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Background: Castilian-Spanish, Catalan, Galician, and European Portuguese are the most widely spoken languages of the Ibero-Romance group. An increasing number of authors have addressed the impact of aphasia on the morphosyntax of these varieties. However, accurate linguistic characterisations are scarce and the different sources of data have not been yet compiled.Aims: To stimulate state-of-the-art research, we provided a comprehensive summary of morphosyntactic aspects of Ibero-Romance and a review of how these are affected in non-fluent aphasia. The topics we dealt with are the use of verb argument structure and morphology, sentential negation and word order, definite articles, personal and reflexive pronouns, passives, topicalised constructions, questions, and relative clauses.Methods & Procedures: An exhaustive fieldwork and search of PubMed, Web of Science, and Medline records were performed to retrieve studies focused on morphosyntactic issues concerning the Ibero-Romance varieties. A total of 27 studies produced by 46 authors of varying background emerged. We did not review studies of category-specific deficits and aspects related to bilingual aphasia, although we assume that most speakers of Galician and Catalan are bilingual. Studies of spontaneous speech were included when no controlled experimental tasks were available.Outcomes & Results: The morphosyntactic commonalities of Ibero-Romance have been tackled from different theoretical perspectives. There exist asymmetries in findings which we explain with the use of different tasks (and task complexity) and individual differences between participants.Conclusions: Discourse-linking factors as well as deviations from the canonical pattern are recurrent answers to these asymmetries. A comprehensive theory of impairments in non-fluent aphasia integrating relevant aspects of both structural and processing accounts seems necessary.
Die nun begonnene Reihe „studieren++“ resultiert aus einer von der Universität Potsdam angebotenen Vorlesungsreihe. Das Besondere an dieser Vorlesungsreihe ist der multidisziplinäre Anspruch und die konsequent umgesetzte Zusammenarbeit über Disziplingrenzen hinweg. Die nicht nur über Instituts-, sondern über Fakultätsgrenzen praktizierte Interdisziplinarität erlaubt die Betrachtung eines Problems oder Sachverhalts aus unterschiedlichen Blickwinkeln. Wissenschaftliche Fragestellungen sind komplex und nicht immer auf eine Disziplin beschränkt. Sie in ihrer Gänze erfassen und nachhaltige Lösungsstrategien oder Konzepte entwickeln zu können gelingt oft nur durch eine multidisziplinäre Kooperation. Eine Lehrveranstaltung wie die vorliegende ist nicht nur für die Studierenden einer Universität eine hervorragende Möglichkeit, um über die Grenzen der eigenen Disziplin hinaus zu blicken und die Zusammenarbeit mit Wissenschaftlerinnen und Wissenschaftlern aus anderen Bereichen zu pflegen. So lernt man, sich in andere Sichtweisen hineinzuversetzen und sich zwischen den Disziplinen zu bewegen – eine Kompetenz, die in der hochkomplexen Arbeitswelt von heute von hohem Nutzen ist.
Der vorliegende erste Band der Reihe hat „Raum und Zahl“ zum Thema und ist aus einer Ringvorlesung aus dem Wintersemester 2013/2014 entstanden. Drei der fünf Fakultäten, insgesamt neun Institute der Universität Potsdam, haben sich an der Vorlesung beteiligt und sich dieses spannenden Themas angenommen. Als jemand, der sich jahrelang wissenschaftlich mit algorithmischer Geometrie sowie mit raumbezogenen Datenbanken und Navigationssystemen beschäftigt hat, kann ich nur bekräftigen, dass die Bezüge zwischen Raum und Zahl, zwischen Räumen und Zahlen, noch viel stärker im öffentlichen Bewusstsein verankert gehören. Räume auch quantitativ zu erfassen und zu verstehen ist eine Kulturtechnik, die an Wichtigkeit eher noch zunimmt, vor allem vor dem Hintergrund, dass wir genetisch nicht allzu gut auf derartige Herausforderungen vorbereitet sind. Denn viele unserer einschlägigen Gene entstammen noch aus der Zeit der Savanne, einer Zeit, zu der das Raumkonzept sich fast ausschließlich auf die unmittelbare räumliche Umgebung bezog und Zahlen jenseits von 10 nur wenig Relevanz für das eigene Überleben hatten.
Als Präsident der Universität Potsdam freut es mich ganz besonders, dass sich die hier vertretenen Wissenschaftler bereit erklärt haben, ihre Überlegungen mit den Studierenden und ihren Kolleginnen und Kollegen zu teilen. Herrn Kollegen Hans-Joachim Petsche möchte ich für sein Engagement danken und ihm zu dieser gelungenen Reihe gratulieren. Der Geist der Wissenschaft, der nicht nur einsam im Büro oder Labor gelebt wird, sondern gerade an einer Universität auch aktiv nach außen getragen werden sollte, wird hier in besonderer Weise sichtbar. Ich wünsche Ihnen viel Freude bei der Lektüre des Bandes und freue mich auf weitere Veröffentlichungen in dieser Reihe.
Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis
(2015)
Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics.
Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status.
Results: After one year of follow-up, nearly 60% of patients continued drug treatment. Donezepil (HR: 0.88; 95% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline.
Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.
Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst healthy participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
The processing of nonverbal auditory stimuli has not yet been sufficiently investigated in patients with aphasia. On the basis of a duration discrimination task, we examined whether patients with left-sided cerebrovascular lesions were able to perceive time differences in the scale of approximately 150ms. Further linguistic and memory-related tasks were used to characterize more exactly the relationships in the performances between auditory nonverbal task and selective linguistic or mnemonic disturbances. All examined conduction aphasics showed increased thresholds in the duration discrimination task. The low thresholds on this task were in a strong correlative relation to the reduced performances in repetition and working memory task. This was interpreted as an indication of a pronounced disturbance in integrating auditory verbal information into a long-term window (sampling disturbance) resulting in an additional load of working memory. In order to determine the lesion topography of patients with sampling disturbances, the anatomical and psychophysical data were correlated on the basis of a voxelwise statistical approach. It was found that tissue damage extending through the insula, the posterior superior temporal gyrus, and the supramarginal gyrus causes impairments in sequencing of time-sensitive information.
Finger-based numerical representations have gained increasing research interest. However, their description and assessment often refer to different numerical principles of ordinality, cardinality and 1-to-1 correspondence. Our aim was to investigate similarities and differences between these principles in finger-based numerical representations. Sixty-eight healthy adults performed ordinal finger counting, cardinal finger montring (showing the number of gestures) and finger-to-number mapping with twisted arms and fingers. We found that counting gestures and montring postures were identical for Number 10 but differed to varying degrees for other numbers. Interestingly, there was no systematic relation between finger-to-number mapping and ordinal finger counting habits. These data question the assumption of a unitary embodied finger-based numerical representation, but suggest that different finger-based representations co-exist and can be recruited flexibly depending on the numerical aspects to be conveyed.