55 research outputs found

    In My View

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    In My View

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    Original research: longitudinal evaluation of cognitively demanding daily function using performance-based functional assessment highlights heterogeneous trajectories in cognitive and functional abilities in people with Parkinson’s disease

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    BackgroundLongitudinal assessment of functional abilities in Parkinson’s disease (PD) is needed to determine the efficacy of cognitive interventions in providing meaningful improvements in daily life. Additionally, subtle changes in instrumental activities of daily living may precede a clinical diagnosis of dementia and could aid earlier detection of and intervention for cognitive decline.ObjectiveThe primary goal was to validate the longitudinal application of the University of California San Diego Performance-Based Skills Assessment (UPSA). An exploratory secondary goal was to determine whether UPSA may identify individuals at higher risk of cognitive decline in PD.MethodsSeventy participants with PD completed the UPSA with at least one follow-up visit. Linear mixed effects modeling was used to identify associations between baseline UPSA score and cognitive composite score (CCS) over time. Descriptive analysis of four heterogeneous cognitive and functional trajectory groups and individual case examples was performed.ResultsBaseline UPSA score predicted CCS at each timepoint for functionally impaired and unimpaired groups (p < 0.01) but did not predict the rate change in CCS over time (p = 0.83). Participants displayed heterogenous trajectories in both UPSA and CCS during the follow-up period. Most participants maintained both cognitive and functional performance (n = 54), though some displayed cognitive and functional decline (n = 4), cognitive decline with functional maintenance (n = 4), and functional decline with cognitive maintenance (n = 8).ConclusionThe UPSA is a valid measure of cognitive functional abilities over time in PD. Given the heterogeneity of functional and cognitive trajectories, this performance-based assessment did not predict cognitive decline with this relatively short follow-up. Further work is needed to understand longitudinal functional assessments in PD-associated cognitive impairment

    Context, cognition and communication in language

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    Questions pertaining to the unique structure and organisation of language have a long history in the field of linguistics. In recent years, researchers have explored cultural evolutionary explanations, showing how language structure emerges from weak biases amplified over repeated patterns of learning and use. One outstanding issue in these frameworks is accounting for the role of context. In particular, many linguistic phenomena are said to to be context-dependent; interpretation does not take place in a void, and requires enrichment from the current state of the conversation, the physical situation, and common knowledge about the world. Modelling the relationship between language structure and context is therefore crucial for developing a cultural evolutionary approach to language. One approach is to use statistical analyses to investigate large-scale, cross-cultural datasets. However, due to the inherent limitations of statistical analyses, especially with regards to the inadequacy of these methods to test hypotheses about causal relationships, I argue that experiments are better suited to address questions pertaining to language structure and context. From here, I present a series of artificial language experiments, with the central aim being to test how manipulations to context influence the structure and organisation of language. Experiment 1 builds upon previous work in iterated learning and communication games through demonstrating that the emergence of optimal communication systems is contingent on the contexts in which languages are learned and used. The results show that language systems gradually evolve to only encode information that is informative for conveying the intended meaning of the speaker - resulting in markedly different systems of communication. Whereas Experiment 1 focused on how context influences the emergence of structure, Experiments 2 and 3 investigate under what circumstances do manipulations to context result in the loss of structure. While the results are inconclusive across these two experiments, there is tentative evidence that manipulations to context can disrupt structure, but only when interacting with other factors. Lastly, Experiment 4 investigates whether the degree of signal autonomy (the capacity for a signal to be interpreted without recourse to contextual information) is shaped by manipulations to contextual predictability: the extent to which a speaker can estimate and exploit contextual information a hearer uses in interpreting an utterance. When the context is predictable, speakers organise languages to be less autonomous (more context-dependent) through combining linguistic signals with contextual information to reduce effort in production and minimise uncertainty in comprehension. By decreasing contextual predictability, speakers increasingly rely on strategies that promote more autonomous signals, as these signals depend less on contextual information to discriminate between possible meanings. Overall, these experiments provide proof-of-concept for investigating the relationship between language structure and context, showing that the organisational principles underpinning language are the result of competing pressures from context, cognition, and communication

    Climate, vocal folds, and tonal languages: Connecting the physiological and geographic dots

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    We summarize a number of findings in laryngology demonstrating that perturbations of phonation, including increased jitter and shimmer, are associated with desiccated ambient air. We predict that, given the relative imprecision of vocal fold vibration in desiccated versus humid contexts, arid and cold ecologies should be less amenable, when contrasted to warm and humid ecologies, to the development of languages with phonemic tone, especially complex tone. This prediction is supported by data from two large independently coded databases representing 3,700+ languages. Languages with complex tonality have generally not developed in very cold or otherwise desiccated climates, in accordance with the physiologically based predictions. The predicted global geographic–linguistic association is shown to operate within continents, within major language families, and across language isolates. Our results offer evidence that human sound systems are influenced by environmental factors

    Influence of documented history of coronary artery disease on outcomes in patients admitted for worsening heart failure with reduced ejection fraction in the EVEREST trial

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    Estudio fotográfico compuesto por 84 imágenes realizadas por el fotógrafo Fernando Alda en el marco del Proyecto _re-HABITAR. Las fotografías reflejan la evolución patrimonial desde una perspectiva del autor, así como la actual realidad de la Barriada de Nuestra Señora del Carmen (Sevilla) y de su entorno urbano
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