A four year prospective study of age-related cognitive change in adults with Down's syndrome

Background. While neuropathological studies indicate a high risk for Alzheimer's disease in adults with Down's syndrome, neuropsychological studies suggest a lower prevalence of dementia. In this study, cognitive deterioration in adults with Down's syndrome was examined prospectively over 4 years to establish rates and profiles of cognitive deterioration.Methods. Fifty-seven people with Down's syndrome aged 30 years or older were assessed using a battery of neuropsychological tests on five occasions across 50 months. Assessments of domains of cognitive function known to change with the onset of Alzheimer related dementia were employed. These included tests of learning, memory, orientation, agnosia, apraxia and aphasia. The individual growth trajectory methodology was used to analyse change over time.Results. Severe cognitive deterioration, such as acquired, apraxia and agnosia, was evident in 28·3% of those aged over 30 and a higher prevalence of these impairments was associated with older age. The rate of cognitive deterioration also increased with age and degree of pre-existing cognitive impairment. Additionally, deterioration in memory, learning and orientation preceded the acquisition of aphasia, agnosia and apraxia.Conclusions. The prevalence of cognitive impairments consistent with the presence of Alzheimer's disease is lower than that suggested by neuropathological studies. The pattern of the acquisition of cognitive impairments in adults with Down's syndrome is similar to that seen in individuals with Alzheimer's disease who do not have Down's syndrome.</jats:p

Psychological Determinants of Medication Adherence in Stroke Survivors: a Systematic Review of Observational Studies

© 2017 The Author (s). This is an Open Access article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.BACKGROUND: Medications targeting stroke risk factors have shown good efficacy, yet adherence is suboptimal. To improve adherence, its determinants must be understood. To date, no systematic review has mapped identified determinants into the Theoretical Domains Framework (TDF) in order to establish a more complete understanding of medication adherence. PURPOSE: The aim of this study was to identify psychological determinants that most influence stroke survivors' medication adherence. METHODS: In line with the prospectively registered protocol (PROSPERO CRD42015016222), five electronic databases were searched (1953-2015). Hand searches of included full text references were undertaken. Two reviewers conducted screening, data extraction and quality assessment. Determinants were mapped into the TDF. RESULTS: Of 32,825 articles, 12 fulfilled selection criteria (N = 43,984 stroke survivors). Tested determinants mapped into 8/14 TDF domains. Studies were too heterogeneous for meta-analysis. Three TDF domains appeared most influential. Negative emotions ('Emotions' domain) such as anxiety and concerns about medications ('Beliefs about Consequences' domain) were associated with reduced adherence. Increased adherence was associated with better knowledge of medications ('Knowledge' domain) and stronger beliefs about medication necessity ('Beliefs about Consequences' domain). Study quality varied, often lacking information on sample size calculations. CONCLUSIONS: This review provides foundations for evidence-based intervention design by establishing psychological determinants most influential in stroke survivors' medication adherence. Six TDF domains do not appear to have been tested, possibly representing gaps in research design. Future research should standardise and clearly report determinant and medication adherence measurement to facilitate meta-analysis. The range of determinants explored should be broadened to enable more complete understanding of stroke survivors' medication adherence.Peer reviewedFinal Published versio

Faculty of Color at Predominantly White Colleges and Universities

Although the United States has experienced major demographic changes, such as an increased population of minorities, there still exists a very low representation of minority faculty members in institutions of higher education compared to White faculty members (Antonino, 2002). There are very few studies that detail the challenges and supports that qualified persons of color experience in obtaining positions in higher education. Therefore, there is a need for further research to identify these challenges and supports that faculty members of color experience to provide insights for other faculty members of color who are pursuing employment at an institution of higher education. The qualitative case study included interviews with five former doctoral fellows, all individuals of color regarding their perceptions of the challenges, and supports, they experienced as minority individuals who sought and obtained faculty positions at predominantly White higher education institutions. The study results indicated that faculty of color at predominately White institutions experienced challenges in seeking and obtaining faculty positions. Many of the challenges were related to understanding the culture of the organization, gaining access to knowledge of positions, and finding support for their candidacy as a viable faculty member. Study participants revealed that the support from a mentor, advisor or doctoral committee member was essential to their success. All participants said that their participation in a pre-doctoral fellowship program was instrumental in their obtaining a faculty position and to their success as a professor

Water Levels Effects on Overall Customer Satisfaction:

Abstract The combination of hydroelectric power generation and the amount of precipitation results in fluctuating water levels on the United States Army Corps of Engineers: Lake Hartwell. Beginning in 2002 and continuing to the end of survey year 2004, water levels ranged from approximately ten feet below full pool to within half a foot under full pool. These fluctuations created difficulty for adjacent landowners to access sufficient water depths for recreational needs. The problems were magnified by a common perception that neighboring lakes\u27, Lake Keowee and Lake Thurmond, water levels had not dropped as dramatically. This study examined the effects that lake water levels have on customer satisfaction of adjacent landowners on Lake Hartwell. The results of this study show that there is a link between satisfaction and water levels

Intracellular Signaling: How do Cells Respond to Single and Multiple Inputs

One important biological question is how the cell processes input information and decides what to respond. The cell can integrate the multiple inputs using linear and nonlinear dynamics to generate an appropriate output. This study focuses on the computerized recording of phototaxis (movement in relation to light direction) of Chlamydomonas cell populations response to green light, which activates the rhodopsin photoreceptor at their eyespots. The inputs are light stimulation of various wavelengths and intensities; and chemicals (IBMX, a PDE inhibitor; 2\u275\u27-dideoxyadenosine, an adenylate cyclase inhibitor, 8-Br-cAMP-Na and Dibutyryl cAMP, cAMP analogs) affecting an important intracellular messenger, cAMP. The quantified output parameters include phototaxis distance, direction and sensitivity, and swimming rate/pattern. Quality and quantity of light, cell strains and conditions, intracellular cAMP, and concentrations of the chemicals play significant roles in determining the extent and direction of a cell\u27s phototaxis behavior. Under this experimental condition, red light has a slight effect on the phototaxis direction; on the other hand, cAMP seems to regulate the phototaxis direction. Evidently, raising intracellular cAMP drives the cell movement toward the green light, while lowering the cAMP does the opposite. The switching of phototaxis direction is a clear indicator of decision making (to go toward or away from light). In combination with results from other techniques in the lab and using appropriate analytical tools, we hope to understand intracellular signaling of the pathway from rhodopsin stimulation to phototaxis behavior on decision making in particular. Eukaryotic cells including human cells have common basic features. Thus, this knowledge may lead to a better understanding of many diseases involving cell signaling and how cells make decisions