Coexisting adult polyglucosan body disease with frontotemporal lobar degeneration with transactivation response DNA-binding protein-43 (TDP-43)-positive neuronal inclusions

Almost one-third of the participants in a neuropsychological study signed the consent form below the given line. The relationship between a signature position on or below the line and participants’ cognitive function was investigated. Fifty drug-dependent individuals, 50 of their siblings, and 50 unrelated control participants completed a battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Individuals signing below, rather than on, the line performed more poorly on tests of visuospatial memory, but no differently on other cognitive tests. Signature positioning may be a soft sign for impairment of the mechanisms involved in visuospatial memory.     

Striatal Morphology is Associated with Tobacco Cigarette Craving

The striatum has a clear role in addictive disorders and is involved in drug-related craving. Recently, enhanced striatal volume was associated with greater lifetime nicotine exposure, suggesting a bridge between striatal function and structural phenotypes. To assess this link between striatal structure and function, we evaluated the relationship between striatal morphology and this brain region''s well-established role in craving. In tobacco smokers, we assessed striatal volume, surface area, and shape using a new segmentation methodology coupled with local shape indices. Striatal morphology was then related with two measures of craving: state-based craving, assessed by the brief questionnaire of smoking urges (QSU), and craving induced by smoking-related images. A positive association was found between left striatal volume and surface area with both measures of craving. A more specific relationship was found between both craving measures and the dorsal, but not in ventral striatum. Evaluating dorsal striatal subregions showed a single relationship between the caudate and QSU. Although cue-induced craving and the QSU were both associated with enlarged striatal volume and surface area, these measures were differentially associated with global or more local striatal volumes. We also report a connection between greater right striatal shape deformations and cue-induced craving. Shape deformations associated with cue-induced craving were specific to striatal subregions involved in habitual responding to rewarding stimuli, which is relevant given the habitual nature of cue-induced craving. The current findings confirm a relationship between striatal function and morphology and suggest that variation in striatal morphology may be a biomarker for craving severity.     

Cannabis and symptoms of PMS and PMDD

Cannabis has been found to alleviate a wide array of medical symptoms, including those that overlap with physical and emotional symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), including insomnia, irritability, depression, and joint pain. Little work has addressed the use of cannabis as a treatment for PMS or PMDD or the role of women’s cannabis treatment expectancies as a predictor of consumption. Women who reported having experienced PMS and PMDD and endorsed lifetime cannabis use (N?=?145), completed an online survey assessing their frequency of cannabis use, PMS/PMDD symptoms, expectancies of cannabis-induced relief from symptoms, as well as cannabis-related problems. Women were found to hold meaningful expectancies that cannabis would treat all PMS/PMDD symptoms, except for overeating/food cravings. Cannabis treatment expectancies were positively associated with PMS/PMDD symptoms and with monthly cannabis use, and were negatively associated with cannabis-related problems. Research should further examine the relationship of cannabis treatment expectancies with individuals’ cannabis use, as findings indicate the potential for these expectancies to serve a punitive or protective role in the development of cannabis-related problems. Increased research on how cannabis might ameliorate symptoms of PMS and PMDD could help establish an alternative treatment plan that offers relief with fewer negative side effects.     

Promoting Father Involvement for Child and Family Health

Paternal involvement in children's lives is associated with a variety of child outcomes, including improved cognition, improved mental health, reduced obesity rates, and asthma exacerbation. Given this evidence, the American Academy of Pediatrics has promoted actions by pediatricians to engage fathers in pediatric care. Despite these recommendations, the mother–child dyad, rather than the mother–father–child triad, remains a frequent focus of care. Furthermore, pediatric care is often leveraged to improve maternal health, such as screening for maternal depression, but paternal health is infrequently addressed even as men tend to exhibit riskier behaviors, poorer primary care utilization, and lower life expectancy. Therefore, increasing efforts by pediatric clinicians to engage fathers may affect the health of both father and child. These efforts to engage fathers are informed by currently used definitions and measures of father involvement, which are discussed here. Factors described in the literature that affect father involvement are also summarized, including culture and context; interpersonal factors; logistics; knowledge and self-efficacy; and attitudes, beliefs, and incentives. Innovative ways to reach fathers both in the clinic and in other settings are currently under investigation, including use of behavior change models, motivational interviewing, mobile technologies, peer support groups, and policy advocacy efforts. These modalities show promise in effectively engaging fathers and improving family health.     

A comparison of consumer-directed and agency-directed personal assistance services programmes

Purpose:?To compare a consumer-directed personal assistance services (PAS) programme with an agency-directed PAS programme.

Method:?A convenience sample was used for this cross-sectional study with one data collection point. Outcomes were compared for consumer-directed and agency-directed PAS. Hierarchical regressions were also used to determine the predictors of outcomes across PAS programmes. In-home interviews were conducted by a trained data collector from April 2000 to December 2001.

Results:?Participants in the consumer-directed programme reported more choices over PAS and satisfaction with PAS. Self-reported outcomes were primarily predicted by the following variables: service arrangement, type of provider, importance of directing PAS, health status, number of personal assistants used in past 12 months, sufficient PAS hours received, and social support.

Conclusions:?Consumer-directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS programme development.     

Performance of normal males on the Boston naming test and the word test

Abstract

Responses on the Boston Naming Test (BNT) and The Word Test (TWT) were compared for 125 normal male subjects between 20 and 69 years. BNT and TWT scores were significantly correlated. Age was significantly correlated with BNT scores, but educational level was not significantly correlated with BNT or TWT scores. Examples of incorrect responses on both tests are provided, and clinical implications are discussed.     

Development of a Real-Time Smartphone Solution for the Management of Women With or at High Risk of Gestational Diabetes

Gestational diabetes mellitus (GDM) is defined as new onset or recognition of glucose intolerance in pregnancy. Evidence supports tight blood glucose regulation to prevent adverse maternal and fetal outcomes. Finger-prick blood glucose (BG) testing with frequent clinic review remains the most common method of managing diabetes in pregnancy. The prevalence of GDM is rising globally, pressuring resource-limited services. We have developed an intuitive, interactive, reliable, and accurate management system to record BG measurements and deliver management of GDM remotely. Following an initial scoping phase, a prototype software application was developed using an Android smartphone with BG meter linkage via Bluetooth. A custom website was built for clinician review of the data transmitted by the smartphone. After system refinement, further evaluation was undertaken for usability and reliability in a 48-patient service development project. Women used the system for an average of 13.1 weeks. In all, 19 686 BG measures were transmitted, 98.6% of which had a meal tag. A total of 466 text messages were transmitted. A mean of 30 BG readings per woman per week were transmitted, and 85% of women submitted the minimum requirement of 18 readings per week. We have developed a novel, real-time, smartphone-based BG monitoring management system that allows clinician review of real-time patient-annotated BG results. Results indicate high usage and excellent compliance by women. Robust clinical, economic, and satisfaction evaluations are required. To address these requirements, we are currently conducting a randomized controlled pilot trial.