Asher Consulting (United States)

Untreated hearing loss has an effect on cognition. It is hypothesized that the additional processing required to compensate for the sensory loss affects the cognitive resources available for other tasks and that this could be mitigated by a hearing device. The impact on cognition of cochlear implants (CIs) was tested in 100 subjects, ≥60 years old, with bilateral moderately-severe to profound post linguistic deafness using hearing aids. Data was compared pre and 12 and 18 months after cochlear implantation for the speech spatial qualities questionnaire, Mini Mental State Examination (MMSE), Trail making test B (TMTB) and digit symbol coding (DSC) from the Wechsler Adult Intelligence Scale version IV and finally the timed up and go test (TUG). Subjects were divided into young old (60-64), middle old (65-75) and old old (75+) groups. Cognitive test scores and times were standardized according to available normative data. Hearing significantly improved pre- to post-operatively across all age groups. There was no change post-implant in outcomes for TMTB, TUG or MMSE tests. Age-corrected values were within normal expectations for all age groups for the TUG and MMSE. However, DSC scores and TMTB times were worse than normal. There was a significant increase in DSC scores between baseline and 12-months for 60- to 64-year-olds (t[153] = 2.608, p = 0.027), which remained at 18 months (t[153] = 2.663, p = 0.023). The improved attention and processing speed in the youngest age group may be a consequence of reallocation of cognitive resources away from auditory processing due to greatly improved hearing. The oldest age group of participants had cognition scores closest to normal values, suggesting that only the most able older seniors tend to come forward for a CI. Severe to profoundly deaf individuals with hearing aids or cochlear implants were still poorer than age-equivalent normally hearing individuals with respect to cognitive flexibility, attention, working memory, processing speed and visuoperceptual functions. Due to a lack of data for the TUG, TMTB and DSC in the literature for hearing impaired individuals, the results reported here provide an important set of reference data for use in future research.

BackgroundEpidemiologic cohort studies have begun to leverage electronic research participant portals to facilitate data collection, integrate wearable technologies, lower costs, and engage participants. However, little is known about the acceptability of portal use by research participants.ObjectiveThe aim of this study is to conduct focus groups among a sample of Cancer Prevention Study-3 (CPS-3) participants to better understand their preferences and concerns about research portals.MethodsCPS-3 participants were stratified based on sex, race and ethnicity, age, and cancer status, and randomly invited to participate. Focus groups used an exploratory case design with semistructured guides to prompt discussion. Using a constant comparison technique, transcripts were assigned codes to identify themes.ResultsParticipants (31/59, 52% women; 52/59, 88% White/non-Latinx) were favorably disposed toward using a research participant portal to take surveys, communicate with the study staff, and upload data. Most participants indicated that a portal would be beneficial and convenient but expressed concerns over data safety. Participants stressed the importance of an easy-to-use and trustworthy portal that is compatible with mobile devices.ConclusionsIn addition to being beneficial to researchers, portals may also benefit participants as long as the portals are secure and simple. Participants believe that portals can provide convenient ways to report data and remain connected to the study.

Objective: In order to describe maternal intranatal processes from a common psychosomatic perspective, the clinical notion of "intranatal regression" or "intranatal psychophysical withdrawal" was presented. However, this idea of an underlying mode of experience pervading the birthing process has never been explored systematically. We further elaborated on this notion by introducing the concept of Intranatal Inward Orientation (IIO), supporting a psychosomatic approach in modern obstetrics. Methods: 73 first-time mothers were interviewed 3 -4 days postpartum. IIO was evaluated on four axes of perceptions: a changing sense 1) of time, 2) of space, 3) of attachment, and 4) a change in the predominant communication style with significant others (partners, midwives). In addition, other subjective variables (questionnaires) and obstetric variables were assessed. Results: A one-factor solution (Eigen-value of >1.0) provides firm statistical support for * Corresponding author. W. Stadlmayr et al. 2 IIO as a consistently integrated scale (C'alpha 0.74). Inter-rater reliability is very good (Intraclass correlation 0.83). IIO is independent of other subjective qualities, like anxiety, coping, and control. IIO is correlated with fewer epidural blocks. Likewise high IIO is more frequently associated with a low birth complication profile (spontaneous delivery, not longer than 12 hours, no oxytocin for augmentation of labour, and no epidural block). Conclusion: IIO is a promising psychosomatic concept. It supports the idea of a psychological, relationship-and interaction-oriented approach to promote more natural childbirth. It may also lead to a better understanding of the emerging of a traumatic birth experience. Further elaboration of the concept is recommended.

There is growing interest in determining the prevalence of depression among postpartum women in general and among immigrant Spanish-speaking women in particular. Identifying and treating Spanish-speaking women with postpartum depression presents unique challenges as this population possesses unique linguistic and cultural traits that must be considered in order to provide effective care. Here, Dr. Laura Sirulnik, a board certified psychiatrist, shares her perspective and insights on treating Spanish-speaking Latinas in New York City and provides two case reports that illustrate her approach to treatment.

Cognitive and memory deficits can be caused or exacerbated by dietary folate deficiency, which has been combatted by the addition of folate to grains and dietary supplements. The recommended dose of the B9 vitamin folate is 400 µg/day for adolescents and non-pregnant adults, and consumption above the recommended daily allowance is not considered to be detrimental. However, the effects of excess folate have not been tested in adolescence when neuro and endocrine development suggest possible vulnerability to long-term cognitive effects. We administered folate-supplemented (8.0 mg folic acid/kg diet) or control lab chow (2.7 mg folic acid/kg diet) to rats ad libitum from 30 to 60 days of age, and subsequently tested their motivation and learning and memory in the Morris water maze. We found that folate-supplemented animals had deficits in motivation and spatial memory, but they showed no changes of the learning- and memory-related molecules growth-associated protein-43 or Gs-α subunit protein in the hippocampus. They had decreased levels of thyroxine (T4) and triiodothyronine (T3) in the periphery and decreased protein levels of thyroid receptor-α1 and -α2 (TRα1 and TRα2) in the hippocampus. The latter may have been due to an observed increase of cytosine-phosphate-guanosine island methylation within the putative thyroid hormone receptor-α promoter, which we have mapped for the first time in the rat. Overall, folate supplementation in adolescence led to motivational and spatial memory deficits that may have been mediated by suppressed thyroid hormone function in the periphery and hippocampus.

Epidemiologic studies of mobile phone users have relied on self reporting or billing records to assess exposure. Herein, we report quantitative measurements of mobile-phone power output as a function of phone technology, environmental terrain, and handset design. Radiofrequency (RF) output data were collected using software-modified phones that recorded power control settings, coupled with a mobile system that recorded and analyzed RF fields measured in a phantom head placed in a vehicle. Data collected from three distinct routes (urban, suburban, and rural) were summarized as averages of peak levels and overall averages of RF power output, and were analyzed using analysis of variance methods. Technology was the strongest predictor of RF power output. The older analog technology produced the highest RF levels, whereas CDMA had the lowest, with GSM and TDMA showing similar intermediate levels. We observed generally higher RF power output in rural areas. There was good correlation between average power control settings in the software-modified phones and power measurements in the phantoms. Our findings suggest that phone technology, and to a lesser extent, degree of urbanization, are the two stronger influences on RF power output. Software-modified phones should be useful for improving epidemiologic exposure assessment.

A number of possible physical mechanisms for radiofrequency (RF) interactions with biological systems have been proposed over the past 50 years. Evaluation of proposed mechanisms of interaction suggests there is no physical reason to expect a low-level non-thermal effect between 100 MHz and 150 GHz, possibly excepting those conditions suitable for radical pair effects on biochemical rates. Experimental and theoretical work suggest that demodulation of RF below a few MHz is possible but practical only at much lower frequencies. In all cases, externally applied fields must be on the order of or exceed endogenous fields to affect biological processes. Most likely, low-level non-thermal RF bioeffects do not exist between 10 MHz and several hundred gigahertz.

The authors showed temperature-independent effects of microwave and far-IR electric fields on the secondary structure of proteins. However, the requisite extreme field strengths are unachievable in the environment or laboratory. Because protein bond effects are amplitude dependent, exposures to subthreshold field strengths would have no effect regardless of exposure duration.

Some biological experiments report effects that depend on low frequency modulation of a radiofrequency (RF) carrier. Such effects require nonlinear responses in biological preparations, which we show could be observed with great generality by the unique frequency signatures that would appear in the scattered RF energy. Following Illinger [Illinger (1982): Bioelectromagnetics 3:9-16], we considered a two part physical system. The greater part, dominated by the properties of water, interacts linearly with the RF field and is described by equilibrium thermodynamics. However, another, much smaller part, e.g., certain biological molecules and molecular subgroups, supports nonlinear interactions and is described by nonequilibrium thermodynamics. For example, a nonlinear interaction might result from scattering of RF photons from oscillators located in a region of strong field gradients, such as at membrane surfaces. A second nonlinear mechanism could appear if stress (elastic) waves were launched within the confines of the exposure vessel by RF heating. Amplitude modulation at angular frequency Omega of a carrier wave with angular frequency omega (omega << omega) produces two peaks in elastic stress in the cell structure during each period; that is, there is "full-wave demodulation." As a result of coherent nonlinear charge motion, modulation products could appear at frequencies omega +/- 2 omega and, in general, at omega +/- n 2 omega (n = 1, 2, em leader ) if vibrational harmonics at 2 n omega also are excited. Although in principle microwaves can alter the stability of a thermodynamic system by pumping a chemical transition, the degree of nonlinear coupling required for an observable instability is so great that its probability is effectively zero, unless field intensity is extremely high. A companion paper suggests an extremely sensitive method and the related instrumentation for detection of the spectrum scattered by living cells during exposure to amplitude modulated RF energy.