Effects of Executive Functioning Abilities on Health Regimen Adherence

Introduction: Adherence is the degree to which an individual accurately completes treatment recommendations, and is defined as a comparison between completed and prescribed events. Cognitively-mediated components of adherence have been identified in past research, and include comprehension of health information, ability to recall information at specific times, and consistency (i.e., regularity of recommendation completion). To date, no studies have explored the role of consistency in adherence for unstructured, behavioral recommendations, nor have any studies explored the association between consistency and complex executive functioning (EF). Methods: The current study examined the relationship between consistency and adherence to a stress monitoring task in 33 healthy college students (Mage= 20.0, SDage= 2.0; 63.6% Male). Participants were administered a battery of simple and complex EF measures, followed by a brief stress psychoeducation session. Participants subsequently tracked their stress online three times per day for seven days. Results: Analyses revealed no association between consistency and adherence in this sample, r= -.08, p= .70. Results from sequential regression analyses indicated EF measures accounted for a significant proportion of variance in consistency, F(6, 16)= 4.62, p< .01, R2adj= 0.5 (large), but not adherence, F(7, 25)= .73, p= .65, R2adj= -.06 (no effect). Moreover, the contributions of simple EF measures to consistency were greater, R2adj= .54 (large), than complex EF, R2adj = .22 (medium). Discussion: This study provides evidence that consistency is dissociable from overall adherence, and that this construct may rely on EF abilities. Given that past research has shown a relationship between consistency and adherence in medically compromised populations, implications of the current study include identification of consistency as both a target for improving adherence and as a potential barrier to execution of treatment recommendations. Future research aims to explore this relationship in cognitively compromised populations, and to understand the impact of dysexecutive symptoms on consistency.M.S., Psychology -- Drexel University, 201

Impact of Compensatory Recommendations on Consistency in Adherence to Behavioral Regimens in Traumatic Brain Injury

Background: Adherence is the extent to which one’s behavior aligns with prescribed healthcare recommendations and it has been found to be a mediating factor of rehabilitation success after traumatic brain injury (TBI). Individuals post- TBI are at risk due to executive dysfunction. Although methods of overcoming executive difficulties as they relate to adherence have been posited (e.g., compensatory strategies), there has been no systematic study of the relationship between adherence behaviors and executive functioning during an unstructured regimen in this population. Moreover, cognitively-mediated aspects of adherence, such as consistency, which may represent targetable mechanisms of non-adherence have not been explored. Objective: The current study aimed to investigate the relationship between compensatory recommendations, executive function, and adherence behaviors during a prescribed behavioral regimen. Primary aims were to investigate: 1) the impact of compensatory recommendations on consistency in adherence, 2) the impact of compensatory recommendations on overall adherence, and 3) the relationship between executive functioning and consistency in adherence. An exploratory aim investigated how relationship between compensatory strategy, executive function, and consistency in adherence changed over the course of the 4-weeks. Method: 13 adults with a history of non-penetrating head injury were recruited for the current study and randomized into two groups: one that received compensatory recommendations (n = 7; Mage = 43.71, SD = 12.16; 43% male) and one that received no strategy (n = 6; Mage = 46.00, SD = 7.13; 67% male). All participants completed cognitive testing before engaging in a 4-week online behavioral regimen. For each day of the regimen, three online cognitive activities were prescribed. Outcome measures included adherence (events completed of 84) and consistency in adherence (variability in timing of event completion). Participants also completed a follow-up survey. Results: A series of Pearson correlations and regression-based analyses revealed that presence of a compensatory strategy did not predict consistency in adherence, nor did it predict overall adherence after controlling for covariates. In supplementary analyses, individuals who received a compensatory strategy had better adherence for the CAT during week 1, but their adherence decreased to be equivalent to the no strategy group over the course of four weeks. Additionally, one measure of executive function (response inhibition) was significantly related to consistency in adherence. Upon further analyses, it was determined this relationship differed by group. Consistency in adherence followed a quadratic pattern over time, such that all individuals were least consistent during the third week of the regimen, but were more consistent before and after that point. Conclusions: Consistency in adherence does not appear to be improved by the addition of a compensatory strategy. Although this component of adherence was related to executive function, this association appeared strongest among individuals who did not receive a strategy and who were more cognitively compromised. Adherence improved with the addition of a compensatory strategy initially, but declined over time to be equal to the no strategy group. Clinically, these findings suggest that compensatory strategies may need to be nuanced and target specific mechanisms of non-adherence. Moreover, the need for regular follow-up during a behavioral regimen to encourage continued motivation over time may be necessary to maximize adherence. Limitations include a small sample size, uneven groups with respect to cognitive function, and executive functioning measures which do not approximate real-world behaviors. Future directions include continuing to identify mechanisms of non-adherence among cognitively compromised individuals as well as continued work into the importance of consistency as a support for adherence to treatment among individuals with cognitive decline.Ph.D., Psychology -- Drexel University, 201

Noncovalent force spectroscopy using wide-field optical and diamond-based magnetic imaging

A realization of the force-induced remnant magnetization spectroscopy (FIRMS) technique of specific biomolecular binding is presented where detection is accomplished with wide-field optical and diamond-based magnetometry using an ensemble of nitrogen-vacancy (NV) color centers. The technique may be adapted for massively parallel screening of arrays of nanoscale samples.Comment: 8 pages, 7 figure

Automatic individual identification of Saimaa ringed seals

In order to monitor an animal population and to track individual animals in a non-invasive way, identification of individual animals based on certain distinctive characteristics is necessary. In this study, automatic image-based individual identification of the endangered Saimaa ringed seal (Phoca hispida saimensis) is considered. Ringed seals have a distinctive permanent pelage pattern that is unique to each individual. This can be used as a basis for the identification process. The authors propose a framework that starts with segmentation of the seal from the background and proceeds to various postprocessing steps to make the pelage pattern more visible and the identification easier. Finally, two existing species independent individual identification methods are compared with a challenging data set of Saimaa ringed seal images. The results show that the segmentation and proposed post-processing steps increase the identification performance.201

Microbial Sensing by Intestinal Myeloid Cells Controls Carcinogenesis and Epithelial Differentiation.

Physiologic microbe-host interactions in the intestine require the maintenance of the microbiota in a luminal compartment through a complex interplay between epithelial and immune cells. However, the roles of mucosal myeloid cells in this process remain incompletely understood. In this study, we identified that decreased myeloid cell phagocytic activity promotes colon tumorigenesis. We show that this is due to bacterial accumulation in the lamina propria and present evidence that the underlying mechanism is bacterial induction of prostaglandin production by myeloid cells. Moreover, we show that similar events in the normal colonic mucosa lead to reductions in Tuft cells, goblet cells, and the mucus barrier of the&nbsp;colonic epithelium. These alterations are again linked to the induction of prostaglandin production in response to bacterial penetration of the mucosa. Altogether, our work highlights immune cell-epithelial cell interactions triggered by the microbiota that control intestinal immunity, epithelial differentiation, and carcinogenesis