Study protocol: EXERcise and Cognition In Sedentary adults with Early-ONset dementia (EXERCISE-ON)

<p>Abstract</p> <p>Background</p> <p>Although the development of early-onset dementia is a radical and invalidating experience for both patient and family there are hardly any non-pharmacological studies that focus on this group of patients. One type of a non-pharmacological intervention that appears to have a beneficial effect on cognition in older persons without dementia and older persons at risk for dementia is exercise. In view of their younger age early-onset dementia patients may be well able to participate in an exercise program. The main aim of the EXERCISE-ON study is to assess whether exercise slows down the progressive course of the symptoms of dementia.</p> <p>Methods/Design</p> <p>One hundred and fifty patients with early-onset dementia are recruited. After completion of the baseline measurements, participants living within a 50 kilometre radius to one of the rehabilitation centres are randomly assigned to either an <it>aerobic exercise program in a rehabilitation centre</it> or a <it>flexibility and relaxation program in a rehabilitation centre</it>. Both programs are applied three times a week during 3 months. Participants living outside the 50 kilometre radius are included in a feasibility study where participants join in a <it>daily physical activity program set at home making use of pedometers</it>. Measurements take place at baseline (entry of the study), after three months (end of the exercise program) and after six months (follow-up). Primary outcomes are cognitive functioning; psychomotor speed and executive functioning; (instrumental) activities of daily living, and quality of life. Secondary outcomes include physical, neuropsychological, and rest-activity rhythm measures.</p> <p>Discussion</p> <p>The EXERCISE-ON study is the first study to offer exercise programs to patients with early-onset dementia. We expect this study to supply evidence regarding the effects of exercise on the symptoms of early-onset dementia, influencing quality of life.</p> <p>Trial registration</p> <p>The present study is registered within The Netherlands National Trial Register (ref: NTR2124)</p

Inclined cable-systems in suspended bridges for restricting dynamic deformations

The present paper deals with the influence of the inclination of cables' system on the decrease of the lateral-torsional motion because of dynamic loadings. For this goal, a mathematical model is proposed. A 3- D analysis is performed for the solution of the bridge model. The theoretical formulation is based on a continuum approach, which has been widely used in the literature to analyze such bridges. The resulting uncoupled equations of motion are solved using the Laplace Transformation, while the case of the coupled motion is solved through the use of the potential energy. Finally, characteristic examples are presented and useful results are obtained. © 2017 Techno-Press, Ltd

Criminality in Greece during the years of financial crisis: 2008-2014

The link between poverty, unemployment and economic downturns and increases in crime rates has long been the subject of social science study. However, the relationships between these phenomena has not been studied sufficiently and through time in most European countries that suffered, or, like Greece, are still suffering the recent financial crisis. We examined if the recent financial crisis in Greece has coincided with an increase in crime, analyzing crime rates since the start of the financial crisis and over an extensive time period (7 years). Crime statistics were taken from the Greek Police. Repeated measures analyses of variance were performed to reveal potential differences in criminality for the years 2008, 2010, 2012 and 2014. There was a significant increase in global criminality rate per 100,000 residents (Wilks&apos; Lambda=0.32, F (3,11)=7.93, p=0.004). There was a significant increase in illegal gun possession (Wilks&apos; Lambda=0.16, F (3,11)=18.68, p=0.001), fraud (Wilks&apos; Lambda=0.10, F (3,11)=32.35, p=0.001), extortion (Wilks&apos; Lambda=0.38, F (3,11)=4.45, p=0.040), and beggary (Wilks&apos; Lambda=0.33, F (3,11)=6.22, p=0.014). A reversed U shape was found for homicides, thefts and robberies, with rates peaking in 2010 and 2012 before dropping off in 2014. Narcotics and sexual exploitation crime rates remained unchanged. Surprisingly, the incidence of rape decreased (Wilks&apos; Lambda=0.42, F (3,11)=5.14, p=0.018). Our results are in agreement with the results of previous broader studies as well as with criminological theories according to which in times of economic stress an increase in both property crimes and violent crimes is expected. As predicted, an increase in financial crime was observed (e.g. fraud and extortions) as well as petty crime related to financial hardship like beggary. Concerns regarding the escalation of white-collar crimes in times of economic downturns that have been raised in the literature warrant further investigation

Development and validation of the Schedule for the Assessment of Insight in Alcohol Dependence (SAI-AD): Dimensions and correlates of insight in alcohol use disorder

Introduction: The objectives of this study were to develop a multidimensional, clinician-rated scale that assess impaired insight into illness in patients with alcohol use disorder (AUD) and to examine its reliability, validity and internal structure. Moreover, we investigated the relationships of overall insight and its dimensions with demographic and clinical characteristics in AUD. Methods: We developed the Schedule for the Assessment of Insight in Alcohol Dependence (SAI-AD), based on scales that has already been used in psychosis and other mental disorders. Sixty-four patients with AUD were assessed with SAI-AD. Hierarchical cluster analysis and multidimensional scaling were used to identify insight components and assess their inter-relationships. Results: The SAI-AD demonstrated good convergent validity (r = −0.73, p < 0.001) and internal consistency (Cronbach's alpha = 0.72). Inter-rater and test-retest reliabilities were high (intra-class correlations 0.90 and 0.88, respectively). Three subscales of SAI-AD were identified which measure major insight components: awareness of illness, recognition of symptoms and need for treatment, and treatment engagement. Higher levels of depression, anxiety and AUD symptom severity were associated with overall insight impairment but not with recognition of symptoms and need for treatment, or with treatment engagement. Illness duration was specifically and positively associated with the treatment engagement component of insight. Conclusions: Insight is a multidimensional construct in AUD and its major components appear to be associated with different clinical aspects of the disorder. The SAI-AD is a valid and reliable tool for the assessment of insight in AUD patients

Suicide in Greece 1992-2012: A time-series analysis

Background and aims: Since 2008, Greece has entered a long period of economic crisis with adverse effects on various aspects of daily life. In this frame, it is quite important to examine the suicide trends in Greece. Method: Our analysis covered the period 1992-2012. 2012 was the last year for which official suicide data were available. The inclusion of data for pre-crisis period enabled us to assess trends in suicide preceding the economic crisis, starting in 2008. Trends in sex- and age-adjusted standardized suicide rates (SSR) were analyzed using joinpoint regression. Results: Total SSR presented statistically significant annual decrease of 0.89% (95% confidence interval (CI): -1.7, -0.1) during the period 1992-2008. After 2009, the trend in total SSR increased statistically significant annual increase (12.48%; 95% CI: 0.3%, 26.1%). SSR in males presented an initial period of modest annual decrease (-0.84%; 95% CI: -1.6%, -0.1%), during the period 1992-2008. After 2009, an annual increase by 9.25% (95% CI: 2.7%, 16.3%) was revealed. No change in female SSR trend was observed during the studied period. Conclusion: According to the results of this study, there is clear evidence of an increase in the overall SSR and male SSR in Greece during the period of the current financial crisis. © SAGE Publications

Clinical dimensions of auditory hallucinations in schizophrenic disorders

Background: Auditory hallucinations occupy, along with delusional beliefs, the center stage of active or &quot;positive&quot; psychotic clinical psychopathology. During the last decade, several sets of auditory hallucinations&apos; clinical features were subjected to multivariate statistical analyses to disclose major dimensions of psychotic patients&apos; overall hallucinatory experience and behavior. However, these studies failed, to a large extent, to provide satisfactory external validations of the thereby extracted factors. Methods: We investigated the major clinical dimensions of verbal auditory hallucinations in a sample of 100 inpatients with schizophrenic disorders. Patients (61 men and 39 women) were examined before the initiation of antipsychotic treatment and their assessment included 18 major clinical features of auditory hallucinations. Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, Global Assessment Scale, and Mini-Mental State Examination were used as external validators. Results: Principal component analysis resulted in the extraction of 5 factors interpreted as the dimensions of severity of auditory hallucinations, emotional and behavioral impact, rate of their intrusion in self-consciousness, delusional elaboration, and similarity to ordinary auditory perception, respectively. The second and third factors extracted in our study correlated with short duration of illness, whereas the first, fourth, and fifth ones correlated with chronicity. Our second factor correlated with clinical severity of patients&apos; current mental state, the fifth factor with severity of their cognitive impairment, and the first and fourth ones with lower clinical depression despite patients&apos; chronicity. Conclusion: The findings of our study contribute to the further elucidation of the major clinical dimensions of auditory hallucinations and the testing of their external validity. © 2007 Elsevier Inc. All rights reserved

An association of economic hardship with depression and suicidality in times of recession in Greece

The interplay between objective and subjective measures of economic hardship on influencing mental health has not been explored during a period of enduring recession. The present study aims to fill this gap by investigating the relationship between income and economic difficulties in evoking major depression and suicidality in Greece, while taking into consideration gender differences. A random and representative sample of 2188 adults participated in a telephone survey in 2013 (response rate = 81%). Major depression and suicidality were assessed with the pertinent modules of SCID-IV; while financial difficulties were measured by the Index of Personal Economic Distress. Information on confounder variables was also gleaned. Income exerted an independent effect on major depression (OR = 0.37, 95%CI = 0.22–0.63), which was more pronounced among men than women. On the contrary, financial difficulties exerted a strong and independent effect on depression (OR = 1.16, 95%CI = 1.13–1.2). Income was found to bear a strong association with suicidality only among men; whereas financial difficulties were unrelated in both genders. Subjective and objective indices of economic hardship exert a differential impact on mental health outcomes amid recession. Gender-sensitive policies and interventions should be geared towards softening the social effects of the recession in the country. © 2019 Elsevier B.V

Selective impairment of auditory attention processing in idiopathic generalized epilepsies: Implications for their cognitive pathophysiology

The neuropsychological characteristics of Idiopathic Generalized Epilepsies (IGEs) as a wide syndrome encompassing different clinical entities have been as yet not well understood. We have studied neuropsychological performance in patients suffering Juvenile Myoclonic Epilepsy (JME) and Generalized Tonic Clonic Seizures (IGE-GTCS-only) to provide indirect-cognitive evidence on the pathophysiology of IGE-related neuropsychological dysfunction. Greater arousal-related impairments were expected for the auditory modality, by drawing on previous anatomo-clinical and neuro-evolutionary accounts. We have studied neurocognitive functioning in 26 IGE patients, suffering either JME (n = 16) or IGE-GTCS-only (n = 10), and their healthy counterparts consisted of 26 (18 females) demographically matched participants. IGE patients (JME and IGE-GTCS-only) did worse with respect to HC (healthy controls) in visual- and auditory- speed of information processing (reaction time), auditory-vigilance and -response inhibition, visuo-motor coordination, visual working memory and motor speed, delayed visual recall, immediate- and delayed verbal episodic recall, lexical access and retrieval, semantic associative processing, auditory-verbal memory span and verbal learning. Although both IGE-GTCS-only and JME patients delayed episodic recall was defective, the former did significantly worse. We believe that IGE patients&apos; neuropsychological derailments represent indirect-secondary manifestations of a primary cortical tone deregulation inherent to IGEs&apos; pathophysiology. In particular, IGE patients’ worse-dissociated performance in auditory TOVA—also seen previously in TBI and schizophrenia—may implicate a grater vulnerability of the auditory information processing system, as well as a possibly shared cognitive pathophysiological component between IGE and the above nosologies. © 2020 Taylor &amp; Francis Group, LLC