A strengths-based case management service for people with serious mental illness in Israel: A randomized controlled trial

Case management services for people with serious mental illness are generally found to be effective, but controlled and randomized studies assessing such services are scarce. The aim of the present study was to assess the effectiveness of a new strengths-based case management (SBCM) service in Israel, using a randomized controlled approach. The sample consisted of 1276 individuals with serious mental illness, who consume psychiatric rehabilitation services (PRS) in the community, and were randomly assigned to receive or not to receive the SBCM service in addition to treatment-as-usual PRS. Quality of life, goal setting and attainment, unmet needs, self-efficacy, interpersonal relationships, symptom severity, and service utilization were assessed by clients at onset and after 20 months. Results show that SBCM participants improved in self-efficacy, unmet needs, and general quality of life, and set more goals than the control group. SBCM participants also consumed fewer services at follow-up. Results suggest that SBCM services are effective in helping individuals with serious mental illness set personal goals and use PRS in a better and more focused manner

ProNGF induces PTEN via p75NTR to suppress Trk-mediated survival signaling in brain neurons

Proneurotrophins and mature neurotrophins activate different signaling pathways with distinct effects on their target cells: proneurotrophins can induce apoptotic signaling via p75NTR, whereas mature neurotrophins activate Trk receptors to influence survival and differentiation. Here, we demonstrate that the PTEN (phosphatase and tensin homolog deleted on chromosome 10) phosphatase represents a novel switch between the survival and apoptotic signaling pathways in rat CNS neurons. Simultaneous activation of p75 NTR by proNGF and TrkB signaling by BDNF elicited apoptosis despite TrkB phosphorylation. Apoptosis induced by p75NTR required suppression of TrkB-induced phosphoinositide-3 kinase signaling, mediated by induction of PTEN, for apoptosis to proceed. Inhibition of PTEN restored the ability of BDNF to phosphorylate Akt and protect cultured basal forebrain neurons from proNGF-induced death. In vivo, inhibition or knockdown of PTEN after pilocarpine-induced seizures protected CNS neurons from p75 NTR-mediated death, demonstrating that PTEN is a crucial factor mediating the balance between p75NTR-induced apoptotic signaling and Trk-mediated survival signaling in brain neurons.Fil: Song, Wenyu. Rutgers University. School of Engineering. Chemical and Biochemical Engineering Department; Estados UnidosFil: Lapid de Volosin, Marta Edith. Rutgers University. School of Engineering. Chemical and Biochemical Engineering Department; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Cragnolini, Andrea Beatriz. Rutgers University. School of Engineering. Chemical and Biochemical Engineering Department; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto de Investigaciones Biológicas y Tecnológicas; ArgentinaFil: Hempstead, Barbara L.. Cornell University; Estados UnidosFil: Friedman, Wilma J.. Rutgers University. School of Engineering. Chemical and Biochemical Engineering Department; Estados Unido

Brain MR Spectroscopy Changes Precede Frontotemporal Lobar Degeneration Phenoconversion in Mapt Mutation Carriers.

Background and purposeThe objective of this study was to longitudinally investigate the trajectory of change in 1 H MRS measurements in asymptomatic MAPT mutation carriers who became symptomatic during follow-up, and to determine the time at which the neurochemical alterations accelerated during disease progression.MethodsWe identified eight MAPT mutations carriers who transitioned from asymptomatic to symptomatic disease during follow-up. All participants were longitudinally followed with an average of 7.75 years (range 4-11 years) and underwent two or more single voxel 1 H MRS examinations from the posterior cingulate voxel, with a total of 60 examinations. The rate of longitudinal change for each metabolite was estimated using linear mixed models. A flex point model was used to estimate the flex time point of the change in slope.ResultsThe decrease in the NAA/mI ratio accelerated 2.09 years prior to symptom onset, and continued to decline. A similar trajectory was observed in the presumed glial marker mI/Cr ratio accelerating 1.86 years prior to symptom onset.ConclusionsOur findings support the potential use of longitudinal 1 H MRS for monitoring the neurodegenerative progression in MAPT mutation carriers starting from the asymptomatic stage

Task-specific transfer of perceptual learning across sensory modalities

It is now widely accepted that primary cortical areas of the brain that were once thought to be sensory-specific undergo significant functional reorganisation following sensory deprivation. For instance, loss of vision or audition leads to the brain areas normally associated with these senses being recruited by the remaining sensory modalities [1]. Despite this, little is known about the rules governing crossmodal plasticity in people who experience typical sensory development, or the potential behavioural consequences. Here, we used a novel perceptual learning paradigm to assess whether the benefits associated with training on a task in one sense transfer to another sense. Participants were randomly assigned to a spatial or temporal task that could be performed visually or aurally, which they practiced for five days; before and after training, we measured discrimination thresholds on all four conditions and calculated the extent of transfer between them. Our results show a clear transfer of learning between sensory modalities; however, generalisation was limited to particular conditions. Specifically, learned improvements on the spatial task transferred from the visual domain to the auditory domain, but not vice versa. Conversely, benefits derived from training on the temporal task transferred from the auditory domain to visual domain, but not vice versa. These results suggest a unidirectional transfer of perceptual learning from dominant to non-dominant sensory modalities and place important constraints on models of multisensory processing and plasticity

Electroconvulsive Therapy Practice Changes in Older Individuals Due to COVID-19: Expert Consensus Statement

© 2020 American Association for Geriatric Psychiatry The ubiquitous coronavirus 2019 (COVID-19) pandemic has required healthcare providers across all disciplines to rapidly adapt to public health guidelines to reduce risk while maintaining quality of care. Electroconvulsive therapy (ECT), which involves an aerosol-generating procedure from manual ventilation with a bag mask valve while under anesthesia, has undergone drastic practice changes in order to minimize disruption of treatment in the midst of COVID-19. In this paper, we provide a consensus statement on the clinical practice changes in ECT specific to older adults based on expert group discussions of ECT practitioners across the country and a systematic review of the literature. There is a universal consensus that ECT is an essential treatment of severe mental illness. In addition, there is a clear consensus on what modifications are imperative to ensure continued delivery of ECT in a manner that is safe for patients and Northwell Health, while maintaining the viability of ECT services. Approaches to modifications in ECT to address infection control, altered ECT procedures, and adjusting ECT operations are almost uniform across the globe. With modified ECT procedures, it is possible to continue to meet the needs of older patients while mitigating risk of transmission to this vulnerable population

Why is there no queer international theory?

Over the last decade, Queer Studies have become Global Queer Studies, generating significant insights into key international political processes. Yet, the transformation from Queer to Global Queer has left the discipline of International Relations largely unaffected, which begs the question: if Queer Studies has gone global, why has the discipline of International Relations not gone somewhat queer? Or, to put it in Martin Wight’s provocative terms, why is there no Queer International Theory? This article claims that the presumed non-existence of Queer International Theory is an effect of how the discipline of International Relations combines homologization, figuration, and gentrification to code various types of theory as failures in order to manage the conduct of international theorizing in all its forms. This means there are generalizable lessons to be drawn from how the discipline categorizes Queer International Theory out of existence to bring a specific understanding of International Relations into existence

Rates of lobar atrophy in asymptomatic MAPT mutation carriers.

IntroductionThe aim of this study was to investigate the rates of lobar atrophy in the asymptomatic microtubule-associated protein tau (MAPT) mutation carriers.MethodsMAPT mutation carriers (n = 14; 10 asymptomatic, 4 converters from asymptomatic to symptomatic) and noncarriers (n = 13) underwent structural magnetic resonance imaging and were followed annually with a median of 9.2 years. Longitudinal changes in lobar atrophy were analyzed using the tensor-based morphometry with symmetric normalization algorithm.ResultsThe rate of temporal lobe atrophy in asymptomatic MAPT mutation carriers was faster than that in noncarriers. Although the greatest rate of atrophy was observed in the temporal lobe in converters, they also had increased atrophy rates in the frontal and parietal lobes compared to noncarriers.DiscussionAccelerated decline in temporal lobe volume occurs in asymptomatic MAPT mutation carriers followed by the frontal and parietal lobe in those who have become symptomatic. The findings have implications for monitoring the progression of neurodegeneration during clinical trials in asymptomatic MAPT mutation carriers

Lipofilling in Post-Treatment Oral Dysfunction in Head and Neck Cancer Patients

Lipofilling is a new treatment option for head- and neck cancer patients who suffer from chronic and severe (chemo-) radiation or surgery-related swallowing problems. Lipofilling is a technique of autologous grafting in which living fat cells are transplanted from one location to another in the same patient. In the case of head and neck cancer patients, volume loss or muscle atrophy of the tongue or pharyngeal musculature caused by the treatment may result in oropharyngeal dysfunction. Firstly, intensive swallowing therapy will be given, but if that offers no further improvement and the functional problems persist, lipofilling can be considered. By transplantation of autologous adipose tissue, the functional outcomes might improve by compensating the existing tissue defects or tissue loss. Only a few studies have been published which evaluated the effectiveness of this new treatment option. The results of those studies show that the lipofilling technique seems safe and of potential value for improving swallowing function in some of the included patients with chronic and severe dysphagia after surgery and/or (chemo-) radiation therapy for head and neck cancer. The lipofilling procedure will be described in detail as well as the clinical implications

Categorical Dimensions of Human Odor Descriptor Space Revealed by Non-Negative Matrix Factorization

In contrast to most other sensory modalities, the basic perceptual dimensions of olfaction remain unclear. Here, we use non-negative matrix factorization (NMF) – a dimensionality reduction technique – to uncover structure in a panel of odor profiles, with each odor defined as a point in multi-dimensional descriptor space. The properties of NMF are favorable for the analysis of such lexical and perceptual data, and lead to a high-dimensional account of odor space. We further provide evidence that odor dimensions apply categorically. That is, odor space is not occupied homogenously, but rather in a discrete and intrinsically clustered manner. We discuss the potential implications of these results for the neural coding of odors, as well as for developing classifiers on larger datasets that may be useful for predicting perceptual qualities from chemical structures

Perception of Filipino physicians on the roles and scope of practice of physical therapy in the Philippines: A multi-method quantitative study

Introduction: Physical therapists (PTs) are licensed practitioners who can assess, diagnose, and provide treatment interventions that restore patients to optimal function. While PTs can deliver complete management plans, the practice of physical therapy (PT) in the Philippines follows a referral system where physicians are the first contact of the patient, emphasizing the importance of physician\u27s perception towards the role of PTs and scope of PT service. This study aimed to determine the internal consistency of the Perception on Physical Therapists Questionnaire (PoPTQ), and to use this tool to report the existing perceptions of Filipino physicians on the practice of PT. Method: This study was divided into two phases and utilized a multi-method quantitative research design. For Phase 1 (psychometric), 18 questionnaires administered to Filipino physicians were used to compute Cronbach\u27s α of PoPTQ. A total of 134 questionnaires of the same population were analyzed for Phase 2 (cross-sectional), in which descriptive statistics and cross tab analysis were used to report the respondents\u27 perceptions. Both phases utilized online means of data gathering done via convenience sampling. Results: Phase 1 revealed a Cronbach\u27s α value of 0.528 for all items of PoPTQ. Phase 2 showed that physicians who have attended lectures discussing the roles of PTs or have experience with working with them have a higher referral rate than those with no prior exposure to PTs. Discussion: Filipino physicians believe that PTs can establish strong patient-therapist relationships, treat different patients, and acknowledge the roles of PTs in clinical and research settings. Data suggest that adequate foundational knowledge, positive perceptions, and high awareness of PTs\u27 roles and scope of practice are observed among Filipino physicians. However, there remains a need to increase collaboration opportunities between PTs and physicians in their academic years and programs that focus on the promotion of PT roles and scope of practice