Postural control,falls and Parkinson’s disease: Are fallers more asymmetric than non-fallers?

Postural control asymmetry is an important aspect of Parkinson’s disease (PD) that may be associated with falls. The aim of this study was to compare the postural control asymmetry during postural tasks between fallers and non-fallers in people with PD and neurological healthy age-matched controls (CG). Individuals with idiopathic PD (n = 24) and CG (n = 24) were sub-divided into groups of fallers and non-fallers based on their fall history over the past year. Participants performed blocks of three 30-s trials of quiet standing with feet in a side-by-side and semi-tandem stance position. The center of pressure parameters for each limb were measured and used to calculate the symmetry index. Fallers compared to non-fallers had decreased asymmetry of vertical force in the side-by-side condition. During the tandem-front leg condition, PD non-fallers increased asymmetry of the medial-lateral velocity of sway compared to CG non-fallers. In addition, for the tandem–back leg condition, PD non-fallers increased asymmetry of total displacement and medial-lateral root mean square and mean velocity of sway compared to PD fallers. The results of the study did not support the hypothesis that PD fallers are more asymmetric than PD non-fallers. On the contrary, our results indicated that PD non-fallers had higher postural control asymmetry, especially during the more challenging (semi-tandem standing) postural task.     

Positive and negative affect and well-being in cardiac patients and their spouses: the mediating role of illness representations

Objective: The aim of this study was to examine whether illness representations of control and consequences mediate the relation of cardiac patients’ affect to well-being. A further aim was to examine this indirect relationship at a dyadic level (i.e. patient and spouse). Design and main outcome measures: One hundred and four patients with a cardiovascular disease and their spouses participated in the study. Positive and negative affect was assessed at baseline; illness representations were assessed 2 months later, and physical and psychological well-being 4 months later. Results: Illness representations generally mediated the impact of patients’ and spouses’ affect on well-being, while several actor and partner effects were found. However, it was only positive affect that was indirectly related to well-being, while the representations of personal and treatment control chiefly acted as mediators. The effects were stronger for patients than spouses, as well as for physical well-being. Conclusion: The results underline the strong connection between illness-related self-regulation and the overall person/environment interaction as depicted by affect. They also indicate the need to integrate theories on adaptation to illness, with models describing adaptation of couples to stressful conditions, and specific theories about the role of emotion in adaptation to illness.     

Examining multiple feature evaluation and classification methods for improving the diagnosis of Parkinson’s disease

An accurate diagnosis of Parkinson’s disease by specialists involves many neurological, psychological and physical examinations. The specialists investigate a number of symptoms and signs when examining the nervous system conditions of a person. The diagnosis involves reviewing the medical history and genetic factor of the person. The recent diagnosis methodology to Parkinson’s disease relies on voice disorders analysis. This methodology entails extracting feature sets of a recorded person’s voice then utilizing a machine learning technique to identify the healthy and Parkinson’s cases from the voice. This paper attempts to improve the diagnoses of Parkinson’s disease by testing multiple feature evaluation and classification machine learning methods based on the voice disorders analysis. The aim of this paper is to find the optimal solution to the problem by (i) proposing a new Multiple Feature Evaluation Approach (MFEA) of a multi-agent system (ii) implementing five independent classification schemas which are Decision Tree, Naïve Bayes, Neural Network, Random Forests, and Support Vector Machine on the Parkinson’s diagnosis before and after applying the MFEA, and (iii) evaluating the diagnosis accuracy of the results. The methodology of the tests encompasses 10-fold cross-validation to evaluate the learning of methods and track variation in their performance. The test results show that the MFEA of the multi-agent system finds the best set of features and improves the performance of the classifiers. The average rate of improvement in the diagnostic accuracy of the classifiers are Decision Tree 10.51%, Naïve Bayes 15.22%, Neural Network 9.19%, Random Forests 12.75%, and Support Vector Machine 9.13%. These results show that the MFEA makes a significant improvement to the classifiers’ diagnosis results.     

‘A necessary evil’: associations with taking medication and their relationship with medication adherence

Cognitive factors, like beliefs, have been studied extensively as determinants of medication adherence, while affect associated with taking medicines has been studied much less. In the present study (N = 525), we investigated affect by assessing patients’ first associations with taking their medicines. Results showed that these associations were related to self-reported medication adherence: Patients who associated taking medicines with negative affect were the least adherent, while those associating taking medicines with the need to take medicines were the most adherent. Our results support the idea that affect should be considered an important determinant of adherence.     

Everyday worry in adolescents with and without chronic pain: a diary study

Young people report frequent worry, but we know little about the extent, character, or consequence of worry in adolescence, or individual differences associated with worry. Adolescents with chronic pain are one population that are known to have high levels of anxiety, which is associated with higher levels of disability and depression, impairing function. In this study we report a diary study: adolescents (N = 60; aged 16–18) recorded their worry over seven days. Our first aim was to describe the characteristics of adolescent worry and its consequences in a community sample. Our second aim was to compare the experience of girls to boys, and to compare the experience of those with and without chronic pain. Adolescents reported characteristics of each worry they had throughout the week, including content, frequency, strength, interference, emotion, and the strength of emotion associated with worry content. Adolescents reported the consequence for each content and the strength of the consequence. Worry content and consequences were categorised into four categories; health, relationship, personal competence, and other. Adolescents reported 675 unique episodes of worry over the seven-day period that were predominantly about personal competence. The strength of worry content was (M = 6.61, SD = 1.27) and the strength associated with the worry consequence was (M = 5.59, SD = 1.41). Worries were not reported as highly interfering (M = 4.14, SD = 1.61). Contrary to predictions, there were no differences in worry characteristics between adolescents with and without chronic pain. To conclude, worry is a frequent occurrence in older adolescents and the characteristics of worry are discussed. Adolescents worry mostly about personal competence. Adolescents with and without chronic pain reported similar worry characteristics.     

Influences on help-seeking pathways among people with chronic illness and disease in a rural South African community

The study sought to explore influences on help-seeking pathways followed by patients with chronic illness and disease (CID) in a rural community of the Limpopo Province, South Africa. The sample consisted of ten people with CID (female = 6; age range 42 to 96 years; sugar diabetes = 50%, and high blood pressure = 30%). The participants responded to semi-structured interviews pertaining to the influences on their choices for help-seeking pathways. The data were analysed applying Interpretative Phenomenological Analysis (IPA). Prevailing influences on help-seeking pathways with CID included presumed cause of the illness, diagnosis agent and family process, nature of preferred treatment modality, and openness to alternative and complementary medicine.     

Executive dysfunction affects word list recall performance: Evidence from amyotrophic lateral sclerosis and other neurodegenerative diseases

The Rey Auditory Verbal Learning Test (RAVLT) is widely used in clinical practice to evaluate verbal episodic memory. While there is evidence that RAVLT performance can be influenced by executive dysfunction, the way executive disorders affect the serial position curve (SPC) has not been yet explored. To this aim, we analysed immediate and delayed recall performances of 13 non‐demented amyotrophic lateral sclerosis (ALS) patients with a specific mild executive dysfunction (ALSci) and compared their performances to those of 48 healthy controls (HC) and 13 cognitively normal patients with ALS. Moreover, to control for the impact of a severe dysexecutive syndrome and a genuine episodic memory deficit on the SPC, we enrolled 15 patients with a diagnosis of behavioural variant of frontotemporal dementia (bvFTD) and 18 patients with probable Alzheimer's disease (AD). Results documented that, compared to cognitively normal subjects, ALSci patients had a selective mid‐list impairment for immediate recall scores. The bvFTD group obtained low performances with a selectively increased forgetting rate for terminal items, whereas the AD group showed a disproportionately large memory loss on the primary and middle part of the SPC for immediate recall scores and were severely impaired in the delayed recall trial. These results suggested that subtle executive dysfunctions might influence the recall of mid‐list items, possibly reflecting deficiency in control strategies at retrieval of word lists, whereas severer dysexecutive syndrome might also affect the recall of terminal items possibly due to attention deficit or retroactive interference.     

Word recognition in Alzheimer's disease: Effects of semantic degeneration

Impairments of word recognition in Alzheimer's disease (AD) have been less widely investigated than impairments affecting word retrieval and production. In particular, we know little about what makes individual words easier or harder for patients with AD to recognize. We used a lexical selection task in which participants were shown sets of four items, each set consisting of one word and three non‐words. The task was simply to point to the word on each trial. Forty patients with mild‐to‐moderate AD were significantly impaired on this task relative to matched controls who made very few errors. The number of patients with AD able to recognize each word correctly was predicted by the frequency, age of acquisition, and imageability of the words, but not by their length or number of orthographic neighbours. Patient Mini‐Mental State Examination and phonological fluency scores also predicted the number of words recognized. We propose that progressive degradation of central semantic representations in AD differentially affects the ability to recognize low‐imageability, low‐frequency, late‐acquired words, with the same factors affecting word recognition as affecting word retrieval.