Childcare Policy and Cognitive Outcomes of Children: Results from a Large Scale Quasi-Experiment on Universal Childcare in Canada

Author(s):  
Pierre Lefebvre ◽  
Phil Merrigan ◽  
Matthieu Verstraete
Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 62
Author(s):  
Hei Long Lam ◽  
Wai Tak Victor Li ◽  
Ismail Laher ◽  
Roger Y. Wong

Dementia is an increasingly common syndrome and while pharmacotherapy is available, its potential benefit is limited, especially in non-cognitive outcomes. Non-pharmacotherapy such as music therapy is potentially associated with improved outcomes. We assessed the effects of music therapy on patients with dementia to evaluate its potential benefits on dementia. Two independent reviewers searched MEDLINE, EMBASE, CINAHL, CENTRAL, and ClinicalTrials.gov databases for clinical trials, using the keywords “music therapy” and “dementia”. Study outcomes included cognitive function, behavioral and psychological symptoms of dementia (BPSD), and quality of life. A total of 82 studies were included, of which 43 were interventional clinical trials, and 39 were systematic reviews or meta-analyses. Significant improvements in verbal fluency occurred after music therapy, with significant reductions in anxiety, depression, and apathy. There were no significant improvements in cognition or daily functioning, and the results on quality of life and agitation were ambiguous. Limitations of studies included low patient numbers, lack of standardized music therapy, and high heterogeneity in outcomes. More large-scale clinical trials would allow for clearer conclusions on the benefits of music therapy in patients with dementia.


2015 ◽  
Vol 28 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Tammy T. Hshieh ◽  
Meaghan L. Fox ◽  
Cyrus M. Kosar ◽  
Michele Cavallari ◽  
Charles R. G. Guttmann ◽  
...  

ABSTRACTBackground:Intracranial volume (ICV) has been proposed as a measure of maximum lifetime brain size. Accurate ICV measures require neuroimaging which is not always feasible for epidemiologic investigations. We examined head circumference as a useful surrogate for ICV in older adults.Methods:99 older adults underwent Magnetic Resonance Imaging (MRI). ICV was measured by Statistical Parametric Mapping 8 (SPM8) software or Functional MRI of the Brain Software Library (FSL) extraction with manual editing, typically considered the gold standard. Head circumferences were determined using standardized tape measurement. We examined estimated correlation coefficients between head circumference and the two MRI-based ICV measurements.Results:Head circumference and ICV by SPM8 were moderately correlated (overall r = 0.73, men r = 0.67, women r = 0.63). Head circumference and ICV by FSL were also moderately correlated (overall r = 0.69, men r = 0.63, women r = 0.49).Conclusions:Head circumference measurement was strongly correlated with MRI-derived ICV. Our study presents a simple method to approximate ICV among older patients, which may prove useful as a surrogate for cognitive reserve in large scale epidemiologic studies of cognitive outcomes. This study also suggests the stability of head circumference correlation with ICV throughout the lifespan.


2020 ◽  
Author(s):  
Hsin-I Chang ◽  
Yu-Tzu Chang ◽  
Chi-Wei Huang ◽  
Kuo-Lun Huang ◽  
Jung-Lung Hsu ◽  
...  

Abstract BackgroundThe clinical manifestations of Alzheimer disease (AD) are related to brain network degeneration, while genetic differences may mediate network change patterns. A number of AD-susceptible loci have been reported using genome-wide association studies, however, how they modulate intracerebral volume and relationships to cognitive outcomes remains to be established. We hypothesized that different genotype groups may modulate large-scale brain networks independently or interact with apolipoprotein E4 (ApoE4) status to determine neurobehavior test scores.MethodsGray matter structural covariance networks were constructed in 324 patients with AD using T1 magnetic resonance imaging with independent component analysis (ICA). We assessed 15 genetic loci (rs9349407, rs3865444, rs670139, rs744373, rs3851179, rs11136000, rs3764650, rs610932, rs6887649, rs7849530, rs4866650, rs3765728, rs34011, rs6656401, rs597668) using the additive, recessive and dominant model on clinical outcomes. Statistical analysis was performed to explore the independent role of each locus, interactions with ApoE4 status, and relationships to brain ICA network integrity score. We used Cognitive Abilities Screening Instrument (CASI) total score or short-term memory (STM) subscore as the major outcome factors, adjusted for covariates of education, disease duration and age.ResultsClinically, the CD2AP G allele showed a protective role in CASI-total and CASI-STM scores independently or via interactions with non-ApoE4 status, while the CR1 A genotype group was associated with lower STM independently of ApoE4 status. Three loci showed synergic interactions with ApoE4: BIN 1 T allele and MS4A6A G allele with non-ApoE4 status, and FTMT G allele with ApoE4 status. The network integrity scores revealed 9 significant ICA networks (anterior and posterior hippocampus, right temporal, right or left thalamus, inferior cerebellum, medial cerebellum, default mode network, frontal attention network) that correlated with cognitive scores, in which only the ApoE4 and MS4A6A genotype group was independently related to the hippocampus network. Genetic loci of MS4A6A, BIN1, CD2AP, CD33, CLU, BIN1, P73, EXOC3L2, CR1 and MS4AE4 exerted network influence independently or via interactions with ApoE4 status.ConclusionsThis study suggests that AD-susceptible loci may exert clinical significance independently, through interactions with ApoE4 status or by modulating ICA networks to determine cognitive outcomes.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
R Kerley ◽  
H Dolphin ◽  
H Cronin ◽  
R Murphy ◽  
R O"lionaird ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is a known risk factor for cognitive impairment and dementia. Recent data suggests that successful restoration of sinus rhythm by catheter ablation improves cognitive outcomes. Purpose: Our aim was to perform a systematic review and meta-analysis of the available data regarding the effectiveness of AF catheter ablation on neurocognitive outcomes. Methods: A comprehensive literature search was performed through December 1, 2020, for all eligible studies comparing neurocognitive outcomes in AF patients with or without AF catheter ablation. Clinical outcomes included rate of dementia, cognitive function by Montreal Cognitive Assessment (MOCA) and Mini-Mental State Examination (MMSE) scores. Additional outcomes included the impact of time in sinus rhythm on neurocognitive outcomes. Results: We identified 11 studies which evaluated the effect of AF catheter ablation on dementia rate, MMSE and MOCA score. Meta-analysis of observational results indicates a decreased risk of dementia (risk ratio 0.51; 95% CI: 0.43 to 0.60; p <0.001) and an improvement in MOCA scores (2.92 points, p < 0.001) but not MMSE scores in patients undergoing AF catheter ablation compared to medical therapy. In addition, the maintenance of sinus rhythm was identified as a significant factor in dementia rate and improvement of MMSE and MOCA scores observed post catheter ablation therapy. Conclusion: AF catheter ablation may reduce the incidence of dementia and improve cognitive function. A large-scale randomized control trial is warranted before recommendations can be made regarding AF ablation and cognitive outcomes. Abstract Figure.


2016 ◽  
Vol 113 (43) ◽  
pp. 12286-12291 ◽  
Author(s):  
Jessica A. Ash ◽  
Hanbing Lu ◽  
Lisa R. Taxier ◽  
Jeffrey M. Long ◽  
Yihong Yang ◽  
...  

Changes in the functional connectivity (FC) of large-scale brain networks are a prominent feature of brain aging, but defining their relationship to variability along the continuum of normal and pathological cognitive outcomes has proved challenging. Here we took advantage of a well-characterized rat model that displays substantial individual differences in hippocampal memory during aging, uncontaminated by slowly progressive, spontaneous neurodegenerative disease. By this approach, we aimed to interrogate the underlying neural network substrates that mediate aging as a uniquely permissive condition and the primary risk for neurodegeneration. Using resting state (rs) blood oxygenation level-dependent fMRI and a restrosplenial/posterior cingulate cortex seed, aged rats demonstrated a large-scale network that had a spatial distribution similar to the default mode network (DMN) in humans, consistent with earlier findings in younger animals. Between-group whole brain contrasts revealed that aged subjects with documented deficits in memory (aged impaired) displayed widespread reductions in cortical FC, prominently including many areas outside the DMN, relative to both young adults (Y) and aged rats with preserved memory (aged unimpaired, AU). Whereas functional connectivity was relatively preserved in AU rats, they exhibited a qualitatively distinct network signature, comprising the loss of an anticorrelated network observed in Y adults. Together the findings demonstrate that changes in rs-FC are specifically coupled to variability in the cognitive outcome of aging, and that successful neurocognitive aging is associated with adaptive remodeling, not simply the persistence of youthful network dynamics.


2006 ◽  
Vol 30 (1) ◽  
pp. 55-66 ◽  
Author(s):  
Alison Pike ◽  
Alessandra C. Iervolino ◽  
Thalia C. Eley ◽  
Thomas S. Price ◽  
Robert Plomin

Using a longitudinal, large-scale sample of British twins, we addressed the prediction of both cognitive abilities and behavioral adjustment from eight domains of environmental risk: minority status, socio-economic status, maternal medical factors, twin medical factors, maternal depression, chaos within the home environment, and parental feelings towards their children and discipline. Participants included 5765 families with twins (49.1% male) born in 1994 and 1995. Aspects of environmental risk were assessed from birth until the children’s third birthdays; outcome measures were assessed at their fourth birthdays. Overall prediction of outcome (via multiple regression analysis) was moderate (R = .23 -.48). SES and chaos were the strongest predictors for the cognitive outcomes whereas for total behavior problems the more proximal parenting factors were also dominant. Future analyses will investigate these environmental risk indicators in the context of the genetically sensitive twin design.


2021 ◽  
Vol 12 ◽  
Author(s):  
Nicholas B. Dadario ◽  
Bledi Brahimaj ◽  
Jacky Yeung ◽  
Michael E. Sughrue

The surgical management of brain tumors is based on the principle that the extent of resection improves patient outcomes. Traditionally, neurosurgeons have considered that lesions in “non-eloquent” cerebrum can be more aggressively surgically managed compared to lesions in “eloquent” regions with more known functional relevance. Furthermore, advancements in multimodal imaging technologies have improved our ability to extend the rate of resection while minimizing the risk of inducing new neurologic deficits, together referred to as the “onco-functional balance.” However, despite the common utilization of invasive techniques such as cortical mapping to identify eloquent tissue responsible for language and motor functions, glioma patients continue to present post-operatively with poor cognitive morbidity in higher-order functions. Such observations are likely related to the difficulty in interpreting the highly-dimensional information these technologies present to us regarding cognition in addition to our classically poor understanding of the functional and structural neuroanatomy underlying complex higher-order cognitive functions. Furthermore, reduction of the brain into isolated cortical regions without consideration of the complex, interacting brain networks which these regions function within to subserve higher-order cognition inherently prevents our successful navigation of true eloquent and non-eloquent cerebrum. Fortunately, recent large-scale movements in the neuroscience community, such as the Human Connectome Project (HCP), have provided updated neural data detailing the many intricate macroscopic connections between cortical regions which integrate and process the information underlying complex human behavior within a brain “connectome.” Connectomic data can provide us better maps on how to understand convoluted cortical and subcortical relationships between tumor and human cerebrum such that neurosurgeons can begin to make more informed decisions during surgery to maximize the onco-functional balance. However, connectome-based neurosurgery and related applications for neurorehabilitation are relatively nascent and require further work moving forward to optimize our ability to add highly valuable connectomic data to our surgical armamentarium. In this manuscript, we review four concepts with detailed examples which will help us better understand post-operative cognitive outcomes and provide a guide for how to utilize connectomics to reduce cognitive morbidity following cerebral surgery.


2020 ◽  
Vol 12 (1) ◽  
pp. 345-366
Author(s):  
Christian Bommer ◽  
Nitya Mittal ◽  
Sebastian Vollmer

Despite growing policy commitment and decades of extensive research, nutritional deficiencies remain a key challenge for health systems worldwide. In addition to causing significant personal costs for those affected, indirect effects, such as reduced overall human capital accumulation or losses in labor productivity, can impose substantial obstacles for the achievement of economic development goals. This review provides an overview of the impact of key interventions aiming to improve nutritional intake in order to reach better physical health and cognitive outcomes among children in developing countries. We argue that, although promising interventions exist, malnutrition is a complex problem, likely requiring a stronger focus on multifactorial approaches. Moreover, more research is necessary to maximize compliance and sustainability if interventions are to successfully transform into large-scale policy programs. We further discuss the emerging double burden of malnutrition as a key challenge for policy makers in resource-poor settings.


2020 ◽  
Vol 1 (11) ◽  
pp. 167-174
Author(s):  
Олександр Петрович Федоришин

The article discusses the importance of understanding how the built environment of schools relates to the socialization process of students. School can be affective systems that promote social, emotional and academic skills of children and can foster motivation. The school has become a primary agency of socialization. It is the first large-scale organization of which the child becomes a member and which reflects what is going on in the wider society. The modern school is facing a challenge of creating the educational environment in a modern form which develops both academic and necessary learning skills, allowing looking for what is needed in future work cases. These skills include the ability to recognize and manage emotions, develop feelings of respect and care for others, build positive relationships, make responsible decisions and cope with various challenges. The school’s potential for socialization lies in the amount of times students spend in school and in activities related to the school. During this time the students acquires a lot from teachers and fellow students. To enhance achievement and socialization among students cooperative learning can be used as an effective teaching strategy. It is a social construction where knowledge is negotiated and acquired through social interaction rather than being transmitted by the teacher. Cooperative learning is suitable to promote a social construction of knowledge, mutual learning, personal and social development. It requires students to work in small groups in order to make possible face-to-face interactions between members. Effectiveness of cooperative learning is that every member of the group is involved in the learning process obtaining the experience of interaction. It represents situations in which teachers structure group work with the aim to maximize both social and cognitive outcomes. Consequently, cooperative learning methods can notably improve the process of socialization of students in school.


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