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  1. Article ; Online: A network approach to subjective cognitive decline: Exploring multivariate relationships in neuropsychological test performance across Alzheimer's disease risk states.

    Grunden, Nicholas / Phillips, Natalie A

    Cortex; a journal devoted to the study of the nervous system and behavior

    2024  Volume 173, Page(s) 313–332

    Abstract: Subjective cognitive decline (SCD) is characterized by subjective concerns of cognitive change despite test performance within normal range. Although those with SCD are at higher risk for developing further cognitive decline, we still lack methods using ... ...

    Abstract Subjective cognitive decline (SCD) is characterized by subjective concerns of cognitive change despite test performance within normal range. Although those with SCD are at higher risk for developing further cognitive decline, we still lack methods using objective cognitive measures that reliably distinguish SCD from cognitively normal aging at the group level. Network analysis may help to address this by modeling cognitive performance as a web of intertwined cognitive abilities, providing insight into the multivariate associations determining cognitive status. Following previous network studies of mild cognitive impairment (MCI) and Alzheimer's dementia (AD), the current study centered upon the novel visualization and analysis of the SCD cognitive network compared to cognitively normal (CN) older adult, MCI, and AD group networks. Cross-sectional neuropsychological data from CIMA-Q and COMPASS-ND cohorts were used to construct Gaussian graphical models for CN (n = 122), SCD (n = 207), MCI (n = 210), and AD (n = 79) groups. Group networks were explored in terms of global network structure, prominent edge weights, and strength centrality indices. CN and SCD group networks were contrasted using the Network Comparison Test. Results indicate that CN and SCD groups did not differ in univariate cognitive performance or global network structure. However, measures of strength centrality, principally in executive functioning and processing speed, showed a CN-SCD-MCI gradient where subtle differences within the SCD network suggest that SCD is an intermediary between CN and MCI stages. Additional results may indicate a distinctiveness of network structure in AD, a reversal in network influence between age and general cognitive status as clinical impairment increases, and potential evidence for cognitive reserve. Together, these results provide evidence that network-specific metrics are sensitive to cognitive performance changes across the dementia risk spectrum and can help to objectively distinguish SCD group cognitive performance from that of the CN group.
    MeSH term(s) Humans ; Aged ; Alzheimer Disease/diagnosis ; Alzheimer Disease/psychology ; Cross-Sectional Studies ; Neuropsychological Tests ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/psychology ; Cognition
    Language English
    Publishing date 2024-02-21
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 280622-8
    ISSN 1973-8102 ; 0010-9452
    ISSN (online) 1973-8102
    ISSN 0010-9452
    DOI 10.1016/j.cortex.2024.02.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Olfactory function reflects episodic memory performance and atrophy in the medial temporal lobe in individuals at risk for Alzheimer's disease.

    Papadatos, Zoe / Phillips, Natalie A

    Neurobiology of aging

    2023  Volume 128, Page(s) 33–42

    Abstract: We examined cognitive domains and brain regions associated with olfactory performance in cognitively unimpaired older adults (CU-OAs) and individuals with or at risk for Alzheimer's Disease (AD). We compared CU-OAs (N = 55), individuals with subjective ... ...

    Abstract We examined cognitive domains and brain regions associated with olfactory performance in cognitively unimpaired older adults (CU-OAs) and individuals with or at risk for Alzheimer's Disease (AD). We compared CU-OAs (N = 55), individuals with subjective cognitive decline (SCD, N = 55), mild cognitive impairment (MCI, N = 101), and AD (N = 45) on measures of olfactory function (Brief Smell Identification Test), cognition (episodic and semantic memory), and medial temporal lobe thickness and volume. Analyses controlled for age, sex, education, and total intracranial volume. Olfactory function decreased from SCD to MCI to AD. CU-OAs outperformed all groups except SCDs on tests of cognition and olfaction. Although these measures did not differ between the CU-OAs and SCDs, olfactory function correlated with episodic memory tests and with entorhinal cortex atrophy only in the SCD group. Olfactory function also correlated with hippocampal volume and right-hemisphere entorhinal cortex thickness in the MCI group. Olfactory dysfunction reflects medial temporal lobe integrity and memory performance in a group at risk for AD with normal cognition and olfaction.
    MeSH term(s) Humans ; Aged ; Alzheimer Disease/psychology ; Memory, Episodic ; Magnetic Resonance Imaging ; Temporal Lobe/pathology ; Cognition ; Cognitive Dysfunction ; Atrophy/pathology ; Neuropsychological Tests
    Language English
    Publishing date 2023-04-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604505-4
    ISSN 1558-1497 ; 0197-4580
    ISSN (online) 1558-1497
    ISSN 0197-4580
    DOI 10.1016/j.neurobiolaging.2023.04.001
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  3. Article ; Online: The Gut-Lymph Model Gives New Treatment Strategies for Organ Failure.

    Windsor, John A / Trevaskis, Natalie L / Phillips, Anthony J

    JAMA surgery

    2022  Volume 157, Issue 6, Page(s) 540–541

    MeSH term(s) Humans ; Lymph ; Shock, Hemorrhagic
    Language English
    Publishing date 2022-04-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2022.0654
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  4. Article ; Online: Audiovisual speech perception in noise in younger and older bilinguals.

    Chauvin, Alexandre / Pellerin, Sophie / Boatswain-Jacques, Anna-Francesca / René, Jean-Louis / Phillips, Natalie A

    Psychology and aging

    2024  

    Abstract: Speech perception in noise becomes increasingly difficult with age. Similarly, bilinguals often have difficulty with speech perception in noise in their second language (L2) due to less developed language knowledge in L2. Little is known about older ... ...

    Abstract Speech perception in noise becomes increasingly difficult with age. Similarly, bilinguals often have difficulty with speech perception in noise in their second language (L2) due to less developed language knowledge in L2. Little is known about older bilinguals, who experience age-related sensory and cognitive changes but have extensive L2 experience. Furthermore, while audiovisual (AV) speech cues and supportive sentence context facilitate speech perception in noise in native listeners, much less is known for bilingual listeners, particularly older bilinguals. This study investigated how much young (
    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 635596-1
    ISSN 1939-1498 ; 0882-7974
    ISSN (online) 1939-1498
    ISSN 0882-7974
    DOI 10.1037/pag0000799
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Quality and accessibility of written development assessment reports provided to caregivers in a publicly funded child developmental assessment service.

    Munro, Martha / Boulton, Kelsie A / Phillips, Natalie / Hodge, M Antoinette / Ong, Natalie / Coghill, David / Silove, Natalie / Guastella, Adam J

    Autism : the international journal of research and practice

    2023  Volume 27, Issue 6, Page(s) 1764–1776

    Abstract: Lay abstract: Despite long wait times, public paediatric developmental assessment services remain crucial for assessment of children. Assessment is a critical opportunity to guide the placement of supports to improve outcomes. There is little research ... ...

    Abstract Lay abstract: Despite long wait times, public paediatric developmental assessment services remain crucial for assessment of children. Assessment is a critical opportunity to guide the placement of supports to improve outcomes. There is little research examining how clinical assessment services conduct their assessments, present results and write reports to families. This study examined 85 reports provided to caregivers at a developmental assessment service. Reports were evaluated for whether they (1) addressed caregiver perceived needs, (2) used available data to provide appropriate information about child needs, (3) provided recommendations that were actionable and specific to needs, (4) had appropriate readability levels and (5) followed existing autism assessment guidelines. Findings showed clinicians were more focused on autism diagnostic needs while caregivers were more focused on non-diagnostic needs. Recommendations related to autism diagnoses were actionable, but they rarely addressed comorbidities such as cognitive impairments or mental health. For instance, only 13% of reports contained recommendations for conditions other than autism spectrum disorder, despite 61% of the population receiving two or more diagnoses. Reports largely followed autism assessment guidelines, but the language used was more complex for families than recommended. Recommendations for future practice are provided so that consideration may be given to how to improve the quality and effectiveness of reports for families attending services.
    MeSH term(s) Child ; Humans ; Autism Spectrum Disorder/psychology ; Caregivers/psychology ; Autistic Disorder/epidemiology ; Mental Health ; Comorbidity
    Language English
    Publishing date 2023-01-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1338513-6
    ISSN 1461-7005 ; 1362-3613
    ISSN (online) 1461-7005
    ISSN 1362-3613
    DOI 10.1177/13623613221145868
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Introduction of diabetic retinopathy screening into an antenatal clinic: Impact on maternal screening and diagnosis rates.

    Phillips, Jessica L / Raja, Vignesh / Mehrotra, Chhaya / Richards, Josephine / Khan, Jane / Graham, Dorothy F

    The Australian & New Zealand journal of obstetrics & gynaecology

    2022  

    Abstract: Pregnancy is a risk factor for the development and progression of diabetic retinopathy (DR) in women with pre-gestational diabetes. However, a minority of pregnant women with diabetes adhere to retinal screening recommendations. The introduction of an ... ...

    Abstract Pregnancy is a risk factor for the development and progression of diabetic retinopathy (DR) in women with pre-gestational diabetes. However, a minority of pregnant women with diabetes adhere to retinal screening recommendations. The introduction of an onsite retinal camera at our tertiary maternity hospital significantly increased the proportion of women who received at least one retinal screen during pregnancy (93.0% vs 54.3%, P < 0.001) and the identification of both DR and DR progression. We conclude that the use of a retinal camera in similar clinics is a feasible option to improve DR screening and diagnosis rates in pregnancy.
    Language English
    Publishing date 2022-06-19
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 390815-x
    ISSN 1479-828X ; 0004-8666
    ISSN (online) 1479-828X
    ISSN 0004-8666
    DOI 10.1111/ajo.13574
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  7. Article ; Online: Bilinguals Show Proportionally Greater Benefit From Visual Speech Cues and Sentence Context in Their Second Compared to Their First Language.

    Chauvin, Alexandre / Phillips, Natalie A

    Ear and hearing

    2021  Volume 43, Issue 4, Page(s) 1316–1326

    Abstract: Objectives: Speech perception in noise is challenging, but evidence suggests that it may be facilitated by visual speech cues (e.g., lip movements) and supportive sentence context in native speakers. Comparatively few studies have investigated speech ... ...

    Abstract Objectives: Speech perception in noise is challenging, but evidence suggests that it may be facilitated by visual speech cues (e.g., lip movements) and supportive sentence context in native speakers. Comparatively few studies have investigated speech perception in noise in bilinguals, and little is known about the impact of visual speech cues and supportive sentence context in a first language compared to a second language within the same individual. The current study addresses this gap by directly investigating the extent to which bilinguals benefit from visual speech cues and supportive sentence context under similarly noisy conditions in their first and second language.
    Design: Thirty young adult English-French/French-English bilinguals were recruited from the undergraduate psychology program at Concordia University and from the Montreal community. They completed a speech perception in noise task during which they were presented with video-recorded sentences and instructed to repeat the last word of each sentence out loud. Sentences were presented in three different modalities: visual-only, auditory-only, and audiovisual. Additionally, sentences had one of two levels of context: moderate (e.g., "In the woods, the hiker saw a bear.") and low (e.g., "I had not thought about that bear."). Each participant completed this task in both their first and second language; crucially, the level of background noise was calibrated individually for each participant and was the same throughout the first language and second language (L2) portions of the experimental task.
    Results: Overall, speech perception in noise was more accurate in bilinguals' first language compared to the second. However, participants benefited from visual speech cues and supportive sentence context to a proportionally greater extent in their second language compared to their first. At the individual level, performance during the speech perception in noise task was related to aspects of bilinguals' experience in their second language (i.e., age of acquisition, relative balance between the first and the second language).
    Conclusions: Bilinguals benefit from visual speech cues and sentence context in their second language during speech in noise and do so to a greater extent than in their first language given the same level of background noise. Together, this indicates that L2 speech perception can be conceptualized within an inverse effectiveness hypothesis framework with a complex interplay of sensory factors (i.e., the quality of the auditory speech signal and visual speech cues) and linguistic factors (i.e., presence or absence of supportive context and L2 experience of the listener).
    MeSH term(s) Cues ; Humans ; Language ; Multilingualism ; Noise ; Speech ; Speech Perception ; Young Adult
    Language English
    Publishing date 2021-12-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603093-2
    ISSN 1538-4667 ; 0196-0202
    ISSN (online) 1538-4667
    ISSN 0196-0202
    DOI 10.1097/AUD.0000000000001182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Strategies used during the cognitive evaluation of older adults with dual sensory impairment: a scoping review.

    Dumassais, Shirley / Pichora-Fuller, Margaret Kathleen / Guthrie, Dawn / Phillips, Natalie A / Savundranayagam, Marie / Wittich, Walter

    Age and ageing

    2024  Volume 53, Issue 3

    Abstract: Background: Dual sensory impairment (DSI), the combination of visual and hearing impairments, is associated with increased risk for age-related cognitive decline and dementia. Administering cognitive tests to individuals with sensory impairment is ... ...

    Abstract Background: Dual sensory impairment (DSI), the combination of visual and hearing impairments, is associated with increased risk for age-related cognitive decline and dementia. Administering cognitive tests to individuals with sensory impairment is challenging because most cognitive measures require sufficient hearing and vision. Considering sensory limitations during cognitive test administration is necessary so that the effects of sensory and cognitive abilities on test performance can be differentiated and the validity of test results optimized.
    Objective: To review empirical strategies that researchers have employed to accommodate DSI during cognitive testing of older adults.
    Methods: Seven databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, Global Health and the Evidence-Based Medicine Reviews databases) were searched for relevant articles integrating the three concepts of cognitive evaluation, aging, and DSI. Given the inclusion criteria, this scoping review included a total of 67 papers.
    Results: Twenty-eight studies reported five categories of strategies for cognitive testing of older adult participants with DSI: the assistance of experts, the modification of standardized test scoring procedures, the use of communication strategies, environmental modifications, and the use of cognitive tests without visual and/or auditory items.
    Conclusions: The most used strategy reported in the included studies was drawing on the assistance of team members from related fields during the administration and interpretation of cognitive screening measures. Alternative strategies were rarely employed. Future research is needed to explore the knowledge-to-practice gap between research and current clinical practice, and to develop standardized testing strategies.
    MeSH term(s) Humans ; Aged ; Aging ; Cognition ; Cognitive Dysfunction ; Communication ; Databases, Factual
    Language English
    Publishing date 2024-03-20
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afae051
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  9. Article ; Online: Feminizing care pathways: Mixed-methods study of reproductive options, decision making, pregnancy, post-natal care and parenting amongst women with kidney disease.

    Mc Laughlin, Leah / Jones, Caron / Neukirchinger, Barbara / Noyes, Jane / Stone, Judith / Williams, Helen / Williams, Denitza / Rapado, Rose / Phillips, Rhiannon / Griffin, Sian

    Journal of advanced nursing

    2023  Volume 79, Issue 8, Page(s) 3127–3146

    Abstract: Aims: To identify the needs, experiences and preferences of women with kidney disease in relation to their reproductive health to inform development of shared decision-making interventions.: Design: UK-wide mixed-methods convergent design (Sep 20-Aug ...

    Abstract Aims: To identify the needs, experiences and preferences of women with kidney disease in relation to their reproductive health to inform development of shared decision-making interventions.
    Design: UK-wide mixed-methods convergent design (Sep 20-Aug 21).
    Methods: Online questionnaire (n = 431) with validated components. Purposively sampled semi-structured interviews (n = 30). Patient and public input throughout.
    Findings: Kidney disease was associated with defeminization, negatively affecting current (sexual) relationships and perceptions of future life goals. There was little evidence that shared decision making was taking place. Unplanned pregnancies were common, sometimes influenced by poor care and support and complicated systems. Reasons for (not) wanting children varied. Complicated pregnancies and miscarriages were common. Women often felt that it was more important to be a "good mother" than to address their health needs, which were often unmet and unrecognized. Impacts of pregnancy on disease and options for alternates to pregnancy were not well understood.
    Conclusion: The needs and reproductive priorities of women are frequently overshadowed by their kidney disease. High-quality shared decision-making interventions need to be embedded as routine in a feminized care pathway that includes reproductive health. Research is needed in parallel to examine the effectiveness of interventions and address inequalities.
    Impact: We do not fully understand the expectations, needs, experiences and preferences of women with kidney disease for planning and starting a family or deciding not to have children. Women lack the knowledge, resources and opportunities to have high-quality conversations with their healthcare professionals. Decisions are highly personal and related to a number of health, social and cultural factors; individualized approaches to care are essential. Healthcare services need to be redesigned to ensure that women are able to make informed choices about pregnancy and alternative routes to becoming a parent.
    Patient or public contribution: The original proposal for this research came from listening to the experiences of women in clinic who reported unmet needs and detailed experiences of their pregnancies (positive and negative). A patient group was involved in developing the funding application and helped to refine the objectives by sharing their experiences. Two women who are mothers living with kidney disease were co-opted as core members of the research team. We hosted an interim findings event and invited patients and wider support services (adoption, fertility, surrogacy, education and maternal chronic kidney disease clinics) from across the UK to attend. We followed the UK national standards for patient and public involvement throughout.
    MeSH term(s) Child ; Female ; Humans ; Pregnancy ; Critical Pathways ; Decision Making ; Kidney Diseases ; Parenting ; Reproduction
    Language English
    Publishing date 2023-03-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 197634-5
    ISSN 1365-2648 ; 0309-2402
    ISSN (online) 1365-2648
    ISSN 0309-2402
    DOI 10.1111/jan.15659
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  10. Article ; Online: Retrospective Study of Prenatal and Postnatal Gaps in Oral Health Care Utilization: Medicaid Policy Implications.

    Puett, Savannah / Tellez, Montserrat / Byrd, Gentry / Weintraub, Jane A / Ciszek, Brittney / Phillips, Ceib / Boggess, Kim / Quinonez, Rocio

    Maternal and child health journal

    2022  Volume 26, Issue 3, Page(s) 642–648

    Abstract: Objective: To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of ...

    Abstract Objective: To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of North Carolina (NC) dental Medicaid policies.
    Methods: We completed a retrospective chart review of pregnant women referred to the program between May 2015 and May 2019. Data were collected from the time of referral until up to 2 years after their estimated due date (EDD). We assessed pre- and post-delivery dental appointment timing and dental treatment completion.
    Results: The initial study population included 264 pregnant women. Overall, 213 patients (81%) attended at least one appointment, and 32 patients (12%) completed recommended treatments prior to their EDD. Fifty patients (19%) returned after delivery to resume dental care, with only 25 patients (10%) completing their recommended treatment plan. Women re-entered dental care at a median of 67 days (range 5-613 days) after their EDD and completed treatment at a median of 378 days (range 52-730 days) following delivery.
    Conclusions for practice: Despite dental clinic referral, most pregnant women do not complete recommended dental treatment before giving birth, and women who resumed dental care after birth demonstrated a lag-time between delivery and care completion. These findings highlight the need for extending post-pregnancy dental care coverage, which is limited under current dental Medicaid policies, posing a major public health issue for new mothers to continue oral health care.
    MeSH term(s) Female ; Humans ; Medicaid ; Oral Health ; Patient Acceptance of Health Care ; Policy ; Pregnancy ; Prenatal Care ; Retrospective Studies ; United States
    Language English
    Publishing date 2022-01-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-021-03343-9
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