Neurobiological Correlates Of Personality And Emotional Expression In Traumatic Brain Injury

Many individuals with traumatic brain injury (TBI) experience cognitive, emotional, and functional deficits, all of which can contribute to chronic stress. Unfortunately, individuals with TBI often engage in less effective coping than non-brain-injured individuals, which has negative implications for rehabilitation. Differences in personality traits have been linked to individual differences in coping styles, physiological stress reactivity, and emotional disclosure. Research on personality and coping after TBI has been sparse. Thus, the present study examined the influence of TBI on the pattern of the relationships between personality, emotional expression, and stress reactivity. Eighty-one adults who sustained moderate to severe TBI and 76 significant others of individuals with TBI participated. Personality was assessed using the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scale, and self-report of affectivity was measured with the Positive and Negative Affect Schedule (PANAS). Verbal and nonverbal emotional expression were gleaned from a 3-minute videotaped speech task for which participants were asked to talk about stressful aspects of recovery from brain injury. Physiological measures of stress were also collected during the speech task. Results indicate that the pattern of relations between personality, emotional expression, and stress reactivity are affected by TBI; however, consistencies between the groups were also found. Both groups showed similar patterns for BIS in terms of propensity toward negative affectivity, as well as concomitant verbal output of negative emotion. Significant others showed a distinctive pattern for BAS sensitivity, which was associated with positive affectivity and low nonverbal expressions of sadness relative to a propensity to express anxiety and anger during the emotional challenge. By comparison, people with TBI showed a global pattern for BAS sensitivity of heightened affectivity (positive and negative affectivity), as well as explicit verbal output reflecting negative emotionality. Like significant others, BAS was associated with the propensity toward nonverbal expression of anxiety during the emotional challenge; however, people with TBI expressed more happiness, and less anxiety and helplessness than did significant others. Impairments in awareness of deficits and impaired cognitive appraisal of stress following TBI are likely to have contributed to the finding that adults with TBI exhibited more happiness and less anxiety than significant others. In general, TBI appears to enhance BAS but not BIS, which is supported by higher BAS sensitivity as a function of TBI severity and relative to individuals without TBI. For both groups, BAS sensitivity was favorably related to acute stress reactivity. In fact, among people with TBI BAS was uniquely related to stress coping, beyond that explained by demographic and injury characteristics. Taken together, the findings generally depict a pattern in which BAS facilitates expression of emotion and may also buffer or relieve experience of stress during emotional challenge. The BIS/BAS theory of personality and scale appear to be promising avenues for future research in these regards. The present study provides insight into how brain injury affects the relations between personality, stress reactivity, and emotional expression. Findings also highlight the importance of considering personality traits when studying emotional expression. Future research investigating the utility of these associations to predict rehabilitation and quality of life outcomes among brain-injured individuals has the potential to inform recovery prognosis and treatment recommendations

Hearing Loss And Verbal Memory Assessment In Older Adults

Prior research has found that adults with hearing loss perform worse on cognitive testing than adults without hearing loss, and some studies have suggested that hearing loss is associated with dementia. Heavy emphasis on tests involving auditory stimuli for memory assessment may result in overdiagnosis of cognitive impairment in individuals with hearing loss. The present study compared visual and auditory versions of a verbal memory test among older adults with and without hearing loss. Forty-one adults with moderate-to-severe, sensorineural hearing loss (HL) and 41 age-matched adults with normal hearing (NH) participated. Age ranged from 55 – 80 years. They completed a neuropsychological battery that included auditory and visual versions of the Hopkins Verbal Learning Testing-Revised (HVLT-R). The auditory conditions included a Natural Auditory condition for which stimuli was presented at a normal speaking volume and a Crossed Auditory condition for which individuals with hearing loss completed the test with amplified volume and individuals with normal hearing completed the test under a hearing loss simulation. Mixed-model ANOVA indicated significant group (HL vs. NH) by condition (Visual vs. Natural Auditory vs. Crossed Auditory HVLT-R) interactions with large effect sizes. Post hoc contrasts showed that the HL group performed significantly worse than the NH group on the Natural Auditory version. The opposite pattern was found for the Crossed Auditory condition: The NH group performed significantly worse than the HL group. The groups were equivalent on the Visual condition and showed small effect sizes. Auditory and visual versions were highly correlated for the NH group but not for the HL group. Groups did not significantly differ on other neuropsychological tests and showed small effect sizes. Moreover, for the HL group, the visual version of the verbal memory test was strongly correlated with other neuropsychological tests whereas the standard auditory version was not. Cognitively intact older adults with hearing loss appeared impaired on an auditory-verbal word list memory test under typical administration conditions. Visual assessment of verbal memory shows evidence of superior validity and is a viable alternative method to assess memory function especially in older populations

Cultivating social interaction in diverse neighbourhoods – one chili at a time - A case study of Linderud Community Garden

This thesis looks at how a community garden can support social interaction in diverse neighbourhoods. It draws upon the case of Linderud Community Garden, an urban garden in Oslo. The Norwegian government launched in February 2021 a national strategy for urban agriculture, where one of the goals is to achieve social inclusion through urban agricultural projects. Our cities have become more diverse over the last decades, and many minorities experience discrimination and exclusion based on their background. Social interaction in public space, both fleeting and meaningful encounters, are believed to build tolerance. While the positive social effects of urban agriculture are well supported in the academic literature, there are also evidence of the risks of exclusion and gentrification. The national strategy advocates for an integration of urban agriculture in city planning, yet there is little formal knowledge on how it should be implemented in planning practice. This thesis thus seeks to contribute to the knowledge on community gardens in diverse neighbourhood to inform planning practice. Through spatial mapping, observation and interviews I have investigated how Linderud Community Garden supports social interaction through how the spatial and social organization affect the use of the garden. I have looked into who the users of the garden are and whether it reflects those who are underrepresented in public outdoor spaces in the neighbourhood. The results demonstrates that a central location close by elemental public functions allows for frequent visits that can be combined with daily routines. It also illustrates how the function of a publicly accessible green space with social area and as a part of the mobility network attracts different types of users to the space for recreation and promenade, regardless of gardening interest. Furthermore, it shows that the social organization plays a significant role in determining both the gardening and public users. The presence of public users seems to be determined by what type of group the frequenting gardeners represent, whether it be minorities, youth or elderly

Anti-EGFR Therapy: Mechanism and Advances in Clinical Efficacy in Breast Cancer

This review will focus on recent advances in the application of antiepidermal growth factor receptor (anti-EGFR) for the treatment of breast cancer. The choice of EGFR, a member of the ErbB tyrosine kinase receptor family, stems from evidence pinpointing its role in various anti-EGFR therapies. Therefore, an increase in our understanding of EGFR mechanism and signaling might reveal novel targets amenable to intervention in the clinic. This knowledge base might also improve existing medical treatment options and identify research gaps in the design of new therapeutic agents. While the approved use of drugs like the dual kinase inhibitor Lapatinib represents significant advances in the clinical management of breast cancer, confirmatory studies must be considered to foster the use of anti-EGFR therapies including safety, pharmacokinetics, and clinical efficacy

Experiences of adult patients living with home parenteral nutrition: a grounded theory study. A qualitative research into the experiences of home parenteral nutrition: discovery of patients’ perspectives.

Introduction Patients with intestinal failure (IF) develop problems of malabsorption and malnutrition associated with short bowel syndrome (SBS). Home parenteral nutrition (HPN) became available to treat these patients since the 1970s. There is a paucity of qualitative research on patients’ experiences in the UK. The study aim was to generate theory that explains the experiences of adults living with HPN and complex medication regimens. Method The grounded theory methodology was used to explore the experiences and to generate theory about this health intervention. Twelve participants were interviewed. The interviews were recorded and transcribed verbatim. The joint process of data collection and analysis followed the principles of constant comparative approach. Results The core categories of stoma care and HPN treatment were supported by the subcategories of maintaining stoma output, access to toilets, maintaining HPN infusion routine, access to technical help to set up HPN infusion, and general health changes. Strategy used to manage living with loss was demonstrated by the subcategory of maintaining daily activities and social interactions. Discussion The theory of living with loss suggests that patients with a stoma receiving HPN experience the sense of loss at home and in social situations. Opportunities for professional practice development are detailed along with implications for future research. Conclusions The findings resonate with the Kubler-Ross Model of the five stages of grief (Kubler-Ross, 1970). The theory of living with loss was generated by the use of the grounded theory methodology. This study identified opportunities for changes and improvement in clinical practice

An Evaluation of Recruitment and Retention Strategies Among Asian American Women in the National Breast and Cervical Cancer Early Detection Program

Asian American women have the lowest mammography and Pap test rates among all other racial and ethnic groups in the U.S. (American Cancer Society, 2006a). The elimination of these health disparities among Asian American women is currently a national priority and strategies to reduce the breast and cervical cancer burden are urgently needed. The purpose of this evaluation study was to assess current strategies and to provide recommendations for improving recruitment, retention and delivery of services to Asian American women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a free screening program for eligible low-income women. A cultural competency conceptual framework formed the basis of this investigation. The study was conducted in three phases: 1) Written surveys completed by 41 NBCCEDP state program directors; 2) Telephone interviews conducted with 28 key NBCCEDP program administrators and service providers; and 3) Site visits in three states with the highest Asian American population, and interviews with 62 Asian American women (40 NBCCEDP participants and 22 non-NBCCEDP participants who were eligible for the program). A utilization focused evaluation approach with both quantitative and qualitative methods were employed to analyze the data. Results revealed that 11 cultural competency strategies are recommended for use by program directors, outreach coordinators, service providers and Asian American women (both NBCCEDP participants and non-participants) when recruiting, retaining, and providing services to Asian American women in the NBCCEDP: (1) conduct demographic profile and assessment of needs, strengths and assets of the client population; (2) develop linguistic competence; (3) use lay health advisors; (4) provide culturally and linguistically appropriate health education materials and strategies; (5) develop partnerships with communities and community organizations; (6) include family and community members; (7) facilitate learning between providers and community; (8) coordinate with practitioners of traditional medicine; (9) develop policies to recruit and retain culturally diverse staff; (10) incorporate administrative and organizational strategies and; (11) provide patient navigation services. Implications for practice directed to the NBCCEDP program administrators, as well as implications for future research on recruitment, retention and service delivery of Asian American women in this national program will be discussed

Integrating environmental management into supply chains: a systematic literature review and theoretical framework

Purpose: the need to integrate environmental management into supply chains has been recognized recently. Yet, there is a lack of theoretical grounding and a conceptual framework guiding such efforts to leverage resources and capabilities across supply chain partners. Grounded on stakeholder and resource orchestration theories, this paper maps the emerging practices, develops a theoretical framework, and proposes future research for understanding an emerging best-practice called ‘green supply chain integration’ (GSCI). Design/methodology/approach: A systematic literature review of 142 academic articles is conducted to ensure the process of framework development is auditable and repeatable. The article selection criteria are aligned with the review question ensuring that related theories and practices are identified and evaluated. Findings: The paper illustrates how stakeholder and resource orchestration theories can be used to explain an integrative approach of environmental management in supply chains. The paper identifies four GSCI practices: internal, supplier, customer, and community stakeholder GSCI. A theoretical framework and proposition also provide new research directions. Research limitations/implications: The results of this paper are drawn from an extensive review of the existing literature and novel practices that have not been revealed and could have been missed. The emerging practices and theoretical framework can be used for further empirical investigation. Originality/value: This paper integrates theoretical concepts and empirical findings from the disparate literature and identifies four emerging practices of environmental management by developing a theoretical framework and proposition for future research

Comprehensive gait analysis of healthy older people: unveiling reasons for lack of long-distance walking

Many older adults do not adhere to the recommended physical activity levels. This study examines the gait changes upon long-distance walking among healthy older adults. Gait tests of 24 adults aged 65 or more were conducted at the baseline, at the end of 30 and 60 minutes of treadmill walk. Spatial temporal, kinematic and kinetic gait data were computed. Perceived level of exertion was evaluated for each subject. Ten subjects (Group B) perceived higher exertion level than the remaining fourteen subjects (Group A). After walking, group B had significant reductions in dominant-side ankle joint range of motion and power, suggesting lower-leg muscle fatigue, which appeared to be compensated by significantly increased non-dominant side knee and hip motions. These changes were not observed in Group A. Differences in gait parameters between Group A and B implied that some biomechanical factors might contribute to the lack of walking of some older adults