Search results for: neurocognitive impairment

Authors: Amedeo D'Angiulli, Kylie Schibli

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Traditionally, children’s brain development research has emphasized the limitative aspects of disability and impairment, electing as an explanatory model the classical clinical notions of brain lesion or functional deficit. In contrast, Positive Educational Neuroscience (PEN) is a new approach that emphasizes strengths and human flourishing related to the brain by exploring how learning practices have the potential to enhance neurocognitive flexibility through neuroplastic overcompensation. This mini-review provides an overview of PEN and shows how it links to the concept of neurocognitive flexibility. We provide examples of how the present concept of neurocognitive flexibility can be applied to special education by exploring examples of neuroplasticity in the learning domain, including: (1) learning to draw in congenitally totally blind children, and (2) music training in children from disadvantaged neighborhoods. PEN encourages educators to focus on children’s strengths by recognizing the brain’s capacity for positive change and to incorporate activities that support children’s individual development.

Keywords: neurocognitive development, positive educational neuroscience, sociocultural approach, special education

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Authors: Cornelia-Eugenia Munteanu

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The goal of this paper is to present the diagnostic contribution that the screening instrument, Mini-Mental State Examination-2: Expanded Version (MMSE-2:EV), brings in detecting the cognitive impairment or in monitoring the progress of degenerative disorders. The diagnostic signification is underlined by the interpretation of the MMSE-2:EV scores, resulted from the test application to patients with mild and major neurocognitive disorders. The original MMSE is one of the most widely used screening tools for detecting the cognitive impairment, in clinical settings, but also in the field of neurocognitive research. Now, the practitioners and researchers are turning their attention to the MMSE-2. To enhance its clinical utility, the new instrument was enriched and reorganized in three versions (MMSE-2:BV, MMSE-2:SV and MMSE-2:EV), each with two forms: blue and red. The MMSE-2 was adapted and used successfully in Romania since 2013. The cases were selected from current practice, in order to cover vast and significant neurocognitive pathology: mild cognitive impairment, Alzheimer’s disease, vascular dementia, mixed dementia, Parkinson’s disease, conversion of the mild cognitive impairment into Alzheimer’s disease. The MMSE-2:EV version was used: it was applied one month after the initial assessment, three months after the first reevaluation and then every six months, alternating the blue and red forms. Correlated with age and educational level, the raw scores were converted in T scores and then, with the mean and the standard deviation, the z scores were calculated. The differences of raw scores between the evaluations were analyzed from the point of view of statistic signification, in order to establish the progression in time of the disease. The results indicated that the psycho-diagnostic approach for the evaluation of the cognitive impairment with MMSE-2:EV is safe and the application interval is optimal. The alternation of the forms prevents the learning phenomenon. The diagnostic accuracy and efficient therapeutic conduct derive from the usage of the national test norms. In clinical settings with a large flux of patients, the application of the MMSE-2:EV is a safe and fast psycho-diagnostic solution. The clinicians can draw objective decisions and for the patients: it doesn’t take too much time and energy, it doesn’t bother them and it doesn’t force them to travel frequently.

Keywords: MMSE-2, dementia, cognitive impairment, neuropsychology

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Authors: Yesim Sucullu Karadag, Pinar Kurt, Sule Bilen, Nese Subutay Oztekin, Fikri Ak

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Background: Primary cervical dystonia is thought to be a purely motor disorder. But recent studies revealed that patients with dystonia had additional non-motor features. Sensory and psychiatric disturbances could be included into the non-motor spectrum of dystonia. The Basal Ganglia receive inputs from all cortical areas and throughout the thalamus project to several cortical areas, thus participating to circuits that have been linked to motor as well as sensory, emotional and cognitive functions. However, there are limited studies indicating cognitive impairment in patients with cervical dystonia. More evidence is required regarding neurocognitive functioning in these patients. Objective: This study is aimed to investigate neurocognitive profile of cervical dystonia patients in comparison to healthy controls (HC) by employing a detailed set of neuropsychological tests in addition to self-reported instruments. Methods: Totally 29 (M/F: 7/22) cervical dystonia patients and 30 HC (M/F: 10/20) were included into the study. Exclusion criteria were depression and not given informed consent. Standard demographic, educational data and clinical reports (disease duration, disability index) were recorded for all patients. After a careful neurological evaluation, all subjects were given a comprehensive battery of neuropsychological tests: Self report of neuropsychological condition (by visual analogue scale-VAS, 0-100), RAVLT, STROOP, PASAT, TMT, SDMT, JLOT, DST, COWAT, ACTT, and FST. Patients and HC were compared regarding demographic, clinical features and neurocognitive tests. Also correlation between disease duration, disability index and self report -VAS were assessed. Results: There was no difference between patients and HCs regarding socio-demographic variables such as age, gender and years of education (p levels were 0.36, 0.436, 0.869; respectively). All of the patients were assessed at the peak of botulinum toxine effect and they were not taking an anticholinergic agent or benzodiazepine. Dystonia patients had significantly impaired verbal learning and memory (RAVLT, p<0.001), divided attention and working memory (ACTT, p<0.001), attention speed (TMT-A and B, p=0.008, 0.050), executive functions (PASAT, p<0.001; SDMT, p= 0.001; FST, p<0.001), verbal attention (DST, p=0.001), verbal fluency (COWAT, p<0.001), visio-spatial processing (JLOT, p<0.001) in comparison to healthy controls. But focused attention (STROOP-spontaneous correction) was not different between two groups (p>0.05). No relationship was found regarding disease duration and disability index with any neurocognitive tests. Conclusions: Our study showed that neurocognitive functions of dystonia patients were worse than control group with the similar age, sex, and education independently clinical expression like disease duration and disability index. This situation may be the result of possible cortical and subcortical changes in dystonia patients. Advanced neuroimaging techniques might be helpful to explain these changes in cervical dystonia patients.

Keywords: cervical dystonia, neurocognitive impairment, neuropsychological test, dystonia disability index

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Authors: Nandini Mohan, Elayne Ahern

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Neurocognitive deficits, as well as psychosocial dysfunction, are typically observed in major depressive disorder (MDD). These deficits persist even after a significant reduction of symptoms and remission from MDD. These deficits have also been linked to greater relapse rates. The link between neurocognitive deficits, relapse, and psychosocial functioning in MDD, on the other hand, has received little attention. This review aimed to conduct an in-depth review of the literature on the association between neurocognitive deficits, relapse, and psychosocial functioning in MDD remission. We used search terms related to MDD, MDD remission, psychosocial functioning, neurocognitive impairments, and relapse to conduct a systematic review of English-language literature in PubMed, PsycArticles, PsycINFO, Medline, and Web of Science to identify relevant studies in the area from which 15 studies were identified for inclusion following an examination against inclusion/ exclusion criteria. Executive functioning, psychomotor speed, and memory were closely related to the psychosocial deficits in the phase of MDD remission. Similarly, Executive function, divided attention, and inhibition were closely related to the relapse in the phase of MDD remission. The limitations of the present review include limited and contradicting evidence that led to fewer studies being included. The implications of this review include an understanding of the difference between clinical and full-functional recovery. This evidence can be the basis for incorporating treatment measures that focus on neurocognitive and psychosocial deficits along with the affective symptoms of MDD.

Keywords: depression, MDD, remission, relapse, neurocognitive functioning, psychosocial deficits

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Authors: Ya-Chuan Tseng, Hsin-Yi Liu, Meei-Fang Lou, Guey-Shiun Huang

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Purpose: Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life (QOL) adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life. Methods: Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library and Airiti Library were conducted between January 2006 and December 2017 using the keywords ‘quality of life,’ ‘life satisfaction,’ ‘well-being,’ ‘hearing impairment’ and ‘visual impairment’ Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author. Results: Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually. Conclusions: A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment and quality of life. Our review can be used to enhance health care personnel’s understanding of sensory impairment in older adults and enable healthcare personnel to actively assess older adults’ sensory functions so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.

Keywords: nursing, older adults, quality of life, systematic review, hearing impairment, visual impairment

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Authors: Sehmus Aslan, Sibel Karacaoglu, Cengiz Sevgin, Ummuhan Bas Aslan

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Objective: Anger expression style is an important moderator of the effects on the person and person’s environment. Anger and anger expression have become important constructs in identifying individuals at high risk for psychological difficulties. To our knowledge, there is no information about anger and anger expression of adolescents with visual impairment. The aim of this study was to compare anger and anger expression among adolescents with and without visual impairment. Methods: Thirty-eight adolescents with visual impairment (18 female, 20 male) and 44 adolescents without visual impairment (22 female, 24 male), in totally 84 adolescents aged between 12 to 15 years, participated in the study. Anger and anger expression of the participants assessed with The State-Trait Anger Scale (STAS). STAS, a self-report questionnaire, is designed to measure the experience and expression of anger. STAS has four subtitles including continuous anger, anger in, anger out and anger control. Reliability and validity of the STAS have been well established among adolescents. Mann-Whitney U Test was used for statistical analysis. Results: No significant differences were found in the scores of continuous anger and anger out between adolescents with and without visual impairment (p < 0.05). On the other hand, there were differences in scores of anger control and anger in between adolescents with and without visual impairment (p>0.05). The score of anger control in adolescents with visual impairment were higher compared with adolescents without visual impairment. Meanwhile, the adolescents with visual impairment had lower score for anger in compared with adolescents without visual impairment. Conclusions: The results of this study suggest that there is no difference in anger level among adolescents with and without visual impairment meanwhile there is difference in anger expression.

Keywords: adolescent, anger, impaired, visual

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Authors: Jentel Van Havermaet, Geert Van Hove, Elisabeth De Schauwer

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This study re-conceptualizes visual impairment in the interdependent context of James, his family, and allies. Living with a visual impairment is understood as an entanglement of assemblages, dynamics, disablism, systems… We narrated this diffractively into two meaningful events: decisions and processes on (inclusive) education and hinderances in connecting with others. We entangled and (un)raveled lived experiences in assemblages in which the contextualized meaning of visual impairment became more clearly. The contextualized narrative of James interwove complex intra-actions; showed the complexity and contextualization of entangled relationalities.

Keywords: disability studies, contextualization, visual impairment, assemblage, entanglement, lived experiences

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Authors: Firoozeh Ghazanfari, Kourosh Amraei, Parisa Poorabadi

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Mild cognitive impairment is one of the neurocognitive disorders that go beyond age-related decline in cognitive functions, but in fact, it is not so severe which affects daily activities. This study aimed to investigate and compare the effectiveness of treatment with cranial electrical stimulation, brain training and their double combination on the language and verbal fluency of the elderly with mild cognitive impairment. This is a single-subject method with comparative intervention designs. Four patients with a definitive diagnosis of mild cognitive impairment by a psychiatrist were selected via purposive and convenience sampling method. Addenbrooke's Cognitive Examination Scale (2017) was used to assess language and verbal fluency. Two groups were formed with different order of cranial electrical stimulation treatment, brain training by pencil and paper method and their double combination, and two patients were randomly replaced in each group. The arrangement of the first group included cranial electrical stimulation, brain training, double combination and the second group included double combination, cranial electrical stimulation and brain training, respectively. Treatment plan included: A1, B, A2, C, A3, D, A4, where electrical stimulation treatment was given in ten 30-minutes sessions (5 mA and frequency of 0.5-500 Hz) and brain training in ten 30-minutes sessions. Each baseline lasted four weeks. Patients in first group who first received cranial electrical stimulation treatment showed a higher percentage of improvement in the language and verbal fluency subscale of Addenbrooke's Cognitive Examination in comparison to patients of the second group. Based on the results, it seems that cranial electrical stimulation with its effect on neurotransmitters and brain blood flow, especially in the brain stem, may prepare the brain at the neurochemical and molecular level for a better effectiveness of brain training at the behavioral level, and the selective treatment of electrical stimulation solitude in the first place may be more effective than combining it with paper-pencil brain training.

Keywords: cranial electrical stimulation, treatment, brain training, verbal fluency, cognitive impairment

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Authors: Pavel Svoboda, Oldřich Müller

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The paper contains a screening of the opinions of helping professional workers working in a home for seniors with individuals with neurocognitive disorders and compares them with the opinions of a younger generation of students who are just preparing for this work. The authors carried out a comparative questionnaire survey with both target groups, focusing on the analysis and comparison of possible differences in their knowledge in the field of care for elderly people with neurocognitive disorders. Specifically, they focused on knowledge and experience with approaches, methods and tools applicable within the framework of music therapy interventions, as they are understood in practice in comparison with the theoretical knowledge of secondary school students focused on social work. The questionnaire was mainly aimed at assessing the knowledge of the possibilities of effective memory stimulation of the elderly and their communication skills using the means of music. The conducted investigation was based on the research of studies dealing with so-called non-pharmacological approaches to the given clientele; for professional caregivers, it followed music therapy lessons, which the authors regularly implemented from the beginning of 2022. Its results will, among other things, serve as the basis for an upcoming study with a scoping design review.

Keywords: neurocognitive disorders, seniors, music therapy intervention, melody, rhythm, text, memory stimulation, communication skills

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Authors: Hanna Lu, Sandra S. M. Chan, Linda C. W. Lam

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Objectives: Intra-individual variability (IIV) has been considered as a biomarker of healthy ageing. However, the composite role of IIV in attention, as an impending indicator for neurocognitive disorders warrants further exploration. This study aims to investigate the IIV, as well as their relationships with attention network functions in adults with neurocognitive disorders (NCD). Methods: 36adults with NCD due to Alzheimer’s disease(NCD-AD), 31adults with NCD due to vascular disease (NCD-vascular), and 137 healthy controls were recruited. Intraindividual standard deviations (iSD) and intraindividual coefficient of variation of reaction time (ICV-RT) were used to evaluate the IIV. Results: NCD groups showed greater IIV (iSD: F= 11.803, p < 0.001; ICV-RT:F= 9.07, p < 0.001). In ROC analyses, the indices of IIV could differentiateNCD-AD (iSD: AUC value = 0.687, p= 0.001; ICV-RT: AUC value = 0.677, p= 0.001) and NCD-vascular (iSD: AUC value = 0.631, p= 0.023;ICV-RT: AUC value = 0.615, p= 0.045) from healthy controls. Moreover, the processing speed could distinguish NCD-AD from NCD-vascular (AUC value = 0.647, p= 0.040). Discussion: Intra-individual variability in attention provides a stable measure of cognitive performance, and seems to help distinguish the senior adults with different cognitive status.

Keywords: intra-individual variability, attention network, neurocognitive disorders, ageing

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Authors: Gwendolyn Royal-Smith

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Cocaine ranks as one of the world’s most addictive and commonly abused stimulant drugs. Recent evidence indicates that the abuse of cocaine has risen so quickly among females that this group now accounts for about 40 percent of all users in the United States. Neuropsychological studies have demonstrated that specific neural activation patterns carry higher risks for neurocognitive and executive function in cocaine addicted females thereby increasing their vulnerability for poorer treatment outcomes and more frequent post-treatment relapse when compared to males. This study examined secondary data with a convenience sample of 164 cocaine addicted male and females to assess neurocognitive and executive function. The principal objective of this study was to assess whether individual performance on the Stroop Word Color Task is predictive of treatment success by gender. A second objective of the study evaluated whether individual performance employing neurocognitive measures including the Stroop Word-Color task, the Rey Auditory Verbal Learning Test (RALVT), the Iowa Gambling Task, the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale (FrSBE) test demonstrated differences in neurocognitive and executive function performance by gender. Logistic regression models were employed utilizing a covariate adjusted model application. Initial analyses of the Stroop Word color tasks indicated significant differences in the performance of males and females, with females experiencing more challenges in derived interference reaction time and associate recall ability. In early testing including the Rey Auditory Verbal Learning Test (RALVT), the number of advantageous vs disadvantageous cards from the Iowa Gambling Task, the number of perseverance errors from the Wisconsin Card Sorting Task (WISCT), the total score from the Barratte Impulsiveness Scale (Version 11) (BIS-11) and the total score from the Frontal Systems Behavioral Scale, results were mixed with women scoring lower in multiple indicators in both neurocognitive and executive function.

Keywords: cocaine addiction, gender, neuropsychology, neurocognitive, executive function

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Authors: Estrella C. Damaris, Ingrid A. Olais, Gloria P. Uicab

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This study explores the relationship between the level of functionality and cognitive impairment in older adult women from the south-east of Mexico. It is a descriptive, cross-sectional study; performed with 172 participants in total who attended a health institute and live in Merida, Yucatan Mexico. After a non-probabilistic sampling, Barthel and Pfeiffer scales were applied. The results show statistically significant correlation between the cognitive impairment (Pfeiffer) and the levels of independence and function (Barthel) (r =0.489; p =0.001). Both determine a dependence level so they need either a little or a lot of help. Society needs that the older woman be healthy and that the professionals of mental health develop activities to prevent and rehabilitate because cognitive impairment and function are directly related with the quality of life.

Keywords: functionality, cognition, routine activities, cognitive impairment

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Authors: Jawaria Zafaror, Najma Iqbal Malik

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The present study has been undertaken to explore the relationship among mild cognitive impairment, loneliness and depression among a convenient sample of old people (N = 100) living in old age homes (n = 50) and family home residence (n = 50). Mild Cognitive Impairment Questionnaire, Depression Subscale of Depression Anxiety Stress Scale and UCLA Loneliness Scales were used. Results revealed that Mild cognitive impairment had a significant positive relationship with depression and loneliness among old people both living in old age homes and family home residences. Results also showed that loneliness was the significant positive predictor of depression. However, t-test analysis revealed that old females had higher depression as compared to old males, but old males suffered a significantly high level of cognitive distortions and loneliness as compared to old females. Mediation analysis suggests that loneliness was the partial mediator between mild cognitive impairment and loneliness among old people. Limitations, suggestions and implications were also discussed.

Keywords: loneliness, mild cognitive impairment, depression, old age

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Authors: Ryo Shikimoto, Hidehito Niimura, Hisashi Kida, Kota Suzuki, Yukiko Miyasaka, Masaru Mimura

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Introduction: In Japan, the most aged country in the world, it is important to explore predictive factors of cognitive function among the elderly. Coping behavior relieves chronic stress and improves lifestyle, and consequently may reduce the risk of cognitive impairment. One of the most widely investigated frameworks evaluated in previous studies is approach-oriented and avoidance-oriented coping strategies. The purpose of this study is to investigate the relationship between cognitive function and coping strategies among elderly residents in urban areas of Japan. Method: This is a part of the cross-sectional Arakawa geriatric cohort study for 1,099 residents (aged 65 to 86 years; mean [SD] = 72.9 [5.2]). Participants were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and diagnosed by psychiatrists in face-to-face interviews. They were then investigated for their each coping behaviors and coping strategies (approach- and avoidance-oriented coping) using stress and coping inventory. A multiple regression analysis was used to investigate the relationship between MMSE score and each coping strategy. Results: Of the 1,099 patients, the mean MMSE score of the study participants was 27.2 (SD = 2.7), and the numbers of the diagnosis of normal, mild cognitive impairment (MCI), and dementia were 815 (74.2%), 248 (22.6%), and 14 (1.3%), respectively. Approach-oriented coping score was significantly associated with MMSE score (B [partial regression coefficient] = 0.12, 95% confidence interval = 0.05 to 0.19) after adjusting for confounding factors including age, sex, and education. Avoidance-oriented coping did not show a significant association with MMSE score (B [partial regression coefficient] = -0.02, 95% confidence interval = -0.09 to 0.06). Conclusion: Approach-oriented coping was clearly associated with neurocognitive function in the Japanese population. A future longitudinal trial is warranted to investigate the protective effects of coping behavior on cognitive function.

Keywords: approach-oriented coping, cognitive impairment, coping behavior, dementia

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Authors: F. Ece Cetin, H. Nezih Ozdemir, Emre Kumral

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Ischemic stroke of the precuneal cortex (PC) alone is extremely rare. This study aims to evaluate the clinical, neurocognitive, and behavioural characteristics of isolated PC infarcts. We assessed neuropsychological and behavioral findings in 12 patients with isolated PC infarct among 3800 patients with ischemic stroke. To determine the most frequently affected brain locus in patients, we first overlapped the ischemic area of patients with specific cognitive disorders and patients without specific cognitive disorders. Secondly, we compared both overlap maps using the 'subtraction plot' function of MRIcroGL. Patients showed various types of cognitive disorders. All patients experienced more than one category of cognitive disorder, except for two patients with only one cognitive disorder. Lesion topographical analysis showed that damage within the anterior precuneal region might lead to consciousness disorders (25%), self-processing impairment (42%), visuospatial disorders (58%), and lesions in the posterior precuneal region caused episodic and semantic memory impairment (33%). The whole precuneus is involved in at least one body awareness disorder. The cause of the stroke was cardioembolism in 5 patients (42%), large artery disease in 3 (25%), and unknown in 4 (33%). This study showed a wide variety of neuropsychological and behavioural disorders in patients with precuneal infarct. Future studies are needed to achieve a proper definition of the function of the precuneus in relation to the extended cortical areas. Precuneal cortex region infarcts have been found to predict a source of embolism from the large arteries or heart.

Keywords: cognition, pericallosal artery, precuneal cortex, ischemic stroke

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Authors: Mary Dorothy Roxas, Jeian Mae Dungca, Reginald Agor, Beatriz Figueroa, Lennon Andre Patricio, Honey Joy Cabahug

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Parentification occurs when children are expected to provide instrumental or emotional caregiving within the family. It was found that parentification has the latter effect on adolescents’ cognitive and emotional vulnerability. Attachment theory helps clarify the process of parentification as it involves the relationship between the child and the parent. Carandang theory of “taga-salo” helps explain parentification in the Philippines setting. The present study examined the potential risk of parentification on adolescent’s memory retention by hypothesizing that there is a correlation between the two. The research was conducted with 249 female adolescents ages 12-24, residing in Valenzuela City. Results indicated that there is a significant inverse correlation between parentification and memory retention.

Keywords: memory retention, neurocognitive, parentification, stress

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Authors: Asher John Mohan, Krishna K. L.

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Objectives: (1) To assess the extent of memory impairment induced by Phenytoin (PHT) at normal and reduced dose on temporal lobe epileptic mice. (2) To evaluate the protective effect of Levetiracetam (LEV) on aggravation of memory impairment in temporal lobe epileptic mice by PHT. Materials and Methods: Albino mice of either sex (n=36) were used for the study for a period of 64 days. Convulsions were induced by intraperitoneal administration of pilocarpine 280 mg/kg on every 6th day. Radial arm maze (RAM) was employed to evaluate the memory impairment activity on every 7th day. The anticonvulsant and memory impairment activity were assessed in PHT normal and reduced doses both alone and in combination with LEV. RAM error scores and convulsive scores were the parameters considered for this study. Brain acetylcholine esterase and glutamate were determined along with histopathological studies of frontal cortex. Results: Administration of PHT for 64 days on mice has shown aggravation of memory impairment activity on temporal lobe epileptic mice. Although the reduction in PHT dose was found to decrease the degree of memory impairment the same decreased the anticonvulsant potency. The combination with LEV not only brought about the correction of impaired memory but also replaced the loss of potency due to the reduction of the dose of the antiepileptic drug employed. These findings were confirmed with enzyme and neurotransmitter levels in addition to histopathological studies. Conclusion: This study thus builds a foundation in combining a nootropic anticonvulsant with an antiepileptic drug to curb the adverse effect of memory impairment associated with temporal lobe epilepsy. However further extensive research is a must for the practical incorporation of this approach into disease therapy.

Keywords: anti-epileptic drug, Phenytoin, memory impairment, Pilocarpine

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Authors: Adebomi M. Oyewumi, Sunday Amaize

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The study was designed to examine the barriers to marital expectations among unmarried persons with hearing impairment in Oyo State, Nigeria. Descriptive survey research design was adopted. Purposive sampling technique was used to select one hundred participants made up forty-four (44) males and fifty-six (56) females, all with varying degrees of hearing impairment. Eight research questions were raised and answered. The instrument used was Marital Expectations Scale with reliability coefficient of 0.86. Data was analyzed using descriptive statistics tools of frequency count and simple percentage as well as inferential statistics tools of T-TEST and ANOVA. The findings revealed that there was a significant relationship existing among the main identified barriers (environmental barrier, communication barrier, hearing loss, unemployment and poor sexuality education) to the marital expectations of unmarried persons with hearing impairment. The joint contribution of the independent variables (identified barriers) to the dependent variable (marital expectations) was significant, F = 5.842, P < 0.05, accounting for about 89% of the variance. The relative contribution of the identified barriers to marital expectations of unmarried persons with hearing impairment is as follows: environmental barrier (β = 0.808, t = 5.176, P < 0.05), communication barrier (β = 0.533, t = 3.305, P < 0.05), hearing loss (β = 0.550, t = 2.233, P < 0.05), unemployment (β = 0.431, t = 2.102, P < 0.05), poor sexuality education (β = 0.361, t = 1.985, P < 0.05). Environmental barrier proved to be the most potent contributor to the poor marital expectations among unmarried persons with hearing impairment. Therefore, it is recommended that society dismantles the nagging environmental barrier through positive identification with individuals suffering from hearing impairment. In this connection, members of society should change their negative attitudes and do away with all the wrong notions about the marital ability of individuals with hearing impairment.

Keywords: environmental barrier, hearing impairment, marriage, marital expectations

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Authors: Bersufekad Wubie

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Introduction: Near visual impairment is presenting near visual acuity of the eye worse than N6 at a 40 cm distance. Teachers' regular duties, such as reading books, writing on the blackboard, and recognizing students' faces, need good near vision. If a teacher has near-visual impairment, the work output is unsatisfactory. Objective: The study was aimed to assess the prevalence and associated factors near vision impairment among school teachers at Gondar city Northwest Ethiopia, August 2022. Methods: To select 567 teachers in Gondar city schools, an institutional-based cross-sectional study design with a multistage sampling technique were used. The study was conducted in selected schools from May 1 to May 30, 2022. Trained data collectors used well-structured Amharic and English language questionnaires and ophthalmic instruments for examination. The collected data were checked for completeness and entered into Epi data version 4.6, then exported to SPSS version 26 for further analysis. A binary and multivariate logistic regression model was fitted. And associated factors of the outcome variable. Result: The prevalence of near visual impairment was 64.6%, with a confidence interval of 60.3%–68.4%. Near visual impairment was significantly associated with age >= 35 years (AOR: 4.90 at 95% CI: 3.15, 7.65), having prolonged years of teaching experience (AOR: 3.29 at 95% CI: 1.70, 4.62), having a history of ocular surgery (AOR: 1.96 at 95% CI: 1.10, 4.62), smokers (AOR: 2.21 at 95% CI: 1.22, 4.07), history of ocular trauma (AOR : 1.80 at 95%CI:1.11,3.18 and uncorrected refractive error (AOR:2.01 at 95%CI:1.13,4.03). Conclusion and recommendations: This study showed the prevalence of near vision impairment among school teachers was high, and it is not a problem of the presbyopia age group alone; it also happens at a young age. So teachers' ocular health should be well accommodated in the school's eye health.

Keywords: Gondar, near visual impairment, school, teachers

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Authors: Kartik Gupta, Virendra Kumar, Sanjeev Sinha, N. Jagannathan

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Introduction: A significant number of patients having human immunodeficiency virus (HIV) infection show a neurocognitive decline (NCD) ranging from minor cognitive impairment to severe dementia. The possible causes of NCD in HIV-infected patients include brain injury by HIV before cART, neurotoxic viral proteins and metabolic abnormalities. In the present study, we compared the level of NCD in asymptomatic HIV-infected patients with changes in brain metabolites measured by using magnetic resonance spectroscopy (MRS). Methods: 43 HIV-positive patients (30 males and 13 females) coming to ART center of the hospital and HIV-seronegative healthy subjects were recruited for the study. All the participants completed MRI and MRS examination, detailed clinical assessments and a battery of neuropsychological tests. All the MR investigations were carried out at 3.0T MRI scanner (Ingenia/Achieva, Philips, Netherlands). MRI examination protocol included the acquisition of T2-weighted imaging in axial, coronal and sagittal planes, T1-weighted, FLAIR, and DWI images in the axial plane. Patients who showed any apparent lesion on MRI were excluded from the study. T2-weighted images in three orthogonal planes were used to localize the voxel in left frontal lobe white matter (FWM) and left basal ganglia (BG) for single voxel MRS. Single voxel MRS spectra were acquired with a point resolved spectroscopy (PRESS) localization pulse sequence at an echo time (TE) of 35 ms and a repetition time (TR) of 2000 ms with 64 or 128 scans. Automated preprocessing and determination of absolute concentrations of metabolites were estimated using LCModel by water scaling method and the Cramer-Rao lower bounds for all metabolites analyzed in the study were below 15\%. Levels of total N-acetyl aspartate (tNAA), total choline (tCho), glutamate + glutamine (Glx), total creatine (tCr), were measured. Cognition was tested using a battery of tests validated for Indian population. The cognitive domains tested were the memory, attention-information processing, abstraction-executive, simple and complex perceptual motor skills. Z-scores normalized according to age, sex and education standard were used to calculate dysfunction in these individual domains. The NCD was defined as dysfunction with Z-score ≤ 2 in at least two domains. One-way ANOVA was used to compare the difference in brain metabolites between the patients and healthy subjects. Results: NCD was found in 23 (53%) patients. There was no significant difference in age, CD4 count and viral load between the two groups. Maximum impairment was found in the domains of memory and simple motor skills i.e., 19/43 (44%). The prevalence of deficit in attention-information processing, complex perceptual motor skills and abstraction-executive function was 37%, 35%, 33% respectively. Subjects with NCD had a higher level of Glutamate in the Frontal region (8.03 ± 2.30 v/s. 10.26 ± 5.24, p-value 0.001). Conclusion: Among newly diagnosed, ART-naïve retroviral disease patients from India, cognitive decline was found in 53\% patients using tests validated for this population. Those with neurocognitive decline had a significantly higher level of Glutamate in the left frontal region. There was no significant difference in age, CD4 count and viral load at initiation of ART between the two groups.

Keywords: HIV, neurocognitive decline, neurometabolites, magnetic resonance spectroscopy

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Authors: Melissa K. Hord, Stephen P. Whiteside

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Impairment in functioning is a requirement for diagnosing psychopathology, identifying individuals in need of treatment, and documenting improvement with treatment. Further, identifying different types of functional impairment can guide educators and treatment providers. However, most assessment tools focus on symptom severity and few measures assess impairment associated with childhood anxiety disorders. The child- and parent-report versions of the Child Sheehan Disability Scale (CSDS) are measures that may provide useful information regarding impairment. The purpose of the present study is to examine whether children diagnosed with different anxiety disorders have greater impairment in school or home functioning based on self or parent report. The sample consisted of 844 children ages 5 to 19 years of age (mean 13.43, 61% female, 90.9% Caucasian), including 281 children diagnosed with obsessive compulsive disorder (OCD), 200 with generalized anxiety disorder (GAD), 176 with social phobia, 83 with separation anxiety, 61 with anxiety not otherwise specified (NOS), 30 with panic disorder, and 13 with panic with agoraphobia. To assess whether children and parents reported greater impairment in school or home functioning, a multivariate analysis of variance was conducted. (The assumptions of independence and homogeneity of variance were checked and met). A significant difference was found, Pillai's trace = .143, F (4, 28) = 4.19, p < .001, partial eta squared = .04. Post hoc comparisons using the Tukey HSD test indicated that children report significantly greater impairment in school with panic disorder (M=5.18, SD=3.28), social phobia (M=4.95, SD=3.20), and OCD (M=4.62, SD=3.32) compared to other diagnoses; whereas parents endorse significantly greater school impairment when their child has a social phobia (M=5.70, SD=3.39) diagnosis. Interestingly, both children and parents reported greater impairment in family functioning for an OCD (child report M=5.37, SD=3.20; parent report M=5.59, SD=3.38) diagnosis compared to other anxiety diagnoses. (Additional findings for the anxiety disorders associated with less impairment will also be presented). The results of the current study have important implications for educators and treatment providers who are working with anxious children. First, understanding that differences exist in how children and parents view impairment related to childhood anxiety can help those working with these families to be more sensitive during interactions. Second, evidence suggests that difficulties in one environment do not necessarily translate to another environment, thus caregivers may benefit from careful explanation of observations obtained by educators. Third, results support the use of the CSDS measure by treatment providers to identify impairment across environments in order to more effectively target interventions.

Keywords: anxiety, childhood, impairment, school functioning

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Authors: Merkineh Markos Lorato, Gedefaw Diress Alene

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Introduction: Visual impairment is any condition of the eye or visual system that results in loss/reduction of visual functioning. It significantly influences the academic routine and social activities of children, and the effect is severe for low-income countries like Ethiopia. So, this study aimed to determine the pooled prevalence of visual impairment among school children in Ethiopia. Methods: Databases such as Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, World Wide Web of Science, and Cochrane Library searched to retrieve eligible articles. In addition, Google Scholar and a reference list of the retrieved eligible articles were addressed. Studies that reported the prevalence of visual impairment were included to estimate the pooled prevalence. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analysis was held using STATA 11 statistical software. I² was used to assess the heterogeneity. Because of considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled prevalence of visual impairment among school children in Ethiopia. Results: The result of 9 eligible studies showed that the pooled prevalence of visual impairment among school children in Ethiopia was 7.01% (95% CI: 5.46, 8.56%). In the subgroup analysis, the highest prevalence was reported in South Nations Nationalities and Tigray region together (7.99%; 3.63, 12.35), while the lowest prevalence was reported in Addis Ababa (5.73%; 3.93, 7.53). Conclusion: The prevalence of visual impairment among school children is significantly high in Ethiopia. If it is not detected and intervened early, it will cause a lifetime threat to visually impaired school children, so that school vision screening program plan and its implementation may cure the life quality of future generations in Ethiopia.

Keywords: visual impairment, school children, Ethiopia, prevalence

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Authors: Mariam Vardiashvili

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The economic value of the asset impairment process is quite large. Impairment reflects the reduction of future economic benefits or service potentials itemized in the asset. The assets owned by public sector entities bring economic benefits or are used for delivery of the free-of-charge services. Consequently, they are classified as cash-generating and non-cash-generating assets. IPSAS 21 - Impairment of non-cash-generating assets, and IPSAS 26 - Impairment of cash-generating assets, have been designed considering this specificity.  When measuring impairment of assets, it is important to select the relevant methods. For measurement of the impaired Non-Cash-Generating Assets, IPSAS 21 recommends three methods: Depreciated Replacement Cost Approach, Restoration Cost Approach, and  Service Units Approach. Impairment of Value in Use of Cash-Generating Assets (according to IPSAS 26) is measured by discounted value of the money sources to be received in future. Value in use of the cash-generating asserts (as per IPSAS 26) is measured by the discounted value of the money sources to be received in the future. The article provides classification of the assets in the public sector  as non-cash-generating assets and cash-generating assets and, deals also with the factors which should be considered when evaluating  impairment of assets. An essence of impairment of the non-financial assets and the methods of measurement thereof evaluation are formulated according to IPSAS 21 and IPSAS 26. The main emphasis is put on different methods of measurement of the value in use of the impaired Cash-Generating Assets and Non-Cash-Generation Assets and the methods of their selection. The traditional and the expected cash flow approaches for calculation of the discounted value are reviewed. The article also discusses the issues of recognition of impairment loss and its reflection in the financial reporting. The article concludes that despite a functional purpose of the impaired asset, whichever method is used for measuring the asset, presentation of realistic information regarding the value of the assets should be ensured in the financial reporting. In the theoretical development of the issue, the methods of scientific abstraction, analysis and synthesis were used. The research was carried out with a systemic approach. The research process uses international standards of accounting, theoretical researches and publications of Georgian and foreign scientists.

Keywords: cash-generating assets, non-cash-generating assets, recoverable (usable restorative) value, value of use

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Authors: Ke Qiu, Minzi Mao, Jianjun Ren, Yu Zhao

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Although much has been done to investigate the influence of obstructive sleep apnea (OSA) on cognitive function, little attention has been paid to the role which gender differences play in this association. In the present study, we aim to explore the gender-specific association between OSA and cognitive impairment. Participants from UK biobank who have completed at least one of the five baseline cognitive tests (visuospatial memory, prospective memory, fluid intelligence, short numeric memory and reaction time) were included and were further categorized into three groups: (1) OSA, (2) self-reported snoring but without OSA, and (3) healthy controls (without OSA or snoring). Multivariable regression analysis was performed to examine the associations among snoring, OSA and performance of each of the five cognitive domains. A total of 267,889 participants (47% male, mean age: 57 years old) were included in our study. In the multivariable regression analysis, female participants in the OSA group had a higher risk of having poor prospective memory (OR: 1.24, 95% CI: 1.02～1.50, p = 0.03). Meanwhile, among female participants, OSA were inversely associated with the performances of fluid intelligence (β: -0.29, 95% CI: -0.46～-0.13, p < 0.001) and short-numeric memory (β: -0.14, 95% CI: -0.35～0.08, p = 0.02). In contrast, among male participants, no significant association was observed between OSA and impairment of the five cognitive domains. Overall, OSA was significantly associated with cognitive impairment in female participants rather than in male participants, indicating that more special attention and timely interventions should be given to female OSA patients to prevent further cognitive impairment.

Keywords: obstructive sleep apnea (OSA), cognitive impairment, gender-specific association, UK biobank

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Authors: Ying Han, Yuanxiang Chen, Yongtao Huang, Jia Fu, Kaile Li, Shangjing Lin, Jianguo Yu

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In long-haul and high-speed optical transmission system, the orthogonal frequency division multiplexing (OFDM) signal suffers various linear and non-linear impairments. In recent years, researchers have proposed compensation schemes for specific impairment, and the effects are remarkable. However, different impairment compensation algorithms have caused an increase in transmission delay. With the widespread application of deep neural networks (DNN) in communication, multi-impairment compensation based on DNN will be a promising scheme. In this paper, we propose and apply DNN to compensate multi-impairment of 16-QAM coherent optical OFDM signal, thereby improving the performance of the transmission system. The trained DNN models are applied in the offline digital signal processing (DSP) module of the transmission system. The models can optimize the constellation mapping signals at the transmitter and compensate multi-impairment of the OFDM decoded signal at the receiver. Furthermore, the models reduce the peak to average power ratio (PAPR) of the transmitted OFDM signal and the bit error rate (BER) of the received signal. We verify the effectiveness of the proposed scheme for 16-QAM Coherent Optical OFDM signal and demonstrate and analyze transmission performance in different transmission scenarios. The experimental results show that the PAPR and BER of the transmission system are significantly reduced after using the trained DNN. It shows that the DNN with specific loss function and network structure can optimize the transmitted signal and learn the channel feature and compensate for multi-impairment in fiber transmission effectively.

Keywords: coherent optical OFDM, deep neural network, multi-impairment compensation, optical transmission

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Authors: Dorottya Horváth, Tímea Harmath-Tánczos

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Attention deficit hyperactivity disorder (ADHD) and learning disabilities are common neurocognitive disorders that can have a significant impact on a child's academic performance. ADHD is characterized by inattention, hyperactivity, and impulsivity, while learning disabilities are characterized by difficulty with specific academic skills, such as reading, writing, or math. The aim of this study was to investigate the working memory, executive, and attention functions of neurotypical children and children with ADHD and learning disabilities in order to fill the gaps in the Hungarian mean test scores of these cognitive functions in children with neurocognitive disorders. Another aim was to specify the neuropsychological differential diagnostic toolkit in terms of the relationships and peculiarities between these cognitive functions. The research question addressed in this study was: How do the working memory, executive, and attention functions of neurotypical children compare to those of children with ADHD and learning disabilities? A self-administered test battery was used as a research tool. Working memory was measured with the Non-Word Repetition Test, the Listening Span Test, the Digit Span Test, and the Reverse Digit Span Test; executive function with the Letter Fluency, Semantic Fluency, and Verb Fluency Tests; and attentional concentration with the d2-R Test. The data for this study was collected from 115 children aged 9-14 years. The children were divided into three groups: neurotypical children (n = 44), children with ADHD without learning disabilities (n = 23), and children with ADHD with learning disabilities (n = 48). The data was analyzed using a variety of statistical methods, including t-tests, ANOVAs, and correlational analyses. The results showed that the performance of children with neurocognitive involvement in working memory, executive functions, and attention was significantly lower than the performance of neurotypical children. However, the results of children with ADHD and ADHD with learning disabilities did not show a significant difference. The findings of this study are important because they provide new insights into the cognitive profiles of children with ADHD and learning disabilities and suggest that working memory, executive functions, and attention are all impaired in children with neurocognitive involvement, regardless of whether they have ADHD or learning disabilities. This information can be used to develop more effective diagnostic and treatment strategies for these disorders.

Keywords: ADHD, attention functions, executive functions, learning disabilities, working memory

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Authors: Yozna Gurung

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This paper presents preliminary findings from an on-going study on the use of Internal State Terms (IST) in the production of narratives of Hindi-English bilinguals in an attempt to identify children at risk for Specific Language Impairment. Narratives were examined for macrostructure (story structure and story complexity) and internal state terms or mental state terms (IST/MST). 31 students generated stories based on six pictures that were matched for content and story structure in L1 (Hindi) and L2 (English) using a wordless picture narrative. From 30 sample population, 2 students are at risk of Specific Language Impairment, according to this study i.e 6.45%. They showed least development in story grammar as well as IST in both their languages.

Keywords: internal state terms, macrostructure, specific language impairment, wordless picture narrative

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Authors: Nurullah Buker, Ezgi Karagoz, Yesim Salik Sengul, Sevay Alsen Guney, Gokhan Yoyler, Aylin Ozbek

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders with heterogeneous clinical features such as inattention, hyperactivity, and impulsivity. Many different types of exercise interventions were employed for children with ADHD. However, previous studies have usually examined the effects of non-specific exercise programs or short-term effects of exercise. The aim of this study is to investigate the effect of the Neurocognitive Exercise Program (NEP), which is a structured exercise program derived from Life Kinetik, and a relatively new for children with ADHD, on symptoms, attention, and dynamic balance in medication-naïve children with ADHD. Fourteen medication-naive children (7-12 years) with ADHD were included in the intervention group. NEP was performed once a week for ten weeks. The intervention group also performed a structured home exercise program for another six days, for ten weeks. The children in the intervention group were assessed at baseline, in the third month, in the sixth month, and in the twelfth month regarding ADHD-related symptoms, attention, and dynamic balance. Fifteen age-matched typically developing children were assessed once for establishing normative values. Hyperactivity-Impulsivity score and dynamic balance were found to improve after NEP in the ADHD group in the 3rd month (p<0.05). In addition, these results were similar for both groups after NEP and at the end of the 12th month (p>0.05). The NEP may provide beneficial effects on hyperactivity-impulsivity, oppositional defiant, and dynamic balance in children with ADHD, and the improvements may be maintained in the long term.

Keywords: ADHD, attention problems, dynamic balance, neurocognitive exercise

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Authors: S. Vijayakumar, S. B. Rathna Kumar, Navnath D Jagadale

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Learning and teaching are the challenges ahead in the education of the students with hearing impairment using sign language (SHISL). Either the students or teachers face difficulties in the process of learning/teaching. Communication is one of the main barriers while teaching SHISL. Further, the courses of study or the subjects are limited to SHISL at least in countries like India. Students with hearing impairment mainly opt for sign language as a communication mode. Subjects like physics, chemistry, advanced mathematics etc. are not available in the curriculum for the SHISL since their content and ideas are complex. In India, exemption for language papers is being given for the students with hearing impairment. It may give opportunity to them to secure secondary/ higher secondary qualifications. It is a known fact that students with hearing impairment are facing difficulty in their future carrier. They secure neither a higher study nor a good employment opportunity. Vocational training in various trades will land them in few jobs with few bucks in pocket. However, not all of them are blessed with higher positions in government or private sectors in competitive fields or where the technical knowledge is required. E learning with sign language instructions can be used for teaching languages and science subjects. Computer Based Instruction (CBI), Computer Based Training (CBT), and Computer Assisted Instruction (CAI) are now part-and-parcel of Modern Education. It will also include signed video clip corresponding to the topic. Learning language subjects will improve the understanding of concepts in different subjects. Learning other science subjects like their hearing counterparts will enable the SHISL to go higher in studies and increase their height to pluck a fruit of the tree of employment.

Keywords: students with hearing impairment using sign language, hearing impairment, language subjects, science subjects, e-learning

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Authors: Sarah Potter, Michele Laliberte

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As eating disorders are associated with high levels of chronicity, impairment, and distress, it is paramount to evaluate factors that may improve treatment outcomes in this group. Individuals with eating disorders exhibit elevated levels of perfectionism and emotion dysregulation, as well as reduced self-compassion. These variables are related to eating disorder outcomes, including shape/weight concerns and psychosocial impairment. Thus, these factors may be tenable targets for treatment within eating disorder populations. However, the relative contributions of perfectionism, emotion dysregulation, and self-compassion to the severity of shape/weight concerns and psychosocial impairment remain largely unexplored. In the current study, mediation analyses were conducted to clarify how perfectionism, emotion dysregulation, and self-compassion are linked to shape/weight concerns and psychosocial impairment. The sample was comprised of 85 patients from an outpatient eating disorder clinic. The patients completed self-report measures of perfectionism, self-compassion, emotion dysregulation, eating disorder symptoms, and psychosocial impairment. Specifically, emotion dysregulation was assessed as a mediator in the relationships between (1) perfectionism and shape/weight concerns, (2) self-compassion and shape/weight concerns, (3) perfectionism and psychosocial impairment, and (4) self-compassion and psychosocial impairment. It was postulated that emotion dysregulation would significantly mediate relationships in the former two models. An a priori hypothesis was not constructed in reference to the latter models, as these analyses were preliminary and exploratory in nature. The PROCESS macro for SPSS was utilized to perform these analyses. Emotion dysregulation fully mediated the relationships between perfectionism and eating disorder outcomes. In the link between self-compassion and psychosocial impairment, emotion dysregulation partially mediated this relationship. Finally, emotion dysregulation did not significantly mediate the relationship between self-compassion and shape/weight concerns. The results suggest that emotion dysregulation and self-compassion may be suitable targets to decrease the severity of psychosocial impairment and shape/weight concerns in individuals with eating disorders. Further research is required to determine the stability of these models over time, between diagnostic groups, and in nonclinical samples.

Keywords: eating disorders, emotion dysregulation, perfectionism, self-compassion

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