Poor Social Interaction Research Articles

DRUG FACTORS INFLUENCING ITS USE AMONG UNDERGRADUATE STUDENTS OF A TERTIARY INSTITUTION IN NIGERIA

OBJECTIVE: Drug use and abuse have been reported to be one of the main causes of impairment of social competence and performance among students. Also, school drop out, criminal tendencies and poor social interaction have also been reported to be associated with drug abuse among these students. Knowing the Prevalence and patterns of drug use, number of drug use, reason for use, sustainability and duration of drug used as drug factors will help in primary prevention strategy in tertiary institutions in Nigeria and globally.METHODS: A descriptive cross sectional study involving four hundred and forty (440) subjects selected through multistage sampling techniques. All the subjects consented and participated in the study. Self administered socio demographic, WHO students’ drug use and drug factors influencing use questionnaires were administered to the subjects to fill through their class representative. Statistical package for social science (SPSS) 15th editions was used in Data analysis. RESULTS:Four hundred and forty (440) students drawn from 3 faculties of the university participated in the study. One hundred and fifty (150) respondents constituting 34.1% were from faculty of Engineering, one hundred and fifteen (115) respondents constituting 26.1% were from faculty of Education while one hundred and seventy five (175) respondents constituting about 39.8% were from college of Medicine. One hundred and thirteen subjects (25.7%) used one and more of all the 10 drugs examined by the questionnaires. Duration of tobacco use revealed that 40 had used it 5years and above, 15 used it between 3-5years, 4 used it between 6months-1year while 2 tobacco users had 1-3years as duration of usage. The differences was statistically significance (df =4, x2= 12.07, p=0.01). All the 6 cocaine users(1.4%) take 3 other drugs alongside cocaine. The difference was also statistically significant (df= 3, x2= 26.21, p=0.00). Multiple drug use of 3 and more was found to be significant with many of the drugs examined.CONCLUSIONS: Prevalence, patterns and drug factors revealed that psychoactive drug use was found among students of Ahmadu Bello University Zaria like in other institutions of higher learning in Nigeria. Appropriate interventions like health education, social support system, counseling, referral systems, parental supervision and enforcement of necessary laws by regulatory agencies were some of the recommendations to curb the menace in our institutions in Nigeria.

Low-income housing layouts under socio-architectural complexities: A parametric study for sustainable slum rehabilitation

Lack of sustainable slum redevelopment guidelines in India is a policy gap that needs immediate attention. A rational design and planning route is necessary to ensure sustainability of the upcoming low-income (LIG) housing stocks. In this study, we performed a cross-sectional evaluation of LIG housing layouts through a socio-architectural and site-based wind-flow analysis route. We hypothesise that a better indoor environment in the LIG housing can be achieved through a better wind driven natural-ventilation in the living spaces, which is a function of the housing layout. Specific objectives of this study were: i) to investigate the influence of socio-architectural and geometric parameters on the LIG housing layouts; ii) to examine the effect of site-wind flow on LIG housing layouts using CFD simulations. BDD chawls of Mumbai were adopted as the case study. Results show that the current form of the LIG houses had a poor indoor environment and social interaction spaces, while the hypothesised iterated layout ‘Form A’ performed better in all the socio-architectural and wind-flow metrics that can promote relatively better quality of life. This study is a first-step approach for the development of regulatory guidelines in LIG housing design that is coherent to the context of the space.

Weibo or WeChat? Assessing Preference for Social Networking Sites and Role of Personality Traits and Psychological Factors.

Research trying to understand individual difference in the use of different social networking sites (SNSs) is minimal. In the present study, we collected data from 714 college students in China (273 males) to assess how personality traits and psychological factors relate to excessive use of WeChat and Weibo. We found that excessive use of Weibo and WeChat correlated positively with neuroticism, loneliness, and external locus of control and negatively with agreeableness, social support, and social interaction. Furthermore, people that scored high on loneliness, lack of social support, and poor social interaction skills excessively used Weibo more than WeChat. These results entail that by fulfilling different needs, WeChat and Weibo attract different kinds of people; significant lesson for future development of SNSs.

Male rats treated with subchronic PCP show intact olfaction and enhanced interest for a social odour in the olfactory habituation/dishabituation test

The olfactory system participates in many sensory processes, and olfactory endophenotypes appear in a variety of neurological disorders such as Alzheimer’s and Parkinson’s disease, depression and schizophrenia. Social withdrawal is a core negative symptom of schizophrenia and animal models have proven to be invaluable for studying the neurobiological mechanisms and cognitive processes behind the formation of social relationships. The subchronic phencyclidine (PCP) rat model is a validated model for negative symptoms of schizophrenia, such as impaired sociability. However, the complete range of social behaviour and deficits in the model are still not fully understood. Intact rodent olfaction is essential for a wide range of social behaviour and disrupted olfactory function could have severe effects on social communication and recognition. In order to examine the olfactory ability of male rats treated with subchronic PCP, we conducted an olfactory habituation/dishabituation test including both non-social and social odours. The subchronic PCP-treated rats successfully recognized and discriminated among the odours, indicative of intact olfaction. Interestingly, the subchronic PCP-treated rats showed greater interest for a novel social odour compared to the saline-treated rats and the rationale remains to be elucidated. Our data indicate that subchronic PCP treatment does not disrupt olfactory function in male rats. By ruling out impaired olfaction as cause for the poor social interaction performance in subchronic PCP-treated rats, our data supports the use of NMDA receptor antagonists to model the negative symptoms of schizophrenia.

Peer-mediated intervention to improve play skills in children with autism spectrum disorder: A feasibility study.

Children with autism spectrum disorder (ASD) frequently demonstrate impaired play skills and poor quality social interactions compared to typically developing peers. Complex interventions to improve play skills should be investigated with randomised control trials (RCT) where possible to support evidence-based practice for occupational therapists. Prior to a RCT, multiple feasibility studies are recommended to identify barriers to the trial. The aim of this study is to adapt a complex intervention to improve play skills in children with ASD and investigate the feasibility of conducting a RCT. Participants were 10 children with ASD paired with typically developing playmates chosen by their families. Pairs attended 10 intervention sessions involving video modelling, therapist- and peer-mediation and free play. Participant numbers needed for future investigation of effectiveness were calculated and time and cost considerations were reviewed. The Test of Playfulness (ToP) was the primary outcome measure; both parent- and child-report outcome measures were evaluated for appropriateness. To determine effectiveness of the intervention 34 pairs in both control and intervention groups will be needed to conduct a RCT over an 18-month timeframe. ToP scores showed a positive, but not statistically significant trend from pre- to post-intervention. These improvements were maintained at follow-up in both clinic and home environments. The Piers-Harris 2 and the Parent Relationship Questionnaire were identified as appropriate secondary outcome measures; additional parent- and teacher-report outcome measures are recommended for the RCT. A RCT to investigate effectiveness of this intervention for improving play skills of children with ASD and their playmates are feasible.

Autizam i MMR vakcina

Autism is a complex neurological developmental disorder with wide range of symptoms. Among them, poor social interaction, limited and repeated behavioral patterns are the most important for diagnosing the disorder. The prevalence of autism is rising constantly. One of the theories drawing the greatest public attention for a long time is a possible association between MMR vaccine and risk of autism. The first study aimed to investigate this association is the one conducted in 1998. As the results supported the theory that MMR vaccine increased the risk of autism, MMR immunization coverage decreased dramatically which further led to measles outbreaks, even in those countries where the disease was almost eradicated. Soon after that publication, new studies denying any association between MMR vaccine and risk of autism were published. Among them, systematic review published in 2012, including 57 epidemiological studies with 14.700.000 children is particularly important. Although the etiology of autism is not completely clarified, there are strong evidence on the presence of neurobiological changes with significant genetic component underlying the etiology. According to recent literature data, morphological changes in brain of children age 6 to 12 months, that is, before the administration of MMR vaccine, precede clinical symptoms of autism.

The path to an autism spectrum disorders diagnosis in Ethiopia: Parent perspective.

This study explores the common characteristics of children with autism spectrum disorders (ASDs) and the available diagnostic and intervention currently practiced for children with ASDs in Ethiopia based on parents' experience. Data gathered from 100 parents in Ethiopia detail the difficulties families face when they suspect their child has an autism spectrum disorder (ASD). The data indicate Ethiopian parents pursued a diagnosis of ASD after noting common ASD behaviors such as hand flapping and unusual attachments to objects. Poor social interactions were the least likely to symptoms to prompt an ASD evaluation. The large majority of parents indicated they were unaware of the services provided to their children and indicated poor parent-agency coordination. Parents noted very limited formal support systems to help cope with the stigma of having a child with ASD. Implication for future research and intervention are discussed. (PsycINFO Database Record

Autism presenting to two child mental health clinics at a tertiary care center in central Sri Lanka: A retrospective clinical record review

Background: Although clinical and demographic patterns in presentation of autism in the developed world have been extensively studied, comparable data from developing countries remain scarce. While a few attempts have been made previously to describe autistic children in some areas in Sri Lanka (SL), there are gaps in the understanding of autism in the local setting. Methods: Data on all patients diagnosed with autism in two child mental health clinics at a tertiary care center in central SL were abstracted retrospectively from clinic records over a period of 30 years since the inception of the clinics. Diagnosis of autism in these clinics has been based on criteria in the International Classification of Diseases-10th version. Results: Autism had been diagnosed in 77 patients. Of them, 58.4% were male. The mean age at first presentation was 6.7 years. While the number of autistic patients presenting to the clinic has increased over time, the age of presentation has remained largely unchanged. Delayed speech (23.4%) and poor social interactions (23.4%) were the two common primary concerns of parents leading to referral. Among medical comorbidities, epilepsy was the commonest (19.5%). The majority of patients (85.7%) had needed help with activities of daily living. In 62.3% of patients, no therapeutic interventions were documented. Conclusions: There are a substantial dearth and delay in presentation of autism in SL. Multiple deficiencies noted in the management of these patients indicate the need to improve awareness as well as resources and services dispensed for autism in SL.

A qualitative study on the mental health needs of elderly in Kerala, South India

Background: The proportion of elderly population in India is increasing and is the highest in Kerala. In an effort to review and modify the existing Old Age Policy, the state government deliberated on the need for elderly centered research. Aims: The aims of this study were to identify the unmet mental health (MH) needs of elderly population with attention to special groups such as widows and tribal population and to understand the gaps in delivery of MH services. Materials and Methods: A cross-sectional, qualitative study was undertaken in five districts of Kerala, selected purposively, ensuring representativeness, using 166 in-depth interviews and nine focus group discussions with elderly people from community and institutions and various key stakeholders. The interviews were transcribed and translated to English. Free listing of responses, domain identification, coding, summarization, and cross-tabulation were done. Semi-quantitative approach was used in analysis and presentation of report. Results: Depression, anxiety, insomnia, somatization, and dementia were the commonly reported MH problems in elderly people, especially institutionalized ones. Loneliness, isolation, neglect, and elder abuse were the major psychosocial issues identified. Poor social activities and interactions and poor utilization of MH services were also observed. Caregiver burden was found to be high and the available family support services were reported to be inadequate. Conclusions: MH problems were common in elderly, but utilization of MH services was low. This study highlights the need to improve accessibility, availability, and quality of MH services and family-support services for elderly.

Neonatal erythropoietin mitigates impaired gait, social interaction and diffusion tensor imaging abnormalities in a rat model of prenatal brain injury

Children who are born preterm are at risk for encephalopathy of prematurity, a leading cause of cerebral palsy, cognitive delay and behavioral disorders. Current interventions are limited and none have been shown to reverse cognitive and behavioral impairments, a primary determinant of poor quality of life for these children. Moreover, the mechanisms of perinatal brain injury that result in functional deficits and imaging abnormalities in the mature brain are poorly defined, limiting the potential to target interventions to those who may benefit most. To determine whether impairments are reversible after a prenatal insult, we investigated a spectrum of functional deficits and diffusion tensor imaging (DTI) abnormalities in young adult animals. We hypothesized that prenatal transient systemic hypoxia-ischemia (TSHI) would induce multiple functional deficits concomitant with reduced microstructural white and gray matter integrity, and tested whether these abnormalities could be ameliorated using postnatal erythropoietin (EPO), an emerging neurorestorative intervention. On embryonic day 18 uterine arteries were transiently occluded for 60min via laparotomy. Shams underwent anesthesia and laparotomy for 60min. Pups were born and TSHI pups were randomized to receive EPO or vehicle via intraperitoneal injection on postnatal days 1 to 5. Gait, social interaction, olfaction and open field testing was performed from postnatal day 25–35 before brains underwent ex vivo DTI to measure fractional anisotropy, axial diffusivity and radial diffusivity. Prenatal TSHI injury causes hyperactivity, impaired gait and poor social interaction in young adult rats that mimic the spectrum of deficits observed in children born preterm. Collectively, these data show for the first time in a model of encephalopathy of prematurity that postnatal EPO treatment mitigates impairments in social interaction, in addition to gait deficits. EPO also normalizes TSHI-induced microstructural abnormalities in fractional anisotropy and radial diffusivity in multiple regions, consistent with improved structural integrity and recovery of myelination. Taken together, these results show behavioral and memory deficits from perinatal brain injury are reversible. Furthermore, resolution of DTI abnormalities may predict responsiveness to emerging interventions, and serve as a biomarker of CNS injury and recovery.

Early Postnatal Exposure to Airborne Fine Particulate Matter Induces Autism-like Phenotypes in Male Rats.

Epidemiological studies have revealed that ambient fine particulate matter (PM2.5) exposure is closely associated with autism spectrum disorder (ASD). However, there is a relative paucity of laboratory data to support this epidemic finding. In order to assess the relationship between PM2.5 exposure and ASD, neonatal male Sprague-Dawley rats were chosen and exposed to PM2.5 (2 or 20 mg/kg body weight, once a day) by intranasal instillation from postnatal day 8 to 22. It was found that when exposed to PM2.5 in the early neonatal period for two weeks, both groups of the exposure rats manifested typical behavioral features of autism, including communication deficits, poor social interaction, and novelty avoidance. And, we further found, among five ASD candidate genes we chose, both the mRNA level and protein expression of SH3 and multiple ankyrin repeat domains 3 (Shank3) decreased significantly in the rat hippocampus after high dose of PM2.5 exposure. Moreover, results showed that PM2.5-exposure significantly increased the levels of proinflammatory cytokines, interleukin 1β, interleukin 6, and tumor necrosis factor alpha in the hippocampus and prefrontal cortex. The expression of glial fibrillary acidic protein and ionized calcium-binding adapter molecule, markers of astrocytes and microglial cell activation, respectively, also increased in the exposed animals. Our work provides new data on the link between postnatal exposure to ambient PM2.5 and the onset of ASD-like symptoms in human beings, and the increased inflammatory response and abnormalities in Shank3 expression in the brain may contribute to the mechanisms of PM2.5 exposure-induced ASD.

Characteristics of socially withdrawn youth in France: A retrospective study.

Poor social interactions have been recognized as a symptom since the beginnings of psychiatry. As far as socially withdrawn youth (SWY) are concerned, studies were mostly conducted on patients seeking care. Our psychiatric outreach team called Psymobile was able to reach SWY patients who were not seeking mental health care. To identify the clinical and socio-demographic characteristics of SWY patients referred to our Psymobile unit. We carried out a retrospective study on the records of patients aged 18-34 years, who were referred to Psymobile for 'withdrawal', between April 2012 and December 2015. In total, 66 patients were included in the study. SWY are predominantly male (80%) from large families or single-parent ones. About 42% had no prior contact with a mental health professional before being referred to Psymobile. The mean duration of withdrawal is 29 months. In all, 42% of SWY use cannabis and 73% present disorders of the sleep-wake schedule. About 71% maintain relations with their families and 73% go out occasionally. They are mostly diagnosed with schizophrenia (37%) or mood disorders (23%). Over one-third of Psymobile patients aged 18-34 years were referred on grounds of social withdrawal. Our data may illustrate more accurately the situation of youth social withdrawal amid the general population than data from help-seeking patients or online questionnaires.

Social Cognitive Training Improves Emotional Processing and Reduces Aggressive Attitudes in Ex-combatants.

Emotional processing (EP) is a complex cognitive function necessary to successfully adjust to social environments where we need to interpret and respond to cues that convey threat or reward signals. Ex-combatants have consistently shown atypical EP as well as poor social interactions. Available reintegration programs aim to facilitate the re-adaptation of ex-combatants to their communities. However, they do not incorporate actions to improve EP and to enhance cognitive-emotional regulation. The present study was aimed at evaluating the usefulness of an intervention focused on Social Cognitive Training (SCT), which was designed to equip ex-combatants enrolled in the Social Reintegration Route with EP and social cognition skills. A group of 31 ex-combatants (mean age of 37.2, 29 men) from Colombian illegal armed groups were recruited into this study. Of these, 16 were invited to take part in a SCT and the other continued with the conventional reintegration intervention. Both groups underwent 12 training sessions in a period 12–14 weeks. They were assessed with a comprehensive protocol which included Psychosocial, Behavioral, and Emotion Processing instruments. The scores on these instruments prior to and after the intervention were compared within and between groups. Both groups were matched at baseline. Ex-combatants receiving the SCT experienced significant improvements in EP and a reduction in aggressive attitudes, effects not observed in those continuing the conventional reintegration intervention. This is the first study that achieves such outcomes in such a population using SCT intervention. We discuss the implications of such results toward better social reintegration strategies.

Neurosensorimotor Reflex Integration for Autism: a New Therapy Modality Paradigm

The goal of this research was to evaluate the effect of the Masgutova Neurosensorimotor Reflex Integration (MNRI) therapy modality in improving the behavioral, cognitive, and physical functioning of individuals diagnosed with Autism Spectrum Disorder (ASD). Our research group utilized the MNRI therapy modality based on knowledge of the neurophysiology of reflexes, clinical observations, and studies of reflex pathologies which can be key to improving neurodevelopment in children diagnosed with ASD. The MNRI program uses specific strategies and techniques which access innate natural resources – reflex circuit pathways of the nervous system aimed at supporting maturation within their neuro-sensorymotor patterns. Symptoms of children with ASD are reflected in their lack of sensory-motor integration, poor social interaction and language development, repetitive behaviors and actions, and hyperactive and anxiety disorders. The current study involved three groups: the Study Group of children (n=524) diagnosed with ASD that received the MNRI program, and two control groups that did not receive the MNRI treatment program – Control Group 1: 94 children diagnosed with ASD (total n=618) and Control Group 2: 683 children with neurotypical development. A Reflex Assessment was given to all children before and after the study period. Statistical analysis revealed that a large spectrum of reflex patterns (86.67% or 26 of 30 patterns) were dysfunctional or pathological in children diagnosed with ASD compared to those with neurotypical development [5]. Based on this specific data, the MNRI program utilized techniques and exercises that targeted the restoration of reflex circuit components and protection functions of the children with ASD. A Reflex Assessment completed prior to and after the MNRI intervention (duration – 6 hours daily, 48 hours total) demonstrated a statistically significant (p<0.05) improvement in 83.3% of the reflex patterns of children with ASD in the Study Group. Further qualitative analysis confirms that children in the Study Group also showed improvement in the level of sensory-motor integration, communication, physical and cognitive functioning, particularly, in such areas such as: postural control, motor coordination, balance, tactile sensitivity, behavioral control, state of “presence” and self-awareness, and other abilities and skills, observed by their therapists, parents, and sometimes even themselves. Based on the data from the current study, MNRI intervention appears to have a beneficial effect on children with autism with 80% of the study participants demonstrating improved sensory-motor integration as well as physical, behavioral, emotional, and cognitive development.

Role of Occupational Therapy in Preventing Work-Related Musculoskeletal Disorders With Recycling Workers: A Pilot Study.

Little is known about injury prevention in recycling workers; therefore, in this study, I aimed to identify physical and psychosocial risk factors for employees involved in single-stream recycling and to explore strategies for prevention and wellness. Fifteen participants who were either recycling workers or supervisors located throughout seven locations on an urban university campus participated. A mixed-methods research design was used to obtain data through a variety of standardized work environment and health questionnaires and semistructured interviews. Approximately 80% of participants expressed satisfaction with their jobs; 50% reported having a musculoskeletal injury; and 33% reported a lack of support from coworkers or supervisors, which created stress and anxiety. Additional risk factors included poor body mechanics, equipment issues, poor social interactions, and lack of supervisor knowledge for prevention. Occupational therapy practitioners are well situated to support preventive interventions that address the combined physical and psychosocial needs of recycling workers.

Magnitude and associated factors of aggressive behaviour among patients with bipolar disorder at Amanual Mental Specialized Hospital, outpatient department, Addis Ababa, Ethiopia: cross-sectional study.

BackgroundAggressive behavior is a challenging behavior among bipolar patients that causes poor social interaction and hospitalization. But, there is no information regards of the magnitude and contributing factors for aggressive behaviour among bipolar patients in Ethiopia. Therefore, this study was designed to assess the prevalence and associated factors of aggressive behaviour among patients with bipolar disorder.MethodAn institutional based cross sectional study was conducted at Amanual Mental Specialized Hospital from May 1 to June 1, 2015 among 411 participants who were selected by systematic random sampling technique. Data was collected by interview technique by using Modified Overt Aggression Scale, entered and analyzed by using Epi Data 3.1 and Statistical Package for Social Science version 20, respectively. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) were used to show the odd and P-value <0.05 was considered as statistically significant.ResultsA total of 411 bipolar patients were included in the study and the prevalence of aggressive behaviour was 29.4%. Significant associated factors for aggression were, having two or more episode [AOR = 2.35 95% CI (1.18, 4.69)], previous history of aggression, [AOR = 3.72, 95% CI (1.54, 8.98)], depressive symptoms [AOR = 3.63, 95% CI (1.89, 6.96)], psychotic symptoms [AOR = 5.41,95% CI (2.88, 10.1)], manic symptoms [AOR = 3.85,95% CI (2.06, 7.19)], poor medication adherence [AOR = 3.73 95% CI (1.71, 8.13)], poor social support [AOR = 2.99 95% CI (1.30, 6.91)] and current use of substance[AOR = 2.17 95% CI (1.16, 4.06)].ConclusionPrevalence of aggression is high among bipolar patients and associated with many factors. So it needs public health attention to decrease aggression among bipolar patients.

Piecing together a different picture: A host of new studies on autism have begun decoding the longstanding puzzle of its causes.

“A developmental disability that hinders the normal functioning of the brain, affecting, in varying degrees, communication skills and social interaction. Repetitive behaviours, and different ways of learning, paying attention, or reacting to things are often distinctive signs”. This standard definition of autism fails to describe the complexity of a condition that ranges in its manifestations from severe intellectual impairment to superior cognitive skills, like in the Asperger syndrome. To comprise such diversity, autism disorders are now covered under the umbrella term “autism spectrum disorder” (ASD). In most cases, ASD manifests during the first 5 years of life, with boys significantly more likely to be diagnosed than girls. ASD usually goes together with several other problems that frequently include anxiety, sleep disorders, or epilepsy. No cure exists; treatment, such as speech therapy, just attempts to alleviate specific deficits of autistic patients. > Nothing is simple in autism. Even the real number of people affected is uncertain. Nothing is simple in autism. Even the real number of people affected is uncertain. The US CDC estimates that about 1 in 68 (or 1.5%) of children in the USA are living with ASD (http://www.cdc.gov/ncbddd/autism/data.html). The WHO has a more conservative estimate, last revised in January this year, of 1 in 160 children, based on a larger set of epidemiological surveys (http://www.who.int/mediacentre/factsheets/autism-spectrum-disorders/en/). Needless to say, most studies were conducted in developed countries, and the prevalence of ASD in many low‐ and middle‐income countries remains largely unknown. > Along the years, many potential causes have been indicated, including genetic and environmental factors, exposure to toxins during pregnancy, wide gaps between parent ages, and so on Although the general consensus is that prevalence rates are increasing globally, this point is debated too. Some analyses indicate that a large percentage of the increase in ASD owes to improved awareness and …

The validity of student tutors' judgments in early detection of struggling in medical school. A prospective cohort study.

Early identification and support of strugglers in medical education is generally recommended in the research literature, though very little evidence of the diagnostic qualities of early teacher judgments in medical education currently exists. The aim of this study was to examine the validity of early diagnosis of struggling in medical school based on informal teacher judgements of in-class behavior. The study design was a prospective cohort study and the outcomes/truth criteria were anatomy failure and medical school drop out. Six weeks into an anatomy course, student tutors attempted to identify medical students, who they reckoned would fail the anatomy course or drop out, based on their everyday experiences with students in a large group educational setting. In addition, they were asked to describe the indicators of struggling they observed. Sixteen student tutors evaluated 429 medical students for signs of struggling. By week six, the student tutors were able to detect approximately 1/4-1/3 of the students who eventually failed or dropped out, and for ¾ of the strugglers they identified, they were correct in their judgments. Informal student tutor's judgements showed incremental validity for both outcomes when controlling for grades obtained in preceeding exams. Lack of participation, lack of commitment, poor academic performance, poor social interactions and general signs of distress were the main indicators of struggling identified. Teachers' informal judgements of in-class behavior may be an untapped source of information in the early identification of struggling medical students with added value above and beyond formal testing.

Searching for meaning in meaningless gestures, pathologic activity in amygdala, hippocampus and temporal pole during planning of gestures in schizophrenia

IntroductionSchizophrenia is characterized by poor social interaction contributing to poor functional outcome. Particularly nonverbal communication is disturbed. Neural correlates of impaired gesturing are currently unclear. We thus tested functional correlates of gesturing in schizophrenia patients and healthy controls.MethodsWe tested 22 patients and 25 controls with an event-related fMRI (instructed delay) paradigm to dissociate brain activation during planning and execution of meaningful (e.g. use scissors) and meaningless novel gestures. Preprocessing included realignment, coregistration, normalization and spatial smoothing. We used a two stage mixed effects model for statistical analysis. Conditions were contrasted against a linguistic control within and between groups. We correlated psychopathological characteristics with beta estimates of brain areas with between group effects.ResultsDuring planning and execution of both gesture subtypes both groups activated brain areas of the ventral and dorsal stream. However patients’ activity was less prominent and more left lateralized. During planning patients showed additional activity in bilateral temporal poles, amygdala and hippocampus associated with the level of delusions. Furthermore patients had increased dorsomedial prefrontal cortex and precuneus activity when planning meaningless gestures.ConclusionDuring the planning of meaningless gestures we detected aberrant activation of limbic structures in patients typically implicated in delusion formation, which also correlated with current severity of delusions. Moreover, planning of meaningless gestures relied on areas relevant for strategic control and attention. These results argue for a pathologic search for meaning in neutral gestures and increased control effort during planning of meaningless gestures in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Dissection of partial 21q monosomy in different phenotypes: clinical and molecular characterization of five cases and review of the literature.

BackgroundPartial deletion of chromosome 21q is a very rare chromosomal abnormality associated with highly variable phenotypes, such as facial dysmorphic features, heart defects, seizures, psychomotor delay, and severe to mild intellectual disability, depending on the location and size of deletions. So far, three broad deletion regions of 21q have been correlated with the clinical phenotype.ResultsWe described the clinical and genetic features of three family members (father and two siblings) and other two unrelated patients with very wide range in age of diagnosis. All of them showed intellectual disability with very variable symptoms, from mild to severe, and carried 21q interstitial deletions with different sizes and position, as detected by conventional karyotype and array-CGH.ConclusionsOur study provided additional cases of partial 21q deletions, allowing to better delineate the genotype-phenotype correlations. In contrast to previous observations, we showed that deletions of the 21q proximal region are not necessarily associated with severe phenotypes and, therefore, that mild phenotypes are not exclusively related to distal deletions. To the best of our knowledge, this is the first report showing 21q deletions in adult patients associated with mild phenotypes, mainly consisting of neurobehavioral abnormalities, such as obsessive-compulsive disorders, poor social interactions and vulnerability to psychosis.