scholarly journals Neurocognitive Function in Persons with HIV and Healthy Controls from Tijuana, a Border Region in Mexico

2019 ◽  
Vol 34 (7) ◽  
pp. 1253-1253
Author(s):  
M L Garcia Gomar ◽  
A J Negrete Cortes ◽  
R Chavez Mendez ◽  
N Castillo Martinez ◽  
A Morlett Paredes ◽  
...  
Keyword(s):  
Executive Function ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Neurocognitive Function ◽  
Mexican Population ◽  
Medium Effect ◽  
Healthy Controls ◽  
Cohen’S D ◽  
Global Cognition ◽  
Cohen's D

Abstract Objective To examine neurocognitive impairment (NCI) in vulnerable HIV infected (HIV+) adults in Mexico. Participants and Method Twenty-eight adults (15 HIV+ and 13 HIV-) living in Tijuana (Mexico) participated in the study (Age: M = 40.5, SD = 11.1; 54% female; Education: M = 8.6, SD = 4.7). Participants with HIV were recruited from the board-and-care home “Las Memorias” (100% AIDS; 93% on ART; Years since HIV diagnosis: Median = 11, IQR = 5,16). Healthy controls, matched in age and education to HIV+ participants, were recruited from the same city. Participants completed a neuropsychological test battery which was comprised of the Modified Wisconsin Card Sorting Test, letter and animal fluency, Trail Making Test Parts A and B, Stroop Color-Word Test, and Symbol-Digit Test. Raw scores garnered from these tests were transformed to percentiles using norms for a Mexican population, and averaged to calculate scores on global cognition and on three cognitive domains (verbal fluency, processing speed and executive function). Wilcoxon rank sum tests were conducted to investigate group differences. NCI was defined as global percentile scores < 16. Results HIV+ participants showed significantly lower scores in global cognition (p = .04, Cohen’s d = 0.86), as well as the domains of processing speed (p = .03, Cohen’s d = 0.87) and executive function (p = .04, Cohen’s d = 0.84), with no significant differences (but medium effect sizes) on verbal fluency (p = .10, Cohen’s d = 0.60). NCI was evident in 53% of HIV+ persons and 15% of healthy controls. Conclusions Approximately half of the persons living with HIV showed notable NCI, which is consistent with findings of prior studies of Latinos in the US with HIV. This pattern of neurocognitive function was also similar to those of prior studies in HIV. Future studies might examine key predictors of HIV-associated NCI in this vulnerable Mexican population, including biological and culturally relevant factors: such as deportation, and discrimination for sexual preference or HIV status.

Neurocognitive Function and Its Impact On Return to Work in Patients Treated with Hematopoietic Cell Transplantation (HCT).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 521-521 ◽  
Author(s):  
F. Lennie Wong ◽  
Alysia Bosworth ◽  
Rose Danao ◽  
Doojduen Villaluna ◽  
Sunita Patel ◽  
...  
Keyword(s):  
Executive Function ◽  
Return To Work ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Cognitive Reserve ◽  
Neurocognitive Function ◽  
Primary Diagnosis ◽  
Immediate Memory ◽  
Allogeneic Hct ◽  
The Impact

Abstract Abstract 521 Patients undergoing HCT are at risk for neurocognitive impairment because of exposure to potential neurotoxic agents such as total body irradiation (TBI) and agents used for prophylaxis/ treatment of graft vs. host disease (GvHD). However, extant studies reporting neurocognitive outcome have been hindered by small sample size, retrospective or cross-sectional study design, limited prospective post-HCT follow-up, and restriction of study populations to either autologous or allogeneic HCT recipients, with inability to compare the two groups. Additionally, no prior studies have systematically assessed the impact of cognitive changes on the ability to return to work. This study addressed these gaps in knowledge by using a prospective longitudinal study design to examine neurocognitive changes from pre-HCT to 2 y after HCT in 284 patients undergoing HCT between 2005 and 2008. This study examined clinical and demographic predictors of neurocognitive function as well as the impact of neurocognitive function on return to part-time (PT) or full-time (FT) work post-HCT. Mean age at HCT was 50 years (range, 18-73); 40% were females; 69% were non-Hispanic whites and 21% were Hispanics. Primary diagnoses included NHL (33%), MM (26%), AML (16%), HL (10%), ALL (7%), and other (8%); 63% received autologous, 16% allogeneic related, and 20% unrelated donor HCT. A standardized 2-hour battery of neurocognitive tests was administered to the study participants at pre-HCT (n=284), 6 mo (n=202), 1 y (n=173), and 2 y (n=97) post-HCT to assess neurocognitive functioning in 8 domains: processing speed, executive function, immediate memory, general memory, working memory, psychomotor speed, verbal speed, and verbal fluency. The Wechsler Abbreviated Scale of Intelligence was used to measure cognitive reserve. Test scores were age-adjusted using normative data. Changes in neurocognitive functions over time and correlates of change were examined using the linear mixed effects model. Demographic factors examined included age at HCT, sex, race/ ethnicity, marital status, annual income at HCT, and education. Clinical factors included primary diagnosis, risk of relapse at HCT, stem cell source, presence of GvHD (for allogeneic HCT), conditioning (specific chemotherapeutic agents or TBI), and GvHD medications (allogeneic HCT only). Compared to pre-HCT, neurocognitive function generally remained unchanged or improved over the 2 years after HCT. At both pre- and post-HCT, higher cognitive reserve and education level were significantly associated with better neurocognitive function. Furthermore, women tended to have significantly better neurocognitive scores than men. However, after adjustment for significant covariates, allogeneic HCT recipients demonstrated significantly worse scores after HCT in processing speed, executive function, and verbal fluency when compared to autologous HCT recipients (p=0.001, p<0.05, p=0.04, respectively) (Figure). No differences were evident by GvHD status among allogeneic patients. Among patients who were employed prior to HCT, 66% were working either PT (27%) or FT (39%) at 1 y post-HCT. Patients with better scores in immediate memory (p=0.02), those who were either <35 y or >55 years of age at HCT (p=0.05), and those who had a primary diagnosis of lymphoma (p=0.03) were more likely to return to work either FT or PT. On the other hand, patients with chronic GvHD were less likely to return to work (p=0.02). Patients working FT at 1 y were more likely to have scored better for verbal speed (p=0.01); were more likely to have had pre-HCT income of $20,000 or more (p=0.002); and were less likely to have received allogeneic HCT (p=0.003). In summary, patients receiving allogeneic HCT are at risk for domain-specific neurocognitive deficits that persist for at least 2 years post-HCT and that are associated with inability to return to work. This study identifies vulnerable subgroups that could benefit from targeted surveillance and early intervention to facilitate smooth reintegration into society. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Effect of Whey Protein Supplementation on Physical Performance and Body Composition in Army Initial Entry Training Soldiers

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1248 ◽  
Author(s):  
Jeremy McAdam ◽  
Kaitlin McGinnis ◽  
Darren Beck ◽  
Cody Haun ◽  
Matthew Romero ◽  
...  
Keyword(s):  
Body Composition ◽  
Whey Protein ◽  
Physical Performance ◽  
Fat Mass ◽  
Fat Free Mass ◽  
Medium Effect ◽  
Cohen’S D ◽  
Cohen's D ◽  
Initial Entry ◽  
Push Up

We investigated the effects of whey protein (WP) supplementation on body composition and physical performance in soldiers participating in Army Initial Entry Training (IET). Sixty-nine, male United States Army soldiers volunteered for supplementation with either twice daily whey protein (WP, 77 g/day protein, ~580 kcal/day; n = 34, age = 19 ± 1 year, height = 173 ± 6 cm, weight = 73.4 ± 12.7 kg) or energy-matched carbohydrate (CHO) drinks (CHO, 127 g/day carbohydrate, ~580 kcal/day; n = 35, age = 19 ± 1 year, height = 173 ± 5 cm, weight = 72.3 ± 10.9 kg) for eight weeks during IET. Physical performance was evaluated using the Army Physical Fitness Test during weeks two and eight. Body composition was assessed using 7-site skinfold assessment during weeks one and nine. Post-testing push-up performance averaged 7 repetitions higher in the WP compared to the CHO group (F = 10.1, p < 0.001) when controlling for baseline. There was a significant decrease in fat mass at post-training (F = 4.63, p = 0.04), but no significant change in run performance (F = 3.50, p = 0.065) or fat-free mass (F = 0.70, p = 0.41). Effect sizes for fat-free mass gains were large for both the WP (Cohen’s d = 0.44) and CHO (Cohen’s d = 0.42) groups. WP had a large effect on fat mass (FM) loss (Cohen’s d = −0.67), while CHO had a medium effect (Cohen’s d = −0.40). Twice daily supplementation with WP improved push-up performance and potentiated reductions in fat mass during IET training in comparison to CHO supplementation.

scholarly journals Highly Predictive Transdiagnostic Features Shared across Schizophrenia, Bipolar Disorder, and ADHD Identified Using a Machine Learning Based Approach

2018 ◽  
Author(s):  
Yuelu Liu ◽  
Monika S. Mellem ◽  
Humberto Gonzalez ◽  
Matthew Kollada ◽  
Atul R. Mahableshwarkar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Patient Group ◽  
Attention Deficit ◽  
The United States ◽  
Self Report ◽  
Healthy Controls ◽  
Cohen’S D ◽  
Cohen's D

AbstractThe Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard for diagnosing psychiatric disorders in the United States. However, evidence has suggested that symptoms in psychiatric disorders are not restricted to the boundaries between DSM categories, implying an underlying latent transdiagnostic structure of psychopathology. Here, we applied an importance-guided machine learning technique for model selection to item-level data from self-reported instruments contained within the Consortium for Neuropsychiatric Phenomics dataset. From 578 questionnaire items, we identified a set of features which consisted of 85 items that were shared across diagnoses of schizophrenia (SCZ), bipolar disorder (BD), and attention deficit/hyperactivity disorder (ADHD). A classifier trained on the transdiagnostic features reliably distinguished the patient group as a whole from healthy controls (classification AUC = 0.95) and only 10 items were needed to attain the performance level of AUC being 0.90. A sum score created from the items produced high separability between patients and healthy controls (Cohen’s d = 2.85), and it outperformed predefined sum scores and sub-scores within the instruments (Cohen’s d ranging between 0.13 and 1.21). The transdiagnostic features comprised both symptom domains (e.g. dysregulated mood, attention deficit, and anhedonia) and personality traits (e.g. neuroticism, impulsivity, and extraversion). Moreover, by comparing the features that were common across the three patient groups with those that were most predictive of a single patient category, we can describe the unique features for each patient group superimposed on the transdiagnostic feature structure. Overall, our results reveal a latent transdiagnostic symptom/behavioral phenotypic structure shared across SCZ, BD, and ADHD and present a new perspective to understand insights offered by self-report psychiatric instruments.

Elevated Anxiety Relates to Future Executive Dysfunction: A Cross-Lagged Panel Network Analysis of Psychopathology and Cognitive Functioning Components

2021 ◽  
Author(s):  
Nur Hani Zainal ◽  
Michelle G. Newman
Keyword(s):  
Executive Function ◽  
Network Analysis ◽  
Cognitive Functioning ◽  
Language Processing ◽  
Verbal Fluency ◽  
Executive Dysfunction ◽  
Causal Inferences ◽  
Cross Sectional ◽  
Motor Behaviors ◽  
Global Cognition

Background: Vulnerability models posit that reduced cognitive functioning abilities (e.g., verbal fluency, working memory (WM)) precede and relate to future heightened psychopathology. Conversely, scar theory postulates that elevated psychopathology coincides with subsequent reduced cognitive functioning. However, most studies so far have been cross-sectional and tested global cognitive functioning-psychopathology relations. Objective: Thus, we used cross-lagged panel network analysis (CLPN) to facilitate causal inferences and differentiation of components on this topic. Method: Community adults (n = 856) participated in this eight-year study across four waves of assessment, each spaced about two years apart. Nine psychopathology components (aberrant motor behaviors (AMB), agitation, apathy, anxiety, delusions, depression, disinhibition, hallucinations, irritability) and seven cognitive functioning (attention, episodic memory, global cognition, language, processing speed, verbal fluency, WM) multi-item nodes were assessed with various performance-based cognitive functioning tests and the caregiver-rated Neuropsychiatric Inventory. Results: Contemporaneous networks consistently showed negative associations among global cognition/verbal fluency and agitation, AMB, or hallucinations, during all waves of assessment. Nodes that were most influential across communities in contemporaneous networks were delusions, depression, WM, and verbal fluency. For temporal networks, heightened anxiety (versus other neuropsychiatric nodes), had the largest negative relations with future decreased executive and related cognitive functioning nodes. Further, executive function nodes (e.g., verbal fluency) tended to be impacted by, rather than influential on, other nodes, across all time-points. Discussion: Findings supported scar (vs. vulnerability) model. The efficacy of evidence-based cognitive-behavioral and related psychopharmacological treatments may be enhanced by adding executive function training. Other theoretical and clinical implications were discussed.

scholarly journals PHYSICAL FRAILTY AND ITS ASSOCIATION WITH COGNITION: THE PREDICTIVE VALUE OF A SYNDROME BEYOND ITS COMPONENT PARTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S100-S101
Author(s):  
Nadia M Chu ◽  
Karen Bandeen-Roche ◽  
A Richey Sharrett ◽  
Michelle C Carlson ◽  
Qianli Xue ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Performance ◽  
Predictive Value ◽  
Cognitive Vulnerability ◽  
Strong Predictor ◽  
Word List ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Cohen’S D ◽  
Cohen's D

Abstract The extent to which frailty (PFP) affects cognitive performance and change beyond that expected from its component parts is uncertain. Leveraging NHATS, a nationally-representative cohort of U.S. Medicare beneficiaries, we quantified associations between each PFP criterion and global and domain-specific cognitive level and change (memory: immediate/delayed word-list test, executive function: clock drawing test (CDT), orientation: date, time, president-vice-resident naming), using adjusted mixed effects models with random slopes (time) and intercepts (person). We tested whether presence of frailty was associated with excess cognitive vulnerability (synergistic/excess effects, Cohen’s d) above and beyond those found for its criteria by adding an interaction term between each PFP criterion and frailty. Among 7,439 community-dwelling older adults (mean age=75.2 years) followed for a weighted mean of 3.2 years (SE= 0.03), 14.1% were frail. The most prevalent PFP criteria were low activity (30.5%) and exhaustion (29.8%). Associations were strongest for executive function, where frailty added predictive value beyond its criteria (excess effects of cognitive vulnerability ranging from -0.38SD (SE-0.05) for slowness to -0.47SD (SE=0.06) for shrinking). Slowness was a strong predictor of cognitive change in both frail and non-frail participants, especially for executive function (frail: Cohen’s d per year=-0.16, SE= 0.02; non-frail: Cohen’s d per year=-0.15, SE= 0.02). PFP is an important measure of frailty that adds predictive value beyond its criteria, especially for cognitive levels. Additionally, gait speed remains an important predictor of change in executive function. These results suggest that frailty’s contribution to cognitive performance amounts to more than the sum of its component parts.

scholarly journals Direct Comparison of Multidimensional Clinical Assessment Tools: Sensitivity to Concussion in Student Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 737-737
Author(s):  
K Wilmoth ◽  
K Mau ◽  
N Guzowski ◽  
B Brett ◽  
M McCrea ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Symptom Severity ◽  
Postural Stability ◽  
Cognitive Testing ◽  
Assessment Tools ◽  
Medium Effect ◽  
Post Injury ◽  
Multidimensional Assessment ◽  
Cohen’S D ◽  
Cohen's D

Abstract Purpose Consensus guidelines recommend multidimensional assessment for concussion diagnosis and management. Among cognitive, oculomotor, and postural stability, it remains unclear which modalities perform best in the acute/subacute periods. We conducted a direct comparison to identify those with the strongest sensitivity to sport-related concussion. Methods High school and collegiate football players (aged 14–24) completed preseason baseline assessments. Concussed (n=91) and matched non-concussed teammates (n=85) underwent repeat testing at 48 hours, 8 days, and 15 days post-injury. Postconcussive symptoms (SCAT-3 symptom severity), cognition (Standardized Assessment of Concussion, Immediate Post-Concussion and Cognitive Testing, Trail Making Test, Wechsler Adult Intelligence Scale-IV Processing Speed Index), oculomotor functioning (King-Devick Test), and postural stability (Balance Error Scoring System) were compared using Cohen’s d and Receiver Operating Characteristic analyses. Results Symptom severity had the greatest sensitivity at 48 hours and 8 days post-injury (Cohen’s d=1.43 and 0.53, AUC=.93 and .63, p<.01). Of the performance-based assessments, BESS was most sensitive to SRC at 48 hours post-injury (Cohen’s d=.74, AUC=.70, p<.01). Oculomotor and cognitive testing via ImPACT, WAIS-IV PSI, and TMT-A were sensitive to a lesser degree (Cohen’s d=.35–.58, p<.05). Verbal memory was the only significant performance-based assessment at days 8 and 15, with small-to-medium effect sizes (Cohen’s d=.37 and .44, p<.05). Other cognitive measures (SAC, TMT-B) were not sensitive to SRC across timepoints (p>.05). Conclusion We observed heterogeneity in clinical assessment performance such that the clinical domains strongest in the initial days post-injury (symptom severity, balance) were less sensitive at later follow-up, supporting the potential need for multidimensional assessment.

scholarly journals S80. CHILDHOOD TRAUMA AND SOCIAL COGNITION IN DELUSIONAL PSYCHOSES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S64-S65
Author(s):  
Covadonga Díaz-Caneja ◽  
Marcos González-Iglesias ◽  
Victoria Del Amo ◽  
Ignacio García-Cabeza ◽  
Celso Arango ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Social Cognition ◽  
Childhood Trauma ◽  
Neuropsychological Functioning ◽  
Attributional Bias ◽  
Cohen’S D ◽  
Dsm Iv ◽  
The Difference ◽  
Cohen's D

Abstract Background Deficits in social cognition could be involved in the pathogenesis of delusions in psychotic disorders (Bentall et al., 2009). Childhood trauma (CT) has been associated with an increased risk for psychosis (Varese et al., 2012). Neurocognitive and social cognition deficits could mediate in the association between CT and psychosis (Mansueto et al., 2019). Social cognition and childhood trauma have been understudied so far in delusional disorder (DD). We aimed to assess social cognition in a sample of patients with delusional psychoses (i.e., DD and schizophrenia) and healthy controls (HC) and to explore the potential effect of childhood trauma on social cognition and delusion. Methods This cross-sectional, transdiagnostic study included 69 patients with a DSM-IV-TR-confirmed diagnosis of DD (mean age 44.06 ± 11.39 years, 53.6% female), 77 with DSM-IV-TR-confirmed schizophrenia (mean age 38.12 ± 9.27 years, 27.3% female), and 63 HC (mean age 43.6 ± 13.0 years, 68.3% female). Attributional bias was assessed with the “Internal, Personal, and Situational Attributions Questionnaire.” Theory of Mind (ToM) performance was assessed with the “Reading the Mind in the Eyes Test” and the “Faux Pas Recognition Test.” Childhood trauma was measured with the “Childhood Trauma Questionnaire.” Neuropsychological functioning was measured with a comprehensive battery assessing attention, verbal learning, working memory, and executive function. We used ANCOVAs and linear regression analyses to assess the association between the three measures of social cognition and i) diagnosis, ii) dimensional measures of delusion proneness (Peters Delusion Inventory, PDI) and intensity (Maudsley Assessment of Delusion Schedule, MADS), and iii) childhood trauma; after controlling for potential confounders (age, sex, socioeconomic status, and estimated premorbid intelligence quotient). Results Patients with DD showed significantly poorer performance on the “Eyes Test” than HC (Cohen’s d=-0.44, p=0.037), after controlling for potential confounding variables. The difference was no longer significant after controlling for verbal memory. Patients with schizophrenia (d=-1.54, p&lt;0.001) and DD (Cohen’s d=-0.60, p=0.002) showed significantly poorer performance than HC on the “Faux Pas Test,” after controlling for potential confounders. The difference between patients with schizophrenia and HC remained significant after controlling for neuropsychological functioning (Cohen’s d=-1.09, p&lt;0.001), while differences between patients with DD and HC were no longer significant after controlling for executive function and working memory performance (Cohen’s d=-0.23, p=0.596). No significant differences were found between diagnostic groups in externalizing or personalizing attributional bias. In the fully adjusted models, intensity of the delusional idea was significantly associated with performance in the “Faux Pas Test” in DD, and with externalizing and personalizing attributional bias in schizophrenia. A positive history of CT was significantly associated with lower performance on the “Faux Pas Test” (Cohen’s d=-0.40, p=.022) and higher delusional proneness scores in the delusional psychosis samples (Cohen’s d=-0.49, p=.006), but not in HC. Discussion Social cognition deficits are associated with delusional intensity in delusional psychoses. Childhood trauma could increase the risk of psychosis through its effect on social cognition.

Processing Speed Mediates Executive Function Difficulties in Very Preterm Children in Middle Childhood

2011 ◽  
Vol 17 (3) ◽  
pp. 445-454 ◽  
Author(s):  
Hanna Mulder ◽  
Nicola J. Pitchford ◽  
Neil Marlow
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Middle Childhood ◽  
Behavioral Problems ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Very Preterm ◽  
Attention Tasks ◽  
Basic Functions ◽  
Attention Difficulties

AbstractExecutive function and attention difficulties are reported in very preterm (VPT) children at school entry, but it is unclear if these remain at later ages and/or if these difficulties are mediated by more basic functions, such as processing speed. Processing speed has been shown to underlie academic and behavioral problems in VPT children in middle childhood (Mulder, Pitchford, & Marlow, 2010, 2011), so may also underpin executive function and attention difficulties. We investigated this by comparing VPT (gestational age <31 weeks; N = 56) to term children (N = 22) aged 9–10 years on a comprehensive battery of executive function and attention tasks from the Test of Everyday Attention for Children (Manly, Robertson, Anderson, & Nimmo-Smith, 1999) and NEPSY (Korkman, Kirk, & Kemp, 1998). Selective and sustained attention, inhibition, working memory, shifting, verbal fluency, planning, and processing speed were examined. Group differences favoring term children were shown on most executive function tasks (i.e., inhibition, working memory, verbal fluency, and shifting), all of which were mediated by slow processing speed in the VPT group, except response inhibition. Seemingly, processing speed is an important determinant underpinning many neuropsychological deficits seen in VPT children in middle childhood. (JINS, 2011, 17, 445–454)

The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients

2013 ◽  
Vol 28 (6) ◽  
pp. 332-339 ◽  
Author(s):  
R. Andersen ◽  
B. Fagerlund ◽  
H. Rasmussen ◽  
B.H. Ebdrup ◽  
B. Aggernaes ◽  
...  
Keyword(s):  
Learning And Memory ◽  
Processing Speed ◽  
Cognitive Impairments ◽  
Visual Learning ◽  
First Episode ◽  
Healthy Controls ◽  
Verbal Intelligence ◽  
Cognitive Domains ◽  
Global Cognition ◽  
First Episode Schizophrenia

AbstractBackground:Impaired cognition is a prominent feature of schizophrenia. To what extent the heterogeneous cognitive impairments can be accounted for by considering only a single underlying impairment or a small number of core impairments remains elusive. This study examined whether cognitive impairments in antipsychotic-naïve, first-episode schizophrenia patients may be determined by a relative slower speed of information processing.Method:Forty-eight antipsychotic-naïve patients with first-episode schizophrenia and 48 matched healthy controls were administered a comprehensive battery of neuropsychological tests to assess domains of cognitive impairments in schizophrenia. Composite scores were calculated, grouping tests into cognitive domains.Results:There were significant differences between patients and healthy controls on global cognition and all cognitive domains, including verbal intelligence, processing speed, sustained attention, working memory, reasoning and problem solving, verbal learning and memory, visual learning and memory, and reaction time. All these significant differences, except for verbal intelligence and global cognition, disappeared when processing speed was included as a covariate.Conclusion:At the first stage of illness, antipsychotic-naïve patients with schizophrenia display moderate/severe impairments in all the cognitive domains assessed. The results support the contention of a global cognitive dysfunction in schizophrenia that to some extent may be determined by impaired processing speed.

scholarly journals The impact of a community based rehabilitation program in Afghanistan: a longitudinal analysis using propensity score matching and difference in difference analysis

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jean-Francois Trani ◽  
Juanita Vasquez-Escallon ◽  
Parul Bakhshi
Keyword(s):  
Daily Living ◽  
Well Being ◽  
Medium Effect ◽  
Community Based ◽  
Persons With Disabilities ◽  
Cohen’S D ◽  
Community Based Rehabilitation ◽  
Medium Effect Size ◽  
Cohen's D ◽  
The Impact

Abstract Background The 2006 United Nations Convention on the Rights of Persons with Disabilities states that the achievement of equal rights, empowerment and social inclusion of people with disabilities requires comprehensive rehabilitation services encompassing all components of the World Health Organization Community based rehabilitation (CBR) matrix: health, education, livelihood, social and empowerment. CBR programs specifically aim to deliver such comprehensive interventions. In the present study, we investigate the impact of a CBR program in Afghanistan on all these components. Methods We enrolled 1861 newly recruited CBR participants with disabilities in the study, from 169 villages between July 2012 and December 2013 as well as 1132 controls with disabilities randomly selected through a two-stage process within 6000 households from 100 villages in the same provinces but outside the catchment area of the CBR program. We interviewed them again after one (midline) and two (end-line) years in the study. Using propensity score matching and difference in difference analysis, we estimated the impact of the CBR on outcomes of interest, namely mobility, activities of daily living, communication, participation in social and community life, emotional well-being and employment. Results Three years on average into the CBR program, participants showed a significant and close to medium effect size reduction in emotional (Cohen’s d = − 0.48, 95%CI[− 0.58--0.38]), and social participation challenges (Cohen’s d = − 0.45, 95%CI[− 0.53−− 0.36]); small to medium effect size reduction in unemployment (Cohen’s d = − 0.21, 95%CI[− 0.33--0.10]), activities of daily living (Cohen’s d = − 0.26, 95%CI[− 0.35--0.18]), mobility (Cohen’s d = − 0.36, 95%CI[− 0.44--.29]) and communication challenges (Cohen’s d = − 0.38, 95%CI[− 0.46--0.3]). Conclusions Our study indicates that a CBR program may provide positive rehabilitation outcomes for persons with disabilities even in a conflict context, and improve overall well-being of all participants with disabilities, whatever their impairment, individual characteristics and the CBR matrix components considered. Trial registration ISRCTN, ISRCTN50214054. Registered August 5th 2020 - retrospectively registered

Sign in / Sign up

Export Citation Format

Share Document