Assertive community treatment for elderly people with severe mental illness

Background: Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness.Methods: We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months.Discussion: This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated

The mystery of the cerebellum: clues from experimental and clinical observations

Abstract The cerebellum has a striking homogeneous cytoarchitecture and participates in both motor and non-motor domains. Indeed, a wealth of evidence from neuroanatomical, electrophysiological, neuroimaging and clinical studies has substantially modified our traditional view on the cerebellum as a sole calibrator of sensorimotor functions. Despite the major advances of the last four decades of cerebellar research, outstanding questions remain regarding the mechanisms and functions of the cerebellar circuitry. We discuss major clues from both experimental and clinical studies, with a focus on rodent models in fear behaviour, on the role of the cerebellum in motor control, on cerebellar contributions to timing and our appraisal of the pathogenesis of cerebellar tremor. The cerebellum occupies a central position to optimize behaviour, motor control, timing procedures and to prevent body oscillations. More than ever, the cerebellum is now considered as a major actor on the scene of disorders affecting the CNS, extending from motor disorders to cognitive and affective disorders. However, the respective roles of the mossy fibres, the climbing fibres, cerebellar cortex and cerebellar nuclei remains unknown or partially known at best in most cases. Research is now moving towards a better definition of the roles of cerebellar modules and microzones. This will impact on the management of cerebellar disorders

Foreign accent strength and listener familiarity with an accent codetermine speed of perceptual adaptation

Contains fulltext : 116500.pdf (publisher's version ) (Open Access)We investigated how the strength of a foreign accent and varying types of experience with foreign-accented speech influence the recognition of accented words. In Experiment 1, native Dutch listeners with limited or extensive prior experience with German-accented Dutch completed a cross-modal priming experiment with strongly, medium, and weakly accented words. Participants with limited experience were primed by the medium and weakly accented words, but not by the strongly accented words. Participants with extensive experience were primed by all accent types. In Experiments 2 and 3, Dutch listeners with limited experience listened to a short story before doing the cross-modal priming task. In Experiment 2, the story was spoken by the priming task speaker and either contained strongly accented words or did not. Strongly accented exposure led to immediate priming by novel strongly accented words, while exposure to the speaker without strongly accented tokens led to priming only in the experiment’s second half. In Experiment 3, listeners listened to the story with strongly accented words spoken by a different German-accented speaker. Listeners were primed by the strongly accented words, but again only in the experiment’s second half. Together, these results show that adaptation to foreign-accented speech is rapid but depends on accent strength and on listener familiarity with those strongly accented words.20 p

Matching in local labor markets: a stochastic frontier approach

Matching function, Technical efficiency, Stochastic frontier analysis, Local labor markets, Heterogeneity, J24, J64,

Consuming Fake News: A Matter of Age? The perception of political fake news stories in Facebook ads

Social media are increasingly being used by young and old as a source of in-formation. Fake news is also on the rise. The role played by age in the con-sumption of fake news on social media, however, is unclear. This paper ex-plores the generational differences in the consumption of fake news, first by discussing previous empirical studies in this field and then on the basis of an empirical study carried out between the beginning of February 2018 and the end of June of 2018. In that empirical study, 14 political fake news articles (e.g., relating to Brexit and Donald Trump) were disseminated in the form of advertisements on Facebook. User interaction with the fake content was tracked in order to analyze the number of users in the age groups 13-17, 18-24, 25-34, 35-44, 45-54, 55-64, 65+. The results of the empirical study show that the articles had a higher reach amongst the older age groups, as well as that many people likely took the headlines at face value without clicking on the link. The number of emotional responses posted by the pro-Brexit and pro-Trump groups was greater than those posted by the pro-remain and anti-Trump groups. All of the posts were permitted to run as advertisements on Facebook despite Facebook’s efforts to limit the spread of fake news on their platform. In the final section, conclusions are drawn, limitations described and implications for future research are outlined