Cognitive and psychological sequelae of hydrocephalus and spina bifida: turning interesting theoretical research into useful clinical intervention and guidelines

Background Ventricular shunts have significantly improved the prognosis of people with hydrocephalus and spina bifida; nevertheless, there are lifelong effects, which in many cases is associated with a cognitive profile of short term memory, attention and executive function difficulties (Iddon et al, 1996, 2001, 2003, 2004). There can also be psychological sequelae including depression and low self-esteem. The aim of this study is to develop clinical practice guidelines to inform intervention strategies to help patients and their carer to manage these difficulties. Materials and methods A three-stage project is being developed. Stage 1: A survey will be carried out to ascertain the needs of the client group, including gaps in local service provision and the impact of cognitive and psychological difficulties on everyday lives. Stage 2: Using data previously collected as well as new data, a detailed review will take place of specific cognitive difficulties and how these relate to everyday functions. Stage 3: A cognitive training programme will be developed as a guideline for practical clinical intervention. Results Data will be presented, showing the unmet need of people with hydrocephalus and spina bifida (N = 150, range of IQ's). Preliminary results of the new project will be presented and discussed. Conclusion It is not possible to provide a complete psychological support for individuals with hydrocephalus attending one London hospital clinic for their annual multi-disciplinary review. However, this project aims to bridge the theoretical/clinical gap we have previously identified in order to inform and guide their local services of the unmet needs of these clients, and to recommend appropriate interventions. This we anticipate will improve patients' quality of life

Cognitive and psychological sequelae of hydrocephalus and spina bifida: correlating subjective data and objective neuropsychological data to establish insight and inform clinical intervention and guidelines

Background Despite significant advances in treating and improving the prognosis of individuals with hydrocephalus and spina bifida, many of these individuals continue to experience specific cognitive difficulties in the areas of memory, language, attention and executive function and these can often have a significant negative impact on everyday functioning [1–3]. Materials and methods A comprehensive questionnaire was designed, based on known cognitive and emotional sequelae, to assess patient and caregiver perceptions of the specific difficulties experienced by people with hydrocephalus and spina bifida and the extent to which these are being addressed. In order to establish levels of insight, this questionnaire was correlated with detailed neuropsychological data to triangulate actual cognitive performance with subjective self-assessment obtained from patients and the objective view of caregivers. Results Questionnaire data will be presented that will highlight specific areas of discrepancy and concordance between patients and their caregivers (n = 60) and will be discussed in relation to actual performance on a range of cognitive tasks and the subsequent implications for strategic advice and intervention. Conclusion The data is being used to tailor specific cognitive strategies based on enhanced self-awareness, as part of small group and individual cognitive training interventions, within a multidisciplinary setting. It is hoped that the dissemination of the materials and methods designed for this study will inform best practice guidelines for these individuals and their caregivers and provide measurable outcomes for cognitive performance discrepancy, meta-awareness, strategy implementation and evaluation

Neuropsychological profile of patients with normal pressure hydrocephalus and Alzheimer's disease

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Do infants discriminate non-linguistic vocal expressions of positive emotions?

Adults are highly proficient in understanding emotional signals from both facial and vocal cues, including when communicating across cultural boundaries. However, the developmental origin of this ability is poorly understood, and in particular, little is known about the ontogeny of differentiation of signals with the same valence. The studies reported here employed a habituation paradigm to test whether preverbal infants discriminate between non-linguistic vocal expressions of relief and triumph. Infants as young as 6 months who had habituated to relief or triumph showed significant discrimination of relief and triumph tokens at test (i.e. greater recovery to the unhabituated stimulus type), when exposed to tokens from a single individual (Study 1). Infants habituated to expressions from multiple individuals showed less consistent discrimination in that consistent discrimination was only found when infants were habituated to relief tokens (Study 2). Further, infants tested with tokens from individuals from different cultures showed dishabituation only when habituated to relief tokens and only at 10–12 months (Study 3). These findings suggest that discrimination between positive emotional expressions develops early and is modulated by learning. Further, infants' categorical representations of emotional expressions, like those of speech sounds, are influenced by speaker-specific information

a_0(980) -> gamma gamma and f_0(980) -> gamma gamma: a consistent description

We work out the Linear Sigma Model (LSM) predictions for the 2 gamma decay rates of the a_0(980),f_0(980) mesons under the assumption that they are respectively the I=1 and I=0 members of the bar q q scalar nonet. Agreement with experimental data is achieved provided we include the contribution of a \kappa meson with mass approx. 900 MeV, and a scalar mixing angle (sigma -f_0 mixing in the {|NS>,|S>} basis) varphi_s approx. -14^\circ, as predicted by the model.Comment: 9 pages, 1 figur

Data acquisition electronics and reconstruction software for directional detection of Dark Matter with MIMAC

Directional detection of galactic Dark Matter requires 3D reconstruction of low energy nuclear recoils tracks. A dedicated acquisition electronics with auto triggering feature and a real time track reconstruction software have been developed within the framework of the MIMAC project of detector. This auto-triggered acquisition electronic uses embedded processing to reduce data transfer to its useful part only, i.e. decoded coordinates of hit tracks and corresponding energy measurements. An acquisition software with on-line monitoring and 3D track reconstruction is also presented.Comment: 17 pages, 12 figure

\Lambda-buildings and base change functors

We prove an analog of the base change functor of \Lambda-trees in the setting of generalized affine buildings. The proof is mainly based on local and global combinatorics of the associated spherical buildings. As an application we obtain that the class of generalized affine building is closed under ultracones and asymptotic cones. Other applications involve a complex of groups decompositions and fixed point theorems for certain classes of generalized affine buildings.Comment: revised version, 29 pages, to appear in Geom. Dedicat

What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment

Introduction Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with “significant comorbidity” or “reduced life expectancy” should be treated this way and age should not be a factor. Methods A Discrete Choice Experiment (DCE) was used to determine the impact of key variables (patient age, comorbidity, cognition, functional status, cancer stage, cancer biology) on healthcare professionals' (HCP) treatment preferences for operable breast cancer among older women. Multinomial logistic regression was used to identify associations. Results 40% (258/641) of questionnaires were returned. Five variables (age, co-morbidity, cognition, functional status and cancer size) independently demonstrated a significant association with treatment preference (p < 0.05). Functional status was omitted from the multivariable model due to collinearity, with all other variables correlating with a preference for operative treatment over no preference (p < 0.05). Only co-morbidity, cognition and cancer size correlated with a preference for PET over no preference (p < 0.05). Conclusion The majority of respondents selected treatment in accordance with current guidelines, however in some scenarios, opinion was divided, and age did appear to be an independent factor that HCPs considered when making a treatment decision in this population

Bragg spectroscopy with an accelerating Bose-Einstein condensate

We present the results of Bragg spectroscopy performed on an accelerating Bose-Einstein condensate. The Bose condensate undergoes circular micro-motion in a magnetic TOP trap and the effect of this motion on the Bragg spectrum is analyzed. A simple frequency modulation model is used to interpret the observed complex structure, and broadening effects are considered using numerical solutions to the Gross-Pitaevskii equation.Comment: 5 pages, 3 figures, to appear in PRA. Minor changes to text and fig

Identifying the quark content of the isoscalar scalar mesons f_0(980), f_0(1370), and f_0(1500) from weak and electromagnetic processes

The assignments of the isoscalar scalar mesons f0(980), f0(1370), and f0(1500) in terms of their qqbar substructure is still a matter of heated dispute. Here we employ the weak and electromagnetic decays D(s)(+) to f0+pi(+) and f0 two-photon decays, respectively, to identify the f0(980) and f0(1500) as mostly ssbar, and the f0(1370) as dominantly nonstrange, in agreement with previous work. The two-photon decays can be satisfactorily described with quark as well as with meson loops, though the latter ones provide a less model-dependent and more quantitative description.Comment: v1, 15 pages, plain LaTeX, 1 eps figure. v2, 18 pages, plain LaTeX (figure included). More discussion, especially on the f0(1370) and its empirical two-photon widt