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Linking cognitive and behavioral reserve: Evidence from the CAN-PROTECT study
Get PDFSupporting Information is available online at: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.12497#support-information-section .INTRODUCTION
Changes to the brain due to Alzheimer's disease and other age-related neuropathologies may present with cognitive and behavioral symptoms, even during preclinical and prodromal stages. While cognitive reserve is known to mitigate cognitive decline in the preclinical stages of Alzheimer's disease, links between cognitive reserve and behavioral symptoms remain unclear. This study investigates the relationship between cognitive reserve and mild behavioral impairment (MBI), a neurodegenerative behavioral prodrome.
METHODS
We analyzed cross-sectional data from 1204 participants in the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN-PROTECT) study. A cognitive reserve score (CRS) was generated based on education, occupation, and personal cognitive reserve proxies. MBI presence (MBI+) and MBI global and domain symptom severity were evaluated using the self-reported MBI Checklist. Initial analyses examined the convergent validity of the CRS through associations with objective neuropsychological test performance and self-reported cognitive symptoms (Everyday Cognition [ECog-II] scale). Models were also fitted to assess MBI status and severity as functions of the CRS.
RESULTS
Higher CRS was associated with better neuropsychological test scores, lower odds of subjective cognitive decline (OR = 0.86, 95% CI: [0.76, 0.98], p = .03), and lower ECog-II total score. Likewise, higher CRS was associated with lower odds of MBI+ (OR = 0.81, 95% CI: [0.71, 0.93], p = .003), and lower MBI symptom severity globally, and in impulse dyscontrol and social inappropriateness domains.
DISCUSSION
We provide preliminary evidence that engagement in activities known to preserve cognitive function in aging and disease may also preserve behavioral function. Future research should disentangle possible pathways through which cognitive reserve may preserve both cognition and behavior, explore common etiologies for these symptoms, and observe outcomes longitudinally to better understand these relationships.
Highlights
* Education, occupation, and personal activities are cognitive reserve proxies.
* Cognitive reserve is linked to lower subjective cognitive decline in older persons.
* Cognitive reserve is linked to lower mild behavioral impairment odds and severity.CAN-PROTECT was supported by Gordie Howe CARES and the Evans Family fund via the Hotchkiss Brain Institute. DXG is supported by the Hotchkiss Brain Institute, Killam Trust, and Alzheimer Society of Canada. MEM is funded by a Dementia Australia Research Foundation—Dementia Centre for Research Collaboration Mid-Career Research Fellowship. GBP was supported by the Canadian Institutes for Health Research (FDN-143290) and the Campus Alberta Innovates Program Chair in Healthy Brain Aging. ZI is supported by the UK National Institute for Health and Care Research Exeter Biomedical Research Centre
Generic and site-specific social life cycle assessment of municipal wastewater treatment systems in Spain: challenges and limitations of the method when applied to resource recovery systems
Get PDFData availability:
All data gathered and analyzed during this study are available in the Supplementary Information. Online Resource 2 will be made available upon reasonable request.Supplementary Information is available online at: https://link.springer.com/article/10.1007/s11367-024-02370-2#Sec31 .Purpose:
This work aims to provide insights on the application of social life cycle assessment (S-LCA) in evaluating the social impacts associated with municipal wastewater treatment (WWT). The study assesses the social risks and social performance of two municipal WWT systems in Catalonia, Spain: a conventional wastewater treatment plant (WWTP) (Reference System) and a novel system that recovers water and other valuable resources (Novel System).
Methods:
S-LCA was conducted at Generic and Site-Specific levels using 1 m3 of wastewater treatment as the functional unit (FU). The Generic assessment was conducted via the Product Social Impact Life Cycle Assessment (PSILCA) database, while the Site-Specific assessment employed the Subcategory Assessment Method (SAM) with four-level reference scales to assess the social performance of the WWTP operator and its first-tier suppliers. Furthermore, activity variables were calculated based on organizations’ shares in the total costs per FU, and the Novel System’s multifunctionality was solved through economic allocation. Results were aggregated by (i) assigning equal weights to organizations and (ii) factoring in organizations’ weights and the allocation factor, leading to results per FU.
Results and discussion:
The Generic analysis results indicated that the Novel System entailed fewer social risks than the Reference System. Most social risks in both systems occurred in the subcategories “Access to material resources,” “Fair salary,” “Freedom of association and collective bargaining,” “Contribution to economic development,” and “Corruption.” In the Site-Specific assessment, the Novel System presented better social performance than the Reference System per 1 m3 of wastewater treatment. The latter’s performance per FU did not meet the basic requirement in four out of eleven subcategories, mainly due to the performance and weight of a chemical supplier. Allocation greatly benefitted the Novel System’s results per FU compared to the results obtained when equal weights were applied.
Conclusions:
Activity variables were used to connect organizations’ conduct with particular WWT systems, and multifunctionality was solved. This approach allowed for obtaining results per FU at both assessment levels. However, social performance was also evaluated by calculating the average social performance of each system without considering activity variables and the FU, leading to different results. The social performance of the Novel System per FU was satisfactory across all subcategories but required improvement in four subcategories based on the average results. Given the limitations of using activity variables and allocation in S-LCA, further research is necessary to appropriately evaluate and compare the social effects of novel resource recovery systems.This work has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No. 869474
Medical school ranking and provider outpatient Medicare Part D claims for antibiotics among older patients in the USA
Get PDFSupplementary data are available online at: https://academic.oup.com/jacamr/article/6/6/dlae191/7907358#supplementary-data .Background:
Our study aimed to assess whether there was a relationship between graduating from higher-ranked medical schools and the rate of prescribing antibiotics among Medicare Part D providers in the USA.
Methods:
The study obtained data from the Medicare Part D Prescribers (FY2013-2021) and the Doctor and Clinicians National repositories. A regression model was fitted to assess the relationship between provider medical school ranking and the rate of antibiotic days supplied per 100 beneficiaries at the provider level.
Results:
A total of 197 540 providers were included. No association was found between the medical school ranking and the rate of antibiotics days supplied per 100 beneficiaries. Instead, the type of provider is associated with the prescription rates. Hospitalists and Emergency Medicine providers had fewer days supplied per 100 beneficiaries than Family Medicine providers. In contrast, students, more experienced providers (>20 years since medical school graduation) and females had more days supplied per 100 beneficiaries.
Conclusion:
Our study highlights the need for robust outpatient stewardship interventions and incorporating an outcome-based approach to antibiotic stewardship curricula in medical and mid-level provider schools.None
The Association between COVID-19 Status and Economic Costs in the Early Stages of the COVID-19 Pandemic: Evidence from a UK Symptom Surveillance Digital Survey
Get PDFData Availability Statement:
These data were obtained from EMIS Health’s COVID-19 Symptom Surveillance tool. Accessing these data requires permission from EMIS Health as it is not publicly available.Code Availability:
The Stata code used for this study is available upon request.Introduction:
In the absence of a vaccination programme, the coronavirus disease 2019 (COVID-19) pandemic had substantial impacts on population health and wellbeing and health care services. We explored the association between COVID-19 status, sociodemographic, socioeconomic and clinical factors and economic costs during the second wave of the COVID-19 pandemic.
Data:
The study used patient-reported digital survey and symptom surveillance data collected between July and December 2020, in collaboration with a primary care computerised medical record system supplier, EMIS Health, in the UK. The study included 11,534 participants.
Methods:
Generalised linear models (GLM) and two-part regression models were used to estimate factors associated with economic costs (£sterling, 2022 prices) estimated from two perspectives: (i) a UK National Health Service (NHS) and personal social services (PSS) perspective and (ii) a societal perspective.
Results:
Experience of the onset of COVID-19 symptoms started more than 3 months ago was associated with significantly higher NHS and PSS costs (GLM: £319.8, two-part: £171.7) (p < 0.001) and societal costs (GLM: £776.9, two-part: £675.6) (p < 0.001) in both models. A positive test result within the previous 14 days was associated with significantly higher NHS and PSS costs (two-part: £389.1) (p < 0.05) and societal costs (GLM: £470.7, two-part: £439.2) (p < 0.01). Age between 31 and 55 years was associated with significantly higher societal costs than age between 16 and 30 years.
Conclusion:
This study identifies and quantifies factors associated with the economic costs incurred during the second wave of the COVID-19 pandemic in the UK. The results of our study can inform cross-country comparisons and other cost comparisons.This study was supported by a grant from the National Institute of Health Research (NIHR) School of Primary Care Research (SPCR) round 5-IV (Grant reference no: 620). Prof. Petrou receives support as a NIHR Senior Investigator (NF-SI-0616-10103) and from the NIHR Applied Research Collaboration Oxford and Thames Valley at the Oxford Health NHS Foundation Trust. Nicodemo receives support from the European Union. The PCR-4-ALL project has received funding under the Horizon Europe research and innovation programme (Grant agreement no. 101095606) and from Thames Valley at the Oxford Health NHS Foundation Trust
Making Tax Smart: Feasibility of Distributed Ledger Technology for Building Tax Compliance Functionality to Central Bank Digital Currency
Get PDFData Availability Statement:
The scalability study dataset is available upon request by the authors.The latest advancements in distributed ledger technology (DLT) and payment architectures such as the UK’s New Payments Architecture present opportunities for leveraging the hidden informational value and intelligence within payments. In this paper, we present Smart Money, an infrastructure capability for a central bank digital currency (CBDC) which enables real-time value-added tax split payments, oversight, controlled access, and smart policy implementation. This capability is implemented as a prototype called Making Tax Smart (MTS), which utilises the open-source R3 Corda DLT framework. The results presented herein confirm that it is feasible to build an MTS capability which is scalable and co-exists with the current payment systems. Smart Money CBDC has the potential to mobilise payments data, transforming the role of money from a blunt instrument to a government policy sensor and actuator without disrupting the existing money system. DLT, smart contracts, and programmable money have a crucial role to play with benefits for government departments, the economy, and society as a whole.This work was funded by the UK’s Engineering and Physical Sciences Research Council [Grant number: EP/P032001/1]. Additional funding support was provided by EPSRC’s Impact Acceleration Account (IAA)
Relational responsibilisation and Equality, Diversity and Inclusion for the 21st Century: The case for reframing equality regulation
Get PDFThis article critiques equality regulation within neoliberal policy regimes and suggests an alternative. We argue that, globally, neoliberal regimes exacerbate social divisions by individualising responsibilities for addressing inequalities. Consequentially, a new policy direction for equality regulation is required. Using the UK economy as an exemplar, we make the case for relational responsibilisation, which involves raising awareness of workplace inequalities on an international basis; attributing responsibility for inequalities onto specific socioeconomic causes and institutions; and systematically developing policies and practices that extend accountability for and ameliorate the negative consequences of workplace inequalities. Theoretically, Bourdieusian social critique and realist sociological imagination are used to conceive responsibilisation in relational terms and to imagine a policy agenda that might make societies more responsible for tackling the forms of inequality they produce. Our overall argument is for the creation of a new equality, diversity and inclusion-aware form of social democracy
Inhuman Music and the Monstrous-Feminine
Get PDFIn video games, female characters have traditionally been meant to be seen and not heard, mirroring the history of women under patriarchy. Those female characters who reject their secondary and primarily visual role often become monstrous, and like Barbara Creed argues, this monstrosity is itself profoundly gendered. This paper focuses on two such female characters whose monstrosity, and also revolt, are indisputably feminine, as well as musical. Both the 2007 classic Portal and the 2017 cult hit Doki Doki Literature Club! feature central antagonists who are sentient artificial female monsters who both start off as the players’ guides through their respective games, their roles similar to those of gendered digital assistants in everyday life. While GLaDOS is voiced throughout Portal, Monika remains silent until the final credits of DDLC!, but the comparison between the two is never as evident as when they sing. Both games end with songs performed by these antagonists, after they have technically been defeated. This paper draws on feminist literary and film theory, as well as musicology and ludomusicology, to deliver both a comparative analysis of the two songs, and a broader formulation of the sonic representation of the monstrous-feminine in video games
Conceptualising aesthetic power in the digitally-mediated city
Get PDFAesthetics, generally understood as an intensified emphasis on the sensorial look and feel of urban environments, has become an important perspective through which urban scholarship is examining the economic, social, political and cultural processes of urban regeneration projects across the globe. Much of this aestheticising work is now mediated by many kinds of digital technologies. The entanglement of digital technologies with the sensorial feel of urban redevelopments manifests in many different ways in different urban locations; it is deeply reshaping the embodied experiencing of urban life; and it enacts specific power relations. It is the focus of this paper. Drawing on the work of Lefebvre and Jansson, this article develops the notion of ‘textured’ space in order to offer an analytic vocabulary that can describe distinctive configurations of urban experience at the intersection of specific urban environments, bodily sensations, and digital devices. Analysing embodied sensory politics is important because various aspects of bodily sensoria are central to human experiences of, and relations between, both self and other. Hence bodies are enrolled differentially into different expressions of these new urban aesthetics: while some are seduced, others are made invisible or repelled, or are ambivalently entangled in digitally mediated aesthetic atmospheres. The article offers some examples of the power relations inherent in the textured aesthetics of three of the most significant, and interrelated, processes of contemporary, digitally mediated urban change: efforts to be seen as a ‘world-class city’ and to facilitate gentrification and tourism.UK Research and Innovation, Economic and Social Research Council Grant Nos: ES/I038128/1 and ES/N014421/1
Recognition of emotions in German laughter across cultures
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All data generated in this study are included in the supplementary online materials of this published article.Laughter conveys a wide range of information relevant for social interaction. In previous research we have shown that laughter can convey information about the sender’s emotional state, however other research did not find such an effect. This paper aims to replicate our previous study using participant samples of diverse cultural backgrounds. 161 participants from Poland, the UK, India, Hong Kong, and other countries classified 121 spontaneously emitted German laughter sounds according to the laughter type, i.e., joyful, schadenfreude, and tickling laughter. Results showed that all participant groups classified the laughter sounds above chance level, and that there is a slight ingroup advantage for Western listeners. This suggests that classification of laughter according to the sender’s emotional state is possible across different cultures, and that there might be a small advantage for classifying laughter of close cultural proximity
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