Quantitative systematic review of the effects of non‐pharmacological interventions on reducing apathy in persons with dementia

AimTo review the quantitative evidence concerning the effects of non‐pharmacological interventions on reducing apathy in persons with dementia.BackgroundApathy, a prevalent behavioural symptom among persons with Alzheimer Disease, is defined as a disorder of motivation with deficits in behavioural, emotional and cognitive domains and is associated with serious social and physical obstacles. Non‐pharmacological interventions show promise as symptom control modalities among persons with dementia.DesignQuantitative systematic review.Data sourcesCINAHL, PubMed, PSYCHinfo and Cochrane Trials databases were searched for published English language research inclusive through December 2014, with no early year limiters set.Review methodsComprehensive searches yielded 16 international randomized controlled trials or quasi‐experimental studies based on inclusion criteria and a rigorous quality appraisal process.ResultsA narrative summary analysis revealed that non‐pharmacological interventions for apathy varied substantially and lacked specificity, conceptual clarity and were methodologically heterogeneous. Select interventions demonstrated effectiveness, but lacked systematic long‐term follow‐up. Limitations include publication bias and lack of a meta‐analytic approach due to the methodological heterogeneity of included studies.ConclusionStudy results demonstrate promise for the use of non‐pharmacological interventions, particularly music‐based interventions, in reducing apathy levels in individuals with dementia. Intervening to reduce apathy may have a positive clinical impact and healthcare providers should be encouraged to incorporate positive sources of interest and intellectual stimulation into care. However, future research is needed to examine the aetiologic mechanism and predictors of apathy, to improve evidence‐based interventions and specificity and to optimize dosage and timing of non‐pharmacological interventions across the disease trajectory.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134246/1/jan13026_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134246/2/jan13026.pd

AIDS-related progressive multifocal leukoencephalopathy (PML): A retrospective study from Pretoria, South Africa

Introduction and objectives. Progressive multifocal leukoencephalopathy (PML), caused by the John Cunningham (JC) virus, results from lytic infection of predominantly oligodendrocytes. Following the HIV pandemic, the incidence of PML has risen sharply, but has rarely been reported in Africa. An increasing number of PML cases were seen recently in a tertiary South African hospital, and this study describes their clinical and radiological features.Methods. Patients with positive cerebrospinal fluid (CSF) JC virus confirmed by real-time polymerase chain reaction (PCR) were retrospectively identified from January 2008 to June 2012. Adults seen at Neurology with PML were identified, and clinical features, laboratory findings and imaging studies were analysed.Results. Of 121 specimens, 19 were positive; records of 17 patients were available (ages 27 - 64; CD4 counts 11 - 328 x106/ìl); clinical manifestations included focal weakness (47%), impaired co-ordination (41%), and speech disturbances (12%), and CSF analysis showedhigh protein in 76%, and pleocytosis in 35%. Fifteen patients had CT brain scans, showing white matter involvement in 12; MRI studies in 13 patients showed typical PML lesions.Conclusion. This report is the first case series of patients with PML from a South African neurology unit, emphasising the fact that PML occurs commonly in South African patients with HIV infection

Orbiting Resonances and Bound States in Molecular Scattering

A family of orbiting resonances in molecular scattering is globally described by using a single pole moving in the complex angular momentum plane. The extrapolation of this pole at negative energies gives the location of the bound states. Then a single pole trajectory, that connects a rotational band of bound states and orbiting resonances, is obtained. These complex angular momentum singularities are derived through a geometrical theory of the orbiting. The downward crossing of the phase-shifts through pi/2, due to the repulsive region of the molecular potential, is estimated by using a simple hard-core model. Some remarks about the difference between diffracted rays and orbiting are also given.Comment: 18 pages, 3 figures, to appear in Physical Review

Report of the International Society of Hypertension (ISH) Hypertension Teaching Seminar organized by the ISH Africa Regional Advisory Group: Maputo, Mozambique, 2016

The International Society of Hypertension (ISH), in fulfilment of its mission of promoting hypertension control and prevention and also of advancing knowledge globally, organizes hypertension teaching seminars or ‘summer schools’ worldwide through the ISH Regional Advisory Groups. In Africa, seven of such seminars have been organized. This is a report of the eighth seminar held in Maputo, Mozambique, April, 2016. The seminar was attended by over 65 participants from 11 African countries. The Faculty consisted of 11 international hypertension experts. The eighth African hypertension seminar was a great success as confirmed by a pre- and post-test questionnaire

Rigid thinking about deformables: do children sometimes overgeneralize the shape bias?

Young children learning English are biased to attend to the shape of solid rigid objects when learning novel names. This study seeks further understanding of the processes that support this behavior by examining a previous finding that three-year-old children are also biased to generalize novel names for objects made from deformable materials by shape, even after the materials are made salient. In two experiments, we examined the noun generalizations of 72 two-, three- and four-year- old children with rigid and deformable stimuli. Data reveal that three-year-old, but not two- or four-year-old, children generalize names for deformable things by shape, and that this behavior is not due to the syntactic context of the task. We suggest this behavior is an overgeneralization of three-year-old children’s knowledge of how rigid things are named and discuss the implications of this finding for a developmental account of the origins of the shape bias

Constraints on the abundances of various molecules in interstellar ice: laboratory studies and astrophysical implications

Wetensch. publicatieFaculteit der Wiskunde en Natuurwetenschappe

Dust Dynamics in Compressible MHD Turbulence

We calculate the relative grain-grain motions arising from interstellar magnetohydrodynamic (MHD) turbulence. The MHD turbulence includes both fluid motions and magnetic fluctuations. While the fluid motions accelerate grains through hydro-drag, the electromagnetic fluctuations accelerate grains through resonant interactions. We consider both incompressive (Alfv\'{e}n) and compressive (fast and slow) MHD modes and use descriptions of MHD turbulence obtained in Cho & Lazarian (2002). Calculations of grain relative motion are made for realistic grain charging and interstellar turbulence that is consistent with the velocity dispersions observed in diffuse gas, including cutoff of the turbulence from various damping processes. We show that fast modes dominate grain acceleration, and can drive grains to supersonic velocities. Grains are also scattered by gyroresonance interactions, but the scattering is less important than acceleration for grains moving with sub-Alfv\'{e}nic velocities. Since the grains are preferentially accelerated with large pitch angles, the supersonic grains will be aligned with long axes perpendicular to the magnetic field. We compare grain velocities arising from MHD turbulence with those arising from photoelectric emission, radiation pressure and H$_{2}$ thrust. We show that for typical interstellar conditions turbulence should prevent these mechanisms from segregating small and large grains. Finally, gyroresonant acceleration is bound to preaccelerate grains that are further accelerated in shocks. Grain-grain collisions in the shock may then contribute to the overabundance of refractory elements in the composition of galactic cosmic rays.Comment: 15 pages, 17 figure

T2Candida assay: diagnostic performance and impact on antifungal prescribing

Objectives: To assess the performance of T2Candida for the diagnosis of invasive candidiasis (IC) against gold standards of candidaemia or consensus IC definitions, and to evaluate the impact of T2Candida on antifungal drug prescribing. Methods: A retrospective review was undertaken of all T2Candida (T2MR technology, T2 Biosystems) performed from October 2020 to February 2022. T2Candida performance was evaluated against confirmed candidaemia or against proven/probable IC within 48 hours of T2Candida, and its impact on antifungal drug prescriptions. Results: T2Candida was performed in 61 patients, with 6 (9.8%) positive results. Diagnostic performance of T2Candida against candidaemia had a specificity of 85.7% and negative predictive value (NPV) of 96.8%. When comparing T2Candida results with consensus definitions of IC, the specificity and NPV of T2Candida was respectively 90% (54/60) and 98.2% (54/55) for proven IC, and 91.4% (53/58) and 96.4% (53/55) for proven/probable IC. Antifungals were initiated in three of six patients (50%) with a positive T2Candida result. Thirty-three patients were receiving empirical antifungals at the time of T2Candida testing, and a negative result prompted cessation of antifungals in 11 (33%) patients, compared with 6 (25%) antifungal prescriptions stopped following negative beta-D-glucan (BDG) testing in a control population (n = 24). Conclusions: T2Candida shows high specificity and NPV compared with evidence of Candida bloodstream infection or consensus definitions for invasive Candida infection, and may play an adjunctive role as a stewardship tool to limit unnecessary antifungal prescriptions