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Sleep has been shown to impact on both physical and mental health, and sleep problems present a considerable burden for individuals and society. There appears to be a complex bidirectional relationship between sleep disturbance and psychiatric symptoms, each potentially influencing the other. In particular, sleep disorders have been associated with more severe symptoms and are predictive of relapse in those with psychotic disorders. This article discusses the relationship between psychosis and insomnia, sleep apnoea, nightmares, circadian rhythm abnormalities and the impact of medications on these relationships. We also discuss the clinical implications of the relationship between sleep disturbance and psychotic disorders along with potential targets for intervention.
Both obesity and type 2 diabetes mellitus have been associated with excessive free sugar consumption. Increasingly, LCS are used to replace free sugar to reduce the energy density of the diet, whilst maintaining diet palatability. However, while experimental data suggest a beneficial effect of LCS on weight management and glycaemic control, data from free-living populations are contradictory and primarily use reported intakes of low-calorie sweetened beverages as a marker of overall LCS consumption. Therefore, a dietary assessment tool that reliably assesses overall LCS consumption and is applicable in large-scale epidemiological studies is desirable. This study aimed to validate an LCS-focused food frequency questionnaire (FFQ) for assessing habitual dietary intake of the LCS using the method of triads. Healthy adults were recruited at Ulster University, Coleraine (n = 120). A 65-item FFQ and a 4-day food diary (FD) were used to assess dietary intake of LCS with amounts based on maximum permitted levels for foods and beverages as per EU legislation. A novel urinary biomarker approach, developed by this research group, was used to objectively assess consumption of 5 commonly used LCS(1). The method of triads was used to validate the FFQ by evaluating the correlations between the FFQ, FD and the urinary biomarkers (reference method). A total of 110 participants (51 males, 59 females) completed all analyses. Median (IQR) total LCS consumption estimated from the FFQ, FD and urinary biomarker was 116.8 (24.9–303.3) mg/d, 27.8 (0.0–247.3) mg/d and 5.0 (0.6–34.9) mg/d respectively. Moderate correlations were observed between the FD and urinary biomarker (r = 0.471; P < 0.001) and between the FFQ and FD (r = 0.471; P < 0.001). There was a low correlation between the FFQ and urinary biomarker (r = 0.291; P < 0.001). Using the method of triads, the overall validity co-efficient for the FFQ was moderate (0.54). These preliminary results indicate potential for this LCS-focused FFQ as a method of assessing LCS consumption in free-living populations. However, as maximum permitted levels of LCS in foods and beverages were used to estimate LCS consumption from the FFQ and FD, they are likely to significantly overestimate actual LCS intakes as compared to the more reliable biomarker approach. Therefore, the FFQ ability to categorise individuals into low-, medium- and high LCS consumers will be tested. Further analysis is ongoing to assess the completeness of urine collections using PABA analysis and will also focus on individual LCS intake.
Late-life depression (LLD) is associated with a decline in physical activity. Typically this is assessed by self-report questionnaires and, more recently, with actigraphy. We sought to explore the utility of a bespoke activity monitor to characterize activity profiles in LLD more precisely.
The activity monitor was worn for 7 days by 29 adults with LLD and 30 healthy controls. Subjects underwent neuropsychological assessment and quality of life (QoL) (36-item Short-Form Health Survey) and activities of daily living (ADL) scales (Instrumental Activities of Daily Living Scale) were administered.
Physical activity was significantly reduced in LLD compared with controls (t = 3.63, p < 0.001), primarily in the morning. LLD subjects showed slower fine motor movements (t = 3.49, p < 0.001). In LLD patients, activity reductions were related to reduced ADL (r = 0.61, p < 0.001), lower QoL (r = 0.65, p < 0.001), associative learning (r = 0.40, p = 0.036), and higher Montgomery–Åsberg Depression Rating Scale score (r = −0.37, p < 0.05).
Patients with LLD had a significant reduction in general physical activity compared with healthy controls. Assessment of specific activity parameters further revealed the correlates of impairments associated with LLD. Our study suggests that novel wearable technology has the potential to provide an objective way of monitoring real-world function.
Background: Postoperative infection is a significant cause of morbidity and mortality in traumatic brain injury (TBI) patients who undergo craniotomy and/or craniectomy. Data on the rates of infections associated with these procedures are limited. We present a single-center retrospective study on the rates of infection in post-traumatic craniotomies, craniectomies and cranioplasties. Methods: Data on 100 TBI adult patients who underwent a craniotomy, craniectomy and/or cranioplasty from 2011-2015 will be analyzed. Demographic and perioperative data including open/closed TBI, peri/postoperative infections, duration of procedure, type and mode of bone flap preservation will be retrieved. Results: Following our data collection (to be completed by the end of February), we expect infection rates of 3-20% in our study. Upon instituting a protocol similar to the Hydrocephalus Clinical Research Network’s (HCRN) ventriculoperitoneal shunt (VP) protocol, we hope to reduce our post-TBI craniotomy/craniectomy/cranioplasty infections rates to less than 10%. Our projection is based on the HCRN protocol’s 3.15% absolute risk reduction of VP shunt infections. Conclusions: The results of this study will emphasize the need for instituting robust perioperative protocols to reduce infections. Further research will be pursued following this study to establish a protocol similar to the VP shunt protocol from the HCRN, in an attempt to reduce perioperative rates of infection.
Low-calorie sweeteners (LCS) are commonly used as sugar substitutes in the diet to provide a desired sweet taste without increased energy intake. The number of LCS available on the market has increased considerably over the years and despite extensive evaluation of their safety prior to approval, debate continues around the effects of consumption on health. In Europe, Member States are obligated to monitor exposure to LCS and methods currently used tend to rely on self-reported dietary intake data alongside LCS concentrations in products. However, the acquisition of accurate data can be costly in terms of resources and time and are inherently imprecise. Although LCS are intensely sweet, they are chemically diverse and a limitation of many studies investigating the health effects of consumption is that they often fail to discern intakes of individual LCS. An approach which objectively assesses intakes of individual LCS would therefore allow robust investigations of their possible effects on health. Biomarker approaches have been utilised for the objective investigation of intakes of a range of dietary components and the feasibility of any such approach depends upon its validity as well as its applicability within the target population. This review aims to provide an overview of current understanding of LCS intake and explore the possibility of implementing a biomarker approach to enhance such understanding. Several commonly used LCS, once absorbed into the body, are excreted via the kidneys; therefore a urinary biomarker approach may be possible for the investigation of short-term exposure to these compounds.
The aim of this study was to examine cross-sectionally whether higher cardiorespiratory fitness (CRF) might favorably modify amyloid-β (Aβ)-related decrements in cognition in a cohort of late-middle-aged adults at risk for Alzheimer’s disease (AD). Sixty-nine enrollees in the Wisconsin Registry for Alzheimer’s Prevention participated in this study. They completed a comprehensive neuropsychological exam, underwent 11C Pittsburgh Compound B (PiB)-PET imaging, and performed a graded treadmill exercise test to volitional exhaustion. Peak oxygen consumption (VO2peak) during the exercise test was used as the index of CRF. Forty-five participants also underwent lumbar puncture for collection of cerebrospinal fluid (CSF) samples, from which Aβ42 was immunoassayed. Covariate-adjusted regression analyses were used to test whether the association between Aβ and cognition was modified by CRF. There were significant VO2peak*PiB-PET interactions for Immediate Memory (p=.041) and Verbal Learning & Memory (p=.025). There were also significant VO2peak*CSF Aβ42 interactions for Immediate Memory (p<.001) and Verbal Learning & Memory (p<.001). Specifically, in the context of high Aβ burden, that is, increased PiB-PET binding or reduced CSF Aβ42, individuals with higher CRF exhibited significantly better cognition compared with individuals with lower CRF. In a late-middle-aged, at-risk cohort, higher CRF is associated with a diminution of Aβ-related effects on cognition. These findings suggest that exercise might play an important role in the prevention of AD. (JINS, 2015, 21, 841–850)
Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12–15-year-olds (n 487; Young Hearts (YH)1) and again in the same individuals at 20–25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the ‘healthy’ DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the ‘sweet tooth’ DP were found to have increased LDL concentrations, systolic blood pressure, and diastolic blood pressure and decreased HDL concentrations, the ‘drinker/social’ DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the ‘Western’ DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods.
Previous studies of neurocognitive performance in bipolar disorder (BD) have demonstrated impairments in visuo-spatial memory. The aim of the present study was to use an object-location memory (OLM) paradigm to assess specific, dissociable processes in visuo-spatial memory and examine their relationship with broader neurocognitive performance.
Fifty participants (25 patients with BD in a current depressive episode and 25 matched healthy controls) completed the OLM paradigm which assessed three different aspects of visuo-spatial memory: positional memory, object-location binding, and a combined process. Secondary neurocognitive measures of visuo-spatial memory, verbal memory, attention and executive function were also administered.
BD patients were significantly impaired on all three OLM processes, with the largest effect in exact positional memory (d = 1.18, p < 0.0001). General deficits were also found across the secondary neurocognitive measures. Using hierarchical regression, verbal learning was found to explain significant variance on the OLM measures where object-identity was present (the object-location binding and combined processes) and accounted for the group difference. The group difference in precise positional memory remained intact.
This study demonstrates that patients with bipolar depression manifest deficits in visuo-spatial memory, with substantial impairment in fine-grain, positional memory. The differential profile of processes underpinning the visuo-spatial memory impairment suggests a form of ‘cognitive scaffolding’, whereby performance on some measures can be supported by verbal memory. These results have important implications for our understanding of the functional cognitive architecture of mood disorder.
Two new integral field units (IFUs) were installed recently on the WIYN Observatory's 3.5-meter telescope at Kitt Peak. These unique IFUs contain fibers of different sizes in the same head. This design allows smaller fibers to sample regions of higher surface brightness, providing higher spatial resolution while maintaining adequate signal-to-noise (S/N). Conversely, larger fibers maintain S/N at the expense of spatial resolution in the lower surface brightness regions of galaxies. The new IFUs were built with funds from NSF award ATI-0804576.
The fall of the Berlin Wall in 1989 and the unification of Germany in 1990 allowed East Germans to finally travel freely to western countries. This new freedom to travel to the West not only impacted the worldview of many former GDR citizens, but also found its way into the writings of East German authors throughout the 1990s and into the present. In her study on contemporary German literature around the turn of the twenty-first century, the literary critic Christine Cosentino examines several tendencies by which contemporary German authors deal with America in their texts. One tendency she describes is “die Reise in die USA als Topos für die Suche nach Identität, die den politischen Hintergrund weitgehend ausspart” (the journey to the USA as a symbol for the search for identity, which largely leaves out the political background). This tendency—finding one's identity by traveling to America—is noticeable in literature by East German authors from the 1990s, one of whom is Angela Krauß. In many of her works, particularly in her novels Die Überfliegerin (1995) and Milliarden neuer Sterne (1999), travel to America is a catalyst for the narrator experiencing her own identity in relation to past experiences, specifically her life in East German society. The exploration of the new world manifests itself in these texts as a discovery of the narrator's inner self.
Sophie von La Roche's America novel, Erscheinungen am See Oneida (Phenomena at Lake Oneida, 1798), centers on a French aristocratic couple from Flanders who go to live on a remote island in upstate New York. Carl and Emilie von Wattines have fled to the United States from the French revolutionary Terror, in which several of their relatives lost their lives. On advice from a Quaker friend in Philadelphia, they find their way to an island in Oneida Lake. There they live without contact with other Europeans for four years, producing two children and making a modest life for themselves, before moving to a new town founded by Dutch and German settlers on the lakeshore. A narrator traveling in the region pieces their story together from what he learns from them and their friends. At the crux of the tale is how the Wattineses, Crusoe-like, manage to survive in their isolation.
Three factors play a role. First, in spite of being aristocrats, they possess a bourgeois ethic, demonstrating qualities like modesty, hard work, and resourcefulness that help them to thrive. Second, they have brought a whole library of reference books with them, including the entire Encyclopédie and Buffon's Histoire naturelle, to which they frequently refer for how-to information. Finally and most interestingly, Emilie Wattines decides to reach out and make contact with the local indigenous people, the Oneidas, when she is about to give birth.
In recent years, the works by the German-Jewish poet Gertrud Kolmar (1894–1943) have found renewed interest among scholars. Raised in the upper middle class of Berlin and fully acculturated in the German cultural heritage, Gertrud Kolmar was persecuted, under the pressure of the National Socialist regime, because of her Jewish roots. Unlike many of her contemporaries, she chose to remain in Nazi Berlin and continued to write until her death in Auschwitz in 1943. Even though her published work spanned the innovative period between 1917 and 1937, Kolmar's poetic oeuvre from the years 1927 to 1937 has received the most attention. Though neglected by scholars, Kolmar's earlier work is fascinating precisely because it gives prescient insight into her poetic adaptations of questions concerning place, power, and gender at the end of the First World War.
My essay investigates an early poem in Kolmar's work: “Die Aztekin” (The Aztec Woman), written around 1920 and published in Früher Zyklus I. In memoriam 1918. Kolmar's “Aztekin” illustrates a testing ground for colonial fantasies and gendered mappings in its imaginary space of a poetic “Aztec empire.” The poem responds not only to preestablished writings on gendered conquests in the New World but also, more specifically, rewrites them in the perceived context of an imperial apocalypse in and after 1918, between megalomaniacal power struggles and the collapse of the Wilhelmine empire.