Revisiting the Global Measures of Overall Neuropsychological Function and the Impact of Race-Based Normative Data in Clinical and Forensic Populations

This study aims to examine the impact of race-based normative data on global measures of overall neuropsychological functioning. Further, it examines the changes made to the Average Impairment Rating (AIR) in the context of race-based norming and the dismissal of a previously included measure, Picture Arrangement. The AIR is a commonly used index to classify the severity of diffuseness related to brain injury. Despite its use, the AIR has a very limited body of research describing the impact of racial norming on the index. Based on a review of the literature, the Picture Arrangement subtest removal was never researched in regard to the impact on the AIR, thus the results of this study would clarify its impact. It is hypothesized that the removal of Picture Arrangement will reclassify the diffuseness and classification of brain disease using the AIR. Further, this study will observe the differences between the AIR and other cognitive measures of overall neuropsychological functioning, such as the General Neuropsychology Deficit Scale (GNDS) and the Halstead Impairment Index (HII) in the context of race-based norms. This study will illuminate the importance or not of including Picture Arrangement in an overall measure of diffuseness such as the AIR and the impact of including, or not, race as a demographic variable to control in the development of neuropsychological norms

The effects of an active-assisted stretching program on functional performance in elderly persons: A pilot study

This study examined the impact of an eight-week active-assisted (AA) stretching program on functionality, mobility, power, and range of motion (ROM) in elderly residents of a residential retirement community. Seventeen volunteers (4 male, 13 female; 88.8 ± 5.36 years) were randomly assigned to an AA or control group. The AA group performed 10 different AA stretches targeting the major joints of the body twice weekly for eight weeks. Controls attended classes requiring limited physical activity. All participants were assessed using four flexibility and six functional tests, one week before and after the eight-week training period. A fully randomized repeated-measures ANCOVA with pretest scores as a covariate was used to detect differences between groups across time. The AA group demonstrated significant increases in ROM for most of the joints evaluated (p < 0.05) and significant increases in all performance measures (p < 0.05). Controls showed no improvements in functional or ROM measures (α = 0.05). Additionally, the AA group showed significantly better performance outcomes across the training period than controls. We conclude that our eight-week flexibility program effectively reduces age-related losses in ROM and improves functional performance in elderly persons with insufficient physical reserves to perform higher-intensity exercises

Metaplasia ossea diagnosticata su leiomioma uterino

Riportiamo un caso di metaplasia ossea in un leiomioma uterino scoperto casualmente in una donna di 53 anni operata di isterectomia totale per una neoformazione annessial

Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment

The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 ± 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA) with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers

Efforts for the Correct Comprehension of Deceitful and Ironic Communicative Intentions in Schizophrenia: A Functional Magnetic Resonance Imaging Study on the Role of the Left Middle Temporal Gyrus

Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia (SZ). In particular, patients have severe problems in communicative-pragmatics, for example, in correctly inferring the speaker’s communicative intention in everyday conversational interactions. This limit is associated with morphological and functional alteration of the left middle temporal gyrus (L-MTG), a cerebral area involved in various communicative processes, in particular in the distinction of ironic communicative intention from sincere and deceitful ones. We performed an fMRI study on 20 patients with SZ and 20 matched healthy controls (HCs) while performing a pragmatic task testing the comprehension of sincere, deceitful, and ironic communicative intentions. We considered the L-MTG as the region of interest. SZ patients showed difficulties in the correct comprehension of all types of communicative intentions and, when correctly answering to the task, they exhibited a higher activation of the L-MTG, as compared to HC, under all experimental conditions. This greater involvement of the L-MTG in the group of patients could depend on different factors, such as the increasing inferential effort required in correctly understanding the speaker’s communicative intentions, and the higher integrative semantic processes involved in sentence processing. Future studies with a larger sample size and functional connectivity analysis are needed to study deeper the specific role of the L-MTG in pragmatic processes in SZ, also in relation to other brain areas

Cold adaptation drives population genomic divergence in the ecological specialist, Drosophila montana

Funding: UK Natural Environment Research Council (Grant Number(s): NE/L501852/1, NE/P000592/1); Academy of Finland (GrantNumber(s): 267244, 268214, 322980), Ella ja Georg Ehrnroothin Säätiö.Detecting signatures of ecological adaptation in comparative genomics is challenging, but analysing population samples with characterised geographic distributions, such as clinal variation, can help identify genes showing covariation with important ecological variation. Here, we analysed patterns of geographic variation in the cold-adapted species Drosophila montana across phenotypes, genotypes and environmental conditions and tested for signatures of cold adaptation in population genomic divergence. We first derived the climatic variables associated with the geographic distribution of 24 populations across two continents to trace the scale of environmental variation experienced by the species, and measured variation in the cold tolerance of the flies of six populations from different geographic contexts. We then performed pooled whole genome sequencing of these six populations, and used Bayesian methods to identify SNPs where genetic differentiation is associated with both climatic variables and the population phenotypic measurements, while controlling for effects of demography and population structure. The top candidate SNPs were enriched on the X and fourth chromosomes, and they also lay near genes implicated in other studies of cold tolerance and population divergence in this species and its close relatives. We conclude that ecological adaptation has contributed to the divergence of D. montana populations throughout the genome and in particular on the X and fourth chromosomes, which also showed highest interpopulation FST. This study demonstrates that ecological selection can drive genomic divergence at different scales, from candidate genes to chromosome-wide effects.Publisher PDFPeer reviewe

Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962]

<p>Abstract</p> <p>Background</p> <p>Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted.</p> <p>Methods</p> <p>The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs.</p> <p>Conclusion</p> <p>A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN58562962.</p

Il corpo tra metapsicologia e mentalizzazione. Linee di ricerca in psicoanalisi, dopo Freud

Gli autori ricostruiscono la questione del corpo negli scritti freudiani, segnalandone i molteplici aspetti teorici e clinici, e mettendone in luce la complessità concettuale attraverso le varie fasi di evoluzione della scoperta psicoanalitica, dalle origini, con l’isteria, alle manifestazioni silenziose della pulsione morte: vertici estremi del percorso di ricerca freudiano che, sul corpo, ha indicato elementi di riflessione articolati e privi di una sistematizzazione univoca e conclusa. Nella molteplicità delle direttrici teoriche diramatesi dagli spunti freudiani, la prevalenza concettuale della prospettiva “economica”, con i concetti di rappresentazione, affetto e narcisismo, caratterizza il contributo francofono contemporaneo sulla questione. Gli autori argomentano le posizioni di alcuni esponenti, in particolare Pierre Marty, André Green, Jean Laplanche e Christophe Dejours. Si precisa che il presente articolo può essere definito una rassegna essenzialmente storica e teorica di una delle possibili diramazioni della letteratura nel campo della psicosomatica psicoanalitica, che segue il filo della coordinata economica a partire dalla metapsicologia freudiana. Al fine di inserire il discorso nel campo del dibattito psicoanalitico attuale, gli autori rimandano, infine, a ulteriori vertici di lettura dello psicosoma