65 research outputs found

    Traumatic brain injury in children:Impact on Brain Structure, Neurocognition & Behavior

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    Oosterlaan, J. [Promotor

    Relationships between gross motor skills, cardiovascular fitness, and visuospatial working memory-related brain activation in 8-to 10-year-old children

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    Relationships between gross motor skills and cardiovascular fitness with visuospatial working memory (VSWM) in children are hypothesized to be mediated by underlying functional brain mechanisms. Because there is little experimental evidence to support this mechanism, the present study was designed to investigate the relationships of gross motor skills and cardiovascular fitness with VSWM-related brain activation in 8- to 10-year-old children. Functional magnetic resonance imaging data obtained during a VSWM-task were analyzed for 80 children from grades 3 (47.5%) and 4 of 21 primary schools in the Netherlands (51.3% girls). Gross motor skills (Korper Koordinationstest für Kinder and Bruininks-Oseretsky Test of Motor Proficiency - 2nd Edition) and cardiovascular fitness (20-meter Shuttle Run Test) were assessed. VSWM-related brain activation was found in a network involving the angular gyrus, the superior parietal cortex, and the thalamus; deactivation was found in the inferior and middle temporal gyri. Although behavioral results showed significant relations of gross motor skills and cardiovascular fitness with VSWM performance, gross motor skills and cardiovascular fitness were not related to VSWM-related brain activation. Therefore, we could not confirm the hypothesis that brain activation underlies the relationship of gross motor skills and cardiovascular fitness with VSWM performance. Our results suggest that either the effects of physical activity on cognition do not necessarily go via changes in gross motor skills and/or cardiovascular fitness, or that brain activation patterns as measured with the blood-oxygen-level dependent (BOLD) signal may not be the mechanism underlying the relationships of gross motor skills and cardiovascular fitness with VSWM

    Assessing the influence of the Responsibility to Protect on the UN Security Council during the Arab Spring

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    This article challenges those perspectives which assert first, that the Security Council’s engagement with the Responsibility to Protect (R2P) during the Arab Spring evidences a generally positive trend, and second, that the response to the Arab Spring, particularly Syria, highlights the need for veto restraint. With respect to the first point, the evidence presented in this article suggests that the manner in which R2P has been employed by the Security Council during this period evidences three key trends: first, a willingness to invoke R2P only in the context of Pillar I; second, a pronounced lack of consensus surrounding Pillar III; and third, the persistent prioritisation of national interests over humanitarian concerns. With respect to veto restraint, this article argues that there is no evidence that this idea will have any significant impact on decision-making at the Security Council; the Council’s response to the Arab Spring suggests that national interests continue to trump humanitarian need

    Intelligence after traumatic brain injury: meta‐analysis of outcomes and prognosis

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    Worldwide, 54-60 million individuals sustain traumatic brain injury (TBI) each year. This meta-analysis aimed to quantify intelligence impairments after TBI and to determine the value of age and injury severity in the prognosis of TBI. An electronic database search identified 81 relevant peer-reviewed articles encompassing 3890 patients. Full-scale IQ (FSIQ), performance IQ (PIQ) and verbal IQ (VIQ) impairments were quantified (Cohen's d) for patients with mild, moderate and severe TBI in the subacute phase of recovery and the chronic phase. Meta-regressions explored prognostic values of age and injury severity measures for intelligence impairments. The results showed that, in the subacute phase, FSIQ impairments were absent for patients with mild TBI, medium-sized for patients with moderate TBI (d = -0.61, P < 0.001) and large for patients with severe TBI (d = -1.09, P < 0.001). In the chronic phase, FSIQ impairments were small for patients with mild or moderate TBI (d = -0.37 and -0.19, P ≤ 0.008) and large for patients with severe TBI (d = -0.80, P < 0.001). Adults with mild TBI had larger PIQ and VIQ impairments in the chronic phase than children (both Q ≥ 5.21, P ≤ 0.02), whilst children with severe TBI had larger FSIQ and VIQ impairments than adults (both Q ≥ 4.40, P ≤ 0.04). Glasgow Coma Scale score, duration of loss of consciousness and post-traumatic amnesia duration moderately to strongly predicted FSIQ, PIQ and VIQ impairments (0.41 ≤ r ≤ 0.82, P ≤ 0.02), but no differences in predictive value were observed. In conclusion, TBI causes persisting intelligence impairments, where children may have better recovery from mild TBI and poorer recovery from severe TBI than adults. Injury severity measures predict intelligence impairments and do not outperform one another

    Post-traumatic amnesia predicts intelligence impairment following traumatic brain injury: a meta-analysis

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    0.05). Conclusions PTA duration is a valuable predictor of intelligence impairment following TBI. Results support the routine assessment of PTA duration in clinical settings

    Physical exercise and executive functions in preadolescent children, adolescents and young adults: a meta-analysis

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    Purpose: The goal of this meta-analysis was to aggregate available empirical studies on the effects of physical exercise on executive functions in preadolescent children (6-12 years of age), adolescents (13-17 years of age) and young adults (18-35 years of age). Method: The electronic databases PubMed, EMBASE and SPORTDiscus were searched for relevant studies reporting on the effects of physical exercise on executive functions. Nineteen studies were selected. Results: There was a significant overall effect of acute physical exercise on executive functions (d=0.52, 95% CI 0.29 to 0.76, p<0.001). There were no significant differences between the three age groups (Q (2)=0.13, p=0.94). Furthermore, no significant overall effect of chronic physical exercise (d=0.14, 95%CI -0.04 to 0.32, p=0.19) on executive functions (Q (1)=5.08, p<0.05) was found. Meta-analytic effect sizes were calculated for the effects of acute physical exercise on the domain's inhibition/interference control (d=0.46, 95% CI 0.33 to 0.60, p<0.001) and working memory (d=0.05, 95% CI -0.51 to 0.61, p=0.86) as well as for the effects of chronic physical exercise on planning (d=0.16, 95% CI 0.18 to 0.89, p=0.18). Conclusions Results suggest that acute physical exercise enhances executive functioning. The number of studies on chronic physical exercise is limited and it should be investigated whether chronic physical exercise shows effects on executive functions comparable to acute physical exercise. This is highly relevant in preadolescent children and adolescents, given the importance of well-developed executive functions for daily life functioning and the current increase in sedentary behaviour in these age groups

    Executive Functions of Sedentary Elderly May Benefit from Walking: A Systematic Review and Meta-Analysis

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    Objective: The goal of the present meta-analysis was to address studies that examined the relationship between walking as one of the most prevalent types of leisure-time activity and executive function being a higher-order cognitive function essential for independent functioning. Methods: The following data sources were used: English-language publications in PubMed, EMBASE, PsycINFO, Cinahl, and Cochrane; the last search took place in January 2012. From these data sources, only randomized controlled trials including older people with (N = 3) and without (N = 5) cognitive impairment were selected. Results: Walking has been shown to improve set-shifting and inhibition in sedentary older persons without cognitive impairment (d = 0.36; 95% confidence interval: 0.16-0.55; z = 3.56; p <0.0001). In older persons with cognitive impairment, walking did not show improvements in executive functioning (d = 0.14; 95% confidence interval:-0.36-0.64; z = 0.35; p = 0.56). Conclusion: This finding is clinically relevant because participation in a walking program may prevent or postpone a (further) decline in executive function in those who are sedentary. © 2014 American Association for Geriatric Psychiatry
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