Tourette syndrome (TS) can be accompanied by neurocognitive impairment. Only a few studies have focused on executive function assessment in TS using design fluency, providing preliminary results. ...This study aimed to characterize the detailed design fluency profile of children with TS compared with neurotypical children, while addressing the central concern of frequent comorbidities in studies on TS by considering tic severity and attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis.
Sixty-one children aged between 6 and 15 years participated and were divided into a TS group (
= 28 (with ADHD
= 15)) and a control group (
= 33). Our objective was addressed by examining a wide range of measures of the Five-Point-Test, presumably sensitive to frontostriatal dysfunction. The total number of designs, repetitions, repetition ratio, unique designs, and numerical, spatial, and total strategies were examined for the total duration of the test (global measures) and at five equal time intervals (process measures).
The TS group produced significantly fewer numerical strategies. Groups did not differ in other global or process measures. ADHD did not affect performance.
Children with TS do not inherently show general executive dysfunction but may present with subtle neurocognitive characteristics here revealed by comprehensive design fluency profiles.
Cognitive training aims to produce a durable transfer to untrained abilities (i.e., far transfer). However, designing effective programs is difficult, because far transfer mechanisms are not well ...understood. Greenwood and Parasuraman (Neuropsychol 30(6):742–755.
https://doi.org/10.1037/neu0000235
, 2016) proposed that the ability to ignore distractions is key in promoting far transfer. While the authors identified working-memory training based on the N-back task as an effective way to train distraction suppression, a recent meta-analysis concluded that this form of training rarely produces far transfer. Such inconsistency casts doubt onto the importance of distraction suppression in far transfer and calls for further examination of the role of this ability in cognitive training effectiveness. We propose here to conceptualize distraction suppression in the light of the load theory of attention, which distinguishes two mechanisms of distractor rejection depending on the level and type of information load involved: perceptual selection and cognitive control. From that standpoint, N-back training engages a single suppression mechanism, namely cognitive control, because it mainly involves low perceptual load. In the present study, we compared the efficacy of N-back training in producing far transfer to that of a new response-competition training paradigm that solicits both distraction suppression mechanisms. Response-competition training was the only one to produce far transfer effects relative to an active control training. These findings provided further support to Greenwood and Parasuraman’s hypothesis and suggest that both selection perception and cognitive control need to be engaged during training to increase the ability to suppress distraction, hence to promote far transfer.
L’entrainement cognitif représente une avenue intéressante pour améliorer les habiletés cognitives chez des personnes de différents âges. Alors que le but ultime de l’entrainement cognitif est de ...transférer les acquis à des processus cognitifs différents de ceux entrainés, un tel transfert est rarement rapporté dans les écrits scientifiques. En fait, les recensions des écrits indiquent que l’efficacité de l’entrainement cognitif semble spécifique à la tâche entrainée et que des recherches supplémentaires s’avèrent nécessaires pour mieux comprendre ce qui pourrait contribuer à produire un transfert distal. La présente thèse cherche à mieux comprendre les facteurs qui contribuent à l’efficacité de l’entrainement cognitif en s’intéressant à la fois au contenu du programme d’entrainement qu’à la forme que prend cet entrainement. Ainsi, la thèse s’intéresse, dans un premier temps, à la nature du processus cognitif entrainé et, dans un deuxième temps, à la ludification de l’entrainement. Une première étude s’intéresse au processus de suppression de distracteurs et vise à déterminer si un transfert distal peut résulter d’un entrainement de deux mécanismes de suppression des distracteurs, la sélection perceptive et le contrôle de l’attention. Les résultats montrent que seul un entrainement adaptatif sollicitant ces deux mécanismes favorise un transfert sur des tâches de mémoire de travail. Le but de la deuxième étude est d’isoler le rôle des éléments de jeu afin de cibler leur apport dans l’entrainement cognitif. Cette deuxième expérience teste l’hypothèse selon laquelle l’utilisation d’un système de pointage et/ou d’un tableau de compétition permettrait d’augmenter le niveau d’engagement dans le programme d’entrainement ainsi que de favoriser le transfert distal. Bien que les résultats infirment cette hypothèse, la présence de ces éléments de jeu semble néanmoins être associée à un taux d’attrition plus faible. Ces expériences appuient l’idée selon laquelle le processus cognitif entrainé et le contexte dans lequel l’entrainement est présenté ont chacun un rôle important dans l’effet de transfert distal. La thèse offre un nouveau paradigme d’entrainement qui semble efficace pour produire un transfert distal à la communauté scientifique et met en lumière l’intérêt d’exploiter les éléments de jeu comme facteur de maintien dans la répétition d’une tâche monotone. Les résultats de la thèse portent à croire que l’entrainement peut être utilisé afin de pallier des déficits cognitifs présents chez certaines populations vulnérables.
Cognitive training represents an interesting avenue to improve cognitive skills in people of different ages. While the ultimate goal of cognitive training is to transfer knowledge to cognitive processes different from those being trained, such transfer is rarely reported in the scientific literature. In fact, literature reviews indicate that the effectiveness of cognitive training appears to be specific to the training task and that further research is needed to better understand what might contribute to producing far transfer. The present thesis seeks to better understand the factors that contribute to the effectiveness of cognitive training by looking at both the content of the training program and the form that training takes. The thesis focuses firstly on the nature of the cognitive process solicited in the training program and, secondly, on training gamification. A first study concentrates on the process of distractor suppression and examines the impact of training perceptual selection and cognitive control—two distractor suppression mechanisms—on far transfer. The results show that only adaptive training based on these two mechanisms promotes transfer to working memory tasks. The aim of the second study is to isolate the role of game elements in order to target their contribution to cognitive training. This second experiment tests the hypothesis that the use of a scoring system and/or a leaderboard would increase the level of engagement in the training program and promote far transfer. Although the results refute this hypothesis, the presence of these game elements seems nonetheless to be associated with lower attrition rates. These experiments support the idea that the cognitive process being trained and the context in which training is presented each play an important role in the far transfer effect. The thesis offers a new training paradigm that appears to be effective in producing far transfer to the scientific community and highlights the value of exploiting the game elements as a maintenance factor in the repetition of a monotonous task. The thesis envisions an encouraging future where cognitive training could be used to compensate for cognitive deficits present in certain vulnerable populations.
Although evidence continues to indicate an urgent need to transition food systems away from industrialized monocultures and toward agroecological production, there is little sign of significant ...policy commitment toward food system transformation in global North geographies. The authors, a consortium of researchers studying the land-food nexus in global North geographies, argue that a key lock-in explaining the lack of reform arises from how most food system interventions work through dominant logics of property to achieve their goals of agroecological production. Doing so fails to recognize how land tenure systems, codified by law and performed by society, construct agricultural land use outcomes. In this perspective, the authors argue that achieving food system “resilience” requires urgent attention to the underlying property norms that drive land access regimes, especially where norms of property appear hegemonic. This paper first reviews research from political ecology, critical property law, and human geography to show how entrenched property relations in the global North frustrate the advancement of alternative models like food sovereignty and agroecology, and work to mediate acceptable forms of “sustainable agriculture.” Drawing on emerging cases of land tenure reform from the authors' collective experience working in Scotland, France, Australia, Canada, and Japan, we next observe how contesting dominant logics of property creates space to forge deep and equitable food system transformation. Equally, these cases demonstrate how powerful actors in the food system attempt to leverage legal and cultural norms of property to legitimize their control over the resources that drive agricultural production. Our formulation suggests that visions for food system “resilience” must embrace the reform of property relations as much as it does diversified farming practices. This work calls for a joint cultural and legal reimagination of our relation to land in places where property functions as an epistemic and apex entitlement.
Patient safety organizations and researchers describe hospital-acquired pneumonia (HAP) as a largely preventable hospital-acquired infection that affects patient safety and quality of care. We ...provide evidence regarding the consequences of HAP among 2019 Medicare beneficiaries.
Retrospective case-control study.
Calendar year 2019 Medicare beneficiaries with HAP during an initial hospitalization, defined by
(ICD-10-CM) coding on inpatient claims (n = 2,457). Beneficiaries with HAP were matched using diagnosis-related group (DRG) codes with beneficiaries who did not experience HAP (n = 2,457).
The 2019 calendar year Medicare 5% Standard Analytic Files (SAF), for inpatient, outpatient, physician, and all postacute hospital settings. The case group (HAP) and control group (non-HAP) were matched on disease severity, age, sex, and race and were compared for hospital length of stay, costs, and mortality during the initial hospitalization and across settings for 30, 60, and 90 days after discharge. The 2019 fiscal year MedPAR Claims data were used to determine Medicare costs.
Medicare beneficiaries with HAP were 2.8 times more likely to die within 90 days compared with matched beneficiaries who did not develop HAP. Among those who survived, beneficiaries with HAP spent 6.6 more days in the hospital (69%) and cost the Medicare program an average of $14,487 (24%) more per episode of care across initial inpatient and postdischarge services.
The findings of higher mortality and cost among Medicare beneficiaries who develop HAP suggest that HAP prevention should be prioritized as a patient safety and quality initiative for the Medicare program.
During the COVID-19 pandemic, the province of Quebec, Canada implemented stringent measures to mitigate virus transmission, which considerably affected the life of people with disabilities (PWD). The ...objective of this study was to explore the experiences of PWD during the first year of COVID-19 restrictions across the province. Participants who self-identified as having a disability in the Ma Vie et la pandémie study (MAVIPAN) were invited to participate in a semi-structured interview between December 2020 and May 2021. A mixed inductive and deductive approach was used to conduct a thematic analysis using NVivo 12. Forty PWD from Quebec, Canada participated in the interviews (mean SD age, 55.4 15.5 years, 50% women). A deterioration in mental health and a reduction in social contact with loved ones were reported. PWD experienced delays and cessation of health services and reported feeling at risk of contracting severe strains of COVID-19 because of their health condition. Enhanced difficulties experienced by PWD and the lack of consideration specific to PWD by public authorities during COVID-19 was particularly concerning for participants in this study. Future studies should explore the value of implementing social programs specifically targeting PWD to enhance support as the pandemic continues.
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Microbial metabolite mimicry is a new concept that promises to deliver compounds that have minimal liabilities and enhanced therapeutic effects in a host. In a previous publication, ...we have shown that microbial metabolites of L-tryptophan, indoles, when chemically altered, yielded potent anti-inflammatory pregnane X Receptor (PXR)-targeting lead compounds, FKK5 and FKK6, targeting intestinal inflammation. Our aim in this study was to further define structure–activity relationships between indole analogs and PXR, we removed the phenyl-sulfonyl group or replaced the pyridyl residue with imidazolopyridyl of FKK6. Our results showed that while removal of the phenyl-sulfonyl group from FKK6 (now called CVK003) shifts agonist activity away from PXR towards the aryl hydrocarbon receptor (AhR), the imidazolopyridyl addition preserves PXR activity in vitro. However, when these compounds are administered to mice, that unlike the parent molecule, FKK6, they exhibit poor induction of PXR target genes in the intestines and the liver. These data suggest that modifications of FKK6 specifically in the pyridyl moiety can result in compounds with weak PXR activity in vivo. These observations are a significant step forward for understanding the structure–activity relationships (SAR) between indole mimics and receptors, PXR and AhR.
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