Cognitive deficits in major depression

Major depression is a mood disorder that is often accompanied by the impairment of cognitive functions. Although suggestive, the large range of existing neuropsychological, neuropsychiatric, and, lately, neuroimaging investigations have not yet given a consistent picture of the psychological and biological disturbances involved in this psychiatric disorder. The present study of the cognitive functions in depression was part of an extensive investigation, including neuropsychological testing, psychiatric examination, and neuroimaging. A representative sample of 40 severely depressed hospitalized patients and a group of 49 closely matched control subjects were tested with an extensive neuropsychological test battery. Results, corrected for various confounding factors, confirmed the current notion that depressed patients suffer from wide-spread cognitive impairments. The group analysis did not allow any hypothesis on a possible pattern to the dysfunctions, but heterogeneity in the test performances calls for further analysis of the data in patient subgroups in relation to neuroimaging results.     

Neuropsychological Functioning in Danish Gulf War Veterans

Research has shown that Danish Gulf War (GW) veterans reported a significantly higher prevalence of neuropsychological symptoms than did military controls 6 years after GW deployment. To explore the possible central nervous system determinants of these complaints, neuropsychological tests were administered to stratified, random samples of the Danish cohort of 916 GW-deployed veterans and 236 non–GW-deployed participants. Multivariate analyses of covariance were used to analyze neuropsychological test outcomes among the 215 male participants (143 GW-deployed and 72 non–GW-deployed soldiers). No significant differences in neuropsychological test performances were found between the GW-deployed and non–GW-deployed groups. Troops deployed to the GW reported significantly more mood complaints (i.e., fatigue and confusion) than their nondeployed counterparts. Because they were assigned to the Gulf region during the postcombat phase, Danish GW soldiers differed from the majority of American GW-deployed troops in military assignments and possible toxicant exposures.     

Vowel perception: A neuroradiological localization of the perception of vowels in the human cortex

Whether the perception of vowels takes place in the right or left cerebral hemisphere, or is dependent on bilateral cortical processes, is of importance in our treatment of patients with language deficiencies. To investigate this problem a phonetic test with a series of vowellike stimuli was administered to 68 right-handed adult patients with cerebral lesions, mainly of vascular origin. The results were compared to the results in a control group of 19 speech therapists. Second, a neuroradiologic method was developed in order to visualize the anatomic site of Wernicke's area in the left hemisphere on CT scans. This method formed the basis for an evaluation of the extent and localization of the patients' lesions in Wernicke's area. Of 46 patients with lesions in the left hemisphere, 19 had no perceptual disturbances and 27 had severe perceptual disturbances with lesions predominantly located in Wernicke's area. Twenty-two patients with lesions in the corresponding area in the right hemisphere showed no perceptual disturbances. The results of this investigation appear to indicate that the perception of vowels in right-handed persons is unilaterally located in Wernicke's area in the left hemisphere.     

A Semantic Interpretation of Husserl's EpochÉ

This paper presents an interpretation of Husserl's phenomenological epoché or bracketing ( Einklammerung), which makes it possible to compare his position with philosophical programs developed within the framework of modern analytical philosophy. At the same time it asks in what sense Husserl's phenomenology is a form of idealism or exceeds the traditional discussion of idealism versus realism.     

Navigating the Relational Psychic Economy of Disability: The Case of M

This paper presents a theoretically-informed psychosocial analysis of the case of M, a physically disabled man from South Africa. We use M’s account as a platform from which to consider projection, melancholic suspension and grief, as these are played out in the negotiation of dependency in relationships for disabled people. Making use of a case study methodology, we examine the various strategies through which M manages those disability stereotypes which are ascribed to him, creating a picture of how identity is negotiated in the face of interpersonal dependency as well as disablist prejudice. A central proposition is that, for M, upholding relationships which bring much-needed assistance means caring for the emotional lives of his carers, in a manner which leaves him more vulnerable to internalizing identity insults, and less able to resist his own oppression. Employing a psychoanalytic frame, we suggest that the “melancholic suspension” which some disabled people may be subject to, may lead to the necessity to “take on” certain projections, in the process of accessing much-needed care. As shall be seen, M maneuvers creatively through this relational realm by engaging in trade-offs between positive identity and physical need, employing strategies which include self-deprecation, the performance of mastery, playing with gender, and humor. With these and other techniques, he navigates the relational and psychic economy of his dependency.     

Test–retest reliability of the soleus H-reflex excitability measured during human walking

The purpose of the study was to investigate with what accuracy the soleus H-reflex modulation and excitability could be measured during human walking on two occasions separated by days. The maximal M-wave (Mmax) was measured at rest in the standing position. During treadmill walking every stimulus elicited an M-wave of 25 ± 10% of Mmax in the soleus muscle and a supra-maximal stimulus elicited a maximal M-wave 60 ms after the first stimulus. Both Mmax during rest and during walking were later used for normalization. When normalized to resting Mmax, the peak reflex amplitude during walking was 5% lower on Day 2 than on Day 1 (p = .32). However, when the peak H-reflex was normalized to Mmax in every sweep, Day 2 showed a significant 15% lower amplitude (p = .037). The same pattern was found for the mean H-reflex. Spearman’s Rho was .92 when normalized to resting Mmax but .88 when normalized to Mmax in every sweep. The Pearson product was used to identify one participant at a time on Day 1 among all seven participants on Day 2. For both normalization procedures 5 of 7 participants were identified by this test. Since 5 of 7 participants were recognized between days, it must be recommended to use 10-15 participants for training or intervention studies as far as the H-reflex pattern of modulation during movement is concerned.     

Challenges to providing a support group for HIV-positive prisoners in South Africa

In prison populations around the world, the prevalence of HIV is often higher than that of the general population. The prison population is at high risk for HIV infection, particularly through the sharing of contaminated needles and high-risk sexual activity. Counselling is regarded as a key element in the prevention and treatment of HIV infection. Support groups provide essential supportive counselling for HIV-positive individuals struggling to cope. This paper looks at the challenges to providing a support group for HIV-positive prisoners. The author's experience of attempting to provide a support group highlights two key challenges: organisational issues which lead to disruptions for the group; and challenges to ensuring confidentiality, a core ethical principle in HIV counselling.     

“Communities isn't just about trees and shops”: students from two South African universities engage in dialogue about ‘community’ and ‘community work’

The question of what constitutes ‘a community’ or even ‘the community’ takes on an extra salience in a divided society such as South Africa where the entire environment remains imprinted with the legacy of enforced segregation along racial lines. Higher education institutions need to prepare emerging health and social service students for the world of practice in a context of diversity, continuing segregation and marked inequality. As one step to helping students deal with working in a divided society, academic departments from two different South African universities have been involved in a collaborative teaching and research project. Fourth year psychology and social work students from the two universities took part in a collaborative, practical course which formed part of their curricula. In this course, students were given the opportunity to engage with the notion of ‘community’ and ‘community work’ with each other. The students came from diverse racial, class and political backgrounds, and by engaging with one another as they did, had the opportunity to ‘visit’ worlds they have rarely had access to. While this course was able to achieve a broadening awareness among students from different backgrounds about the notion of community, it will take both more engagement with courses of this kind, and a continuing history of change in South Africa, for students to feel more comfortable in transcending both physical and psychological boundaries. Copyright © 2007 John Wiley & Sons, Ltd.     

Public health issues related to infection in pregnancy and cerebral palsy

Cerebral palsy is the most common neuromotor developmental disability of childhood, affecting as many as 8,000 to 12,000 children born in the U.S. each year (corresponding to a prevalence rate of between 2 and 3 per 1000 children). Recent improvements in neonatal care have not resulted in a decline in the overall prevalence of cerebral palsy and, in fact, greater numbers of very preterm/very low birth weight infants are surviving with cerebral palsy and other developmental problems. Infection in pregnancy may be an important cause of the disorder. In preterm infants, there appears to be about a 2-fold increased risk for cerebral palsy from chorioamnionitis, and in term infants the estimated increased risk is about 4-fold. Provisionally, chorioamnionitis might account for 12% of spastic cerebral palsy in term infants and 28% of cerebral palsy in preterm infants. Studies of biochemical markers of fetal inflammation typically associated with infection also suggest that an inflammatory response may be an important independent etiologic factor. If a substantial proportion of cerebral palsy is attributable to acute amnionitis infection and/or neonatal sepsis, cerebral palsy should have decreased in the United States after administration of intrapartum antibiotics became widespread in response to publication of public health consensus guidelines for Group B streptococcus in 1996. However, failure to detect declines could have a number of explanations and these explanations illustrate the many public health challenges related to intrauterine infection and cerebral palsy. Given the gaps in our current knowledge about intrauterine infection and cerebral palsy, public health recommendations for timely and specific prevention activities are limited at this time.