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Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management
Get PDFVisual hallucinations are common in older people and are especially associated with ophthalmological and neurological disorders, including dementia and Parkinson's disease. Uncertainties remain whether there is a single underlying mechanism for visual hallucinations or they have different disease-dependent causes. However, irrespective of mechanism, visual hallucinations are difficult to treat. The National Institute for Health Research (NIHR) funded a research programme to investigate visual hallucinations in the key and high burden areas of eye disease, dementia and Parkinson's disease, culminating in a workshop to develop a unified framework for their clinical management. Here we summarise the evidence base, current practice and consensus guidelines that emerged from the workshop. Irrespective of clinical condition, case ascertainment strategies are required to overcome reporting stigma. Once hallucinations are identified, physical, cognitive and ophthalmological health should be reviewed, with education and self-help techniques provided. Not all hallucinations require intervention but for those that are clinically significant, current evidence supports pharmacological modification of cholinergic, GABAergic, serotonergic or dopaminergic systems, or reduction of cortical excitability. A broad treatment perspective is needed, including carer support. Despite their frequency and clinical significance, there is a paucity of randomised, placebo-controlled clinical trial evidence where the primary outcome is an improvement in visual hallucinations. Key areas for future research include the development of valid and reliable assessment tools for use in mechanistic studies and clinical trials, transdiagnostic studies of shared and distinct mechanisms and when and how to treat visual hallucinations
Improved metabolic function and cognitive performance in middle‑aged adults following a single dose of wild blueberry
No full textPurposeResearch has demonstrated cognitive benefits following acute polyphenol-rich berry consumption in children and young adults. Berry intake also has been associated with metabolic benefits. No study has yet examined cognitive performance in middle-aged adults. We investigated the relationships among cognitive and metabolic outcomes in middle-aged adults following wild blueberry (WBB) consumption.MethodsThirty-five individuals aged 40–65 years participated in a randomized, double blind, cross-over study. Participants consumed a breakfast meal and 1-cup equivalent WBB drink or matched placebo beverage on two occasions. Participants completed cognitive tasks and had blood drawn before and at regular intervals for 8 h after each meal/treatment. Changes in episodic memory and executive function (EF) were assessed alongside plasma levels of glucose, insulin, and triglyceride.ResultsAnalysis of the memory-related Auditory Verbal Learning Task (AVLT) word recognition measure revealed a decrease in performance over the test day after placebo intake, whereas performance after WBB was maintained. For the AVLT word rejection measure, participants identified more foils following WBB in comparison to placebo. Benefits were also observed for EF on the Go/No-Go task with fewer errors following WBB intake on cognitively demanding invalid No-Go trials in comparison to placebo. Furthermore, in comparison to placebo, response times were faster for the Go/No-Go task, specifically at 4 h and 8 h following WBB treatment. We also observed reduced post-meal glucose and insulin, but not triglyceride, concentrations in comparison to placebo over the first 2 h following ingestion. Though the addition of Age, BMI, glucose and insulin as covariates to the analysis reduced the significant effect of beverage for AVLT word rejection, metabolic outcomes did not interact with treatment to predict cognitive performance with the exception of one isolated trend.ConclusionsThis study indicated acute cognitive benefits of WBB intake in cognitively healthy middle-aged individuals, particularly in the context of demanding tasks and cognitive fatigue. WBB improved glucose and insulin responses to a meal. Further research is required to elucidate the underlying mechanism by which WBB improves cognitive function
Queenship at the Renaissance Courts of Britain: Catherine of Aragon and Margaret Tudor, 1503–1533. Michelle L. Beer. Studies in History. Rochester, NY: Boydell Press, 2018. xvi + 186 pp. $90.
No full textImproving growth of infants with congenital heart disease using a consensus-based nutritional pathway
No full textObjective: Infants with congenital heart disease (CHD) often experience growth failure prior to surgery, which is associated with increased paediatric-intensive-care unit length of stay (PICU-LOS) and post-operative complications. This study assessed the impact of a pre-operative, consensus-based nutritional pathway (including support from a multi-disciplinary team) on growth and clinical outcome. Design: Single-centre prospective pilot study. Setting: Tertiary paediatric cardiology surgical centre. Patients: Infants with CHD. Intervention: Infants with CHD were followed for up to 4-months-of-age before cardiac surgery and then to 12-months-of-age following the implementation of the consensus-based nutritional-pathway (Intervention group: November 2017–August 2018), with outcomes compared to a historic control group. The nutrition pathway involved a dietitian contacting parents of infants with the highest risk of growth failure weekly; reviewing weight gain and providing feeding support. Main outcome measure: Growth (weight-for-age, WAZ, and height-for-age-z-score, HAZ) at 4 and 12 months-of-age. Results: 44 infants in the intervention group were compared to 38 in the control group. Median (inter quartile range) change in WAZ from birth to 4 months-of-age (−0.9 (−1.5, 0.7)) and from birth to 12 months-of-age (−0.09 (−1.3, 1.1)) in the intervention group compared to the control group (−1.5 (−2.0, −0.4) (p = 0.04)) at 4 months-of age and at 12 months-of-age (−0.4 (1.9, 0.2) (p = 0.03)). HAZ at 4 months-of-age was −0.7 (−1.4, −0.1) vs. −1.0 (−1.9, −0.3) (p = 0.6) in the intervention and control groups respectively, and at 12 months-of-age HAZ was −0.7 (−1.9, −0.07) in the intervention group vs.-1.6 (−2.6, −0.4) in the control group (p = 0.04). Duration of PICU-LOS was 8.2 ± 11.6 days intervention vs. 18.3 ± 24.0 days control (p = 0.006). Conclusion: Overall weight was well maintained and growth improved in infants who followed the pre-operative nutritional-pathway. The duration of PICU-LOS was significantly lower in the intervention group, which may be due to improved nutritional status, although this requires further investigation
Afterword: histories of women’s higher education, time and temporalities
Get PDFThe Afterword focuses on the question of time and the temporalities, rhythms and tempos that thread through the special issue and and shed light on change, contingency and continuity as women sought to become and to be academics and to belong in the academy. I deploy a notion of multiple temporalities in which time comprises both a singular whole and specific fragments that flow with varying speeds and intensities to constitute what Suzanne Langer terms the volume of time. The discussion attends to two aspects of temporality that Elizabeth Grosz argues are important for understanding the production of conceivable futures: (i) inventing new ways of addressing and opening up new types of subjectivity and new relations between subjects and objects; and (ii) understanding and addressing the force of the past and the present in attempting to pre-apprehend and control the new
Out of Love for any thing? A response to Vlieghe and Zamojski on some pedagogical problems with an object-oriented “educational love”
Get PDFIn this paper we consider some of the problems inherent in the attempt to define and circumscribe an exclusively ‘educational love’, as presented by Joris Vlieghe and Piotr Zamojski in a recent paper for this journal. In seeking to move beyond the confusing interpersonal relations involved in student‐centred discourses on teaching, the authors aim to articulate an ‘educational love’ that is more oriented towards subject matter than the student subject. In the process, the concept of love itself becomes increasingly abstract and open to interpretation. Further, the attempt to reconcile these elements in an uncomplicated ‘love for the object’, following the example of Alain Badiou's St Paul, constitutes an injustice to the other subjects—the students—involved in the teaching situation. We consider the ways in which such abstractions might sit with student teachers, to demonstrate how and why the intersubjective dimension—with some of the possible emotive messiness that is implied therein—must not fade from view, if we are to avoid conceiving of education as something that can be purified of individual interest, motivation and desire
Examining Attitudes Toward Homosexuality Among Young, Athletic BME Men in the UK
Get PDFThis article examines the influence of ethnicity on sporting men’s attitudes towards homosexuality. We employed Herek’s Attitudes Toward Lesbians and Gay Men, Revised Version (ATLG-R) scale to collect data with British undergraduate sports students, as well as interview data with the players of an English Premier League (EPL) football academy, to show that black and minority ethnic (BME) men espouse more conservative attitudes toward homosexuality than their White counterparts. This, we theorize, is attributable to multiple factors, such as socialization into a fundamentalist version of Christianity by family, and the influence of immigration from countries where attitudes toward homosexuality remain more conservative in comparison to the UK. In documenting these findings, this research is consistent with other studies which document higher rates of intolerance among groups of BME men
‘Women Power’ in Renewable Energy:The Role of Nested Institutions in Vocational Training of Solar Energy Entrepreneurs in India
No full textConventional myths such as the poor are misfit to manage smart technologies or women-led rural enterprises generally fall through faster than men have since been broken as evidenced by various empirical studies. In the context of solar energy enterprises managed by women particularly in rural or peri-urban areas are much understudied, however, the impact of such women-led entrepreneurial energy-based start-ups has significant personal, social and community level consequential impact. A range of institutional arrangements that support these entrepreneurs starting from identifying, training to building and sustaining of such start-ups are highlighted in this paper. Not only do women collectively run these enterprises but they also help incubate others in their business model. The context of solar energy in rural communities has become all the more important for both a practitioner as well as a theoretical understanding of women entrepreneurship. This research deploys a qualitative method approach that uses both primary and secondary data; this is then put through a lens of systematic thematic analysis for a deeper discussion. The work concludes with an objective to contribute to policy discussions as well as build an empirical knowledge of how women-led solar technology-based enterprises are built, managed, sustained and scaled in rural areas.<br/
