The effects of aging and bilingualism on language-specific attention control

Relational elements of language (e.g. , prepositions, articles) act to direct attention to other aspects of the incoming message. The listener or reader must be able to use these elements to focus and refocus attention on the mental representation that is being constructed. Recent research has shown that this type of attention control is specific to language and can be distinguished from more general attention control. This thesis contains two papers that examine language-specific attention control in two different groups, older monolingual adults and younger bilingual adults, each as compared to younger monolingual adults. Participants completed two conditions of a task switching paradigm. The relational condition involved processing spatial prepositions, and the semantic condition involved processing nouns and adjectives. Attention control was operationalized in terms of shift costs obtained in an alternating runs experimental design. Results indicated that both older adults and younger bilingual adults had similar switch costs in the relational and semantic conditions, whereas the younger monolingual adults had significantly larger switch costs (i.e., lower attention control) in the relational condition than the semantic condition. Switch costs did not correlate with measures of working memory or inhibition for any of the three groups. Implications of the results are discussed

The contribution of bilingualism to differences in brain structure and function in aging, mild cognitive impairment, and Alzheimer disease

This dissertation presents findings that address several questions with respect to research demonstrating protection from age-related cognitive decline and dementia in older bilinguals relative to monolinguals. Manuscript 1 (Chapter 4) reports research investigating the contribution of bilingualism to cognitive reserve by examining the clinical and neurophysiological manifestations of dementia in monolingual and multilingual patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). Neuropsychological assessment data, demographic information, cortical thickness, and gray matter tissue density are compared between monolinguals and bilinguals. Results in AD patients indicated lower grey matter density in the posterior parahippocampal gyri (and similar directional trends for the rhinal cortices) for multilinguals compared to monolinguals, despite the fact that the groups were matched for functioning on two episodic memory tests. Results in both MCI and AD patients showed thicker cortex and greater tissue density in a number of regions related to bilingualism in multilinguals compared to monolingual. Additionally, this study also found significant correlations between brain regions related to language and cognitive control and episodic memory measures, for multilingual patients but no monolingual patients. This provides evidence towards our hypothesis that for multilingual patients, greater brain matter in cognitive control regions may form part of compensatory memory network. Manuscript 2 (Chapter 5) reports research investigating functional differences in the brain activity of younger and older monolinguals and bilinguals while completing cognitive control tasks (i.e., Stroop, Simon, and Eriksen flanker tasks). Previously collected and published data (Kousaie & Phillips, 2012b; 2017) are re-analysed using novel electrophysiological measures to investigate whether bilingualism contributes to differences in brain responses between monolinguals and bilinguals, and whether these effects vary as a function of aging. As was seen in the previously published research, neither the younger nor the older participants show conflict-specific language-group differences in behavioural results (with the exception of the Stroop task for the older adults). However, differences are seen in electrical brain activity between the four groups suggesting differences in cognitive control processing. Broadly, we found an overall age difference in power (with older adults lower higher power in the alpha and theta frequency bands, and more suppression in the beta frequency band than younger adults), and some evidence for conflict-specific language-group differences (with younger and older bilinguals showing larger conflict effects in power than their monolingual counterparts). We also found that induced activity was a better marker of conflict processing than evoked activity and that the locus of the conflict differed across the three tasks with respect to the manifestation of trial type differences in event-related power

Development and Validation of a Short Form for the MCS-DR

Using two independent samples of parents with a shared minor child but not currently in a relationship, this study explores the development and validation of a new 12-item short form for the Multidimensional Co-Parenting Scale for Dissolved Relationships (MCS-DR12). Confirmatory factor analysis will be used to assess the four-factor structure of the MCS-DR12 and then internal reliability, construct validity, and criterion validity will be assessed. The development of this short form provides a 12-item assessment of four impactful areas of co-parenting which is invaluable, especially for those working with court-mandated parenting programs who are in need of brief instruments to assess program efficacy

Polysaccharide utilization loci and nutritional specialization in a dominant group of butyrate-producing human colonic Firmicutes

Acknowledgements The Rowett Institute of Nutrition and Health (University of Aberdeen) receives financial support from the Scottish Government Rural and Environmental Sciences and Analytical Services (RESAS). POS is a PhD student supported by the Scottish Government (RESAS) and the Science Foundation Ireland, through a centre award to the APC Microbiome Institute, Cork, Ireland. Data Summary The high-quality draft genomes generated in this work were deposited at the European Nucleotide Archive under the following accession numbers: 1. Eubacterium rectale T1-815; CVRQ01000001–CVRQ0100 0090: http://www.ebi.ac.uk/ena/data/view/PRJEB9320 2. Roseburia faecis M72/1; CVRR01000001–CVRR010001 01: http://www.ebi.ac.uk/ena/data/view/PRJEB9321 3. Roseburia inulinivorans L1-83; CVRS01000001–CVRS0 100 0151: http://www.ebi.ac.uk/ena/data/view/PRJEB9322Peer reviewedPublisher PD

Structural brain differences between monolingual and multilingual patients with mild cognitive impairment and Alzheimer disease: Evidence for cognitive reserve

Two independent lines of research provide evidence that speaking more than one language may 1) contribute to increased grey matter in healthy younger and older adults and 2) delay cognitive symptoms in mild cognitive impairment (MCI) or Alzheimer disease (AD). We examined cortical thickness and tissue density in monolingual and multilingual MCI and AD patients matched (within Diagnosis Groups) on demographic and cognitive variables. In medial temporal disease-related (DR) areas, we found higher tissue density in multilingual MCIs versus monolingual MCIs, but similar or lower tissue density in multilingual AD versus monolingual AD, a pattern consistent with cognitive reserve in AD. In areas related to language and cognitive control (LCC), both multilingual MCI and AD patients had thicker cortex than the monolinguals. Results were largely replicated in our native-born Canadian MCI participants, ruling out immigration as a potential confound. Finally, multilingual patients showed a correlation between cortical thickness in LCC regions and performance on episodic memory tasks. Given that multilinguals and monolinguals were matched on memory functioning, this suggests that increased gray matter in these regions may provide support to memory functioning. Our results suggest that being multilingual may contribute to increased gray matter in LCC areas and may also delay the cognitive effects of disease-related atrophy

Has increased clinical experience with methotrexate reduced the direct costs of medical management of ectopic pregnancy compared to surgery?

<p>Abstract</p> <p>Background</p> <p>There is a debate about the cost-efficiency of methotrexate for the management of ectopic pregnancy (EP), especially for patients presenting with serum human chorionic gonadotrophin levels of >1500 IU/L. We hypothesised that further experience with methotrexate, and increased use of guideline-based protocols, has reduced the direct costs of management with methotrexate.</p> <p>Methods</p> <p>We conducted a retrospective cost analysis on women treated for EP in a large UK teaching hospital to (1) investigate whether the cost of medical management is less expensive than surgical management for those patients eligible for both treatments and (2) to compare the cost of medical management for women with hCG concentrations 1500–3000 IU/L against those with similar hCG concentrations that elected for surgery. Three distinct treatment groups were identified: (1) those who had initial medical management with methotrexate, (2) those who were eligible for initial medical management but chose surgery (‘elected’ surgery) and (3) those who initially ‘required’ surgery and did not meet the eligibility criteria for methotrexate. We calculated the costs from the point of view of the National Health Service (NHS) in the UK. We summarised the cost per study group using the mean, standard deviation, median and range and, to account for the skewed nature of the data, we calculated 95% confidence intervals for differential costs using the nonparametric bootstrap method.</p> <p>Results</p> <p>Methotrexate was £1179 (CI 819–1550) per patient cheaper than surgery but there were no significant savings with methotrexate in women with hCG >1500 IU/L due to treatment failures.</p> <p>Conclusions</p> <p>Our data support an ongoing unmet economic need for better medical treatments for EP with hCG >1500 IU/L.</p

Goal-setting intervention in patients with active asthma: Protocol for a pilot cluster-randomised controlled trial

Background: Supporting self-management behaviours is recommended guidance for people with asthma. Preliminary work suggests that a brief, intensive, patient-centred intervention may be successful in supporting people with asthma to participate in life roles and activities they value. We seek to assess the feasibility of undertaking a cluster-randomised controlled trial (cRCT) of a brief, goal-setting intervention delivered in the context of an asthma review consultation. Methods/design: A two armed, single-blinded, multi-centre, cluster-randomised controlled feasibility trial will be conducted in UK primary care. Randomisation will take place at the practice level. We aim to recruit a total of 80 primary care patients with active asthma from at least eight practices across two health boards in Scotland (10 patients per practice resulting in ~40 in each arm). Patients in the intervention arm will be asked to complete a novel goal-setting tool immediately prior to an asthma review consultation. This will be used to underpin a focussed discussion about their goals during the asthma review. A tailored management plan will then be negotiated to facilitate achieving their prioritised goals. Patients in the control arm will receive a usual care guideline-based review of asthma. Data on quality of life, asthma control and patient confidence will be collected from both arms at baseline and 3 and 6 months post-intervention. Data on health services resource use will be collected from all patient records 6 months pre- and post-intervention. Semi-structured interviews will be carried out with healthcare staff and a purposive sample of patients to elicit their views and experiences of the trial. The outcomes of interest in this feasibility trial are the ability to recruit patients and healthcare staff, the optimal method of delivering the intervention within routine clinical practice, and acceptability and perceived utility of the intervention among patients and staff

Placental Growth Factor:A Promising Diagnostic Biomarker for Tubal Ectopic Pregnancy

CONTEXT: Tubal ectopic pregnancy is common but accurate diagnosis is difficult and costly. There is currently no serum test to differentiate tubal from intrauterine implantation and an effective biomarker of ectopic pregnancy would be a major clinical advance. OBJECTIVE: A key feature of successful intrauterine implantation is the establishment of a supportive vascular network and this has been associated with the activity of placental growth factor (PIGF). We hypothesized that the local decidual environment facilitates PIGF-dependent angiogenesis and that this pathway is not active in tubal implantation. We aimed to determine whether tubal implantation is manifest by an attenuation of the normal trophoblast PIGF-response and whether serum PIGF levels are different in ectopic compared to intrauterine pregnancy. DESIGN: Tissue and serum analysis. SETTING: A large UK teaching hospital. PATIENTS: Gestation-matched pregnant women undergoing surgical termination of pregnancy (viable intrauterine) (n=15), evacuation of uterus for embryonic missed miscarriage (non-viable intrauterine) (n=10) and surgery for tubal ectopic pregnancy (n=15). INTERVENTIONS: Trophoblast was examined by immunohistochemistry and quantitative RT-PCR, and serum was analyzed by ELISA. RESULTS: PIGF was localized to the cytotrophoblast cells. Expression of PIGF mRNA was reduced in trophoblast isolated from women with ectopic compared to intrauterine pregnancies (P<0.05). Serum PIGF was undetectable in women with tubal ectopic pregnancies and reduced, or undetectable, in miscarriage compared to viable intrauterine pregnancies (P<0.01). CONCLUSIONS: Serum PIGF is a promising novel diagnostic biomarker for early pregnancy location and outcome, and large-scale studies are now required to determine its clinical utility