The functional impact of HIV -related neuropsychiatric comorbidities

Approximately 40,000 individuals acquire the human immunodeficiency virus (HIV) each year. While New York City contains 3% of the United States population, 15.3% of those living with AIDS in the United States reside in New York City. HIV-infection is known to have neurological and neuropsychiatric consequences, but relatively little work has evaluated how HIV-associated NP deficits and depression relate to independent activities of daily living (IADL). The first hypothesized aim of this study, identification of a relationship between global and domain specific NP functioning and concurrent and follow-up (6 month) IADL abilities, was significant, with three baseline NP domains (Speed of Information Processing, Motor Skills, and Executive functioning) each uniquely associated with IADL abilities. The second hypothesis of this study, investigation of the relationship between Major Depressive Disorder (MDD) and IADL abilities, was not supported. The third hypothesis of this study, to identify if a predictive relationship existed between NP functioning and a standardized measure of depression on IADL abilities in an urban, ethnically diverse cohort was supported both concurrently, and in the progression of individuals from IADL independence at baseline to IADL dependence at 6 month follow-up. The fourth hypothesis of this study, to explore whether NP abilities, depression, or IADL functioning uniquely or jointly related to mortality, was not supported. The current findings point to the importance of cognitive remediation, environmental modification, and treatment of depressive symptomology in order to preserve IADL functioning and improve quality of life in an ethnically diverse, urban, HIV-seropositive population

Executive functions and social skills in survivors of pediatric brain tumor.

Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper and pencil measures of social skills and real world executive skills. Social functioning was related to a specific aspect of executive functions, i.e., the survivors’ variability in response time, such that inconsistent responding was associated with better parent-report and survivor-report social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed

Children\u27s Oncology Group\u27s 2023 blueprint for research: Behavioral science

As survival rates for childhood cancer have improved, there has been increasing focus on identifying and addressing adverse impacts of cancer and its treatment on children and their families during treatment and into survivorship. The Behavioral Science Committee (BSC) of the Children\u27s Oncology Group (COG), comprised of psychologists, neuropsychologists, social workers, nurses, physicians, and clinical research associates, aims to improve the lives of children with cancer and their families through research and dissemination of empirically supported knowledge. Key achievements of the BSC include enhanced interprofessional collaboration through integration of liaisons into other key committees within COG, successful measurement of critical neurocognitive outcomes through standardized neurocognitive assessment strategies, contributions to evidence-based guidelines, and optimization of patient-reported outcome measurement. The collection of neurocognitive and behavioral data continues to be an essential function of the BSC, in the context of therapeutic trials that are modifying treatments to maximize event-free survival, minimize adverse outcomes, and optimize quality of life. In addition, through hypothesis-driven research and multidisciplinary collaborations, the BSC will also begin to prioritize initiatives to expand the systematic collection of predictive factors (e.g., social determinants of health) and psychosocial outcomes, with overarching goals of addressing health inequities in cancer care and outcomes, and promoting evidence-based interventions to improve outcomes for all children, adolescents, and young adults with cancer