Schizophrenia-like topological changes in the structural connectome of individuals with subclinical psychotic experiences.

Schizophrenia is often regarded as a "dysconnectivity" disorder and recent work using graph theory has been used to better characterize dysconnectivity of the structural connectome in schizophrenia. However, there are still little data on the topology of connectomes in less severe forms of the condition. Such analysis will identify topological markers of less severe disease states and provide potential predictors of further disease development.

Interaction Between Functional Genetic Variation of DRD2 and Cannabis Use on Risk of Psychosis.

Both cannabis use and the dopamine receptor (DRD2) gene have been associated with schizophrenia, psychosis-like experiences, and cognition. However, there are no published data investigating whether genetically determined variation in DRD2 dopaminergic signaling might play a role in individual susceptibility to cannabis-associated psychosis. We genotyped (1) a case-control study of 272 patients with their first episode of psychosis and 234 controls, and also from (2) a sample of 252 healthy subjects, for functional variation in DRD2, rs1076560.

Medical assistants' roles in electronic health record processes in primary care practices: the untold story.

The role of the medical assistant has been undervalued in the past. Many publications have detailed the integral role of the nursing staff and physicians, but the medical assistant role has come last in formal recognition. As healthcare settings move toward a more Patient-Centered Medical Home (PCMH) model, the attitudes of this model will need to be adopted, two of which are team-based care and adoption of the electronic health record (EHR).

Syntheses of arnottin I and arnottin II.

Short total syntheses of arnottin I and II were accomplished in 5 and 6 steps, respectively. A sesamol-benzyne cycloaddition with a 3-furyl-benzoate followed by regiospecific lactonization provided rapid, large-scale access to the core of arnottin I. Saponification of arnottin I and hypervalent iodide mediated spirocyclization provided an efficient and direct preparation of racemic arnottin II.

Fluphenazine decanoate (depot) and enanthate for schizophrenia.

Background: Intramuscular injections (depot preparations) offer an advantage over oral medication for treating schizophrenia by reducing poor compliance. The benefits gained by long-acting preparations, however, may be offset by a higher incidence of adverse effects.

Objectives: To assess the effects of fluphenazine decanoate and enanthate versus oral anti-psychotics and other depot neuroleptic preparations for individuals with schizophrenia in terms of clinical, social and economic outcomes.

Contemporary teaching strategies of exemplary community preceptors--is technology helping?

Background And Objectives: Many schools rely upon community preceptors for office-based education of medical students. These preceptors struggle to balance clinical care with the learning needs of students. We aim to gain a deeper understanding of the teaching rewards and challenges of current community preceptors.

Predictors of response to a cognitive behavioral intervention for impulse control behaviors in Parkinson's disease.

Background: Limited trial evidence suggests that cognitive-behavioral therapy (CBT) may be effective in managing impulse control behavior (ICBs) in Parkinson's disease.

Aims: To examine predictors of outcome in trial, participants (N=42) receiving treatment immediately or after a waiting time.

Methods: Dependent variables were Clinical Global Impression of Change (CGI-C) and the Neuropsychiatric Inventory (NPI).

Exploring neural dysfunction in 'clinical high risk' for psychosis: a quantitative review of fMRI studies.

Individuals at clinical high risk (CHR) of developing psychosis present with widespread functional abnormalities in the brain. Cognitive deficits, including working memory (WM) problems, as commonly elicited by n-back tasks, are observed in CHR individuals. However, functional MRI (fMRI) studies, comprising a heterogeneous cluster of general and social cognition paradigms, have not necessarily demonstrated consistent and conclusive results in this population.

Physiotherapy for functional motor disorders: a consensus recommendation.

Background: Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment.

Probing the charging mechanisms of carbon nanomaterial polyelectrolytes.

Chemical charging of single-walled carbon nanotubes (SWCNTs) and graphenes to generate soluble salts shows great promise as a processing route for electronic applications, but raises fundamental questions. The reduction potentials of highly-charged nanocarbon polyelectrolyte ions were investigated by considering their chemical reactivity towards metal salts/complexes in forming metal nanoparticles. The redox activity, degree of functionalisation and charge utilisation were quantified via the relative metal nanoparticle content, established using thermogravimetric analysis (TGA), inductively coupled plasma atomic emission spectroscopy (ICP-AES) and X-ray photoelectron spectroscopy (XPS).

Symptom profiles in depersonalization and anxiety disorders: an analysis of the Beck Anxiety Inventory.

Background: Depersonalization disorder (DPD) entails distressing alterations in self-experiencing. However, it has long been recognized that depersonalisation symptoms occur in other disorders, particularly anxiety and panic. One strand of research proposes that depersonalization phenomenology arises through altered autonomic arousal in response to stress.

Clinical spectrum of impulse control disorders in Parkinson's disease.

Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa.

Building a workforce of physicians to care for underserved patients.

There is a shortage of physicians to care for underserved populations. Medical educators at The Warren Alpert Medical School of Brown University have used five years of Health Resources and Services Administration funding to train medical students to provide outstanding primary care for underserved populations. The grant has two major goals: 1) to increase the number of graduating medical students who practice primary care in underserved communities ("Professional Development"); and 2) to prepare all medical school graduates to care for underserved patients, regardless of specialty choice ("Curriculum Development").

Teaching and addressing health disparities through the family medicine social and community context of care project.

By training future physicians to care for patients with backgrounds different from their own, medical schools can help reduce health disparities. To address the need for education in this area, the leaders of the Family Medicine Clerkship at the Warren Alpert Medical School of Brown University developed the Social and Community Context of Care project, required of all medical students rotating through this clerkship. Students develop a hypothetical intervention addressing a health issue seen at their preceptor site, and are assessed on their grasp of the social and contextual issues affecting that health issue in their particular community.

Brain derived Neurotropic Factor (BDNF) is associated with childhood abuse but not cognitive domains in first episode psychosis.

Background: The Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome.

Aims: We investigated the hypothesis that BDNF is associated with both CT and cognitive deficits in a sample of first-episode psychosis (FEP) cases and unaffected controls.

Role of Environmental Confounding in the Association between FKBP5 and First-Episode Psychosis.

Background: Failure to account for the etiological diversity that typically occurs in psychiatric cohorts may increase the potential for confounding as a proportion of genetic variance will be specific to exposures that have varying distributions in cases. This study investigated whether minimizing the potential for such confounding strengthened the evidence for a genetic candidate currently unsupported at the genome-wide level.

Methods: Two hundred and ninety-one first-episode psychosis cases from South London, UK and 218 unaffected controls were evaluated for a functional polymorphism at the rs1360780 locus in FKBP5.

A structural MRI study of cortical thickness in depersonalisation disorder.

Depersonalisation disorder (DPD) is characterised by a sense of unreality about the self and the world. Research suggests altered autonomic responsivity and dysfunction in prefrontal and temporal lobe areas in this condition. We report the first structural magnetic resonance imaging study of 20 patients with DPD and 21 controls using the FreeSurfer analysis tool employing both region-of-interest and vertex-based methods.

Effects of age on metacognitive efficiency.

Humans have a capacity to become aware of thoughts and behaviours known as metacognition. Metacognitive efficiency refers to the relationship between subjective reports and objective behaviour. Understanding how this efficiency changes as we age is important because poor metacognition can lead to negative consequences, such as believing one is a good driver despite a recent spate of accidents.

Jumping to conclusions, neuropsychological functioning, and delusional beliefs in first episode psychosis.

Background: The "jumping to conclusions" (JTC) data-gathering bias is implicated in the development and maintenance of psychosis but has only recently been studied in first episode psychosis (FEP). In this study, we set out to establish the relationship of JTC in FEP with delusions and neuropsychological functioning.

Methods: One hundred and eight FEP patients and 101 age-matched controls completed assessments of delusions, general intelligence (IQ), working memory (WM), and JTC (the probabilistic reasoning "beads" task).

Self-rated and performance-based empathy in schizophrenia: the impact of cognitive deficits.

People may be much less empathic than they think they are. It is not clear whether patients with schizophrenia who have impaired empathic abilities also exhibit diminished ability to accurately appraise their own such skills. The present study aimed to examine: (a) the accuracy of self-appraisal of empathy and (b) the impact of specific cognitive functions on both self-rated and performance-based empathy in schizophrenia patients and healthy volunteers.

Cardiac risk factors: new cholesterol and blood pressure management guidelines.

The 2013 American College of Cardiology/American Heart Association cholesterol guidelines depart from low-density lipoprotein (LDL) treatment targets and recommend treating four specific patient groups with statins. Statins are the only cholesterol-lowering drugs with randomized trial evidence of benefit for preventing atherosclerotic cardiovascular disease (ASCVD). The groups are patients with clinical ASCVD; patients ages 40 to 75 years with diabetes and LDL of 70 to 189 mg/dL but no clinical ASCVD; patients 21 years or older with LDL levels of 190 mg/dL or higher; and patients ages 40 to 75 years with LDL of 70 to 189 mg/dL without clinical ASCVD or diabetes but with 10-year ASCVD risk of 7.