Dual tasking in Parkinson's disease: cognitive consequences while walking

Published in final edited form as: Neuropsychology. 2017 September; 31(6): 613–623. doi:10.1037/neu0000331.OBJECTIVE: Cognitive deficits are common in Parkinson's disease (PD) and exacerbate the functional limitations imposed by PD's hallmark motor symptoms, including impairments in walking. Though much research has addressed the effect of dual cognitive-locomotor tasks on walking, less is known about their effect on cognition. The purpose of this study was to investigate the relation between gait and executive function, with the hypothesis that dual tasking would exacerbate cognitive vulnerabilities in PD as well as being associated with gait disturbances. METHOD: Nineteen individuals with mild-moderate PD without dementia and 13 age- and education-matched normal control adults (NC) participated. Executive function (set-shifting) and walking were assessed singly and during dual tasking. RESULTS: Dual tasking had a significant effect on cognition (reduced set-shifting) and on walking (speed, stride length) for both PD and NC, and also on stride frequency for PD only. The impact of dual tasking on walking speed and stride frequency was significantly greater for PD than NC. Though the group by condition interaction was not significant, PD had fewer set-shifts than NC on dual task. Further, relative to NC, PD showed significantly greater variability in cognitive performance under dual tasking, whereas variability in motor performance remained unaffected by dual tasking. CONCLUSIONS: Dual tasking had a significantly greater effect in PD than in NC on cognition as well as on walking. The results suggest that assessment and treatment of PD should consider the cognitive as well as the gait components of PD-related deficits under dual-task conditions. (PsycINFO Database Record)

COVID-19 shines a light on health inequities in communities of color: a youth-driven photovoice inquiry

This manuscript reports on a youth-driven health assessment engaging youth of color in identifying community health priorities during the coronavirus disease 2019 (COVID-19) pandemic. Photovoice, a participatory visual ethnographic health assessment strategy, was used to explore the question: What does health or healthiness mean to you and/or your community? Youth captured images that represented their priorities. The photos were discussed using the SHOWed framework and analyzed thematically. Four themes related to community health were identified. Additionally, youth captured their narrative of COVID-19 as "a revealing force that highlights systemic inequities, driving individuals and communities to both cultivate their resilience and take healthcare into their own hands in response to government and policy level failures." Youth are acutely aware of the historical and structural inequities that create multi-level barriers to healthcare access. Health inequities existed long before the pandemic, but the current crisis requires us to examine ways to transform the healthcare landscape moving forward.UL1 TR001430 - NCATS NIH HHSPublished versio

In-routes and “on the outs”: dually-involved Black and Latino youth and young adults’ transition experiences from the child welfare system to the juvenile legal system and during reentry

Youth involved with the United States juvenile legal system (JLS) experience multiple institutional transitions — movements into, between, and out of state agencies — throughout their lifecourse. For youth and young adults dually-involved with both the child welfare system (CWS) and the JLS, two primary forms of institutional transitions include:1) crossover from the CWS to the JLS; and 2) reentry back into the community following prolonged system involvement. While all system-impacted youth experience adverse outcomes and navigate significant challenges during these transitions, a growing body of evidence demonstrates that dually-involved Black, Indigenous, and Youth of Color (BIYOC) fare even worse than their white system-involved peers. Research on dual involvement has focused on the demographic factors, events, and contexts associated with the crossover phenomenon, while research on reentry — particularly for dually-involved youth — has focused on the barriers and facilitators of positive reentry experiences, predominantly conceptualizing recidivism as the indicator by which to measure successful reentry. Less attention has been paid to the subjective experiences of dually-involved BIYOC, including how they conceptualize, navigate, and make sense of these transitions. Drawing from the Phenomenological Variant of Ecological Systems Theory and phenomenological approaches, this three-paper mixed methods dissertation contributes to scholarship on dually-involved youth by focusing on the subjective experiences of youth and young adults of color during crossover and reentry. Paper one is a qualitative study based on in depth semi-structured interviews (N=31) with dually-involved Black and Latino youth and young adults in Massachusetts. This study uses Reflexive Thematic Analyses to investigate the factors youth and young adults identify as contributing to their transitions from the CWS to the JLS and their subjective experiences of the CWS, JLS, and crossover. Paper two uses a subset of these interviews with Black and Latina girls and young women (N=10) and draws on Interpretative Phenomenological Analysis to examine their experiences with the CWS, JLS, and during reentry, tracing their life trajectories and their goals, hopes, and expectations beyond incarceration. Paper three uses linked child welfare and juvenile legal administrative data (N=1226) to further understand dually-involved youth and young adults’ reentry experiences, conceptualizing participation in reentry programming as a strengths-based metric for successful reentry. One central finding is that the CWS and JLS are highly porous, with nearly two thirds of youth committed to the Massachusetts JLS between 2015-2019 having experienced an open case with the CWS, and 43.6% having been removed from their homes. Youth and young adults’ narratives suggest that factors including CWS rules and regulations, subpar living conditions within congregate care facilities, and surveillance from multiple systems facilitate crossover into the JLS. Findings also suggest that when juxtaposed to CWS placements, dually-involved Black and Latino youth and young adults view the JLS context more favorably, describing the existence of a reactive but robust social safety net within JLS placements. This safety net is not only characterized by social services and support, but several forms of care including what I refer to as care-as-structure and care-as-relationships. Relationships between youth and JLS caseworkers are especially salient for girls and young women, who order their system trajectories through the lens of their relational constellations. The implications are manyfold and include the need for further research examining information-sharing practices between youth-facing agencies, the youth categorization mechanisms that facilitate crossover, and the nature of care within carceral contexts. Policy and structural implications include implementing youth programming focused on relationships rather than rules, redistributing social services to communities upstream of agency involvement, and facilitating kinship and chosen family networks within communities.2025-05-15T00:00:00

Tweeting Toward Transformation: Prison Abolition and Criminal Justice Reform in 140 Characters

The United States is the world leader in confining bodies behind bars. As scholars, practitioners, and activists struggle against the problem of mass incarceration, this article makes a distinction between two competing perspectives, both of which seek to change the current criminal legal system: “prison abolition” and “reformism.” Each represents ideological and political differences in how mass incarceration should and could be resolved. Prior research has relied on historical methods and data to examine theoretical departures between prison reform and prison abolition, yet to our knowledge, there have been no explorations of these perspectives on new media. This article fills the gap, drawing on a sample of 2,112,206 tweets between 2011 and 2020 and engaging in an in-depth qualitative analysis of nearly 5,000 tweets over a 6-year period in order to investigate the ways Twitter users disclose and define their positions on criminal justice reform on one hand, and prison abolition on the other, and how these discussions have changed over time