Neurocognitive aging data release with behavioral, structural and multi-echo functional MRI measures.

Central to understanding human behavior is a comprehensive mapping of brain-behavior relations within the context of lifespan development. Reproducible discoveries depend upon well-powered samples of reliable data. We provide to the scientific community two, 10-minute, multi-echo functional MRI (ME-fMRI) runs, and structural MRI (T1-MPRAGE), from 181 healthy younger (ages 18-34 y) and 120 older adults (ages 60-89 y). T2-FLAIR MRIs and behavioral assessments are available in a majority subset of over 250 participants. Behavioral assessments include fluid and crystallized cognition, self-reported measures of personality, and socioemotional functioning. Initial quality control and validation of these data is provided. This dataset will be of value to scientists interested in BOLD signal specifically isolated from ME-fMRI, individual differences in brain-behavioral associations, and cross-sectional aging effects in healthy adults. Demographic and behavioral data are available within the Open Science Framework project "Goal-Directed Cognition in Older and Younger Adults" ( http://osf.io/yhzxe/ ), which will be augmented over time; neuroimaging data are available on OpenNeuro ( https://openneuro.org/datasets/ds003592 ).

White matter lesion load is associated with lower within- and greater between- network connectivity across older age.

White matter hyperintensities (WMH) are among the most prominent structural changes observed in older adulthood. These changes coincide with functional changes to the intrinsic network organization of the aging brain. Yet little is known about how WMH are associated with changes to the whole-brain functional connectome in normal aging. We used a lesion prediction algorithm to quantify WMH as well as resting-state multiecho functional magnetic resonance imaging to characterize resting-state functional connectivity in a cross-sectional sample of healthy older adults (N = 105, 60-83 years of age). In a multivariate analysis, we found that higher lesion load was associated with a global pattern of network dedifferentiation, marked by lower within- and greater between- network connectivity. Network specific changes included greater visual network integration and greater posterior-anterior connectivity. The relationship between WMH and resting-state functional connectivity was negatively associated with fluid IQ as well as Blood Oxygen Level Dependent signal dimensionality. Reduced functional network segregation is a widely observed pattern of age-related change. Our findings show that these functional changes are associated with the accumulation of WMH in older adulthood.

Employment Outcomes 2 Years After Bariatric Surgery: Relationship to Quality of Life and Psychosocial Predictors.

OBJECTIVES: Bariatric surgery is the most effective long-term treatment for severe obesity. In addition to sustained weight loss, bariatric surgery can result in improvements in mental and physical health-related quality of life (HRQOL) and, consequently, work capacity. The purpose of our study was to evaluate changes to employment impairment (EI) and related HRQOL in patients 2 years post-bariatric surgery. METHODS: Prospective data was collected on a cohort of 211 patients who underwent bariatric surgery. The Lam Employment Absence and Productivity Scale (LEAPS) and the 36-Item Short Form Survey (SF-36) were used to assess pre- and post-operative EI and physical and mental HRQOL, respectively. Predictors of work impairment changes were analyzed via multiple regression analysis and included demographic variables, history of psychiatric illness, and depression and anxiety self-report measures. RESULTS: Significant improvements in employment outcomes 2 years following surgery were noted with 68% of participants reporting an overall decrease in EI (total LEAPS score change = - 2.43 ± 5.76, p < 0.001), and 44% participants reporting an increase in work productivity (LEAPS productivity score change = - 0.67 ± 2.38, p < 0.001). Bariatric surgery was also associated with significant improvements in physical (change = 17.41 ± 10.72, p < 0.001) and mental (change = 2.67 ± 12.89, p = 0.001). Improvements in HRQOL predicted improvements in work-related impairment and productivity, while history of psychiatric illness predicted was associated with reduced improvement in work productivity. CONCLUSIONS: Our results provide further evidence of improvement in work productivity and reduction in EI post-bariatric surgery. This study also provides insights into potential predictors of work-related impairment and productivity.

Ethical, Stigma, and Policy Implications of Food Addiction: A Scoping Review.

The concept of food addiction has generated much controversy. In comparison to research examining the construct of food addiction and its validity, relatively little research has examined the broader implications of food addiction. The purpose of the current scoping review was to examine the potential ethical, stigma, and health policy implications of food addiction. Major themes were identified in the literature, and extensive overlap was identified between several of the themes. Ethics sub-themes related primarily to individual responsibility and included: (i) personal control, will power, and choice; and (ii) blame and weight bias. Stigma sub-themes included: (i) the impact on self-stigma and stigma from others, (ii) the differential impact of substance use disorder versus behavioral addiction on stigma, and (iii) the additive stigma of addiction plus obesity and/or eating disorder. Policy implications were broadly derived from comparisons to the tobacco industry and focused on addictive foods as opposed to food addiction. This scoping review underscored the need for increased awareness of food addiction and the role of the food industry, empirical research to identify specific hyperpalatable food substances, and policy interventions that are not simply extrapolated from tobacco.

Binge Eating, Loss of Control over Eating, Emotional Eating, and Night Eating After Bariatric Surgery: Results from the Toronto Bari-PSYCH Cohort Study.

OBJECTIVES: We explored the severity of binge eating, loss of control over eating, emotional eating, and night eating before bariatric surgery and annually for 3 years following surgery. We also assessed the impact of post-operative eating psychopathology on weight outcomes. METHODS: Eight hundred forty-four patients participated in this prospective cohort study. Demographic factors, self-report measures of eating pathology (BES, NEQ, EES, EDE-Q), and weights (kg) were collected pre-surgery and annually for 3 years after surgery. RESULTS: The severity of problematic eating behaviors decreased after surgery and remained lower than baseline throughout follow-up. An increase was noted in binge eating scores (change in mean score ± SD = 0.85 ± 4.71; p = 0.002), emotional eating scores (2.00 ± 13.63; p = 0.033), and loss of control eating scores (1.11 ± 7.01; p < 0.001) after the first post-operative year that continued to the third post-operative year. There was also an increase in night eating scores between 2 and 3 years post-surgery (2.52 ± 8.00; p = 0.01). Higher 1-year post-operative binge eating scores were a significant predictor of lower 2-year % total weight loss (ß = - 0.39, confidence interval (CI) - 1.23, - 0.16, p = 0.012). CONCLUSIONS: The severity of problematic eating behaviors decrease after bariatric surgery, but increase significantly between the first and third post-operative years. Binge Eating Scale score at 1 year post-surgery was the only significant predictor of reduced percent total weight loss at 2 years. Additional prospective studies with adequate power are required to assess the progression of these eating pathologies beyond 3 years and their impact on weight outcomes beyond 2 years.

Inter-professional delirium education and care: a qualitative feasibility study of implementing a delirium Smartphone application.

BACKGROUND: Delirium is a common medical condition with a high prevalence in hospital settings. Effective delirium management requires a multi-component intervention, including the use of Interprofessional teams and evidence-based interventions at the point of care. One vehicle for increasing access of delirium practice tools at the point of care is E-health. There has been a paucity of studies describing the implementation of delirium related clinical application. The purpose of this current study is to acquire users' perceptions of the utility, feasibility and effectiveness of a smartphone application for delirium care in a general surgery unit. In addition, the authors aimed to elucidate the potential challenges with implementing this application. METHODS: This quantitative study was conducted between January 2015 and June 2015 at the University Health Network, Toronto General Hospital site. Participants met inclusion criteria if they were clinical staff on the General Surgery Unit at the Toronto General Hospital site and had experience caring for patients with delirium. At the conclusion of the 4 weeks after the implementation of the intervention, participants were invited by email to participate in a focus group to discuss their perspectives related to using the delirium application RESULTS: Our findings identified several themes related to the implementation and use of this smartphone application in an acute care clinical setting. These themes will provide clinicians preparing to use a smartphone application to support delirium care with an implementation framework. CONCLUSIONS: This study is one of the first to demonstrate the potential utility of a smartphone application for delirium inter-professional education. While this technology does appeal to healthcare professionals, it is important to note potential implementation challenges. Our findings provide insights into these potential barriers and can be used to assist healthcare professionals considering the development and use of an inter-professional clinical care application in their setting.

Employment outcomes one year after bariatric surgery: the role of patient and psychosocial factors.

BACKGROUND: Patients undergoing bariatric surgery generally report improved work performance after this procedure; however, previous research has been limited by a lack of standardized employment measures and a failure to account for the impact of psychiatric illness on employment outcomes. To address these limitations, this study aims to assess changes in patients' employment impairment and productivity 12 months post-surgery and to identify psychosocial predictors of change in employment outcomes. METHODS: A total of 164 patients underwent bariatric surgery between February 2010 and November 2012 in this prospective cohort study. The primary outcome was a change in employment impairment (EI) as measured by total Lam Employment Absence and Productivity Scale (LEAPS) scores and changes in participants' job status category. Multiple linear regression models assessed whether baseline demographic or clinical factors, including a history of psychiatric illness and changes in depressive, anxiety and quality of life (QOL) symptoms, were associated with a change in LEAPS scores. RESULTS: Participants reported a significant reduction in EI post-surgery (p < 0.0001) and improvement in work productivity (p < 0.0001) 12 months after surgery. Only changes in depression (confidence interval (CI) 0.46, 0.76, p < 0.0001), anxiety (CI 0.49, 0.85, p < 0.0001) and mental QOL (CI -0.30, -0.17, p < 0.0001) were significant predictors of change in EI total scores. Logistic regression analysis did not identify significant predictors of change in participant job status. CONCLUSIONS: Patients with pre-bariatric surgery psychiatric distress are more likely to report greater employment impairment and worse employment productivity pre-surgery. These patients also experience the greatest improvements in post-surgery employment functioning.