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GeroScience Oct 2023The capacity to learn and memorize is a key determinant for the quality of life but is known to decline to varying degrees with age. However, neural correlates of memory...
The capacity to learn and memorize is a key determinant for the quality of life but is known to decline to varying degrees with age. However, neural correlates of memory formation and the critical features that determine the extent to which aging affects learning are still not well understood. By employing a visual sequence learning task, we were able to track the behavioral and neurophysiological markers of gradual learning over several repetitions, which is not possible in traditional approaches that utilize a remember vs. forgotten comparison. On a neurophysiological level, we focused on two learning-related centro-parietal event-related potential (ERP) components: the expectancy-driven P300 and memory-related broader positivity (BP). Our results revealed that although both age groups showed significant learning progress, young individuals learned faster and remembered more stimuli than older participants. Successful learning was directly linked to a decrease of P300 and BP amplitudes. However, young participants showed larger P300 amplitudes with a sharper decrease during the learning, even after correcting for an observed age-related longer P300 latency and increased P300 peak variability. Additionally, the P300 amplitude predicted learning success in both age groups and showed good test-retest reliability. On the other hand, the memory formation processes, reflected by the BP amplitude, revealed a similar level of engagement in both age groups. However, this engagement did not translate into the same learning progress in the older participants. We suggest that the slower and more variable timing of the stimulus identification process reflected in the P300 means that despite the older participants engaging the memory formation process, there is less time for it to translate the categorical stimulus location information into a solidified memory trace. The results highlight the important role of the P300 and BP as a neurophysiological marker of learning and may enable the development of preventive measures for cognitive decline.
Topics: Humans; Electroencephalography; Healthy Aging; Reproducibility of Results; Quality of Life; Spatial Learning
PubMed: 37171560
DOI: 10.1007/s11357-023-00811-8 -
Cerebral Cortex (New York, N.Y. : 1991) May 2024We report an investigation of the neural processes involved in the processing of faces and objects of brain-lesioned patient PS, a well-documented case of pure acquired...
We report an investigation of the neural processes involved in the processing of faces and objects of brain-lesioned patient PS, a well-documented case of pure acquired prosopagnosia. We gathered a substantial dataset of high-density electrophysiological recordings from both PS and neurotypicals. Using representational similarity analysis, we produced time-resolved brain representations in a format that facilitates direct comparisons across time points, different individuals, and computational models. To understand how the lesions in PS's ventral stream affect the temporal evolution of her brain representations, we computed the temporal generalization of her brain representations. We uncovered that PS's early brain representations exhibit an unusual similarity to later representations, implying an excessive generalization of early visual patterns. To reveal the underlying computational deficits, we correlated PS' brain representations with those of deep neural networks (DNN). We found that the computations underlying PS' brain activity bore a closer resemblance to early layers of a visual DNN than those of controls. However, the brain representations in neurotypicals became more akin to those of the later layers of the model compared to PS. We confirmed PS's deficits in high-level brain representations by demonstrating that her brain representations exhibited less similarity with those of a DNN of semantics.
Topics: Humans; Prosopagnosia; Female; Adult; Brain; Neural Networks, Computer; Middle Aged; Pattern Recognition, Visual; Male; Models, Neurological
PubMed: 38795358
DOI: 10.1093/cercor/bhae211 -
Journal of Affective Disorders Aug 2023Individuals with major depressive disorder (MDD) are at higher risk for obesity. In turn, weight gain is a predisposing factor for depression. Although clinical data are...
BACKGROUND
Individuals with major depressive disorder (MDD) are at higher risk for obesity. In turn, weight gain is a predisposing factor for depression. Although clinical data are sparse, suicide risk also appears to be elevated in obese patients. This study used data from the European Group for the Study of Resistant Depression (GSRD) to investigate clinical outcomes associated with body mass index (BMI) in MDD.
METHODS
Data were drawn from 892 participants with MDD over the age of 18 years (580 female, 50.5 ± 13.6 years). Response and resistance to antidepressant medication, depression rating scale scores, and further clinical and sociodemographic variables were compared using multiple logistic and linear regressions controlled for age, sex, and risk of weight gain due to psychopharmacotherapy.
RESULTS
Of the 892 participants, 323 were categorized as treatment-responsive and 569 as treatment-resistant. Within this cohort, 278 (31.1 %) were overweight (BMI = 25-29.9 kg/m) and 151 (16.9 %) were obese (BMI > 30 kg/m). Elevated BMI was significantly associated with higher suicidality, longer duration of psychiatric hospitalizations over their lifetimes, earlier age of onset of MDD, and comorbidities. There was a trend-wise association of BMI with treatment resistance.
LIMITATIONS
Data were analyzed in a retrospective, cross-sectional design. BMI was used as an exclusive measure of overweight and obesity.
CONCLUSIONS
Participants with comorbid MDD and overweight/obesity were at risk for worse clinical outcomes, suggesting that weight gain should be closely monitored in individuals with MDD in daily clinical practice. Further studies are needed to explore the neurobiological mechanisms linking elevated BMI to impaired brain health.
Topics: Humans; Female; Adult; Middle Aged; Depressive Disorder, Major; Body Mass Index; Retrospective Studies; Overweight; Cross-Sectional Studies; Obesity; Weight Gain
PubMed: 37196934
DOI: 10.1016/j.jad.2023.05.042 -
Administration and Policy in Mental... May 2024To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally...
To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children's Health (2016-2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication. Expanded SoP for psychologists and nurse practitioners was measured based on the child's state of residence and the year of the survey. The associations between both SoP expansion and both outcomes were assessed using logistic regression models adjusted for multiple covariates. The probability of having unmet mental health needs was 5.4 percentage points lower (95% CI - 0.102, - 0.006) for children living in a state with psychologist SoP expansion; however, there was no significant difference in unmet mental health needs between states with and without NP SoP expansion. The probability of receiving a mental health medication was 2.0 percentage points higher (95% CI 0.007, 0.034) for children living in a state with psychologist SoP expansion. Conversely, the probability of receiving a mental health medication was 1.5 percentage points lower (95% CI - 0.023, - 0.007) for children living in a state with NP SoP expansion. Expanded SoP for psychologists is associated with improved access to pediatric mental health care in terms of both unmet need and receiving medication. Expanded SoP for NPs, however, was not associated with unmet need and lower receipt of medication.
Topics: Humans; Mental Health Services; Child; Male; Female; Adolescent; Health Services Accessibility; Nurse Practitioners; Scope of Practice; United States; Child, Preschool; Child Health Services; Mental Disorders; Health Services Needs and Demand; Psychology
PubMed: 38349470
DOI: 10.1007/s10488-024-01342-w -
Implementation Science : IS Nov 2023Increased breast density augments breast cancer risk and reduces mammography sensitivity. Supplemental breast MRI screening can significantly increase cancer detection...
Protocol for a pragmatic stepped wedge cluster randomized clinical trial testing behavioral economic implementation strategies to increase supplemental breast MRI screening among patients with extremely dense breasts.
BACKGROUND
Increased breast density augments breast cancer risk and reduces mammography sensitivity. Supplemental breast MRI screening can significantly increase cancer detection among women with dense breasts. However, few women undergo this exam, and screening is consistently lower among racially minoritized populations. Implementation strategies informed by behavioral economics ("nudges") can promote evidence-based practices by improving clinician decision-making under conditions of uncertainty. Nudges directed toward clinicians and patients may facilitate the implementation of supplemental breast MRI.
METHODS
Approximately 1600 patients identified as having extremely dense breasts after non-actionable mammograms, along with about 1100 clinicians involved with their care at 32 primary care or OB/GYN clinics across a racially diverse academically based health system, will be enrolled. A 2 × 2 randomized pragmatic trial will test nudges to patients, clinicians, both, or neither to promote supplemental breast MRI screening. Before implementation, rapid cycle approaches informed by clinician and patient experiences and behavioral economics and health equity frameworks guided nudge design. Clinicians will be clustered into clinic groups based on existing administrative departments and care patterns, and these clinic groups will be randomized to have the nudge activated at different times per a stepped wedge design. Clinicians will receive nudges integrated into the routine mammographic report or sent through electronic health record (EHR) in-basket messaging once their clinic group (i.e., wedge) is randomized to receive the intervention. Independently, patients will be randomized to receive text message nudges or not. The primary outcome will be defined as ordering or scheduling supplemental breast MRI. Secondary outcomes include MRI completion, cancer detection rates, and false-positive rates. Patient sociodemographic information and clinic-level variables will be examined as moderators of nudge effectiveness. Qualitative interviews conducted at the trial's conclusion will examine barriers and facilitators to implementation.
DISCUSSION
This study will add to the growing literature on the effectiveness of behavioral economics-informed implementation strategies to promote evidence-based interventions. The design will facilitate testing the relative effects of nudges to patients and clinicians and the effects of moderators of nudge effectiveness, including key indicators of health disparities. The results may inform the introduction of low-cost, scalable implementation strategies to promote early breast cancer detection.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05787249. Registered on March 28, 2023.
Topics: Humans; Female; Breast Neoplasms; Breast Density; Mammography; Economics, Behavioral; Magnetic Resonance Imaging; Randomized Controlled Trials as Topic
PubMed: 38001506
DOI: 10.1186/s13012-023-01323-x -
Frontiers in Public Health 2023Oral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people's... (Review)
Review
BACKGROUND
Oral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people's decision-making and self-management capacities in a cost-efficient manner. As a result, these interventions could be valuable tools for fostering improved oral care habits. This critical review explores potential behavioral nudges applicable to promoting oral health.
METHODS
A thorough electronic literature search was conducted on Scopus, Embase, and PubMed databases for papers published post-2008. The search focused on empirical evidence concerning the direct and indirect application of Nudge theory in oral health enhancement. In addition, the investigation included the nudge intervention's role in managing common non-communicable disease risk factors (tobacco, alcohol, and sugar) and their use in other health sectors.
RESULTS AND CONCLUSION
There is a dearth of studies on behavioral economics, particularly those involving reward and reminder techniques. However, various successful nudge interventions have been identified in other sectors that aim to improve health decisions. These include strategies encouraging healthier nutritional choices, tobacco and alcohol cessation, medication compliance, routine physical activity, and regular health check-ups. Such interventions can also have direct or indirect positive impacts on oral health. Implementing these interventions within an oral care framework could promote oral health due to similar underlying cognitive mechanisms. However, different types of nudge interventions have varying degrees of effectiveness. Furthermore, factors such as the method of delivery and the characteristics of the targeted population significantly influence the outcome of the intervention. Hence, it is imperative to conduct extensive studies in diverse socioeconomic settings to fully understand the potentials, limitations, and impacts of nudge interventions in promoting oral health.
Topics: Humans; Health Promotion; Oral Health; Economics, Behavioral; Risk Factors; Self-Management
PubMed: 38145077
DOI: 10.3389/fpubh.2023.1243246 -
Acta Psychologica Jul 2024
Topics: Humans; Psychology; Jungian Theory
PubMed: 38749773
DOI: 10.1016/j.actpsy.2024.104302 -
Soins; La Revue de Reference Infirmiere 2024Restraints in the healthcare context is a controversial and complex topic. Used for providing care, the latter could lead to psychological implication for both patients...
Restraints in the healthcare context is a controversial and complex topic. Used for providing care, the latter could lead to psychological implication for both patients and caregivers. A thorough understanding of those psychological consequences can support the decision-making as well as considering the safety and emotional needs of the patient.
Topics: Humans; Restraint, Physical; Caregivers; Health Facilities
PubMed: 38296421
DOI: 10.1016/j.soin.2023.12.011 -
Archives of Sexual Behavior Jun 2024Bondage/discipline, Dominance/submission, and Sadism/Masochism (BDSM) have gained increased attention and discussion in recent years. This prevalence is accompanied by a... (Review)
Review
Bondage/discipline, Dominance/submission, and Sadism/Masochism (BDSM) have gained increased attention and discussion in recent years. This prevalence is accompanied by a shift in perceptions of BDSM, including the declassification of sadomasochism as a paraphilic disorder. Evolutionary psychology offers a unique perspective of why some individuals are interested in BDSM and why some prefer certain elements of BDSM over others (e.g., dominance versus submission). In this paper, we examine BDSM from an evolutionary standpoint, examining biopsychosocial factors that underlie the BDSM interests and practice. We articulate this perspective via an exploration of: proximate processes, such as the role of childhood experiences, sexual conditioning, and physiological factors; as well as ultimate explanations for power play and pain play dimensions of BDSM, highlighting the potential adaptive advantages of each. While BDSM may not be adaptive in itself, we examine the literature of sex differences in BDSM role preferences and argue that these preferences may stem from the extreme forms of behaviors which enhance reproductive success. In the realm of pain play, we explore the intersection of pain and pleasure from both physiological and psychological perspectives, highlighting the crucial role of psychological and play partner factors in modulating the experience of pain. Finally, we encourage future research in social sciences to utilize evolutionary frameworks to further explore the subject and help alleviate the mystification surrounding BDSM. This multifaceted exploration of BDSM provides valuable insights for clinicians, kink-identified individuals, and scholars seeking to understand the evolutionary perspectives of human sexual behavior and preferences.
Topics: Female; Humans; Male; Masochism; Paraphilic Disorders; Sadism; Sexual Behavior
PubMed: 38769280
DOI: 10.1007/s10508-024-02881-x -
Dyslexia (Chichester, England) Nov 2023Many studies have highlighted short-term memory (STM) impairment in dyslexic individuals. Several studies showed deficits for both item and serial order aspects of...
Many studies have highlighted short-term memory (STM) impairment in dyslexic individuals. Several studies showed deficits for both item and serial order aspects of verbal STM in dyslexic individuals. These group-based studies, however, do not inform us about the prevalence of these deficits and, importantly, their potential heterogeneity at the individual level. The present study examined both group-level and individual STM profiles in dyslexic and age-matched non-dyslexic children. While confirming previous group-based results of both item and serial order STM deficits, individual analyses indicated two distinct profiles: one profile was associated with verbal item STM and phonological impairment while another profile showed selective serial STM deficits in both verbal and visual domains. Our results highlight the need for practitioners to consider the heterogeneous nature of STM impairment in dyslexia and to adapt STM and reading treatment strategies accordingly.
Topics: Humans; Child; Memory, Short-Term; Dyslexia; Memory Disorders; Reading; Articulation Disorders; Phonetics
PubMed: 37519030
DOI: 10.1002/dys.1749