Non-pharmacological interventions for Lewy body dementia: a systematic review.

Lewy body dementia (consisting of dementia with Lewy bodies and Parkinson's disease dementia) is a common neurodegenerative disease characterised by visual hallucinations, fluctuating attention, motor disturbances, falls, and sensitivity to antipsychotics. This combination of features presents challenges for pharmacological management. Given this, we sought to review evidence for non-pharmacological interventions with patients with Lewy body dementia and their carers. Bibliographic databases were searched using a wide range of search terms and no restrictions were placed on study design, language, or clinical setting. Two reviewers independently assessed papers for inclusion, rated study quality, and extracted data. The search identified 21 studies including two randomised controlled trials with available subgroup data, seven case series, and 12 case studies. Most studies reported beneficial effects of the interventions used, though the only sizeable study was on dysphagia, showing a benefit of honey-thickened liquids. Given the heterogeneity of interventions and poor quality of the studies overall, no quantitative synthesis was possible. Overall, identified studies suggested possible benefits of non-pharmacological interventions in Lewy body dementia, but the small sample sizes and low quality of studies mean no definite recommendations can be offered. Our findings underscore the clear and urgent need for future research on this topic

Development of an online food frequency questionnaire and estimation of misreporting of energy intake during the COVID-19 pandemic among young adults in Peru

Background: The Young Lives longitudinal study switched to remote data collection methods including the adaptation of dietary intake assessment to online modes due to the physical contact restrictions imposed by the COVID-19 pandemic. This study aimed to describe the adaptation process and validation of an online quantitative food frequency questionnaire (FFQ) for Peruvian young adults. Methods: A previously validated face-to-face FFQ for the adult Peruvian population was adapted to be administered through an online self-administered questionnaire using a multi-stage process. Questionnaire development was informed by experts’ opinions and pilot surveys. FFQ validity was assessed by estimating misreporting of energy intake (EI) using the McCrory method, and the FFQ reliability with Cronbach alpha. Logistic regressions were used to examine associations of misreporting with sociodemographic, body mass index (BMI), and physical activity covariates. Results: The FFQ was completed by 426 Peruvian young adults from urban and rural areas, among whom 31% were classified as misreporters, with most of them (16.2%) overreporting daily EI. Men had a lower risk of under-reporting and a higher risk of over-reporting (OR = 0.28 and 1.89). Participants without a higher education degree had a lower risk of under-reporting and a higher risk of over-reporting (OR = 2.18 and 0.36, respectively). No major difference in misreporting was found across age groups, areas, studying as the main activity, being physically active or sedentary, or BMI. Results showed good internal reliability for the overall FFQ (Cronbach alpha = 0.82). Conclusion: Misreporting of EI was mostly explained by education level and sex across participants. Other sociodemographic characteristics, physical activity, sedentary behavior, and BMI did not explain the differences in EI misreporting. The adapted online FFQ proved to be reliable and valid for assessing dietary intakes among Peruvian young adults during the COVID pandemic. Further studies should aim at using and validating innovative dietary intake data collection methods, such as those described, for informing public health policies targeting malnutrition in different contexts after the COVID-19 pandemic

The role of acoustical cues in decoding emotion from performance expression and compositional structure

Emotional meaning can be communicated through performance expression and compositional structure. In this study, we assessed the capacity of musicians to communicate emotions through both these channels separately as well as combined. Three expressive conditions were created: performed only, composed only and performed and composed. To assess the role of performance expression, eight musicians performed emotionally neutral compositions with the intention to express the emotions of anger, fear, happiness, sadness, tenderness and neutral. They then composed melodies with the intention to express the same six emotions, controlling the number of notes. These melodies were put into MIDI format to create stimuli with neutral performance expression where only pitch and rhythm cues were available. Finally, musicians performed their own compositions. Performances were presented to 42 listeners who made forced choice judgements of the emotion conveyed. An acoustic analysis on the musical stimuli was conducted to identify the attributes used by musicians to convey emotion and by listeners to identify emotion. Results indicated that emotional decoding was dependent on emotion and expressive condition. The acoustic analysis confirmed that compositional structure and performance expression access somewhat different emotional cues.4 page(s

Composers and performers have different capacities to manipulate arousal and valence

In two studies, we investigated the capacity of compositional structure and performance expression to communicate the affective dimensions of valence and arousal. We expected that performance and composition would differ in their expressive capacities, with composition better suited to expressing changes in valence and performance better suited to expressing changes in arousal. Eight highly trained musicians attempted to communicate distinct emotions in three ways: composition alone (pitches and durations composed by musicians and recorded as MIDI files), performed versions of those melodic fragments, and performance alone (e.g., changes in intensity, tempo, timing) applied to neutral or ambiguous melodic fragments. In Experiment 1, we compared valence and arousal scores for the composition and combined conditions. In Experiment 2, we compared valence and arousal scores for the performance condition. Mean scores for both dimensions varied significantly as a function of the intended emotion. Regression analyses indicated that both composition and performance contributed to valence and arousal scores. However, compositional cues had a greater influence on valence scores and performance cues had a greater influence on arousal scores. The findings underscore the collaborative and complementary nature of emotional communication by composers and performers.14 page(s

Composing by listening : a computer-assisted system for creating emotional music

Most people communicate emotion through their voice, facial expressions, and gestures. However, it is assumed that only "experts" can communicate emotions in music. The authors have developed a computer-based system that enables musically untrained users to select relevant acoustic attributes to compose emotional melodies. Nonmusicians (Experiment 1) and musicians (Experiment 3) were progressively presented with pairs of melodies that each differed in an acoustic attribute (e.g., intensity - loud vs. soft). For each pair, participants chose the melody that most strongly conveyed a target emotion (anger, fear, happiness, sadness or tenderness). Once all decisions were made, a final melody containing all choices was generated. The system allowed both untrained and trained participants to compose a range of emotional melodies. New listeners successfully decoded the emotional melodies of nonmusicians (Experiment 2) and musicians (Experiment 4). Results indicate that human-computer interaction can facilitate the composition of emotional music by musically untrained and trained individuals.20 page(s

Music and emotion : psychological considerations

This chapter reviews theoretical accounts of the relation between music and emotion and presents a cognitive-motor framework for understanding some of its most powerful effects. We first review selected theories and investigations of emotional responses to music. We next discuss evidence that specific attributes of music are individually associated with distinct emotional interpretations, and may be manipulated by performers and composers to convey complex and dynamic emotional messages. We also describe empirical investigations that attempt to disentangle the contributions of cross-cultural and culture-specific associations between music and emotion. Finally, we introduce a body of theory and data concerning the cognitive-motor implications of music, and argue that important emotional effects can arise because music is optimally tailored to instantiate cognitive-motor processes of synchronization. This conception focuses on the capacity of music to resonate with psychological processes that function in human synchronization, and to elicit emotional effects related to these processes.19 page(s

The Contributions of compositional structure and performance expression to the communication of emotion in music

In this investigation, eight highly-trained musicians communicated emotions through composition, performance expression, or the combination of the two. In the performance condition, they performed melodies with the intention of expressing six target emotions: anger, fear, happiness, neutral, sadness, and tenderness. In the composition condition, they composed melodies to express the same six emotions. The notated compositions were then played digitally without performance expression. In the combined condition, musicians performed the melodies they composed to convey the target emotions. Forty-two listeners heard the stimuli and attempted to decode the emotions in a forced-choice paradigm. Decoding accuracy varied significantly as a function of the channel of communication. Fear was comparatively well-decoded in the composition condition whereas anger was comparatively well decoded in the performance condition. Happiness and sadness were comparatively well-decoded in all three channels of communication. A principal component analysis of cues used by musicians clarified the distinct approaches adopted in composition and performance to differentiate emotional intentions. The results confirm that composition and performance involve the manipulation of distinct cues and have different emotional capabilities.22 page(s

Audio-visual integration of emotional cues in song

14 page(s