Normal adults recall poorly social feedback that refers to them, is negative, and pertains to core self-aspects. This phenomenon, dubbed the mnemic neglect effect, is equivalent to inhibitory repression. It is instigated under conditions of high self-threat, it implicates not-thinking during encoding, and it involves memories that are recoverable with such techniques as recognition accuracy.

It is often assumed that similar domain-specific behavioural impairments found in cases of adult brain damage and developmental disorders correspond to similar underlying causes, and can serve as convergent evidence for the modular structure of the normal adult cognitive system. We argue that this correspondence is contingent on an unsupported assumption that atypical development can produce selective deficits while the rest of the system develops normally (Residual Normality), and that this assumption tends to bias data collection in (...) the field. Based on a review of connectionist models of acquired and developmental disorders in the domains of reading and past tense, as well as on new simulations, we explore the computational viability of Residual Normality and the potential role of development in producing behavioural deficits. Simulations demonstrate that damage to a developmental model can produce very different effects depending on whether it occurs prior to or following the training process. Because developmental disorders typically involve damage prior to learning, we conclude that the developmental process is a key component of the explanation of endstate impairments in such disorders. Further simulations demonstrate that in simple connectionist learning systems, the assumption of Residual Normality is undermined by processes of compensation or alteration elsewhere in the system. We outline the precise computational conditions required for Residual Normality to hold in development, and suggest that in many cases it is an unlikely hypothesis. We conclude that in developmental disorders, inferences from behavioural deficits to underlying structure crucially depend on developmental conditions, and that the process of ontogenetic development cannot be ignored in constructing models of developmental disorders. Key Words: Acquired and developmental disorders; connectionist models; modularity; past tense; reading. (shrink)

The choice to cooperate or compete with others confronts us on a daily basis, and it is plausible that we use our mentalising skills to aid decision-making in such situations. We investigated the relationship between mentalising and decision-making in the prisoner's dilemma in adults with autism spectrum disorders , who show impaired mentalising, and normal adults. After completion of three versions of the prisoner's dilemma, we conducted a semi-structured interview. This interview attempted to elicit a participant's spontaneous strategy when (...) playing each version of the game, as well as on their conception of the nature and strategy choice of their opponents . Contrary to expectations, the behavioural choices of the adults with and without ASD were quantitatively similar, as were the qualitative responses to questions used in the interview. The consistency of the evidence from both measures suggests that mentalising ability was not involved in selecting the choices made in these prisoner's dilemma tasks. Instead they suggest the hypothesis that a purely logical strategy may have been adopted. The introspections of at least a subgroup of high-functioning individuals with ASD can on the whole be trusted and this use of mixed methods strengthens the validity of the conclusions drawn. (shrink)

SummaryEarly onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010–11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. (...) Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45±1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height and negatively associated with BMI. Students from urban areas attained menarche earlier than those from rural areas. Students from small-sized families attained menarche earlier than those from larger families. First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight. The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts. (shrink)

Clinical investigators must engage in just subject recruitment and selection and avoid unduly influencing research participation. There may be tension between the practice of keeping payments to participants low to avoid undue influence and the requirements of justice when recruiting normal healthy volunteers for phase 1 drug studies. By intentionally keeping payments low to avoid unduly influenced participation, investigators, on the recommendation or insistence of institutional review boards, may be targeting or systematically recruiting healthy adult members of lower (...) socio-economic groups for participation in phase 1 studies. Investigators are at risk of routinely failing to fulfill the obligation of justice, which prohibits the systematic targeting and recruiting of subjects for reasons unrelated to the nature of the study. Insofar as we take seriously the obligation to engage in just subject recruitment and selection, I argue that we must acknowledge the implications low payments might have for subject recruitment and selection and examine the effect of low payments. If low payments de facto target the less well-off for phase 1 studies, we must defend the priority ranking of the obligation to avoid undue influence over the obligation of justice or adopt an alternative recruitment approach. This paper identifies a number of alternatives to the current system of low-value payments to research participants. (shrink)

El presente trabajo tiene como objetivo determinar los tipos de actividades de reformulación conversacional que aparecen en conversaciones en adultos mayores con diferentes niveles de desempeño cognitivo: normales y trastorno cognitivo leve, a partir de una tarea de construcción de un discurso narrativo-argumentativo. Desde una perspectiva de investigación cualitativa, se obtuvo un corpus de 4 entrevistas, que fue codificado con la ayuda del software ATLAS.ti lo que permitió la generación de conceptos y el desarrollo de explicaciones a partir de los (...) datos, los que fueron contrastados con el marco teórico disponible. Los resultados indicaron que los hablantes realizaron actividades de auto-reformulación auto-iniciada, auto-reformulación iniciada por otro y hetero-reformulación derivada del auto-inicio. Las dos primeras se redujeron en los hablantes identificados con trastorno cognitivo leve, mientras que el último tipo de actividad fue el más frecuente y dominante en la conversación. Los hablantes con trastorno cognitivo leve realizaron reformulaciones que no corregían o adecuaban el discurso, por lo que no cumplieron con la finalidad de la reparación. This study aimed to determine the types of activities of conversational reformulation that occur during oral dialogues with older adults who have varying levels of cognitive performance. Study participants, who ranged between normal cognitive function and mild cognitive impairment, were given the task of constructing a narrative-argumentative dialogue. For qualitative investigation purposes, a corpus of four interviews was obtained. Each series of interviews were encoded using ATLAS.ti software which generated linked concepts and explanations from the data. Findings were then compared with the available theoretical framework. The results indicated that participants exhibited three modes of reformulation technique: self-initiated self-reformulation activities; self-reformulation started by another person; and hetero-reformulation derived from self-start. The first two were reduced in speakers exhibiting mild cognitive impairment, while the latter was the most frequent and dominant mode in the conversation. Speakers with mild cognitive impairment executed reformulations that did not correct or enhance the speech, and as such did not meet the purpose of reformulation. (shrink)

In this chapter, I argue that we can make sense of moral norms against consensual, adult incest by appealing to the value of familial relationships and the potential for sex to damage them. Viewing sex as unconscionable between family members helps to enable the loving intimacy normally associated with family relationships. Therefore, there is good reason for incest, even when consensual and between adults, to remain taboo. That being said, I argue that there is insufficient legal justification for all (...) consensual, adult incest to be criminalised. I examine four potential arguments in favor of consensual, adult incest being illegal, and conclude that none of them succeeds in justifying a total legal prohibition against it. (shrink)

ObjectiveAre people with a characteristically large physiological sway rendered particularly unstable when standing on a moving surface? Is postural sway in standing individuals idiosyncratic? In this study, we examine postural sway in individuals standing normally, and when subtle continuous sinusoidal disturbances are applied to their support platform. We calculate consistency between conditions to verify if sway can be considered characteristic of each individual. We also correlate two different aspects of participants’ responses to disturbance; their sway velocity and their regulation of (...) body orientation.MethodsNineteen healthy adults (age 29.2 ± 3.2 years) stood freely on footplates coaxially aligned with their ankles and attached to a motorized platform. They had their eyes closed, and hips and knees locked with a light wooden board attached to their body. Participants either stood quietly on a fixed platform or on a slowly tilting platform (0.1 Hz sinusoid; 0.2 and 0.4 deg). Postural sway size was separated into two entities: (1) the spontaneous sway velocity component (natural random relatively rapid postural adjustments, RMS body angular velocity) and (2) the evoked tilt gain component (much slower 0.1 Hz synchronous tilt induced by the movement of the platform, measured as peak-to-peak (p-p) gain, ratio of body angle to applied footplate rotation).ResultsThere was no correlation between the velocity of an individual’s sway and their evoked tilt gain (r= 0.34,p= 0.15 andr= 0.30,p= 0.22). However, when considered separately, each of the two measurements showed fair to good absolute agreement within conditions. Spontaneous sway velocity consistently increased as participants were subjected to increasing disturbance. Participants who swayed more (or less) did so across all conditions [ICC(3,k)= 0.95]. Evoked tilt gain also showed consistency between conditions [ICC(3,k)= 0.79], but decreased from least to most disturbed conditions.ConclusionThe two measurements remain consistent between conditions. Consistency between conditions of two very distinct unrelated measurements reflects the idiosyncratic nature of postural sway. However, sway velocity and tilt gain are not related, which supports the idea that the short-term regulation of stability and the longer-term regulation of orientation are controlled by different processes. (shrink)

While cognitive changes in aging and neurodegenerative disease have been widely studied, language changes in these populations are less well understood. Inflecting novel words in a language with complex inflectional paradigms provides a good opportunity to observe how language processes change in normal and abnormal aging. Studies of language acquisition suggest that children inflect novel words based on their phonological similarity to real words they already know. It is unclear whether speakers continue to use the same strategy when encountering (...) novel words throughout the lifespan or whether adult speakers apply symbolic rules. We administered a simple speech elicitation task involving Finnish‐conforming pseudo‐words and real Finnish words to healthy older adults, individuals with mild cognitive impairment, and individuals with Alzheimer's disease (AD) to investigate inflectional choices in these groups and how linguistic variables and disease severity predict inflection patterns. Phonological resemblance of novel words to both a regular and an irregular inflectional type, as well as bigram frequency of the novel words, significantly influenced participants' inflectional choices for novel words among the healthy elderly group and people with AD. The results support theories of inflection by phonological analogy (single‐route models) and contradict theories advocating for formal symbolic rules (dual‐route models). (shrink)

Selective mutism is an anxiety disorder in which an individual is unable to speak in certain social situations though may speak normally in other settings (Hua & Major, 2016 ). Selective mutism in adults is rare, though people with this condition might have other methods of communicating their needs outside of verbal communication. Healthcare professionals rely on a patient’s ability to communicate to establish if they have decision-making capacity. This commentary responds to a case of a young adult patient (...) with selective mutism and social anxieties that significantly limited his ability to communicate with anyone in the healthcare team. This required a creative, patient-centered approach to engage in meaningful communication. (shrink)

During normal aging there is a decline in cognitive functions that includes deficits in oral discourse production. A higher level of education and more frequent reading and writing habits might delay the onset of the cognitive decline during aging. This study aimed at investigating the effect of education and RWH on oral discourse production in older adults. Picture-based narratives were collected from 117 healthy adults, aged between 51 and 82 years with 0–20 years of formal education. Measures of macro, (...) microlinguistic and modalizations were computed and entered as dependent variables in hierarchical regression analyses that included age, education and RWH as regressors. Results revealed that higher education explained a better performance at the macrostructure and microstructure dimensions. Higher frequency of RWH explained the production of fewer modalizations. These results demonstrate the positive effect of education and RWH in oral discourse production in older adults. Therefore, higher attention should be given to these social factors. (shrink)

This article reports in detail an ethics case consultation involving a decision to forgo life-sustaining treatment for a middle-aged man following a massive cerebral bleed resulting in profound brain damage, but not unconsciousness. An unusual feature of this case is that, despite normal intelligence, caring family relationships and a history of life-threatening cardiac disease, vigorous and sustained inquiry could not elicitany indications of this patient's values, perceptions or preferences regarding end of life care.Other than a deliberately autobiographical methodological prologue (...) and a few brief comments at the end, the case is presented straightforwardly and without intercurrent analysis. (shrink)

There is a gap in the clinical bioethics literature concerning the approach to assessment of medical decision-making capacity of adolescents or young adults who demonstrate diminished maturity due to longstanding reliance on caregiver support, despite having reached the age of majority. This paper attempts to address this question via the examination of a particular case involving assessment of the decision-making capacity of a young adult pregnant patient who also had a physically disabling neurological condition. Drawing on concepts from adolescent (...) bioethics and feminist critiques of bioethical theory, we argue that limited life experience, secondary to a disabling neurological condition, can result in a lack of adult-like capacity even in a patient who is legally an adult. In such cases, it may be that autonomy, to the extent that it is to be relevant and meaningful, must be viewed through a relational lens. Furthermore, clinicians may avoid unjustifiably paternalistic practices by working with the patient help her gain a better appreciation of the consequences of her decision, thereby calling forward her capacity rather than resorting to being directive in counseling. We conclude that lessons from this case can be used to approach ethically complex instances of medical decision-making in adult patients with normal cognition but diminished experiential maturity. (shrink)

Attachment style, relationship status, gender and relational competences among young adults The seeking of a lifetime partner/spouse, establishing and maintaining close relationships are central developmental tasks in young adulthood. In successful achievement of these tasks relational competences may play a crucial role, thus making it reasonable to study their conditions. This article provides a theoretical and empirical analysis of the relationship between relational competences and attachment style, relationship status, and gender. It presents a study of a normal sample of (...) 423 young adults, aged 20-35, who completed The Questionnaire of Relational Competences in Intimate Relationships, Revised Adult Attachment Scale, and Demographic Questionnaire. The analysis of the data revealed that in the description of various relational competences all three factors play an important role. It has also turned out that the association between relational competences and attachment style is influenced by the circumstances pertaining to relationship status. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review (...) was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

Single-sided deafness (SSD) or profound unilateral hearing loss obligates the only serviceable ear to capture all acoustic information. This loss of binaural function taxes cognitive resources for accurate listening performance, especially under adverse environments or challenging tasks. We hypothesized that adults with SSD would manifest both functional and structural brain plasticity compared to controls with normal binaural hearing. We evaluated functional alterations using magnetoencephalographic imaging (MEGI) of brain activation during performance of a moderately difficult auditory syllable sequence reproduction task (...) and assessed structural integrity using diffusion tensor magnetic resonance imaging (DTI). MEGI showed the SSD cohort to have increased induced oscillations in the theta band over the left superior temporal cortex and decreased induced gamma band oscillations over the frontal and parietal cortices between 175-475 ms following stimulus onset. DTI showed the SSD cohort to have extensive fractional anisotropy reduction in both auditory and non-auditory tracts and regions. Overlaying functional and structural changes revealed by the two imaging techniques demonstrated close registration of cortical areas and white matter tracts that expressed brain plasticity. Hence, complete loss of input from one ear in adulthood triggers both functional and structural alterations to dorsal temporal and frontal-parietal areas. (shrink)

The Gait Deviation Index is a multivariate measure of overall gait pathology based on 15 gait features derived from three-dimensional kinematic data. GDI aims at providing a comprehensive, easy to interpret, and clinically meaningful metric of overall gait function. It has been used as an outcome measure to study gait in several conditions: cerebral palsy, post-stroke hemiparetic gait, Duchenne muscular dystrophy, and Parkinson’s disease, among others. Nevertheless, its use in population with Spinal Cord Injury has not been studied yet. The (...) aim of the present study was to investigate the applicability of the GDI to SCI through the assessment of the relationship of the GDI with the Walking Index for Spinal Cord Injury II. 3D gait kinematics of 34 patients with incomplete SCI was obtained. Besides, 3D gait kinematics of a sample of 50 healthy volunteers was also gathered with Codamotion motion capture system. A total of 302 and 446 strides were collected. GDI was calculated for each stride and grouped for each WISCI II level. HV data were analyzed as an additional set. Normal distribution for each group was assessed with Kolmogorov-Smirnov tests. Afterward, ANOVA tests were performed between each pair of WISCI II levels to identify differences among groups. The results showed that the GDI was normally distributed across all WISCI II levels in both iSCI and HV groups. Furthermore, our results showed an increasing relationship between the GDI values and WISCI II levels in subjects with iSCI, but only discriminative in WISCI II levels 13, 19, and 20. The index successfully distinguished HV group from all the individuals with iSCI. Findings of this study indicated that the GDI is not an appropriate multivariate walking metric to represent the deviation of gait pattern in adult population with iSCI from a normal gait profile when it is compared with the levels of walking impairment described by the WISCI II. Future work should aim at defining and validating an overall gait index derived from 3D kinematic gait variables appropriate for SCI, additionally taking into account other walking ability outcome measures. (shrink)

Background Speech understanding may rely not only on auditory, but also on visual information. Non-invasive functional neuroimaging techniques can expose the neural processes underlying the integration of multisensory processes required for speech understanding in humans. Nevertheless, noise (from fMRI) limits the usefulness in auditory experiments, and electromagnetic artefacts caused by electronic implants worn by subjects can severely distort the scans (EEG, fMRI). Therefore, we assessed audio-visual activation of temporal cortex with a silent, optical neuroimaging technique: functional near-infrared spectroscopy (fNIRS). Methods (...) We studied temporal cortical activation as represented by concentration changes of oxy- and deoxy-hemoglobin in four, easy-to-apply fNIRS optical channels of 33 normal-hearing adult subjects and 5 post-lingually deaf cochlear implant (CI) users in response to supra-threshold unisensory auditory and visual, as well as to congruent auditory-visual speech stimuli. Results Activation effects were not visible from single fNIRS channels. However, by discounting physiological noise through reference channel subtraction, auditory, visual and audiovisual speech stimuli evoked concentration changes for all sensory modalities in both cohorts (p<0.001). Auditory stimulation evoked larger concentration changes than visual stimuli (p<0.001). A saturation effect was observed for the audiovisual condition. Conclusions Physiological, systemic noise can be removed from fNIRS signals by reference channel subtraction. The observed multisensory enhancement of an auditory cortical channel can be plausibly described by a simple addition of the auditory and visual signals with saturation. (shrink)

Psychologically normal adult humans make sense of intentional actions by trying to decide for which reason they were performed. This is a datum that requires our understanding. Although there have been interesting recent debates about how we should understand ‘reasons’, I will follow a long tradition and assume that, at a bare minimum, to act for a reason involves having appropriately interrelated beliefs and desires. He left the party because he believed the host had insulted him. She will (...) head for the cabin in the woods because she wants peace and quiet. These are typical examples of reason explanations, one backward looking and the other future facing. Both imply more than they say. To leave a party because of a suspected insult suggests that one desires not to be insulted, or at least it implies that the desire to avoid insult is stronger than that for some other good on offer. Similarly, to seek tranquillity in an isolated cabin implies that one believes that it can be found there, or at least more so than elsewhere. Despite the fact that the situations and characters involved in these dramas are woefully under-described, we are able to ‘make sense’ of these actions in a basic manner using the belief/desire schema. This involves designating a particular pairing of a belief and a desire, each with its own specified propositional content, in a way that rests on a quiet understanding of the way propositional attitudes inter-relate. To understand which beliefs and desires were responsible for a person’s action is normally only to understand why they acted in a quite skeletal way. Maximally, to understand why someone acted requires a more or less detailed description of his or her circumstances, other propositional attitudes (hopes, fears), more basic perceptions and emotions and perhaps even his or her character, current situation and history. In short, to fully grasp why someone took action on a particular occasion requires relating that.. (shrink)

The present chapter provides a review of the literature addressing changes in memory performance in older adults (often retired individuals with an age between 60 and 80 years), compared to younger adults (often college students around age 20). While it is well-established that memory performance declines in older adults (e.g., Kausler, 1994; Ryan, 1992), it is now clear that not all aspects of memory are impaired (e.g., Balota & Duchek, 1988; Burke & Light, 1981; Craik, 1983; Schacter, Kihlstrom, Kaszniak & (...) Valdiserri, 1993; Shimamura, 1989). Dissociations across age groups with respect to impairments in different memory types/processes have provided (a) insights into the influence of aging on neuropsychological underpinnings of memory, and (b) leverage for memory theorists to develop a better understanding of normal memory functioning. This chapter involves three sections: First, we provide a summary of selected empirical findings that document the nature of age-related changes across a wide set of memory tasks. Although it is beyond the scope of the present chapter to review the rich literature concerning memory and aging, this section will acquaint the reader with examples of paradigms used to study distinct aspects of memory and the conclusions that researchers have reached regarding the influence of age on each memory type/process. Second, we discuss the major theoretical perspectives that have been proposed as explanatory constructs for these age-related memory deficits. Finally, we provide an overview of recent developments that shed some light on understanding the possible neurological underpinnings of aging on memory functioning. (shrink)

In recent years, foreign language learning has been proposed as a possible cognitive intervention for older adults. However, the brain network and cognitive functions underlying FLL has remained largely unconfirmed in older adults. In particular, older and younger adults have markedly different cognitive profile—while older adults tend to exhibit decline in most cognitive domains, their semantic memory usually remains intact. As such, older adults may engage the semantic functions to a larger extent than the other cognitive functions traditionally considered the (...) most important. Using anatomical measurements and a cognitive test battery, the present study examined this hypothesis in twenty cognitively normal older adults, who participated in a two-month Italian learning programme. Results showed that the immediate learning success and long-term retention of Italian vocabularies were most consistently predicted by the anatomical measures of the left pars orbitalis and left caudal middle frontal cortex, which are implicated in semantic and episodic memory functions. Convergent evidence was also found based on the pattern of cognitive associations. Our results are consistent with a prominent role of semantic and episodic memory functions in vocabulary learning in older learners. (shrink)

Hearing loss in old age, which often goes untreated, has far-reaching consequences. Furthermore, reduction of cognitive abilities and dementia can also occur, which also affects quality of life. The aim of this study was to investigate the hearing performance of seniors without hearing complaints with respect to speech perception in noise and the ability to localize sounds. Results were tested for correlations with age and cognitive performance. The study included 40 subjects aged between 60 and 90 years with not self-reported (...) hearing problems. The subjects were screened for dementia. Audiological tests included pure-tone audiometry and speech perception in two types of background noise which was either co-located or spatially separated from the target speech. Sound localization ability was assessed and hearing performance was self-evaluated by a questionnaire. Speech in noise and sound localization was compared with young normal hearing adults. Although considering themselves as hearing normal, 17 subjects had at least a mild hearing loss. There was a significant negative correlation between hearing loss and dementia screening score. Speech perception in noise decreased significantly with age. There were significant negative correlations between speech perception in noise and DemTect score for both spatial configurations. Mean SRTs obtained in the co-located noise condition with amplitude-modulated noise were on average 3.1 dB better than with continuous noise. This gap-listening effect was severely diminished compared to a younger normal hearing subject group. In continuous noise, spatial separation of speech and noise led to better SRTs compared to the co-located masker condition. SRTs in MSNF deteriorated in modulated noise compared to continuous noise by 2.6 dB. Highest impact of age was found for speech perception scores using noise stimuli with temporal modulation in binaural test conditions. Mean localization error was in the range of young adults. Mean amount of front/back confusions was 11.5% higher than for young adults. Speech perception tests in the presence of temporally modulated noise can serve as a screening method for early detection of hearing disorders in older adults. This allows for early prescription of hearing aids. (shrink)

IntroductionThis study aimed to evaluate, in adults with mild cognitive impairment, the brain atrophy that may distinguish between three AT biomarker-based profiles, and to determine its clinical value.MethodsStructural MRI was employed to evaluate the volume and cortical thickness differences in MCI patients with different AT profiles, namely, A−T−−: normal AD biomarkers; A+T−−: AD pathologic change; and A+T++: prodromal AD. Sensitivity and specificity of these changes were also estimated.ResultsAn initial atrophy in medial temporal lobe areas was found in the A+T−− (...) and A+T++ groups, spreading toward the parietal and frontal regions in A+T++ patients. These structural changes allowed distinguishing AT profiles within the AD continuum; however, the profiles and their pattern of neurodegeneration were unsuccessful to determine the current clinical status.ConclusionsMRI is useful in the determination of the specific brain structural changes of AT profiles along the AD continuum, allowing differentiation between MCI adults with or without pathological AD biomarkers. (shrink)

The Test of Basic Auditory Capabilities is a battery of auditory-discrimination tasks and speech-identification tasks that has been normed on several hundred young normal-hearing adults. Previous research with the TBAC suggested that cognitive function may impact the performance of older adults. Here, we examined differences in performance on several TBAC tasks between a group of 34 young adults with a mean age of 22.5 years and a group of 115 older adults with a mean age of 69.2 years recruited (...) from the local community. Performance of the young adults was consistent with prior norms for this age group. Not surprisingly, the two groups differed significantly in hearing loss and working memory with the older adults having more hearing loss and poorer working memory than the young adults. The two age groups also differed significantly in performance on six of the nine measures extracted from the TBAC with the older adults consistently performing worse than the young adults. However, when these age-group comparisons were repeated with working memory and hearing loss as covariates, the groups differed in performance on only one of the nine auditory measures from the TBAC. For eight of the nine TBAC measures, working memory was a significant covariate and hearing loss never emerged as a significant factor. Thus, the age-group deficits observed initially on the TBAC most often appeared to be mediated by age-related differences in working memory rather than deficits in auditory processing. The results of these analyses of age-group differences were supported further by linear-regression analyses with each of the 9 TBAC scores serving as the dependent measure and age, hearing loss, and working memory as the predictors. Regression analyses were conducted for the full set of 149 adults and for just the 115 older adults. Working memory again emerged as the predominant factor impacting TBAC performance. It is concluded that working memory should be considered when comparing the performance of young and older adults on auditory tasks, including the TBAC. (shrink)

Nation-wide community quarantines and social distancing are part of the new normal because of the global COVID-19 pandemic. Since extensive and prolonged lockdowns are relatively novel experiences, not much is known about the well-being of individuals in such extreme situations. This research effort investigated the relationship between well-being elements and resiliency of 533 Filipino adults who were placed under the nationwide enhanced community quarantine during the COVID-19 pandemic. Participants comprised of 376 females and 157 males. The median and mode (...) ages of the participants is 23 years, while 25 is the mean age. PERMA Profiler was used to measure participants’ well-being elements, while Connor-Davidson Resiliency Scale-10 was used to measure their resiliency. Collected data were analyzed using the regression model and necessary condition analysis. This study corroborated that all the five pillars of well-being are significant positive correlates of resiliency in quarantined adults. The results shown accomplishment positively predicts resiliency, while negative emotions negatively predict resiliency. Lastly, the five pillars of well-being are necessary-but-not-sufficient conditions of resiliency. Our results cast a new light on well-being elements as constraints rather than enablers of resiliency. This novel result shows that optimum resiliency is only possible when all the five pillars of well-being are taken care of and when a person is at least minimally contented with their physical health. The present findings underscore the importance of a holistic as against an atomistic approach to maintaining good mental health, which suggests that deficiencies in certain areas of well-being may not be fully addressed by overcompensating on other areas, as all five pillars of well-being are necessary-but-not-sufficient conditions of resiliency. The study ends with the recommendation for the use of necessary condition analysis to study both classical and novel psychological research problems. (shrink)

IntroductionThe present study aimed to evaluate the effects of the Active Communication Education program on the social/emotional impacts of hearing loss in a group of older adults with a cochlear implant.DesignProspective cohort study design, with a “within-subject” control procedure.Study SampleTwenty adults over-65 post-lingually deafened CI users. All subjects were required to be native Italian speakers, to have normal cognitive level, have no significant psychiatric conditions and/or diagnosed incident dementia, and used CI for at least 9 months.Materials and MethodsTwenty participants (...) were assessed using the Hearing Handicap Inventory for the Elderly, the Geriatric Depression Scale, and the Speech, Spatial, and Qualities of Hearing Scale before, during, and after ACE program, with a one and 6-month follow up. The cognitive and audiological evaluation was carried out before commencing the ACE program.ResultsThe ACE program had a positive impact by reducing HL’s social/emotional effects. Participants benefited from a rehabilitative approach by improving multilevel skills: comprehension of audiological and hearing dimensions, acquisition of communicative, pragmatic and problem-solving strategies, and interaction and sharing of experiences with peers.ConclusionAlthough targeting the older adults with moderate HL, the ACE program also seemed to benefit older adult CI users. An improvement in social and emotional adaptation to hearing difficulties can, in turn, significantly promote optimal use of CI in the older adults, thereby possibly reducing the risk of losing motivation and engagement in device use and in rehabilitation protocols. (shrink)

It is commonly believed that we humans are justified in exploiting animals because we are “higher” beings:persons who have highly complex, autonomous lives as moral agents. However, there are many “marginal” humans who are not and never will be persons. Those who think it is permissible to exploit animal nonpersons but wrong to do the same to human nonpersons must show that there is a morally relevant difference between the two groups. Speciesists, who believe that membership in a species whose (...) normal adults are persons is sufficient for a right to life, attempt to do just this. As the failure of the best arguments which can be marshalled on their behalf indicates, they are unable to justify their view. I conclude that, although there is a morally relevant difference between human nonpersons and most animal nonpersons, this difference is not an indication of superior moral status. We would do better to abandon speciesism and the assumption thatpersonhood is morally paramount for a view which implies that both human and nonhuman nonpersons are morally considerable and have a right to life. (shrink)

ObjectiveThis study aimed to develop a diagnostic model of multi-kinematic parameters for patients with amnestic mild cognitive impairment (aMCI).MethodIn this cross-sectional study, 94 older adults were included (33 cognitively normal, CN; and 61 aMCI). We conducted neuropsychological battery tests, such as global cognition and cognitive domains, and collected gait parameters by an inertial-sensor gait analysis system. Multivariable regression models were used to identify the potential diagnostic variables for aMCI. Receiver operating characteristic (ROC) curves were applied to assess the diagnostic (...) accuracy of kinematic parameters in discriminating aMCI from healthy subjects.ResultsMultivariable regression showed that multi-kinematic parameters were the potential diagnostic variables for aMCI. The multi-kinematic parameter model, developed using Timed Up and Go (TUG) time, stride length, toe-off/heel stride angles, one-leg standing (OLS) time, and braking force, showed areas under ROC (AUC), 0.96 [95% confidence interval (CI), 0.905–0.857]; sensitivity, 0.90; and specificity, 0.91. In contrast, a single kinematic parameter’s sensitivity was 0.26–0.95 and specificity was 0.21–0.90. Notably, the separating capacity of multi-kinematic parameters was highly similar to Montreal Cognitive Assessment (MoCA; AUC: 0.96 vs. 0.95). Compared to cognitive domain tests, the separating ability was comparable to Auditory Verbal Learning Test (AVLT) and Boston Naming Test (BNT; AUC: 0.96 vs. 0.97; AUC: 0.96 vs. 0.94).ConclusionWe developed one diagnostic model of multi-kinematic parameters for patients with aMCI in Foshan. (shrink)

Advance care planning (ACP) is a process that seeks to elicit patients’ goals, values, and preferences for future medical care. While most commonly employed in adult patients, pediatric ACP is becoming a standard of practice for adolescent and young adult patients with potentially life-limiting illnesses. The majority of research has focused on patients and their families; little attention has been paid to the perspectives of healthcare providers (HCPs) regarding their perspectives on the process and its potential benefits and (...) limitations. Focus groups were conducted with 15 physicians as part of a larger study of adolescent and young adult ACP in hematopoietic stem cell transplant (HSCT) patients. This study identified two categories important to the utility of ACP in pediatric HSCT patients; (1) the temporal context of ACP and decision making and (2) the limitations of pediatric ACP, with subcategories identified as (a) embodied and witnessed knowing, (b) the impact of clinical cascades—when the treatment of one organ system creates complications in another system that needs to be treated—and a creation of a “new normal” following complications of illness and its treatment in the pediatric intensive care unit (PICU), (c) the balancing of adolescents’ autonomy with their capacity to make informed medical decisions, and (d) the epistemological frames that differ between HCP and patients and their families. These findings support ACP in adolescent and young adult HSCT patients, with a number of implications for practice as this process becomes more common. (shrink)

BackgroundDreams can be affected by recent life events and long-term life experiences. Previous evidence has shown that childhood adverse experiences are associated with sleep quality and dream experiences.ObjectiveThe aim of this study was to explore the relationship between childhood adverse experiences and dream content in adults.Participants and SettingA total of 163 participants without current or past physical or mental disorders aged between 18 and 35 were screened in the hospital. Among them, 120 subjects who completed a dream content record at (...) home and whose anxiety and depression levels and sleep quality were within the normal range were included in the data analysis.MethodsA cross-sectional survey was conducted from June 2017 to December 2019. Dream content for 10 consecutive days was recorded by the participants and coded by the Hall and Van de Castle coding system. Childhood adversity was assessed by the Childhood Trauma Questionnaire. In the end, 719 dreams out of 626 nights for 120 participants were included in the data analysis, gender differences between groups were analyzed using t-tests or U tests, and Spearman’s partial correlation and multiple linear regression were used to investigate the relationship between childhood trauma and dream content.ResultsChildhood adversity was associated with characters, friendly interactions, and objects in dream content. Regression models of childhood adversity predicting characters and objects in dream content were constructed. There were no gender differences in general demographic data, sleep quality, emotional state, childhood adversity, dream recall frequency, or dream content.ConclusionChildhood adversity is associated with adult dream content. (shrink)

Background: Contact heat evoked potentials is used to diagnose small fiber neuropathy. We established the normal values of CHEPs parameters in Chinese adults, optimized the test technique, and determined its reproducibility.Methods: We recruited 151 healthy adults. CHEPs was performed on the right forearm to determine the optimal number of stimuli, and then conducted at different sites to establish normal values, determine the effects of demographic characteristics and baseline temperature, and assess the short- and long-term reproducibility. N2 latency/height varied (...) with age and sex, while P2 latency/height and N2–P2 amplitude varied with age. The optimal number of stimuli was three.Results: N2 latency/height and P2 latency/height decreased and N2–P2 amplitude and visual analog scale score increased with increased baseline temperature. CHEPs parameters did not differ with time.Conclusion: We established normal CHEPs values in Chinese adults. We found that CHEPs parameters changed with baseline temperature and that the short- and long-term test reproducibility were satisfactory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fitness, Fatness, and Aesthetic Judgments of the Female Body:What the AMA Decision to Medicalize Obesity means for other Non–Normal Female BodiesSara R. Jordan“I’ll be happy to refer you to our dietician to get you on a program to help you get your weight under control before it becomes a problem”.As my new physician spun around out of the examination room door, my head spun faster. I had heard (...) the phrase “get your weight under control” twice that morning, but the contexts in which the phrase was uttered could not have been more different.At 7:30 a.m., my fitness trainer was imploring me to get my weights under control as I struggled under a bar, laden with slightly less than my body weight, to do a final set of front squats. At 11:15 a.m., my new general practitioner was imploring me to get my weight under control, by which he meant to learn how to reduce my body mass index (BMI) to match the chart prominently displayed on his office wall. The exhortation to get my weight under control meant such radically different things in these two contexts that it was difficult to comprehend the meaning of the phrase.I am 5’4” and 158 pounds. This gives me a BMI of 27.3, which means that I am considered overweight; right in the middle of the category of overweight. Or, according to the definition of the BMI found on the calculator pinned to the National Heart Lung and Blood Institutes (NHLBI) webpage, I am over fat. If the BMI is, “a measure of body fat based on height and weight that applies to adult men and women” then I carry a health–threatening percentage of body fat. If my fitness trainer, with his 12 point skin–fold caliper test is correct, my body fat percentage of 17% is within the limits expected of female (non–endurance) athletes. In terms of health, then, I am a paradox: according to one standard, I am healthy and fit, according to another, I am unhealthy and fat.As this new physician picked apart my weight, suggesting I should lose between 15 and 20 pounds to bring myself to “full health”, I found myself quite annoyed. He was a small, rail thin, man with greying hair, tired eyes, unpressed khakis, and a beaten pair of black–ish grey “Crocs” on his feet. He looked disheveled and as if he had not seen the inside of a weights room in his life. As I listened to him address my history, current vitals, and how being overweight in my 30s could lead to being [End Page 101] “fat and 40”, I looked him over and made a snap judgment of “I could bench (press) you [right out this window]”. While I was angry with his delivery, I tried to remind myself that he was an overworked physician in a multi–lingual office, trying to operate under a new paradigm in healthcare policy, practice, and diagnostic categories. Specifically, prompted by the medicalization of the condition of obesity by the American Medical Association, my physician was reflecting the professional wisdom that I suffer from a condition needing preventive treatment. He was trying to be a good practitioner to recommend preventive treatment, but to me, he was being a terrible physician.The AMA Declares Obesity a DiseaseThe declaration by the American Medical Association in 2013 that the condition of being obese is one that requires medical treatment is one that I, on the face of it, support. By inviting the medicalization of the condition, the AMA opens the door for individuals who wage a deeply personal battle with their weight to find support in their physicians’ offices and from their insurance companies. Yet, the blunt tools that are used to assess these conditions raise my ire, emotionally and intellectually.Intellectually, the use of the BMI calculator for snap diagnosis of all individuals makes easy sense. It is an easily comprehended tool and, for a normally distributed population, such a simple tool is an excellent choice. But, it stands to treat outliers like me poorly. Outliers, such as particularly fit... (shrink)

ObjectivesThe global COVID-19 pandemic in 2020 heavily affected the arts and creative industries due to the instigation of lockdown measures in the United Kingdom and closure of venues. However, it also provided new opportunities for arts and cultural engagement through virtual activities and streamed performances. Yet it remains unclear who was likely to engage with the arts at home during lockdown, how this engagement differed from patterns of arts engagement prior to COVID-19, and whether home-based arts engagement was related to (...) people’s ability to cope with their emotions during lockdown. This study was therefore designed to address these questions.MethodsWe used data collected in late May from the United Kingdom COVID-19 Social Study run by University College London. Multivariate regressions were used for the analysis. Identified factors included demographic factors, socio-economic position, psychosocial wellbeing and health conditions, adverse events/worries, and coping styles.ResultsFour types of home-based arts engagement were identified during the COVID-19 pandemic: digital arts and writing, musical activities, crafts, and reading for pleasure. Our results show that the strongest predictors of the engagement were age, education attainment, social support, and emotion-focused or supportive coping styles. In particular, younger adults, non-keyworkers, people with greater social support, people who had lost work, those who were worried about catching the virus, and those with an emotion-focused, problem-focused or supportive coping style were more likely to have increased arts engagement during lockdown. Arts activities were used as approach and avoidance strategies to help cope with emotions, as well as to help improve self-development.ConclusionOverall, our study suggests that while some people who engaged in the arts during the COVID-19 pandemic were those who typically engage under normal circumstances, the pandemic has also created new incentives and opportunities for others to engage virtually. Additionally, this study highlights the value of the arts as coping tools during stressful situations. (shrink)

The mere presence of irrelevant external stimuli results in interference with the fidelity of details retrieved from long-term memory (LTM). Recent studies suggest that distractibility during LTM retrieval occurs when the focus of resource-limited, top-down mechanisms that guide the selection of relevant mnemonic details is disrupted by representations of external distractors. We review findings from four studies that reveal distractibility during episodic retrieval. The approach cued participants to recall previously studied visual details when their eyes were closed, or were open (...) and irrelevant visual information was present. The results showed a negative impact of the distractors on the fidelity of details retrieved from LTM. An fMRI experiment using the same paradigm replicated the behavioral results and found that diminished episodic memory was associated with the disruption of functional connectivity in whole-brain networks. Specifically, network connectivity supported recollection of details based on visual imagery when eyes were closed, but connectivity declined in the presence of visual distractors. Another experiment using auditory distractors found equivalent effects for auditory and visual distraction during cued recall, suggesting that the negative impact of distractibility is a domain-general phenomenon in LTM. Comparisons between older and younger adults revealed an aging-related increase in the negative impact of distractibility on retrieval of LTM. Finally, a new study that compared categorization abilities between younger and older adults suggests a cause underlying age-related decline of visual details in LTM. The sum of our findings suggests that cognitive control resources, although limited, have the capability to resolve interference from distractors during tasks of moderate effort, but these resources are overwhelmed when additional processes associated with episodic retrieval, or categorization of complex prototypes, are required. (shrink)

This paper examines human planning abilities, using as its inspiration planning techniques developed in artificial intelligence. AI research has shown that in certain problems partial‐order planners, which manipulate partial plans while not committing to a particular ordering of those partial plans, are more efficient than total‐order planners, which represent all partial plans as totally ordered. This research asks whether total‐order planning and/or partial‐order planning are accurate descriptions of human planning, and if different populations use different planning techniques. Using a simple (...) planning task modeled after tasks designed in artificial intelligence we tested 7–8 year‐old children, 11–13 year‐old children, adult controls, and adults with damage to the prefrontal cortex. We found that adults and older children exhibited performance on planning tasks of varying complexity which matched that of artificial partial‐order planners, and that this pattern of performance did not vary with multiple presentations of the planning task. In contrast, young children and adults with damage to the prefrontal cortex exhibited performance matching that of artificial total‐order planners. This pattern of performance did vary, however, with multiple presentations of the planning task, with the young children and adults with cortical damage displaying aspects of total‐order planning. In a further study we found that adolescents who had sustained damage to the prefrontal cortex as children displayed two different patterns of performance; when measures of reaction time were analyzed they revealed a pattern of performance suggestive of partial‐order plan representations. However, analyses of the adolescents' protocols revealed a pattern of performance suggestive of total‐order plan representations. The significance of these results to psychology, neuroscience, and artificial intelligence are discussed. (shrink)

SCL (TAL1/TCL5) is a member of the helix‐loop‐helix family of transcription factors. Originally identified because of its involvement in a tumour‐specific chromosomal translocation, overexpression of the SCL gene is the most common molecular abnormality found in human T cell leukaemia. Transgenic models have now formally demonstrated that overexpression of SCL within the T cell lineage is capable of causing malignant transformation. Gene targeting experiments have revealed that the SCL gene is crucial for the development of primitive haematopoiesis in the mouse (...) and is also required for the generation of all adult haematopoietic lineages. Biochemical studies have indicated some of the proteins which interact with SCL and this has refined the hypotheses concerning the mechanisms by which SCL plays a role in leukaemogenesis and haematopoietic development. (shrink)