HIV Associated Neurocognitive Disorder: Exploring the complexity

Background Human Immunodeficiency Virus (HIV) infection is now a chronic disease. As people living with HIV (PLHIV) age they are at risk of a neurological co-morbid disease called HIV associated Neurocognitive Disorder (HAND), which causes varied levels of disability affecting quality of life. Early identification and diagnosis is important, as HAND is potentially treatable. Informal and professional caregivers may assist in identification of HAND. Aim To explore the complexities of identifying HAND by PLHIV, their informal or professional caregivers. Objectives: • Explore whether PLHIV and their informal caregivers can identify HAND. • Explore the experience of HAND in PLHIV. • Explore whether community based health care professionals can identify HAND. Design A pragmatic explanatory sequential design. Method A mixed method approach explored the complexities of identifying HAND through a preliminary observational multisite pilot study followed by three subsequent study phases, an online survey, a cross sectional file audit of two community based HIV teams and a modified Delphi study. Results The pilot study noted that both PLHIV and informal caregivers can identify signs and symptoms of HAND leading to diagnosis of HAND. The online survey noted PLHIV were concerned about HAND; were experiencing signs and symptoms of HAND and additionally wanted support in discussing HAND with others. The file audit noted that community based professionals were not collecting the appropriate information to identify HAND. The modified Delphi method lead to development of an initial and monitoring tool for community-based professionals to use to identify those PLHIV at risk of HAND who should be referred for formal assessment. Conclusion HAND is a potentially treatable condition. Early recognition can have a positive impact on health and quality of life of PLHIV as they age. Diagnosis of HAND is complex, but the observational and other experiences of PLHIV and their caregivers, can offer unique insights into cognitive changes in PLHIV. For those PLHIV without the support of an informal caregiver and/or who live alone, professional caregivers can act as an alternative to an informal caregiver, being well placed to observe changes in cognitive behaviour over time

Lost in translation? Theory, policy and practice in systems-based environmental approaches to obesity prevention in the Healthy Towns programme in England.

This paper explores how system-wide approaches to obesity prevention were 'theorised' and translated into practice in the 'Healthy Towns' programme implemented in nine areas in England. Semi-structured interviews with 20 informants, purposively selected to represent national and local programme development, management and delivery were undertaken. Results suggest that informants articulated a theoretical understanding of a system-wide approach to obesity prevention, but simplifying this complex task in the context of uncertainty over programme aims and objectives, and absence of a clear direction from the central government, resulted in local programmes relying on traditional multi-component approaches to programme delivery. The development of clear, practical guidance on implementation should form a central part of future system-wide approaches to obesity prevention

AKR1D1 knockout mice develop a sex-dependent metabolic phenotype

Steroid 5β-reductase (AKR1D1) plays important role in hepatic bile acid synthesis and glucocorticoid clearance. Bile acids and glucocorticoids are potent metabolic regulators, but whether AKR1D1 controls metabolic phenotype in vivo is unknown. Akr1d1–/– mice were generated on a C57BL/6 background. Liquid chromatography/mass spectrometry, metabolomic and transcriptomic approaches were used to determine effects on glucocorticoid and bile acid homeostasis. Metabolic phenotypes including body weight and composition, lipid homeostasis, glucose tolerance and insulin tolerance were evaluated. Molecular changes were assessed by RNA-Seq and Western blotting. Male Akr1d1–/– mice were challenged with a high fat diet (60% kcal from fat) for 20 weeks. Akr1d1–/– mice had a sex-specific metabolic phenotype. At 30 weeks of age, male, but not female, Akr1d1–/– mice were more insulin tolerant and had reduced lipid accumulation in the liver and adipose tissue yet had hypertriglyceridemia and increased intramuscular triacylglycerol. This phenotype was associated with sexually dimorphic changes in bile acid metabolism and composition but without overt effects on circulating glucocorticoid levels or glucocorticoid-regulated gene expression in the liver. Male Akr1d1–/– mice were not protected against diet-induced obesity and insulin resistance. In conclusion, this study shows that AKR1D1 controls bile acid homeostasis in vivo and that altering its activity can affect insulin tolerance and lipid homeostasis in a sex-dependent manner.</p

Neural Correlates of Causal Power Judgments

Causal inference is a fundamental component of cognition and perception. Probabilistic theories of causal judgment (most notably causal Bayes networks) derive causal judgments using metrics that integrate contingency information. But human estimates typically diverge from these normative predictions. This is because human causal power judgments are typically strongly influenced by beliefs concerning underlying causal mechanisms, and because of the way knowledge is retrieved from human memory during the judgment process. Neuroimaging studies indicate that the brain distinguishes causal events from mere covariation, and between perceived and inferred causality. Areas involved in error prediction are also activated, implying automatic activation of possible exception cases during causal decision-making

Cognitive evolutionary psychology without representational nativism

Abstract. A viable evolutionary cognitive psychology requires that specific cognitive capacities be (a) heritable and (b) ‘quasi-independent ’ from other heritable traits. They must be heritable because there can be no selection for traits that are not. They must be quasi-independent from other heritable traits, since adaptive variations in a specific cognitive capacity could have no distinctive consequences for fitness if effecting those variations required widespread changes in other unrelated traits and capacities as well. These requirements would be satisfied by innate cognitive modules, as the dominant paradigm in evolutionary cognitive psychology assumes. However, those requirements would also be satisfied by heritable learning biases, perhaps in the form of architectural or chronotopic constraints, that operated to increase the canalization of specific cognitive capacities in the ancestral environment (Cummins and Cummins 1999). As an organism develops, cognitive capacities that are highly canalized as the result of heritable learning biases might result in an organism that is behaviourally quite similar to an organism whose innate modules come on line as the result of various environmental triggers. Taking this possibility seriously is increasingly important as the case against innate cognitive modules becomes increasingly strong

A quantitative risk assessment of E.coli 0157:H7 in Irish minced beef

End of Project ReportA national quantitative risk assessment was undertaken for minced beef in the Republic of Ireland. The objective was to estimate the probability of E. coli O157:H7 infection from consumption of Irish beef and to investigate the parts of the beef chain contributing most to the risk posed by this pathogen.The quantitative risk assessment was broken into 3 main modules: 1) production of boxed beef trimmings; 2) processing of trimmings and burger formation and 3) retail/domestic consumption phase. Key points in each module (beef hide, beef trimmings and beef products at retail) were validated using data derived from microbiology sampling at beef abattoirs, supermarkets and butchers’ shops in Ireland

Memory &amp; Cognition

Naive theories and causal deduction A growing body of evidence indicates that humans show systematic response preferences when reasoning about classes of events that have high adaptive consequence

Reciprocity in Ranked Relationships: Does Social Structure Influence Social Reasoning?

Many economic and evolutionary theories have modeled cooperation as the evolutionary outcome of decisions made by autonomous, self-interested agents operating in a social vacuum. In this paper we consider the implications for cooperative interactions when prior social structures and corresponding social norms exist. In particular we investigate the influence of social rank/status on perceptions of fairness and tolerance of cheating. We review evidence from a series of experiments employing the Wason selection task (a test of conditional reasoning) and the ledger task (a decision making task) suggesting that people cued to adopt a perspective of high social rank are more tolerant of cheating and simultaneously believe that they have been more fairly treated (even when cheated) than people cued to adopt a perspective of low social rank. However, the evidence also suggests interesting cross-cultural differences in perceptions of fairness and tolerance of cheating in ranked relationships. Copyright Kluwer Academic Publishers 2001cooperation, cheater detection, cross-cultural differences, dominance theory, evolutionary psychology, hierarchy, norms, relative deprivation, social contract theory, status, Wason selection task,