Executive Functioning in Daily Life in Parkinson's Disease: Initiative, Planning and Multi-Task Performance

Impairments in executive functioning are frequently observed in Parkinson's disease (PD). However, executive functioning needed in daily life is difficult to measure. Considering this difficulty the Cognitive Effort Test (CET) was recently developed. In this multi-task test the goals are specified but participants are free in their approach. This study applies the CET in PD patients and investigates whether initiative, planning and multi-tasking are associated with aspects of executive functions and psychomotor speed. Thirty-six PD patients with a mild to moderate disease severity and thirty-four healthy participants were included in this study. PD patients planned and demonstrated more sequential task execution, which was associated with a decreased psychomotor speed. Furthermore, patients with a moderate PD planned to execute fewer tasks at the same time than patients with a mild PD. No differences were found between these groups for multi-tasking. In conclusion, PD patients planned and executed the tasks of the CET sequentially rather than in parallel presumably reflecting a compensation strategy for a decreased psychomotor speed. Furthermore, patients with moderate PD appeared to take their impairments into consideration when planning how to engage the tasks of the test. This compensation could not be detected in patients with mild PD

Nutritional characterisation of low-income households of Nairobi: socioeconomic, livestock and gender considerations and predictors of malnutrition from a cross-sectional survey

Background: In sub-Saharan Africa, urban informal settlements are rapidly expanding, leading to overcrowding and constituting challenging environments for food and water supplies, health and nutrition. The study objectives were to characterise and compare two low-income areas of Nairobi according to socioeconomic (including livestock and gender) indicators and the nutritional status of non-pregnant women of reproductive age and 1 to 3 year-old children; and to investigate socioeconomic predictors of malnutrition in these areas. Methods: In this cross-sectional survey 205 low-income households in deprived areas of Dagoretti and Korogocho (Nairobi) were randomly selected. Socioeconomic data were collected via an interviewer-administered questionnaire. Maternal and child dietary data were collected by a 24-h dietary recall. Maternal and child anthropometric and haemoglobin measurements were taken. Chi-square, t-test and Wilcoxon-Mann–Whitney test were used to compare groups and multivariable linear regression to assess predictors of malnutrition. Results: Dagoretti consistently showed better socioeconomic indicators including: income, education and occupation of household head, land ownership, housing quality and domestic asset ownership. Animal ownership was more than twice as high in Dagoretti as in Korogocho (53.0 % vs 22.9 % of households; p-value < 0.0001). A double burden of malnutrition existed: 41.5 % of children were stunted, and 29.0 % of women were overweight. In addition, 74.0 % of the children and 25.9 % of the women were anaemic, and were at risk of inadequate intakes for a number of micronutrients. Nutritional status and nutrient intakes were consistently better in Dagoretti than Korogocho; height-for-age (0.47 Z-scores higher; p-value = 0.004), the minimum dietary diversity (80.0 % vs 57.7 % in children, p-value = 0.001) and intakes of several nutrients were significantly higher. Positive predictors of maternal nutritional status were income, age and not having a premature delivery. Positive predictors of child nutritional status were area, household head education, mother not being married, female animal ownership and child’s sex (female). Conclusions: Malnutrition is prevalent in these settings, which could be partly due to low nutrient intakes, and to socioeconomic factors (including poverty), thus requiring comprehensive approaches that include increased accessibility and affordability of nutrient-dense foods. This study indicates that differences among low-income areas may need consideration for prioritisation and design of interventions

Multi-stemming and mechanical traits ensure persistence of subalpine woody plants exposed to a disturbance gradient

Question: Many woody plants persist in a temporal ‘persistence’ niche, through resprouting after disturbance events. Will multi-stemming (as a consequence of resprouting or life form) and biomechanical traits enable certain species to survive disturbance and occupy a persistence niche? Location A 1200-m long avalanche corridor in the French Alps, with disturbance events ca. every 2 yr. Methods: We measured tree/shrub size and multi-stemming in transects along and around the avalanche corridor. The mechanical traits, wood density, modulus of elasticity (Ed), bending strength (σ) and stiffness (EI), along stems of several subalpine tree/shrub species were measured to test for differences in flexibility and strength. Results: The multi-stemmed pioneer shrubs Alnus viridis, Salix appendiculata and to a lesser extent, Corylus avellana, were more abundant where disturbance was most severe. Multi-stemming broadleaf species, in particular Fagus sylvatica, had more tapered, shorter and more numerous stems in severely disturbed zones. Single-stemmed conifers were usually found furthest from the avalanche track. A. viridis, codominant at the centre of the track, had the lowest Ed, σ and EI. In A. viridis, Alnus incana, F. sylvatica and Betula pendula, Ed was lower at the stem base and increased with height up the stem. Alnus viridis and C. avellana stems were most flexible (low EI), whereas single-stem tree forms, Picea abies and B. pendula, were stiffest. Corylus avellana had the highest σ and lowest wood mechanical construction cost (ρ) per unit function (Ed), whereas P. abies had highest construction cost. Conclusions: High flexibility of A. viridis, and to a lesser extent C. avellana and the multi-stemmed form of F. sylvatica, allows individuals to bend during snow loading, before an avalanche; therefore, stem damage and uprooting during an avalanche are minimized. Increased stem basal flexibility in these species will also facilitate bending during snow loading. More rigid distal sections will confer extra mechanical advantage to stems that need to grow quickly upwards, dominate and maintain their position in the canopy during the growing seaso