Faculty Bibliography

OBJECTIVE: Investigate efficacy of 13.3 mg/24 h rivastigmine patch in patients with severe Alzheimer's disease on Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale-Severe Impairment Version items and domains. METHODS: Retrospective analysis of the 24-week, randomized, double-blind ACTivities of daily living and cognitION (ACTION) study, using factor analysis to establish "best fit" for Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale-Severe Impairment Version items into domains. Treatment differences (13.3 vs 4.6 mg/24 h patch) on items and domains were assessed. RESULTS: Overall, 632 patients provided Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale-Severe Impairment Version data. Factor analysis yielded four domains. The 13.3 versus 4.6 mg/24 h patch demonstrated significantly greater efficacy on "Daily function" (p = 0.038), supported by greatest effect sizes on items within this domain, and trend toward greater efficacy on "Communication" (p = 0.052). No significant between-group differences were observed on "Independence" (p = 0.600) or "Environment" (p = 0.261). CONCLUSION: The 13.3 mg/24 h patch was superior to 4.6 mg/24 h patch on "Daily function" in severe Alzheimer's disease.

We examine the extent to which executive functions (EFs), as opposed to other cognitive skills, account for socioeconomically based disparities in school readiness. Participants are 226 American children (aged 36-71 months) enrolled in either needs-based or private preschools. Children completed 6 tasks designed to measure EFs as well as assessments of general intelligence and speed of cognitive processing. Children were also assessed on math, reading, and vocabulary skills. EFs accounted for unique variance across all academic measures even when controlling for speed of processing and general intelligence and partially accounted for disparities in school readiness associated with type of preschool enrollment. When vocabulary was controlled in the model, EFs only mediated associations between type of preschool and math. Vocabulary skills accounted for associations between socioeconomic status and both math and reading achievement. General intelligence and speed of processing did not uniquely account for associations between disadvantage and school readiness. (C) 2013 Elsevier Ltd. All rights reserved.

OBJECTIVE: This paper reviews available studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. METHODS: We search electronic databases and conducted a thematic analysis of empirical studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. Studies were mapped to describe their methods, target population and the health behaviors or health outcomes studied. Forty-five studies met the inclusion criteria. RESULTS: The studies reviewed used the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions. The model was also used as an analysis tool, to sift through text and data in order to separate, define and delineate emerging themes. PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes. Finally, the studies reviewed highlighted the utility of the model with examining cultural practices that are critical to positive health behaviors, unique practices that have a neutral impact on health and the negative factors that are likely to have an adverse influence on health. DISCUSSION: The limitations of model and the role for future studies are discussed relative to the importance of using PEN-3 cultural model to explore the influence of culture in promoting positive health behaviors, eliminating health disparities and designing and implementing sustainable public health interventions.

Reducing HIV/AIDS-related stigma is critical in the fight against HIV/AIDS. Although national campaigns and prevention programs have been implemented across South Africa to address this critical concern, assessing the impact of these initiatives is difficult as it requires that measurement of HIV/AIDS-related stigma is uniform and comparable nationwide. The appropriateness of existing stigma measures for this task is unclear as measurement of HIV/AIDS-related stigma may be qualitatively different across South Africa's diverse population. The current study assesses a theoretically and culturally informed multidimensional, HIV/AIDS-related stigma scale for measurement invariance across a sample drawn from two culturally distinct South African provinces: Limpopo (n = 597) and Western Cape (n = 598). Results suggest measurement invariance across groups for the HIV/AIDS stigma scale, supporting the scale's integrity and appropriateness for use across diverse populations.

Prior research with adults suggests mixed evidence for the relations of state and trait anxiety to prefrontal executive functions (EF). Trait anxiety is hypothesised to impair the efficiency of prefrontal areas and goal-directed attention and has been largely associated with poorer performance on executive functioning tasks. Fewer studies have investigated state anxiety, and the findings have been mixed. As studies of these processes in children have been limited by small sample sizes and a focus on working memory, we examine whether state and trait anxiety are associated with performance on two EF tasks in a sample of urban, low-income children, ages 9-12. Results indicated that higher trait anxiety predicted lower executive functioning on both tasks. In addition, higher state anxiety was related to better performance on the Stroop task. Results demonstrate that, consistent with the adult literature, higher trait anxiety is related to lower executive functioning in children.

Effective early education is essential for academic achievement and positive life outcomes, particularly for children in poverty. Advances in neuroscience suggest that a focus on self-regulation in education can enhance children's engagement in learning and establish beneficial academic trajectories in the early elementary grades. Here, we experimentally evaluate an innovative approach to the education of children in kindergarten that embeds support for self-regulation, particularly executive functions, into literacy, mathematics, and science learning activities. Results from a cluster randomized controlled trial involving 29 schools, 79 classrooms, and 759 children indicated positive effects on executive functions, reasoning ability, the control of attention, and levels of salivary cortisol and alpha amylase. Results also demonstrated improvements in reading, vocabulary, and mathematics at the end of kindergarten that increased into the first grade. A number of effects were specific to high-poverty schools, suggesting that a focus on executive functions and associated aspects of self-regulation in early elementary education holds promise for closing the achievement gap.

Using data from a diverse sample of 620 families residing in rural, predominately low-income communities, this study examined longitudinal links between fathers' sensitive parenting in infancy and toddlerhood and children's early executive functioning, as well as the contribution of maternal sensitive parenting. After accounting for the quality of concurrent and prior parental care, children's early cognitive ability, and other child and family factors, fathers' and mothers' sensitive and supportive parenting during play at 24 months predicted children's executive functioning at 3 years of age. In contrast, paternal parenting quality during play at 7 months did not make an independent contribution above that of maternal care, but the links between maternal sensitive and supportive parenting and executive functioning seemed to operate in similar ways during infancy and toddlerhood. These findings add to prior work on early experience and children's executive functioning, suggesting that both fathers and mothers play a distinct and complementary role in the development of these self-regulatory skills.