Heart Rate Variability as an Index of Resilience.

Introduction: Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility.

Allostatic Load as a Complex Clinical Construct: A Case-Based Computational Modeling Approach.

Allostatic load (AL) is a complex clinical construct, providing a unique window into the cumulative impact of stress. However, due to its inherent complexity, AL presents two major measurement challenges to conventional statistical modeling (the field's dominant methodology): it is comprised of a complex causal network of bioallostatic systems, represented by an even larger set of dynamic biomarkers; and, it is situated within a web of antecedent socioecological systems, linking AL to differences in health outcomes and disparities. To address these challenges, we employed case-based computational modeling (CBM), which allowed us to make four advances: (1) we developed a multisystem, 7-factor (20 biomarker) model of AL's network of allostatic systems; (2) used it to create a catalog of nine different clinical AL profiles (causal pathways); (3) linked each clinical profile to a typology of 23 health outcomes; and (4) explored our results (post hoc) as a function of gender, a key socioecological factor.

Expansion of a VR Exposure Therapy System for Combat-Related PTSD to Medics/Corpsman and Persons Following Military Sexual Trauma.

The stressful experiences that have been characteristic of the combat environments in Iraq and Afghanistan have produced significant numbers of returning service members at risk for developing posttraumatic stress disorder and other psychosocial/behavioral health conditions. This paper describes a set of projects that are expanding the content for inclusion in a newly updated "Virtual Iraq/Afghanistan" Virtual Reality system for the delivery of exposure therapy (VRET) for PTSD with Service Members and Veterans. In addition to the complete rebuilding of this VRET system using the latest version of the Unity Game Engine, the system's content and functionality has been expanded to now support the use of VRET with combat medics/corpsmen and persons who have experienced military sexual trauma (MST).

Self-Reported Differences in Personality, Emotion Control, and Presence Between Pre-Military and Non-Military Groups in a Pilot Study Using the Stress Resilience in Virtual Environments (STRIVE) System.

Mental health disorders are the signature wounds of war resulting from extended U.S. Military conflicts in the Middle East [1].

STRIVE: Stress Resilience In Virtual Environments: a pre-deployment VR system for training emotional coping skills and assessing chronic and acute stress responses.

The incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. This has served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. One emerging form of treatment for combat-related PTSD that has shown promise involves the delivery of exposure therapy using immersive Virtual Reality (VR).

Regional atrophy of the corpus callosum in dementia.

The regional distribution of degeneration of the corpus callosum (CC) in dementia is not yet clear. This study compared regional CC size in participants (n = 179) from the Cache County Memory and Aging Study. Participants represented a range of cognitive function: Alzheimer's disease (AD), vascular dementia (VaD), mild ambiguous (MA-cognitive problems, but not severe enough for diagnosis of dementia), and healthy older adults.

Incidence of dementia in long-term hormone users.

Results from epidemiologic studies of postmenopausal hormone use and dementia have been conflicting. Investigators from the Women's Health Initiative Memory Study reported that the incidence of dementia in women aged >/=65 years assigned to hormone use was increased. Here the authors report results from a prospective cohort study of 2,906 dementia-free women (1,519 hormone users and 1,387 hormone nonusers) aged > or =75 years who were recruited from a Southern California health plan in 1999 and followed through 2003.

A controlled clinical comparison of attention performance in children with ADHD in a virtual reality classroom compared to standard neuropsychological methods.

In this initial pilot study, a controlled clinical comparison was made of attention perforance in children with attention deficit-hyperactivity disorder (ADHD) in a virtual reality (VR) classroom. Ten boys diagnosed with ADHD and ten normal control boys participated in the study. Groups did not significantly differ in mean age, grade level, ethnicity, or handedness.

Validation of the Cognitive Assessment of Later Life Status (CALLS) instrument: a computerized telephonic measure.

Background: Brief screening tests have been developed to measure cognitive performance and dementia, yet they measure limited cognitive domains and often lack construct validity. Neuropsychological assessments, while comprehensive, are too costly and time-consuming for epidemiological studies. This study's aim was to develop a psychometrically valid telephone administered test of cognitive function in aging.

Menopause transition stage and endogenous estradiol and follicle-stimulating hormone levels are not related to cognitive performance: cross-sectional results from the study of women's health across the nation (SWAN).

Background: By one estimate, 60% of women experiencing the menopause transition perceive that they have memory problems, but most studies that have used cognitive function tests have not substantiated a relation between menopause stage and cognitive performance. We sought to describe the cross-sectional relation between menopause status, estradiol (E(2)), follicle-stimulating hormone (FSH), and measured cognitive function.

Methods: Cross sectional analysis of a community-based cohort of midlife women was used.

Dietary genistein intake and cognitive performance in a multiethnic cohort of midlife women.

Objective: To examine the relationship between food frequency questionnaire estimated isoflavone intakes and cognitive performance.

Design: The Study of Women's Health Across the Nation (SWAN), is a multiethnic, community based, longitudinal study of women aged 42 to 52 years at entry. Dietary isoflavone intakes were estimated from an interviewer-administered food frequency questionnaire at baseline.

Cognitive domains associated with performance on the telephone interview for cognitive status-modified.

Global cognitive screening tests are increasingly used in clinical and research settings. However, many have not been developed following systematic psychometric principles; thus, construct validity is not clearly defined. It is the aim of this study to identify the cognitive domains that are associated with the total score from the Telephone Interview for Cognitive Status-modified (TICS-m).

A virtual reality scenario for all seasons: the virtual classroom.

Treatment and rehabilitation of the cognitive, psychological, and motor sequelae of central nervous system dysfunction often relies on assessment instruments to inform diagnosis and to track changes in clinical status. Typically, these assessments employ paper-and-pencil psychometrics, hands-on analog/computer tests, and rating of behavior within the context of real-world functional environments. Virtual reality offers the option to produce and distribute identical "standard" simulation environments in which performance can be measured and rehabilitated.

Cognitive performance of older women who have survived cancer.

Based on anecdotal reports and a few empirical studies, there is concern about the cognitive effects of cancer and its treatment effects among adults. A cross-sectional comparison of the cognitive performance of 541 elderly women who reported at least one hospitalization for cancer and 3,123 who had no reported hospitalizations for cancer was conducted. The difference between cancer survivors and those with no history of cancer on a screening test of global cognitive functioning was not significant, nor were there differences on a subtest of the global test that assesses verbal memory.

Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey.

The epidemiology of prolapse and incontinence questionnaire (EPIQ) was developed to screen for female pelvic floor disorders (PFD). Content and face validity, reliability, internal consistency and criterion validity of the EPIQ to detect the presence of pelvic organ prolapse (POP), stress urinary incontinence (SUI), overactive bladder (OAB) and anal incontinence (AI) is presented. Cronbach's alpha; Spearman's, kappa, intraclass correlations, factor analysis and Chi-Squared tests were used for analysis.

Blood pressure levels before dementia.

Background: The association between blood pressure (BP) and dementia is not easily interpreted, but some prospective studies suggest that dementia may lower BP.

Objective: To examine the relationship between BP during a 10-year period and the prevalence of dementia.

Design: Comparison of longitudinal BP between participants who had dementia, participants who were cognitively impaired, and unimpaired participants selected from an ongoing cohort study.

The use of Visual Analog Scale in urogynecologic research: a psychometric evaluation.

Objective: The purpose of this study was to assess the validity of Visual Analog Scales in urogynecologic research.

Study Design: In phase I, 35 women completed short forms of the urogenital distress inventory, incontinence impact questionnaire, and Beck depression inventory fast screen using the Likert-type scale and Visual Analog Scale formats. Reliability was estimated with Spearman's correlations and Cronbach's alpha; construct validity was assessed with the use of factor analyses.

Physician recognition of cognitive impairment: evaluating the need for improvement.

Objectives: To assess physician recognition of dementia and cognitive impairment, compare recognition with documentation, and identify physician and patient factors associated with recognition.

Design: Survey of physicians and review of medical records.

Setting: Health maintenance organization in southern California.

Backpropagation and regression: comparative utility for neuropsychologists.

The aim of this research was to compare the data analytic applicability of a backpropagated neural network with that of regression analysis. Thirty individuals between the ages of 64 and 86 (Mean age = 73.6; Mean years education = 15.

Diabetes mellitus and cognitive performance in older women.

Purpose: This cross-sectional study sought to identify diabetes accurately in a study population of 3681 women age 75 and older and to determine the association of diabetes with cognitive performance.

Methods: A previously validated test, the Telephone Interview of Cognitive Screening-Modified (TICSm) was given to assess cognitive status. A diabetes case identification database, medical record review and self-report were used to determine diabetes cases.

How the question is asked makes a difference in the assessment of depressive symptoms in older persons.

Objective: The authors examined whether older adults respond comparably to two standard depression instruments rating symptoms by frequency/duration or degree of severity/"bother."

Methods: Data for this cross sectional analysis of a prospective cohort came from 699 community-dwelling individuals within the communities of Durham, North Carolina, and New Haven, Connecticut. Differences in response between the Center for Epidemiological Studies-Depression (CES-D) survey, emphasizing symptom frequency, were compared with the Hopkins Symptom Checklist (HSCL) subscale, emphasizing bother or discomfort related to those symptoms.

Sex differences in mental rotation and spatial rotation in a virtual environment.

The visuospatial ability referred to as mental rotation has been shown to produce one of the largest and most consistent sex differences, in favor of males, in the cognitive literature. The current study utilizes both a paper-and-pencil version of the mental rotations test (MRT) and a virtual environment for investigating rotational ability among 44 adult subjects. Results replicate sex differences traditionally seen on paper-and-pencil measures, while no sex effects were observed in the virtual environment.

Hormone use and cognitive performance in women of advanced age.

Objectives: To explore the association between hormone replacement therapy (HRT) and cognitive performance in a group of elderly women (>/=75) using a battery of well-standardized neuropsychological instruments.

Design: Equivalent samples from existing cohort.

Setting: Healthcare provider organization.

Presurgical cognitive deficits in patients receiving coronary artery bypass graft surgery.

Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) can produce a higher incidence of neuropsychological complications than other types of highly invasive noncardiac vascular surgery. Cognitive complications most likely arise from either embolization or hypoxia. An alternative surgical procedure has been developed that allows CABG to be performed without stopping the heart ("off-pump" CABG, or OPCABG).