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Although cognitive remediation (CR) improves cognition and functioning, the key features that promote or inhibit its effectiveness, especially between cognitive domains, remain unknown. Discovering these key features will help to develop CR for more impact.
Aim
To identify interrelations between cognition, symptoms, and functioning, using a novel network analysis approach and how CR affects these recovery outcomes.
Methods
A secondary analysis of randomized controlled trial data (N = 165) of CR in early psychosis. Regularized partial correlation networks were estimated, including symptoms, cognition, and functioning, for pre-, post-treatment, and change over time. Pre- and post-CR networks were compared on global strength, structure, edge invariance, and centrality invariance.
Results
Cognition, negative, and positive symptoms were separable constructs, with symptoms showing independent relationships with cognition. Negative symptoms were central to the CR networks and most strongly associated with change in functioning. Verbal and visual learning improvement showed independent relationships to improved social functioning and negative symptoms. Only visual learning improvement was positively associated with personal goal achievement. Pre- and post-CR networks did not differ in structure (M = 0.20, p = 0.45) but differed in global strength, reflecting greater overall connectivity in the post-CR network (S = 0.91, p = 0.03).
Conclusions
Negative symptoms influenced network changes following therapy, and their reduction was linked to improvement in verbal and visual learning following CR. Independent relationships between visual and verbal learning and functioning suggest that they may be key intervention targets to enhance social and occupational functioning.
Using the African Neuropsychology Battery (ANB), we seek to develop normative data by examining the demographic effects for two learning process scores: initial learning (Trial One) and learning ratio (LR, the percentage of items learned relative of to-be-learned material following Trial 1).
Methods:
Healthy participants from the Democratic Republic of Congo completed the four memory tests of the ANB: the African Story Memory Test (ASMT), African List Memory Test (ALMT), African Visuospatial Memory Test (AVMT), and African Contextual Visuospatial Memory Test (ACVMT). We developed indices of learning for each subtest, as well as aggregate learning indices for Trial 1 and LR, and composite indices examining verbal, visual, contextual, and noncontextual learning, and grand indices comprising all four subtests.
Results:
Trial 1 and LR scores each demonstrated acceptable intercorrelations across memory tests. We present normative data for Trial 1 and LR by age and education.
Conclusion:
These data provide normative standards for evaluating learning in Sub-Saharan Africa.
Among nursing home outbreaks of coronavirus disease 2019 (COVID-19) with ≥3 breakthrough infections when the predominant severe acute respiratory coronavirus virus 2 (SARS-CoV-2) variant circulating was the SARS-CoV-2 δ (delta) variant, fully vaccinated residents were 28% less likely to be infected than were unvaccinated residents. Once infected, they had approximately half the risk for all-cause hospitalization and all-cause death compared with unvaccinated infected residents.
THIS chapter has its origin in a study published in connection with the AHRC-funded research project ‘The Norman Edge: Identity and State-Formation on the Frontiers of Europe, c. 1050–c. 1200’. Taking as its focus a sample of settler families in the Anglo-Scottish marches, it explored the survival of some sense of Norman identity over the generations, or rather the centuries. As might have been expected, the arguments depended heavily on the records available for the higher nobility and among medievalists it is, indeed, something of a truism that ‘the range of possible identities [increases] further up the social hierarchy’. But one dynasty of the gentry or knightly class, the Normanvilles, did receive brief consideration and what follows aims to give this family the fuller coverage it merits. The Normanvilles’ role as lords of Maxton in Roxburghshire had previously earned some attention from Scottish historians, just as their lordship of Stamfordham in Northumberland had not escaped the notice of English historians. In each case, however, there was no acknowledgement that the Normanvilles had more than just local concerns within a single polity, so that even their connections across the border gained no recognition. Less surprisingly, no historian – not even Geoffrey Barrow in his work on Scotland's ‘Norman’ families – had realised that the Normanvilles were also landowners in the Pays de Caux of Upper Normandy, because much of the documentation in question remained unpublished and was (and still is) virtually uncatalogued. The chief sources survive in the collections of the Archives départementales de Seine- Maritime at Rouen, particularly among the muniments of the abbeys of Fécamp (fonds 7H), Saint-Wandrille (16H) and Valmont (19HP). Nowadays it is reasonably well understood that in the twelfth and thirteenth centuries the Anglo-Scottish border was no barrier to the creation of gentry as well as magnate estates; the Normanvilles’ cross-Channel landholding before and, indeed, after the Capetian conquest of Normandy in 1204 gives them a wider significance for British and French history alike. By the same token, their activities allow us to explore a universe that may well be as revealing as the trans-frontier worlds inhabited by those great nobles on whom other studies have concentrated.
THE year 1979 saw a series of momentous events whose consequences still reverberate today. Margaret Thatcher became prime minister of the United Kingdom, Saddam Hussein took over in Iraq, Rhodesia was supplanted by Zimbabwe, the U.S.S.R. invaded Afghanistan – and Sandy Grant arrived to take up a lectureship in history at Lancaster University. He came from Queen's University, Belfast, and was naturally highly recommended by, among others, Lewis Warren – though if memory serves it was stressed that allowances would have to be made for his fervent support of clubs competing in the Scottish football league. For the next thirty-five years, until Sandy's retirement in September 2014, Lancaster's history department was his professional home and it is on his role as a contributor to departmental life that this appreciation begins. Sandy replaced Anthony Tuck, who left for the mastership of Collingwood College, Durham, and Sandy made an immediate impact, not least by strengthening the department's ability to offer medieval and renaissance courses in genuinely British history at a time when such were far from fashionable. He progressed to senior lecturer in 1992 – in an era when such appointments were exceptionally difficult to obtain – and he was awarded a very well-merited readership in 1995. Never a shrinking violet, Sandy also established himself as a lively and vociferous – as well as, in some guises, a challenging and dissenting – colleague, one who was and remained very much part of the lifeblood of the department. What marked out his many contributions to the department's affairs can be summed up in two words: passion and commitment.
Only the most introverted of Sandy's colleagues remained unaware of his impressive range of academic contacts beyond Lancaster, especially north of the border; none failed to appreciate his burgeoning scholarly reputation, particularly (but by no means exclusively) in the field of medieval Scottish studies. We shall say more about his research and publications shortly but it was characteristic of Sandy's loyalty to the department that as a co-editor and/or contributor he was involved in the production of as many as seven books that bore something of a distinctive ‘Lancaster stamp’.
Through drinking water, humans are commonly exposed to atrazine, a herbicide that acts as an endocrine and metabolic disruptor. It interferes with steroidogenesis, including promoting oestrogen production and altering cell metabolism. However, its precise impact on uterine development remains unknown. This study aimed to determine the effect of prolonged atrazine exposure on the uterus. Pregnant mice (n = 5/group) received 5 mg/kg body weight/day atrazine or DMSO in drinking water from gestational day 9.5 until weaning. Offspring continued to be exposed until 3 or 6 months of age (n = 5–9/group), when uteri were collected for morphological and molecular analyses and steroid quantification. Endometrial hyperplasia and leiomyoma were evident in the uteri of atrazine-exposed mice. Uterine oestrogen concentration, oestrogen receptor expression, and localisation were similar between groups, at both ages (P > 0.1). The expression and localisation of key epithelial-to-mesenchymal transition (EMT) genes and proteins, critical for tumourigenesis, remained unchanged between treatments, at both ages (P > 0.1). Hence, oestrogen-mediated changes to established EMT markers do not appear to underlie abnormal uterine morphology evident in atrazine exposure mice. This is the first report of abnormal uterine morphology following prolonged atrazine exposure starting in utero, it is likely that the abnormalities identified would negatively affect female fertility, although mechanisms remain unknown and require further study.
Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version.
Design:
An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment.
Setting:
Community settings in the UK.
Participants:
One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer’s disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI.
Measurements:
The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures.
Results:
Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score (Kendall’s Tau −.388, −.445, −.497, −.569). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures.
Conclusion:
The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.
To identify the intracochlear electrode position in cochlear implant recipients and determine the correlation to speech perception for two peri-modiolar electrode arrays.
Methods
Post-operative cone-beam computed tomography images of 92 adult recipients of the ‘CI512’ electrode and 18 adult recipients of the ‘CI532’ electrode were analysed. Phonemes scores were recorded pre-implantation, and at 3 and 12 months post-implantation.
Results
All CI532 electrodes were wholly within scala tympani. Of the 79 CI512 electrodes intended to be in scala tympani, 58 (73 per cent) were in scala tympani, 14 (17 per cent) were translocated and 7 (9 per cent) were wholly in scala vestibuli. Thirteen CI512 electrodes were deliberately inserted into scala vestibuli. Speech perception scores for post-lingual recipients were higher in the scala tympani group (69.1 per cent) compared with the scala vestibuli (54.2 per cent) and translocation (50 per cent) groups (p < 0.05). Electrode location outside of scala tympani independently resulted in a 10.5 per cent decrease in phoneme scores.
Conclusion
Cone-beam computed tomography was valuable for demonstrating electrode position. The rate of scala tympani insertion was higher in CI532 than in CI512 electrodes. Scala vestibuli insertion and translocation were associated with poorer speech perception outcomes.
This article investigates the use of payments for environmental services to support a wildlife corridor between two Priority Tiger Conservation Landscapes in central Sumatra, Indonesia. Several hundred smallholders operate within a Protection Forest linking the Tiger Conservation Landscapes. This study explores the willingness of these smallholders to accept a payment requiring them to forgo access to their land for five years. In addition to asking households directly what they would be willing to accept (WTA), we also ask them to infer what their neighbour would accept. The study finds evidence of hypothetical bias in the conventional WTA values, with a statistically significant difference between what people say they would be willing to accept when surveyed, compared to what they say would actually be willing to accept in a ‘real life’ situation. We show how inferred valuation techniques can mitigate against this.
Currently policies enabling cattle herds to regain Official Tuberculosis Free (OTF) status after a bovine tuberculosis (bTB) herd incident vary between individual parts of the British Isles from requiring only one negative single comparative intradermal tuberculin test (SCITT) herd test when bTB infection is not confirmed to needing two consecutively negative SCITT herd tests after disclosure of two or more reactors, irrespective of bTB confirmation. This study used Kaplan–Meier curves and univariable and multivariable Cox Proportional Hazard models to evaluate the effect of the number of SCITT reactors and bTB confirmation on the risk of future bTB herd incident utilising data extracted from the national animal health database in Northern Ireland. Based on multivariable analyses the risk of a future bTB herd incident was positively associated with the number of SCITT reactors identified during the incident period (hazard ratio = 1.861 in incidents >5 SCITT reactors compared to incidents with only one SCITT reactor; P < 0.001), but not with bTB confirmation. These findings suggest that the probability of residual bTB infection in a herd increases with an increasing number of SCITT reactors disclosed during a bTB herd incident. It was concluded that bTB herd incidents with multiple SCITT reactors should be subjected to stricter control measures irrespective of bTB infection confirmation status.
This volume has its genesis in a two-day conference held at Durham University in January 2012, which was organised by the late Richard Britnell under the auspices of Durham's Institute of Medieval and Renaissance Studies. The aim was to explore shared elements in the development of socio-political institutions, landscape and agriculture on either side of the Anglo-Scottish Border before the onset of the Wars of Independence in 1296. As Richard Britnell expressed it, his desire was to encourage ‘focused exchanges of knowledge between historians of Scotland and northern England concerning common or cognate features of the two regions’. To that end, he invited scholars specialising in particular fields to re-visit the primary evidence in the light of the latest scholarship, taking a comparative approach across ‘middle Britain’, the region bisected by the Anglo-Scottish Border. Before he fell ill, he had secured the agreement of speakers at the Durham conference to develop their papers with a view to publishing a volume of collected essays. The present editors took over responsibility for the volume after Richard Britnell's death in December 2013. Since then some changes have been made to its scope by commissioning additional chapters from Janet Burton on religious institutions and culture, David Ditchburn on towns and trade, and Philip Dixon and Chris Tabraham on fortifications, in order to ensure more comprehensive thematic coverage.
The book's development has also resulted in a shift of emphasis from similarities to similarities and differences. Although the ‘common foundations’ that underlie medieval middle Britain, be they institutional, environmental or otherwise, are carefully investigated in the pages that follow, there is also much discussion of how far and why northern England and southern Scotland developed differently from one another, not least in the context of the gradual emergence of two independent medieval ‘nation-states’ and their distinctive trajectories. Common foundations were a pervasive and striking aspect of middle Britain, but they tell only one part of its story in the formative centuries of the central Middle Ages.
We would like to acknowledge Richard Britnell's initiative in organising the conference from which this volume stems, and to express our appreciation to our fellow contributors for their support and patience. We are likewise much obliged to the Department of History, Lancaster University, and to the Institute of Medieval and Renaissance Studies, Durham University, for funding the production of the maps by Cath D'Alton.