A Systematic Review of Cognition in Chiari I Malformation

Displacement of the cerebellar tonsils in Chiari type I malformation (CMI) can affect functions controlled by the cerebellum and brainstem. While playing an integral role in the control of movement, the cerebellum also has widespread cortical connections, influencing a range of cognitive process. A systematic literature review was conducted to examine the relationship between cognition and CMI, assessing evidence for general or domain-specific cognitive change. The search protocol examined the AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus databases. Articles meeting the following criteria were included in this review (i) examined children or adults with a clinically defined diagnosis of CMI, (ii) assessed cognitive function with a prospective examination, (iii) included at least one standardized instrument designed to measure general or specific domains of cognitive function, and (iv) were published in English in a peer-reviewed journal. Twelve articles were identified, including 783 cases aged 3 months to 64 years. General cognition, processing speed, and learning and memory appeared less affected, while language deficits appeared to diminish with age. Executive dysfunction was the most commonly reported cognitive impairment, while attention and working memory, and visuospatial and perceptual skills also appeared vulnerable. Numerous methodological limitations were identified that should be considered in interpreting the impact of CMI and planning future investigations. Overall, there is currently insufficient evidence to describe a valid and reliable profile of cognitive impairment in CMI. Further research is required to confirm these preliminary psychometric results and integrate them with pathophysiological models     

Working with Research Integrity—Guidance for Research Performing Organisations: The Bonn PRINTEGER Statement

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on the following key issues:

1. § 1.
   Providing information about research integrity
    
2. § 2.
   Providing education, training and mentoring
    
3. § 3.
   Strengthening a research integrity culture
    
4. § 4.
   Facilitating open dialogue
    
5. § 5.
   Wise incentive management
    
6. § 6.
   Implementing quality assurance procedures
    
7. § 7.
   Improving the work environment and work satisfaction
    
8. § 8.
   Increasing transparency of misconduct cases
    
9. § 9.
   Opening up research
    
10. § 10.
    Implementing safe and effective whistle-blowing channels
     
11. § 11.
    Protecting the alleged perpetrators
     
12. § 12.
    Establishing a research integrity committee and appointing an ombudsperson
     
13. § 13.
    Making explicit the applicable standards for research integrity
     

     

An exploration of cognitive appraisals following spinal cord injury

This study explored the cognitive appraisals that people make following spinal cord injury (SCI) about their situation and their ability to cope with it. Appraisals are thought to be important in determining individual responses to different events and have been shown to predict psychological well-being following injury. A cross-sectional interview study was used. Ten individuals who had recently started rehabilitation at the National Spinal Injuries Centre following an SCI were interviewed. Eight men and two women with a variety of injury level and completeness participated. Interviews were semi-structured and aimed to elicit participants' appraisals of their experiences and their ability to cope. Interviews were analysed qualitatively using interpretative phenomenological analysis. Four super-ordinate themes emerged from the interviews. These were making sense of a traumatic experience, impact of the SCI, coping and altered view of self and life. The interviews revealed that appraisals following SCI are complex and relate not only to the individual but also to their context, life stage, roles and relationships. The study adds to the theoretical understanding of the appraisal process following SCI. Ideas for further research are generated and clinical implications for improving patient experiences and developing appraisal-focused interventions are considered.