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  • Mcpherson Risager posted an update 6 days, 19 hours ago

    People living with HIV (PLWH) residing in high-income countries (HICs) are, in theory, well positioned to benefit from clinical care strategies that predict optimal neurocognitive and neuropsychiatric outcomes. AZ20 However, there is substantial inter-individual variability in access to clinical care, prevalence of co-occurring risk factors, and comorbid health conditions that represent barriers to achieving the full potential of antiretroviral therapy (ART). Complex interactions between these variables translate into heterogeneity in HIV clinical phenotypes, including abnormalities in brain structure and function. The growing population of PLWH in HICs who are now reaching advanced age introduces additional causal pathways of neurocognitive variability among PLWH receiving ART. These patterns foreshadow trends expected to develop globally in response to increased access to ART. This chapter reviews the combination of highly dimensional risk factors for neurocognitive complications among PLWH residing in HICs. We begin with a brief description of the neuropathological, neuroimaging, and neurocognitive signatures of HIV, followed by a summary of controversies regarding the clinical presentation of HIV-associated neurocognitive disorders (HAND), including putative synergies between HIV disease dynamics and advanced age. Finally, we introduce innovative research strategies that have potential to advance the existing conceptual framework of HAND and, ideally, catalyze the development and of clinical interventions needed to achieve HIV treatment and eradication efforts.Bipolar disorders are severe and have a high prevalence; despite this, the neurobiological mechanisms are far from being elucidated, and this limits the development of new treatments. Although the aetiology of bipolar disorders is not yet fully understood, it is accepted that the disorder(s) may result from the interaction between genetic factors that cause susceptibility and predisposing, precipitating and perpetuating environmental factors, such as stress and traumatic events. A pathophysiological formulation of the disease suggests that dysfunctions in intracellular biochemical cascades, oxidative stress and mitochondrial dysfunction impair the processes linked to neuronal plasticity, leading to cell damage and the consequent loss of brain tissue that has been identified in post-mortem and neuroimaging studies. The data we have reviewed suggests that peripheral biomarkers related to hormones, inflammation, oxidative stress and neurotrophins are altered in bipolar disorders, especially during acute mood episodes. Together, these changes have been associated with a systemic toxicity of the disease and the damage resulting from multiple episodes. Systemic toxicity related to recurrent episodes in bipolar disorder may influence brain anatomical changes associated with the progression of stress and neuroplasticity in bipolar disorder and the response to treatment.Although parents’ socialization of children’s emotional experiences and expression has been widely studied in typically developing (TD) populations, these processes have been largely unexplored in families of children with autism spectrum disorder (ASD). The present study examined parent emotion socialization in a well-characterized sample of verbally fluent children with ASD and comorbid anxiety disorders. Participants included 64 children, aged 8-15 years, who had ASD and co-occurring anxiety and 24 matched TD children without psychiatric disorders. Parents completed ratings of their responses to their children’s emotional experiences using the Coping with Children’s Negative Emotions Scale (CCNES), and both parents and children completed ratings of child anxiety using the Multidimensional Anxiety Rating Scale (MASC). Parents of children with ASD and anxiety did not differ from parents of TD children without psychiatric disorders in their endorsement of different emotion socialization practices. However, among children with ASD and anxiety, greater anxiety was associated with more emotion-focused responses from parents, and for children with less ASD symptom severity, lower levels of anxiety were associated with more punitive responses from parents. Results suggest that certain types of more directive emotion socialization approaches may be associated with lower anxiety in children with ASD, whereas emotion socialization approaches focused on altering the child’s emotional experiences may be associated with greater anxiety in this population. While it is likely that parent emotion socialization practices impact children’s emotional experiences of anxiety, it is also likely that children with distinct profiles of anxiety and ASD symptomology elicit specific styles of emotion socialization from parents.Every women’s and men’s world records from 5 km to the marathon has been broken since the introduction of carbon fibre plate (CFP) shoes in 2016. This step-wise increase in performance coincides with recent advancements in shoe technology that increase the elastic properties of the shoe thereby reducing the energy cost of running. The latest CFP shoes are acknowledged to increase running economy by more than 4%, corresponding to a greater than 2% improvement in performance/run time. The recently modified rules governing competition shoes for elite athletes, announced by World Athletics, that includes sole thickness must not exceed 40 mm and must not contain more than one rigid embedded plate, appear contrary to the true essence and credibility of sport as access to this performance-defining technology becomes the primary differentiator of sporting performance in elite athletes. This is a particular problem in sports such as athletics where the primary sponsor of the athlete is very often a footwear manufacturing company. The postponement of the 2020 Summer Olympics provides a unique opportunity for reflection by the world of sport and time to commission an independent review to evaluate the impact of technology on the integrity of sporting competition. A potential solution to solve this issue can involve the reduction of the stack height of a shoe to 20 mm. This simple and practical solution would prevent shoe technology from having too large an impact on the energy cost of running and, therefore, determining the performance outcome.

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