Effects of a comprehensive educational group intervention in older women with cognitive complaints: a randomized controlled trial

Hoogenhout, E. M., De Groot, R. H. M., Van der Elst, W., Jolles J. (2012). Effects of a comprehensive educational group intervention in older women with cognitive complaints: a randomized controlled trial. Aging & Mental Health, 16, 135-144. doi:10.1080/13607863.2011.598846OBJECTIVE: The current study presents a new comprehensive educational group intervention that offers psycho-education about cognitive aging and contextual factors (i.e., negative age stereotypes, beliefs, health, and lifestyle), focuses on skills and compensatory behavior, and incorporates group discussion. Its effects were investigated in community-dwelling older women who report normal age-related cognitive complaints. METHODS: A randomized controlled trial with an experimental and waiting list control condition was carried out in a sample of 50 women aged 60-75 years. As the main problem of these individuals were perceived cognitive deficits without actual cognitive decrements, metacognition served as the primary outcome measure. Objective cognitive functioning and psychological wellbeing were secondary outcome measures. A double baseline and a follow- up assessment were carried out. RESULTS: Participants in the experimental condition reported significantly fewer negative emotional reactions towards cognitive functioning (U = 164.500, p = .004). The reported effect size (δ = -.473) could be interpreted as large. CONCLUSIONS: This new comprehensive educational group intervention reduces negative emotional reactions towards cognitive functioning, which seems a prerequisite for improved subjective cognitive functioning and wellbeing. It can potentially contribute the wellbeing of an important and large group of older adults

Dendritic cell-mediated HIV-1 transmission to T cells of LAD-1 patients is impaired due to the defect in LFA-1

BACKGROUND: Dendritic cells (DC) have been proposed to mediate sexual HIV-1 transmission by capturing the virus in the mucosa and subsequently presenting it to CD4(+ )T cells. We have demonstrated before that DC subsets expressing higher levels of intercellular adhesion molecule-1 (ICAM-1) are better HIV-1 transmitters. ICAM-1 binds leukocyte function-associated molecule-1 (LFA-1) on T cells, an integrin responsible for adhesion and signaling at the immunological synapse. To corroborate the importance of the ICAM-1— LFA-1 interaction, we performed transmission experiments to LFA-1 negative leukocytes from Leukocyte Adhesion Deficiency type 1 (LAD-1) patients. RESULTS: We clearly show that DC-mediated HIV-1 transmission to LAD-1 T cells is impaired in comparison to healthy controls. Furthermore, HIV-1 transmission to T cells from a unique LAD-1 patient with a well characterized LFA-1 activation defect was impaired as well, demonstrating that activation of LFA-1 is crucial for efficient transmission. Decreased cell adhesion between DC and LAD-1 T cells could also be illustrated by significantly smaller DC-T cell clusters after HIV-1 transmission. CONCLUSION: By making use of LFA-1 defect cells from unique patients, this study provides more insight into the mechanism of HIV-1 transmission by DC. This may offer new treatment options to reduce sexual transmission of HIV-1

Applying evidence-based medicine in general practice : a video-stimulated interview study on workplace-based observation

BACKGROUND: Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient's preferences and the general practitioner's (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other's consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other's EBM behaviour through observation, and by identifying aspects that influence their recognition. METHODS: We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner's consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner's actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other's considerations well with those who did not, we developed a model describing the aspects that influence the observer's recognition of an actor's EBM behaviour. RESULTS: Overall, there was moderate similarity between an actor's EBM behaviour and the observer's recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. CONCLUSIONS: GP trainees and supervisors do not fully recognise EBM behaviour through observing each other's consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines

Reproducible White Matter Tract Segmentation Using 3D U-Net on a Large-scale DTI Dataset

Tract-specific diffusion measures, as derived from brain diffusion MRI, have been linked to white matter tract structural integrity and neurodegeneration. As a consequence, there is a large interest in the automatic segmentation of white matter tract in diffusion tensor MRI data. Methods based on the tractography are popular for white matter tract segmentation. However, because of the limited consistency and long processing time, such methods may not be suitable for clinical practice. We therefore developed a novel convolutional neural network based method to directly segment white matter tract trained on a low-resolution dataset of 9149 DTI images. The method is optimized on input, loss function and network architecture selections. We evaluated both segmentation accuracy and reproducibility, and reproducibility of determining tract-specific diffusion measures. The reproducibility of the method is higher than that of the reference standard and the determined diffusion measures are consistent. Therefore, we expect our method to be applicable in clinical practice and in longitudinal analysis of white matter microstructure.Comment: Machine Learning in Medical Imaging (MLMI), 201

Covid interactieve lesmodule:invulling van een inhaal en/of ondersteuningsprogramma als gevolg van de Coronacrisis voor basisscholen.

De interactieve lesmodule is gebaseerd op de theorie van Marzano: ‘Leren in 5 dimensies’. De vijf dimensies die Marzano beschrijft zijn: motivatie (1), nieuwe kennis verwerven en integreren (2), bestaande kennis verbreden en verdiepen (3), onderzoek doen (4) en reflectie (5). Marzano beschouwt deze vijf dimensies als noodzakelijk voor het actief en authentiek leren van leerlingen. Voor elke dimensie is een filmpje beschikbaar met meer informatie en uitleg over de theorie van Marzano