composers began to write what we now recognise as monodies. There may perhaps have been a sense of liberation at not having to go through the process of converting polyphony into solo song, but from a technical point of view the vocal delivery cannot have been very different. Singers always had to be aware of the verticality of harmony, or they would have got lost when extemporising. They were also aware of having a special obligation towards the poetic text, and this would have been enhanced by their experience of the more declamatory recitative. There was plenty of instruction available about how to deliver texts or high-speed ornaments, but the detail of how these things were really achieved is not yet visible in the surviving sources. The seventeenth century saw the triumph of the virtuoso and virtuosa, but the art was not just in the velocity of the divisions. This becomes more evident towards the end of the century, when we have the reflections of older singers looking back at the singing of their youth, and we are able to fill in some of the gaps with evidence of devices such as portamento, messa di voce and rubato. None of these (and many other subtle additions to the stylistic repertoire) has an identifiable point of origin: our sources are always conservative and retrospective, leaving us to speculate.
Why do we sing and what first drove early humans to sing? How might they have sung and how might those styles have survived to the present day? This history addresses these questions and many more, examining singing as a historical and cross-cultural phenomenon. It explores the evolution of singing in a global context - from Neanderthal Man to Auto-tune via the infinite varieties of world music from Orient to Occident, classical music from medieval music to the avant-garde and popular music from vaudeville to rock and beyond. Considering singing as a universal human activity, the book provides an in-depth perspective on singing from many cultures and periods: Western and non-Western, prehistoric to present. Written in a lively and entertaining style, the history contains a comprehensive reference section for those who wish to explore the topic further and will appeal to an international readership of singers, students and scholars.